Serotonin-Related Gene Variants in Patients with Irritable Bowel Syndrome and Depressive or Anxiety Disorders

Aim. To assess the association of six polymorphisms in serotonin-related genes with depressive or anxiety disorders in patients with irritable bowel syndrome (IBS). Methods. The lifetime prevalence of depressive and anxiety disorders was assessed in 95 IBS patients (85% women) using the Munich version of the Composite International Diagnostic Interview (CIDI). IBS was diagnosed according to the Rome III criteria. SCL6A4 HTTLPR polymorphism (rs4795541) was determined using PCR-based method. Single-nucleotide polymorphisms in HTR1A (rs6295), HTR2A (rs6313 and rs6311), HTR2C (rs6318), and TPH1 (rs1800532) were detected by minisequencing method. Results. IBS patients with depressive disorders were characterized by higher frequency of 5-HTTLPR L allele in comparison to IBS patients with anxiety disorders. The lower frequency of 1438 A allele in HTR2A was found in IBS patients with depressive disorders in comparison to IBS patients without mental disorders. The lower G allele frequency in HTR2C rs6318 polymorphism among IBS patients with anxiety disorders was also observed. Conclusions. Our results provide further evidence for the involvement of SLC6A4 rs4795541 and HTR2A rs6311 polymorphisms in the pathophysiology of depressive disorders in IBS patients. The new findings indicate that HTR2C rs6318 polymorphism may be associated with the susceptibility to anxiety disorders in IBS patients

Self-Injuries and Their Functions with Respect to Suicide Risk in Adolescents with Conduct Disorder: Findings from a Path Analysis

Non-suicidal self-injuries (NSSIs) have been identified as one of the most predictive factors of suicidal behaviours in adolescents. However, it remains unknown whether certain functions of NSSIs are associated with suicide risk, and what are the underlying mechanisms. Therefore, we aimed to investigate the association between functions of NSSIs and suicide risk in adolescents with conduct disorder (CD), which shares some common characteristics with NSSIs. Participants were 215 adolescents (155 females, 72.1%) with CD. Functions of NSSIs, depressive symptoms, the levels of impulsivity, anxiety, self-esteem and aggression were examined. There were 77 adolescents with lifetime history of NSSIs (35.8%). Among them, adolescents with lifetime history of suicide attempt were significantly more likely to report anti-dissociation and anti-suicide function of NSSIs. They had significantly higher levels of anxiety as well as significantly lower self-esteem. Higher lifetime number of NSSIs was associated with higher odds of reporting anti-dissociation and anti-suicide functions. Moreover, these two functions fully mediated the association between lifetime number of NSSIs and suicide risk after co-varying for depressive and anxiety symptoms as well as self-esteem. The present findings indicate that anti-suicide and anti-dissociation functions of NSSIs might be crucial predictors of suicide risk in adolescents with CD

High anxiety level in patients with suspected but excluded vasovagal syncope

Wstęp. Pacjenci kierowani na test pochyleniowy, u których wykluczono omdlenia wazowagalne, są grupą mało poznaną. Objawy zaburzeń lękowych i prodromalne objawy omdlenia wazowagalnego nakładają się na siebie, co może utrudniać rozpoznanie. Cel pracy. Ocena poziomu lęku w grupie młodych kobiet, u których na podstawie wywiadu i wyniku testu pochyleniowego wykluczono występowanie omdleń wazowagalnych. Materiał i metody. Grupa badana składała się z 14 kobiet, które pochodziły z grupy 55 kobiet kierowanych na test pochyleniowy w wieku 21–40 lat, u których na podstawie wywiadu i wyniku testu pochyleniowego wykluczono występowanie omdleń wazowagalnych. Przed wykonaniem testu pochyleniowego u badanych kobiet przeprowadzono badanie z użyciem kwestionariusza Spilbergera i oceniono poziom lęku jako stanu (KS1) i jako cechy (KS2). Grupę kontrolną stanowiły 124 kobiety, które zaprzeczały występowaniu omdleń w wywiadzie, które anomimowo wypełniły kwestionariusz Spilbergera oraz kwestionariusz dotyczący stanu zdrowia. Wyniki. Stwierdzono: 1) istotnie wyższy poziom lęku jako cechy i stanu (KS1 i KS2) w grupie badanej niż w grupie kontrolnej, 2) wartość poziomu lęku jako stanu (KS1) ponad 32 ze 100% czułością i 34,7% swoistością pozwala odróżnić pacjentów z grupy badanej od osób z grupy kontrolnej, 3) wartość poziomu lęku jako cechy (KS2) ponad 44 ze 64,3% czułością i 74,2% swoistością pozwala odróżnić pacjentów z grupy badanej od osób z grupy kontrolnej. Wnioski. 1. U około 20% pacjentek kierowanych na test pochyleniowy wykonanie badania i ocena zgłaszanych dolegliwości oraz reprodukcji objawów spontanicznych podczas testu pochyleniowego pozwala na wykluczenie omdleń wazowagalnych jako przyczyny zgłaszanych dolegliwości. 2. U pacjentek w grupie badanej stwierdza się wysoki poziom lęku jako cechy i jako stanu, co wskazuje na możliwość występowania zaburzeń lękowych jako podłoża zgłaszanych dolegliwości. 3. Wykluczenie rozpoznania omdleń wazowagalnych u młodych kobiet kierowanych z takim podejrzeniem na test pochyleniowy powinno zwrócić uwagę na możliwość występowaniu u nich zaburzeń lękowych.Background. Patients referred for tilt test, who did not have vasovagal syncope are little known group. Symptoms of anxiety disorders and prodromal symptoms of vasovagal syncope overlap which can make it difficult to recognize. Objectives. The aim of the study is to assess the level of anxiety in a group of young women with excluded vasovagal syncope on the basis of medical history and tilt test results. Material and methods. The study group consisted of 14 women who came from a whole group of 55 women at the age of 21–40 years referred for tilt testing, who were excluded the presence of vasovagal syncope. Before performing the tilt test at the women were surveyed using a questionnaire Spielberg and rated the level of state anxiety (KS1) and the trait anxiety (KS2). Control group consisted of 124 women who had denied the occurrence of syncope. Results. 1. Results found significantly higher levels of trait anxiety and state anxiety (KS1 and KS2) in the study group than in the control group: 2. It was found that the value of the level of state anxiety (KS1) over 32 with 100% sensitivity and 34.7% specificity allows to distinguish case patients from the control group. 3. It was found that the value of the level of trait anxiety (KS2) over 44 with 64.3% sensitivity and 74.2% specificity allows to distinguish case patients from the control group. Conclusions. 1. Approximately 20% of patients referred for tilt testing have excluded vasovagal syncope as the cause of reported problems. 2. Patients in the study group found a high level of anxiety as a trait and as a state which indicates the possibility of anxiety as substrate of their complaints. 3. Exclusion of vasovagal syncope diagnosis in young women should pay attention to the possibility of the occurrence of anxiety disorders in them

Assessment of the frequency criterion for the diagnosis of non-suicidal self-injury disorder in female adolescents with conduct disorder

Recent studies suggest a higher threshold number of self-injuries during the past year than the one proposed in the DSM-5 criteria for non-suicidal self-injury disorder (NSSID). Therefore, we aimed to test a validity of the frequency criterion in girls with conduct disorder (CD) based on psychopathology and the level of functioning. Mixture modelling analysis revealed that the frequency of at least 8 self-harm behaviours in the previous year differentiated adolescents with CD. Thus, we divided adolescents into three subgroups: group 1: at least 8 self-harm acts; group 2: 1–7 self-harm behaviours and group 3: those who did not injure themselves during the last 12 months. Individuals from group 1 were significantly younger and had earlier age of self-harm onset. There were significant differences between groups 1 and 3 in terms of anxiety and depressive symptoms, self-esteem, aggression and the global functioning level. The group 1 scored significantly higher on depressive symptoms compared to the group 2. The group 2 scored significantly higher than the group 3 on the level of hostility. Our results provide further evidence supporting the need for modification of the NSSID frequency criterion

Not all drugs are created equal : impaired future thinking in opiate, but not alcohol, users

Episodic future thinking refers to the ability to travel forward in time to pre-experience an event. Although future thinking has been intimately linked with self and identity, to our knowledge, no prior research has compared episodic future thinking in populations with different substance use disorders. This study investigates whether there are differences in episodic future thinking between these alcohol and opiate users. The study recruited participants who were on the opiate substitution program (n = 31) and individuals who had been diagnosed with alcohol dependence (n = 21) from the Royal Prince Alfred Hospital Drug and Health Services. Healthy controls (n = 23) were recruited via Royal Prince Alfred Hospital databases and the general community. Past and future thinking was measured using four cue words. After each cue word, participants rated their phenomenological experience (e.g. emotion, reliving experience). Results indicated that alcohol-dependent individuals performed significantly higher in episodic future thinking compared to opiate users. These findings indicate that not all substance use disorder groups share similar episodic thinking capabilities. Our results suggest that the self-projection component of rehabilitation programs may have to be tailored to the different episodic construction abilities found in substance use disorder groups