Prediction of Early Childhood Negative Emotionality and Inhibition From Maternal Distress During Pregnancy

The association was investigated between psychological distress reported during each trimester of pregnancy and maternal ratings of temperament when the children were 6 months and 5 years of age. Mothers in the greater Helsinki area who were to give birth during a 1-year period completed a brief questionnaire describing their psychological adjustment and medical symptoms at each prenatal visit to government health clinics. Mothers rated their children\u27s temperament at ages 6 months and 5 years. Maternal psychological distress during pregnancy was only modestly associated with infant temperament. However, maternal distress during the first trimester was associated with ratings of negative emotionality at age 5 years, with a stronger correlation for males. Inhibition at age 5 was predicted by infant distress to novelty, particularly for males

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Psychotherapy effectiveness for major depression : a randomized trial in a Finnish community

Background: The purpose of this study is to assess the relative effectiveness of Interpersonal Psychotherapy (IPT), Psychoeducative Group Therapy (PeGT), and treatment as usual (TAU) for patients with Major Depressive Disorder (MDD) in municipal psychiatric secondary care in one Finnish region. Methods: All adult patients (N = 1515) with MDD symptoms referred to secondary care in 2004-2006 were screened. Eligible, consenting patients were assigned randomly to 10-week IPT (N = 46), PeGT (N = 42), or TAU (N = 46) treatment arms. Antidepressant pharmacotherapy among study participants was evaluated. The Hamilton Depression Rating scale (HAM-D) was the primary outcome measure. Assessment occurred at 1, 5, 3, 6, and 12 months. Actual amount of therapists' labor was also evaluated. All statistical analyses were performed with R software. Results: All three treatment cells showed marked improvement at 12-month follow-up. At 3 months, 42 % in IPT, 61 % in PeGT, and 42 % in TAU showed a mean >= 50 % in HAM-D improvement; after 12 months, these values were 61 %, 76 %, and 68 %. Concomitant medication and limited sample size minimized between-treatment differences. Statistically significant differences emerged only between PeGT and TAU favoring PeGT. Secondary outcome measures (CGI-s and SOFAS) showed parallel results. Conclusion: All three treatments notably benefited highly comorbid MDD patients in a public sector secondary care unit.Peer reviewe

Phospholipids and insulin resistance in psychosis : a lipidomics study of twin pairs discordant for schizophrenia

BACKGROUND: Several theories have been proposed to conceptualize the pathological processes inherent to schizophrenia. The "prostaglandin deficiency" hypothesis postulates that defective enzyme systems converting essential fatty acids to prostaglandins lead to diminished levels of prostaglandins, which in turn affect synaptic transmission. METHODS: Herein we sought to determine the lipidomic profiles associated with schizophrenia in twin pairs discordant for schizophrenia as well as unaffected twin pairs. The study included serum samples from 19 twin pairs discordant for schizophrenia (mean age 51 +/- 10 years; 7 monozygotic pairs; 13 female pairs) and 34 age and gender matched healthy twins as controls. Neurocognitive assessment data and gray matter density measurements taken from high-resolution magnetic resonance images were also obtained. Lipidomics platform using Ultra Performance Liquid Chromatography coupled to time-of-flight mass spectrometry was applied for the analysis of serum samples. RESULTS: In comparison to their healthy co-twins, the patients had elevated triglycerides and were more insulin resistant. They had diminished lysophosphatidylcholine levels which associated with decreased cognitive speed. CONCLUSIONS: Our findings may be of pathophysiological relevance since lysophosphatidylcholines, byproducts of phospholipase A2-catalyzed phospholipid hydrolysis, are preferred carriers of polyunsaturated fatty acids across the blood-brain barrier. Furthermore, diminishment of lysophosphatidylcholines suggests that subjects at risk of schizophrenia may be more susceptible to infections. Their association with cognitive speed supports the view that altered neurotransmission in schizophrenia may be in part mediated by reactive lipids such as prostaglandins.Peer reviewe

Psykiatrian diagnoosit ammatti- ja maallikkokielessä

Kirja-arvioKapiala, Ulla-Helena: Voiko mielenterveyden häiriöitä ymmärtää ja nimetä? Psykiatria ja sen diagnoosinimekkeet

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Prodromal psychosis screening in adolescent psychiatry clinics.

Research has identified a syndrome conferring ultra-high risk (UHR) for psychosis, although UHR interviews require intensive staff training, time and patient burden. Previously, we developed the Prodromal Questionnaire (PQ) to screen more efficiently for UHR syndromes.This study examined the concurrent validity of the PQ against UHR status and preliminary predictive validity for later psychotic disorder.We assessed a consecutive patient sample of 408 adolescents who presented to psychiatry clinics in Helsinki, Finland, seeking mental health treatment, including 80 participants who completed the Structured Interview for Prodromal Syndromes (SIPS).A cut-off score of 18 or more positive symptoms on the PQ predicted UHR diagnoses on the SIPS with 82% sensitivity and 49% specificity. Three of 14 (21%) participants with high PQ scores and SIPS UHR diagnoses developed full psychotic disorders within 1 year.Using the PQ and SIPS together can be an efficient two-stage screening process for prodromal psychosis in mental health clinics