EEG CHARACTERISTICS IN DEPRESSION, „NEGATIVE“ AND „POSITIVE“ SCHIZOPHRENA

Objective: qEEG investigations present differences in the comparison of schizophrenic patients and healthy examinees, as well as of depressive patients and healthy controls. The comparison of “positive” and “negative” schizophrenia also presents differences in the qEEG parameters. Changes in qEEG are various in these studies, but not always consistent. In this research we wanted to compare “positive” schizophrenia, “negative” schizophrenia and depression. Subjects and methods: The sample comprised 55 examinees (all women): 20 patients with “positive” schizophrenia, 15 patients with “negative” schizophrenia and 20 patients with depression. The standard EEG registration was done in all of them. From the recorded material, the 20-second period without artifacts was analyzed by the FFT method. The results were presented as absolute special power values (μV2) for individual segments of the spectrum: delta (0.5-4.0), theta (4.0-8.0), alpha (8.0-13.0) and beta (13.0-30.0). The observed regions included Fp1, Fp2, F3, F4, F7, F8, T3, T4, P3, P4, O1 and O2. Results: The “positive” type schizophrenia differs from the “negative” in the increase in both delta and theta activities, and in the decline of beta activity over frontal regions. The “positive” type of schizophrenia differs from depression in the increase in delta activity over frontal regions, while the “negative” form of schizophrenia differs from it in the decrease in beta activity over frontal regions. Conclusions: qEEG parameters differ in the comparison of “positive” and “negative” types of schizophrenia. These differences are more numerous and more significant than those obtained in the comparison of each of these types of schizophrenia with depression

Posttraumatic Stress Disorder in Women – Experiences form the Psychiatric Clinic, University Hospital Center Zagreb, Croatia

Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this study was to examine rates and sociodemographic and clinical characteristics of women with PTSD who were hospitalized at the Psychiatric clinic of University Hospital Center in Croatia over the years 1990–2007. Data were gathered retrospectively from the medical charts. We found that 67 women were diagnosed with PTSD which is 0.58% of all admissions over these years. Majority suffered from comorbid depression (N=51) and various somatic conditions, especially malignant gynecological tumors (N=23). No significant differences were found in distribution of PTSD symptoms in relation to the combat vs. civilian trauma. We found that patients with combat trauma often suffer from comorbid depression, while those with civilian traumas more often reported somatic conditions, especially malignant gynecological tumors. Our institution is a speciality clinic at a tertiary care medical center which tends to accumulate patients with serious forms of the disorder, and therefore our results can not be generalized to other settings involved in working with women with PTSD. Our results indicate that psychiatrists’ assessment of female patients should inevitably include lifetime traumatic experiences, and among those with PTSD, special attention should be paid to comorbid depression and malignant tumors

The significance of anhedonia and deficits in emotion perception for global functioning in schizophrenia

Cilj rada je istražiti ulogu anhedonije i emocionalne percepcije u općem funkcioniranju shizofrenih bolesnica. Neposredni ciljevi su istražiti izraženost anhedonije i deficita u emocionalnoj percepciji ovisno o trajanju bolesti i dobi bolesnika kada je bolest počela, te povezanost s pozitivnim i negativnim simptomima i sociodemografskim karakteristikama ispitanica. U istraživanju je sudjelovalo 65 bolesnica s dijagnozom shizofrenije prema kriterijima DSM-IV i MKB-10 liječenih risperidonom ili olanzapinom. Ispitanice su procjenjivane ocjenskim ljestvicama PANSS, SANS i GAF. Sposobnost prepoznavanja emocionalnih stanja ispitivana je primjenom Penn Emotion Recognition Test - 40 Faces version (ER40), a anhedonija je procjenjivana samoocjenskim ljestvicama za fizičku i socijalnu anhedoniju Physical Anhedonia Scale and Revised Social Anhedonia Scale. Statističkom obradom odredili smo povezanost anhedonije i sposobnosti prepoznavanja emocija s općim funkcioniranjem i kliničkim pokazateljima.----- Rezultati: Fizička anhedonija prisutna je u 43.1% ispitanica, socijalna anhedonija u 52.3% ispitanica, a mjereno objema ljestvicama anhedonija je prisutna u 30.8% ispitanica. Ispitanice s izraženom fizičkom anhedonijom imaju i izraženije negativne simptome bolesti, ispitanice s izraženom socijalnom anhedonijom imaju izraženije sve domene simptoma i lošije opće funkcioniranje a ispitanice s izraženom i fizičkom i socijalnom anhedonijom imaju loše opće funkcioniranje i izraženije sve domene simptoma osim pozitivnih. Anhedonija nije povezana s trajanjem bolesti. Prosječna uspješnost prepoznavanja svih emocija je 66,9%. Pojedinačno gledano najuspješnije se prepoznaje sreća u (92,5% točnih prepoznavanja) i ujedno s najmanjom varijabilnosti. Zatim slijedi tuga s 79% uspješnosti, neutralna ekspresija 61%, strah 51,2% i ljutnja 50,8%. Ukupno prepoznavanje emocija i zasebno prepoznavanje neutralne ekspresije u negativnoj su korelaciji s negativnom dimenzijom PANSS ljestvice. Dob početka bolesti utječe na prepoznavanje emocije strah, a trajanje bolesti utječe na prepoznavanje emocije tuga. Na ukupno prepoznavanje emocija ne utječe spol promatrane osobe, ali utječe vrsta i intenzitet emocije. Analiza pojedninačnog prepoznavanja emocija pokazuje da se na muškom i ženskom licu bolje prepoznaje ljutnja jakog intenziteta od ljutnje srednjeg intenziteta; na ženskom licu se bolje prepoznaje strah srednjeg intenziteta od straha jakog intenziteta, dok se na muškom licu bolje prepoznaje strah jakog intenziteta od straha srednjeg intenziteta; intenzitet značajno utječe na prepoznavanje tuge na muškom licu, dok ne utječe na prepoznavanje tuge na ženskom licu a sreća se bez obzira na intenzitet jednako prepoznaje na muškom i ženskom licu. Pri krivom prepoznavanju emocija, svim se kategorijama emocija najčešće krivo pripisuje neutralna ekspresija. Nema razlike u prepoznavanju emocija između anhedoničnih i neanhedoničnih ispitanica, ispitanica na različitoj terapiji i različitih kliničkih slika. Analizirajući pojedine kategorije emocija pojedinačno pokazalo se da prepoznavanje emocija na licu s neutralnom ekspresijom statistički značajno ovisi o izraženosti socijalne anhedonije, ukupnoj vrijednosti na PANSS ljestvici i podljestvicama negativnih simptoma i opće psihopatologije, ukupnoj vrijednosti na SANS ljestvici i podljestvicama zaravnjen afekt i alogija. Ispitanice koje licu s neutralnom ekspresijom pripisuju emociju tuga ili ljutnja imaju više izražene simptome bolesti, osobito negativne simptome; ispitanice koje licu s neutralnom ekspresijom priprisuju emociju strah imaju općenito izraženije simptome bolesti dok one koje licu s neutralnom ekspresijom priprisuju pozitivnu emociju sreća imaju izraženiju socijalnu anhedoniju. Nije nađena povezanost prepoznavanja emocija i općeg funkcioniranja. ----- Zaključak: Ukupna izraženost anhedonije (fizičke i socijalne) te socijalna anhedonija zasebno utječe na opće funkcioniranje shizofrenih bolesnica. Nije nađena povezanost između sposobnosti prepoznavanja emocija i općeg funkcioniranja shizofrenih bolesnica.The objectives of the present study were (1) to verify the relationships between anhedonia and emotion recognition deficits for global functioning in schizophrenic patients and (2) to explore possible correlations between anhedonia and emotion recognition deficits on one side and schizophrenic symptoms, duration of illness, age at onset of the illness and other sociodemographic characteristics on the other side. We recruited 65 female schizophrenic patients following DSM-IV and ICD-10 criteria treated with olanzapine or risperidone. The intensity of symptoms was assessed by PANSS and SANS and global functioning was assessed by GAF. Emotion recognition ability was assessed using the Penn Emotion Recognition Test - 40 Faces version (ER40), and anhedonia was assessed using self-rating scales for physical and social anhedonia: PAS – Physical Anhedonia Scale and RSAS - Revised Social Anhedonia Scale. ----- Results: Anhedonia reached significant levels only in a subgroup of patients, with social anhedonia (52.3%) being more frequent than physical anhedonia (43.1%). Overall anhedonia was present in 30.8% participants. Our findings demonstrated no relationship between anhedonia and age, illness duration and age of onset of the illness. Positive correlations were found between physical anhedonia and negative symptoms, and between social anhedonia and all domains of the illness. Participants with physical and social anhedonia had lower levels of global functioning and more severe negative symptoms and symptoms of general psychopathology. Overall emotion recognition accuracy (percentage of correct answers) was 66,9%. Patients were most accurate at recognizing happy expressions (92,5%), followed by sadness (79%) neutral expressions (61%), fear 51,2% and anger 50,8%. Negative correlations were found between global emotion recognition ability and PANSS negative dimension. Recognition of neutral expressions also showed negative correlation with PANSS negative dimension. Negative correlations were found between recognizing fear and age of onset of the illness, and between recognizing sadness and illness duration. Global emotion recognition depends on emotion category and emotion intensity but not on the poser’s gender. The analysis of emotion categories separately showed better recognition of high intensity anger on male and female faces; better recognition of moderate intensity fear on female face and better recognition of high intensity fear on male face; the effect of intensity on recognizing sadness is limited to male faces with no effect of intensity on recognizing sadness in female faces while happy faces are equally recognized regardless of intensity and poser’s gender. Happy, sad, fearful and angry expressions were most frequently misclassified as neutral, while neutral expressions were most frequently misclassified as sad. No difference in emotion recognition ability was found between anhedonic and non-anhedonic patients, between patients receiving treatment with different antipsychotics and those with different clinical features. Patients attributing sadness to neutral expressions had more severe symptoms; followed by those attribution anger and fear to neutral expressions. Patients attributing happiness to neutral expressions have more prominent social anhedonia. ----- Conclusion: Global anhedonia affects global functioning in female schizophrenic patients. The same was found for social anhedonia separately. We found no correlations between emotion recognition ability and global functioning in female schizophrenic patients

Značenje anhedonije i poremećaja emocionalne percepcije za opće funkcioniranje u shizofreniji [The significance of anhedonia and deficits in emotion perception for global functioning in schizophrenia]

The objectives of the present study were (1) to verify the relationships between anhedonia and emotion recognition deficits for global functioning in schizophrenic patients and (2) to explore possible correlations between anhedonia and emotion recognition deficits on one side and schizophrenic symptoms, duration of illness, age at onset of the illness and other sociodemographic characteristics on the other side. We recruited 65 female schizophrenic patients following DSM-IV and ICD-10 criteria treated with olanzapine or risperidone. The intensity of symptoms was assessed by PANSS and SANS and global functioning was assessed by GAF. Emotion recognition ability was assessed using the Penn Emotion Recognition Test - 40 Faces version (ER40), and anhedonia was assessed using self-rating scales for physical and social anhedonia: PAS – Physical Anhedonia Scale and RSAS - Revised Social Anhedonia Scale. ----- Results: Anhedonia reached significant levels only in a subgroup of patients, with social anhedonia (52.3%) being more frequent than physical anhedonia (43.1%). Overall anhedonia was present in 30.8% participants. Our findings demonstrated no relationship between anhedonia and age, illness duration and age of onset of the illness. Positive correlations were found between physical anhedonia and negative symptoms, and between social anhedonia and all domains of the illness. Participants with physical and social anhedonia had lower levels of global functioning and more severe negative symptoms and symptoms of general psychopathology. Overall emotion recognition accuracy (percentage of correct answers) was 66,9%. Patients were most accurate at recognizing happy expressions (92,5%), followed by sadness (79%) neutral expressions (61%), fear 51,2% and anger 50,8%. Negative correlations were found between global emotion recognition ability and PANSS negative dimension. Recognition of neutral expressions also showed negative correlation with PANSS negative dimension. Negative correlations were found between recognizing fear and age of onset of the illness, and between recognizing sadness and illness duration. Global emotion recognition depends on emotion category and emotion intensity but not on the poser’s gender. The analysis of emotion categories separately showed better recognition of high intensity anger on male and female faces; better recognition of moderate intensity fear on female face and better recognition of high intensity fear on male face; the effect of intensity on recognizing sadness is limited to male faces with no effect of intensity on recognizing sadness in female faces while happy faces are equally recognized regardless of intensity and poser’s gender. Happy, sad, fearful and angry expressions were most frequently misclassified as neutral, while neutral expressions were most frequently misclassified as sad. No difference in emotion recognition ability was found between anhedonic and non-anhedonic patients, between patients receiving treatment with different antipsychotics and those with different clinical features. Patients attributing sadness to neutral expressions had more severe symptoms; followed by those attribution anger and fear to neutral expressions. Patients attributing happiness to neutral expressions have more prominent social anhedonia. ----- Conclusion: Global anhedonia affects global functioning in female schizophrenic patients. The same was found for social anhedonia separately. We found no correlations between emotion recognition ability and global functioning in female schizophrenic patients

The significance of anhedonia and deficits in emotion perception for global functioning in schizophrenia

Cilj rada je istražiti ulogu anhedonije i emocionalne percepcije u općem funkcioniranju shizofrenih bolesnica. Neposredni ciljevi su istražiti izraženost anhedonije i deficita u emocionalnoj percepciji ovisno o trajanju bolesti i dobi bolesnika kada je bolest počela, te povezanost s pozitivnim i negativnim simptomima i sociodemografskim karakteristikama ispitanica. U istraživanju je sudjelovalo 65 bolesnica s dijagnozom shizofrenije prema kriterijima DSM-IV i MKB-10 liječenih risperidonom ili olanzapinom. Ispitanice su procjenjivane ocjenskim ljestvicama PANSS, SANS i GAF. Sposobnost prepoznavanja emocionalnih stanja ispitivana je primjenom Penn Emotion Recognition Test - 40 Faces version (ER40), a anhedonija je procjenjivana samoocjenskim ljestvicama za fizičku i socijalnu anhedoniju Physical Anhedonia Scale and Revised Social Anhedonia Scale. Statističkom obradom odredili smo povezanost anhedonije i sposobnosti prepoznavanja emocija s općim funkcioniranjem i kliničkim pokazateljima.----- Rezultati: Fizička anhedonija prisutna je u 43.1% ispitanica, socijalna anhedonija u 52.3% ispitanica, a mjereno objema ljestvicama anhedonija je prisutna u 30.8% ispitanica. Ispitanice s izraženom fizičkom anhedonijom imaju i izraženije negativne simptome bolesti, ispitanice s izraženom socijalnom anhedonijom imaju izraženije sve domene simptoma i lošije opće funkcioniranje a ispitanice s izraženom i fizičkom i socijalnom anhedonijom imaju loše opće funkcioniranje i izraženije sve domene simptoma osim pozitivnih. Anhedonija nije povezana s trajanjem bolesti. Prosječna uspješnost prepoznavanja svih emocija je 66,9%. Pojedinačno gledano najuspješnije se prepoznaje sreća u (92,5% točnih prepoznavanja) i ujedno s najmanjom varijabilnosti. Zatim slijedi tuga s 79% uspješnosti, neutralna ekspresija 61%, strah 51,2% i ljutnja 50,8%. Ukupno prepoznavanje emocija i zasebno prepoznavanje neutralne ekspresije u negativnoj su korelaciji s negativnom dimenzijom PANSS ljestvice. Dob početka bolesti utječe na prepoznavanje emocije strah, a trajanje bolesti utječe na prepoznavanje emocije tuga. Na ukupno prepoznavanje emocija ne utječe spol promatrane osobe, ali utječe vrsta i intenzitet emocije. Analiza pojedninačnog prepoznavanja emocija pokazuje da se na muškom i ženskom licu bolje prepoznaje ljutnja jakog intenziteta od ljutnje srednjeg intenziteta; na ženskom licu se bolje prepoznaje strah srednjeg intenziteta od straha jakog intenziteta, dok se na muškom licu bolje prepoznaje strah jakog intenziteta od straha srednjeg intenziteta; intenzitet značajno utječe na prepoznavanje tuge na muškom licu, dok ne utječe na prepoznavanje tuge na ženskom licu a sreća se bez obzira na intenzitet jednako prepoznaje na muškom i ženskom licu. Pri krivom prepoznavanju emocija, svim se kategorijama emocija najčešće krivo pripisuje neutralna ekspresija. Nema razlike u prepoznavanju emocija između anhedoničnih i neanhedoničnih ispitanica, ispitanica na različitoj terapiji i različitih kliničkih slika. Analizirajući pojedine kategorije emocija pojedinačno pokazalo se da prepoznavanje emocija na licu s neutralnom ekspresijom statistički značajno ovisi o izraženosti socijalne anhedonije, ukupnoj vrijednosti na PANSS ljestvici i podljestvicama negativnih simptoma i opće psihopatologije, ukupnoj vrijednosti na SANS ljestvici i podljestvicama zaravnjen afekt i alogija. Ispitanice koje licu s neutralnom ekspresijom pripisuju emociju tuga ili ljutnja imaju više izražene simptome bolesti, osobito negativne simptome; ispitanice koje licu s neutralnom ekspresijom priprisuju emociju strah imaju općenito izraženije simptome bolesti dok one koje licu s neutralnom ekspresijom priprisuju pozitivnu emociju sreća imaju izraženiju socijalnu anhedoniju. Nije nađena povezanost prepoznavanja emocija i općeg funkcioniranja. ----- Zaključak: Ukupna izraženost anhedonije (fizičke i socijalne) te socijalna anhedonija zasebno utječe na opće funkcioniranje shizofrenih bolesnica. Nije nađena povezanost između sposobnosti prepoznavanja emocija i općeg funkcioniranja shizofrenih bolesnica.The objectives of the present study were (1) to verify the relationships between anhedonia and emotion recognition deficits for global functioning in schizophrenic patients and (2) to explore possible correlations between anhedonia and emotion recognition deficits on one side and schizophrenic symptoms, duration of illness, age at onset of the illness and other sociodemographic characteristics on the other side. We recruited 65 female schizophrenic patients following DSM-IV and ICD-10 criteria treated with olanzapine or risperidone. The intensity of symptoms was assessed by PANSS and SANS and global functioning was assessed by GAF. Emotion recognition ability was assessed using the Penn Emotion Recognition Test - 40 Faces version (ER40), and anhedonia was assessed using self-rating scales for physical and social anhedonia: PAS – Physical Anhedonia Scale and RSAS - Revised Social Anhedonia Scale. ----- Results: Anhedonia reached significant levels only in a subgroup of patients, with social anhedonia (52.3%) being more frequent than physical anhedonia (43.1%). Overall anhedonia was present in 30.8% participants. Our findings demonstrated no relationship between anhedonia and age, illness duration and age of onset of the illness. Positive correlations were found between physical anhedonia and negative symptoms, and between social anhedonia and all domains of the illness. Participants with physical and social anhedonia had lower levels of global functioning and more severe negative symptoms and symptoms of general psychopathology. Overall emotion recognition accuracy (percentage of correct answers) was 66,9%. Patients were most accurate at recognizing happy expressions (92,5%), followed by sadness (79%) neutral expressions (61%), fear 51,2% and anger 50,8%. Negative correlations were found between global emotion recognition ability and PANSS negative dimension. Recognition of neutral expressions also showed negative correlation with PANSS negative dimension. Negative correlations were found between recognizing fear and age of onset of the illness, and between recognizing sadness and illness duration. Global emotion recognition depends on emotion category and emotion intensity but not on the poser’s gender. The analysis of emotion categories separately showed better recognition of high intensity anger on male and female faces; better recognition of moderate intensity fear on female face and better recognition of high intensity fear on male face; the effect of intensity on recognizing sadness is limited to male faces with no effect of intensity on recognizing sadness in female faces while happy faces are equally recognized regardless of intensity and poser’s gender. Happy, sad, fearful and angry expressions were most frequently misclassified as neutral, while neutral expressions were most frequently misclassified as sad. No difference in emotion recognition ability was found between anhedonic and non-anhedonic patients, between patients receiving treatment with different antipsychotics and those with different clinical features. Patients attributing sadness to neutral expressions had more severe symptoms; followed by those attribution anger and fear to neutral expressions. Patients attributing happiness to neutral expressions have more prominent social anhedonia. ----- Conclusion: Global anhedonia affects global functioning in female schizophrenic patients. The same was found for social anhedonia separately. We found no correlations between emotion recognition ability and global functioning in female schizophrenic patients

The significance of anhedonia and deficits in emotion perception for global functioning in schizophrenia

Cilj rada je istražiti ulogu anhedonije i emocionalne percepcije u općem funkcioniranju shizofrenih bolesnica. Neposredni ciljevi su istražiti izraženost anhedonije i deficita u emocionalnoj percepciji ovisno o trajanju bolesti i dobi bolesnika kada je bolest počela, te povezanost s pozitivnim i negativnim simptomima i sociodemografskim karakteristikama ispitanica. U istraživanju je sudjelovalo 65 bolesnica s dijagnozom shizofrenije prema kriterijima DSM-IV i MKB-10 liječenih risperidonom ili olanzapinom. Ispitanice su procjenjivane ocjenskim ljestvicama PANSS, SANS i GAF. Sposobnost prepoznavanja emocionalnih stanja ispitivana je primjenom Penn Emotion Recognition Test - 40 Faces version (ER40), a anhedonija je procjenjivana samoocjenskim ljestvicama za fizičku i socijalnu anhedoniju Physical Anhedonia Scale and Revised Social Anhedonia Scale. Statističkom obradom odredili smo povezanost anhedonije i sposobnosti prepoznavanja emocija s općim funkcioniranjem i kliničkim pokazateljima.----- Rezultati: Fizička anhedonija prisutna je u 43.1% ispitanica, socijalna anhedonija u 52.3% ispitanica, a mjereno objema ljestvicama anhedonija je prisutna u 30.8% ispitanica. Ispitanice s izraženom fizičkom anhedonijom imaju i izraženije negativne simptome bolesti, ispitanice s izraženom socijalnom anhedonijom imaju izraženije sve domene simptoma i lošije opće funkcioniranje a ispitanice s izraženom i fizičkom i socijalnom anhedonijom imaju loše opće funkcioniranje i izraženije sve domene simptoma osim pozitivnih. Anhedonija nije povezana s trajanjem bolesti. Prosječna uspješnost prepoznavanja svih emocija je 66,9%. Pojedinačno gledano najuspješnije se prepoznaje sreća u (92,5% točnih prepoznavanja) i ujedno s najmanjom varijabilnosti. Zatim slijedi tuga s 79% uspješnosti, neutralna ekspresija 61%, strah 51,2% i ljutnja 50,8%. Ukupno prepoznavanje emocija i zasebno prepoznavanje neutralne ekspresije u negativnoj su korelaciji s negativnom dimenzijom PANSS ljestvice. Dob početka bolesti utječe na prepoznavanje emocije strah, a trajanje bolesti utječe na prepoznavanje emocije tuga. Na ukupno prepoznavanje emocija ne utječe spol promatrane osobe, ali utječe vrsta i intenzitet emocije. Analiza pojedninačnog prepoznavanja emocija pokazuje da se na muškom i ženskom licu bolje prepoznaje ljutnja jakog intenziteta od ljutnje srednjeg intenziteta; na ženskom licu se bolje prepoznaje strah srednjeg intenziteta od straha jakog intenziteta, dok se na muškom licu bolje prepoznaje strah jakog intenziteta od straha srednjeg intenziteta; intenzitet značajno utječe na prepoznavanje tuge na muškom licu, dok ne utječe na prepoznavanje tuge na ženskom licu a sreća se bez obzira na intenzitet jednako prepoznaje na muškom i ženskom licu. Pri krivom prepoznavanju emocija, svim se kategorijama emocija najčešće krivo pripisuje neutralna ekspresija. Nema razlike u prepoznavanju emocija između anhedoničnih i neanhedoničnih ispitanica, ispitanica na različitoj terapiji i različitih kliničkih slika. Analizirajući pojedine kategorije emocija pojedinačno pokazalo se da prepoznavanje emocija na licu s neutralnom ekspresijom statistički značajno ovisi o izraženosti socijalne anhedonije, ukupnoj vrijednosti na PANSS ljestvici i podljestvicama negativnih simptoma i opće psihopatologije, ukupnoj vrijednosti na SANS ljestvici i podljestvicama zaravnjen afekt i alogija. Ispitanice koje licu s neutralnom ekspresijom pripisuju emociju tuga ili ljutnja imaju više izražene simptome bolesti, osobito negativne simptome; ispitanice koje licu s neutralnom ekspresijom priprisuju emociju strah imaju općenito izraženije simptome bolesti dok one koje licu s neutralnom ekspresijom priprisuju pozitivnu emociju sreća imaju izraženiju socijalnu anhedoniju. Nije nađena povezanost prepoznavanja emocija i općeg funkcioniranja. ----- Zaključak: Ukupna izraženost anhedonije (fizičke i socijalne) te socijalna anhedonija zasebno utječe na opće funkcioniranje shizofrenih bolesnica. Nije nađena povezanost između sposobnosti prepoznavanja emocija i općeg funkcioniranja shizofrenih bolesnica.The objectives of the present study were (1) to verify the relationships between anhedonia and emotion recognition deficits for global functioning in schizophrenic patients and (2) to explore possible correlations between anhedonia and emotion recognition deficits on one side and schizophrenic symptoms, duration of illness, age at onset of the illness and other sociodemographic characteristics on the other side. We recruited 65 female schizophrenic patients following DSM-IV and ICD-10 criteria treated with olanzapine or risperidone. The intensity of symptoms was assessed by PANSS and SANS and global functioning was assessed by GAF. Emotion recognition ability was assessed using the Penn Emotion Recognition Test - 40 Faces version (ER40), and anhedonia was assessed using self-rating scales for physical and social anhedonia: PAS – Physical Anhedonia Scale and RSAS - Revised Social Anhedonia Scale. ----- Results: Anhedonia reached significant levels only in a subgroup of patients, with social anhedonia (52.3%) being more frequent than physical anhedonia (43.1%). Overall anhedonia was present in 30.8% participants. Our findings demonstrated no relationship between anhedonia and age, illness duration and age of onset of the illness. Positive correlations were found between physical anhedonia and negative symptoms, and between social anhedonia and all domains of the illness. Participants with physical and social anhedonia had lower levels of global functioning and more severe negative symptoms and symptoms of general psychopathology. Overall emotion recognition accuracy (percentage of correct answers) was 66,9%. Patients were most accurate at recognizing happy expressions (92,5%), followed by sadness (79%) neutral expressions (61%), fear 51,2% and anger 50,8%. Negative correlations were found between global emotion recognition ability and PANSS negative dimension. Recognition of neutral expressions also showed negative correlation with PANSS negative dimension. Negative correlations were found between recognizing fear and age of onset of the illness, and between recognizing sadness and illness duration. Global emotion recognition depends on emotion category and emotion intensity but not on the poser’s gender. The analysis of emotion categories separately showed better recognition of high intensity anger on male and female faces; better recognition of moderate intensity fear on female face and better recognition of high intensity fear on male face; the effect of intensity on recognizing sadness is limited to male faces with no effect of intensity on recognizing sadness in female faces while happy faces are equally recognized regardless of intensity and poser’s gender. Happy, sad, fearful and angry expressions were most frequently misclassified as neutral, while neutral expressions were most frequently misclassified as sad. No difference in emotion recognition ability was found between anhedonic and non-anhedonic patients, between patients receiving treatment with different antipsychotics and those with different clinical features. Patients attributing sadness to neutral expressions had more severe symptoms; followed by those attribution anger and fear to neutral expressions. Patients attributing happiness to neutral expressions have more prominent social anhedonia. ----- Conclusion: Global anhedonia affects global functioning in female schizophrenic patients. The same was found for social anhedonia separately. We found no correlations between emotion recognition ability and global functioning in female schizophrenic patients

Posttraumatic stress disorder in women - experiences form the Psychiatric Clinic, University Hospital Center Zagreb, Croatia [Posttraumatski stresni poremećaj u žena - iskustva Klinike za psihijatriju Kliničkog bolničkog centra Zagreb, Hrvatska]

Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this study was to examine rates and sociodemographic and clinical characteristics of women with PTSD who were hospitalized at the Psychiatric clinic of University Hospital Center in Croatia over the years 1990-2007. Data were gathered retrospectively from the medical charts. We found that 67 women were diagnosed with PTSD which is 0.58% of all admissions over these years. Majority suffered from comorbid depression (N = 51) and various somatic conditions, especially malignant gynecological tumors (N = 23). No significant differences were found in distribution of PTSD symptoms in relation to the combat vs. civilian trauma. We found that patients with combat trauma often suffer from comorbid depression, while those with civilian traumas more often reported somatic conditions, especially malignant gynecological tumors. Our institution is a speciality clinic at a tertiary care medical center which tends to accumulate patients with serious forms of the disorder, and therefore our results can not be generalized to other settings involved in working with women with PTSD. Our results indicate that psychiatrists' assessment of female patients should inevitably include lifetime traumatic experiences, and among those with PTSD, special attention should be paid to comorbid depression and malignant tumors

Attitudes of Medical Staff Towards the Psychiatric Label »Schizophrenic Patient« Tested by an Anti-Stigma Questionnaire

The aim of this research was to investigate the opinions and attitudes of medical staff towards schizophrenic patients. The research included three groups of examinees, 200 physicians of various specialties, 200 nurses and technicians working in Zagreb city hospitals, and 200 3rd and 4th year students of the School of Medicine in Zagreb. Previously validated anti-stigma questionnaire was used, consisting of 25 questions divided into three thematic groups, structured and adapted to the specific requirements of this study. The results were mutually compared and statistically analyzed by applying the 2-test. Significant difference (p < 0.01) between the answers of physicians and those of medical students was found in questions 2, 4, 5, 6, 11, 13, 15, 16, 18, 22, 23, 25, and between physicians and nurses/technicians in answers to questions 4, 15, 22, 23. Significant difference (p < 0.01) between the answers given by nurses/technicians and medical students was found in questions 10, 13, 22, 23. The results point to the existence of prejudices and stigmatizing attitudes in all three investigated groups. The most frequent reasons for stigmatizing attitude of students are based on fear and insufficient knowledge about mental patients and schizophrenia as a disease, while there are a high percentage of positive answers to the questions on rehabilitation and resocialization. The nurses/ technicians also show a high degree of mistrust towards schizophrenic patients and mostly answer with »I don\u27t know«, thus presenting insufficiently formed attitudes about the mentioned problems. The physicians in their answers confirm fear, mistrust and stigmatizing attitudes towards schizophrenic patients found in general population in Croatia1. The consequences of such attitudes are the low quality of life of schizophrenic patients, and slow, often incomplete, resocialization

QUANTITATIVE ELECTROENCEPHALOGRAPHY IN SCHIZOPHRENIA AND DEPRESSION

Background: Standard (qualitative) electroencephalography (EEG) is routinely used in the diagnostic evaluation of psychiatric patients. Quantitative EEG (qEEG) findings differ between patients with schizophrenia, patients with depression, but results are not consistent. The aim of our study was to determine the differences in qEEG parameters between patients with schizophrenia, patients with depression, and healthy subjects. Subjects and methods: The study included 30 patients with schizophrenia, 33 patients with depression, and 30 healthy subjects. All study participants underwent standard EEG. Artifact-free 100-second epochs were selected from the recorded material and analyzed with Fast Fourier Transformation (FFT) analysis. Results: The results are presented as absolute spectral power values (μV2) of delta, theta, alpha, and beta components of the EEG spectrum. EEGs were recorded from 12 locations including Fp1, Fp2, F3, F4, F7, F8, T3, T4, P3, P4, O1, and O2. In comparison with healthy subjects, patients with schizophrenia showed increased delta, theta, and beta activity and decreased alpha activity. Similar results were obtained in patients with depression, but in fewer regions. In patients with schizophrenia, delta power over Fp1, Fp2, F4, and F8 regions was increased in comparison with those in patients with depression. Interhemispheric asymmetry was found in patients with schizophrenia and healthy subjects, but not in patients with depression. Conclusion: The finding that patients with schizophrenia differed from patients with depression in delta power values could be potentially used in differential diagnosis between schizophrenia and depression. The role of qEEG in clinical differentiation between these two mental disorders may be especially important in cases of negative-symptom schizophrenia