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Sample records for ad symptom severity

  1. Comorbid Anxiety and Social Avoidance in Treatment of Severe Childhood Aggression: Response to Adding Risperidone to Stimulant and Parent Training; Mediation of Disruptive Symptom Response

    PubMed Central

    Gadow, Kenneth D.; Farmer, Cristan A.; Findling, Robert L.; Bukstein, Oscar; Molina, Brooke S.G.; Brown, Nicole V.; Li, Xiaobai; Rundberg-Rivera, E. Victoria; Bangalore, Srihari; Buchan-Page, Kristin; Hurt, Elizabeth A.; Rice, Robert; McNamara, Nora K.; Aman, Michael G.

    2015-01-01

    Abstract Objective: In the four-site Treatment of Severe Childhood Aggression (TOSCA) study, addition of risperidone to stimulant and parent training moderately improved parent-rated disruptive behavior disorder (DBD) symptoms. This secondary study explores outcomes other than DBD and attention-deficit/hyperactivity disorder (ADHD) as measured by the Child and Adolescent Symptom Inventory-4R (CASI-4R). Methods: A total of 168 children ages 6–12 with severe aggression (physical harm), DBD, and ADHD were randomized to parent training plus stimulant plus placebo (basic treatment) or parent training plus stimulant plus risperidone (augmented treatment) for 9 weeks. All received only parent training plus stimulant for the first 3 weeks, then those with room for improvement received a second drug (placebo or risperidone) for 6 weeks. CASI-4R category item means at baseline and week 9 were entered into linear mixed-effects models for repeated measures to evaluate group differences in changes. Mediation of the primary DBD outcome was explored. Results: Parent ratings were nonsignificant with small/negligible effects, but teacher ratings (n=46 with complete data) showed significant augmented treatment advantage for symptoms of anxiety (p=0.013, d=0.71), schizophrenia spectrum (p=0.017, d=0.45), and impairment in these domains (p=0.02, d=0.26), all remaining significant after false discovery rate correction for multiple tests. Improvement in teacher-rated anxiety significantly (p=0.001) mediated the effect of risperidone augmentation on the primary outcome, the Disruptive-total of the parent-rated Nisonger Child Behavior Rating Form. Conclusions: Addition of risperidone to parent training plus stimulant improves not only parent-rated DBD as previously reported, but also teacher-rated anxiety–social avoidance. Improvement in anxiety mediates improvement in DBD, suggesting anxiety-driven fight-or-flight disruptive behavior with aggression, with implications for potential

  2. Nut allergy: symptom and severity reporting.

    PubMed

    Dunbar, H; Luyt, D

    1999-01-01

    Nut allergy, in particular peanut allergy, is becoming more common in children. Immune sensitisation to nuts appears to be occurring earlier in life. High incidence of other allergic diseases in children with nut allergy. Onset of anaphylactic symptoms is quick but symptoms last for a short time. Necessity for hospital admission due to severity of allergic reaction is low.

  3. Severity of Neuropsychiatric Symptoms in Nursing Home Residents

    PubMed Central

    Helvik, Anne-Sofie; Engedal, Knut; Wu, Bei; Benth, Jūratė Šaltytė; Corazzini, Kirsten; Røen, Irene; Selbæk, Geir

    2016-01-01

    We aimed at assessing time shift in the severity of neuropsychiatric symptoms (NPS) in nursing home residents between 2004/2005 and 2010/2011 and associations between NPS and socio-demographic variables, physical health status, dementia severity, and the use of psychotropic drugs. The Neuropsychiatric Inventory Nursing Home Version was used in 2004/2005 (n = 1,163) and 2010/2011 (n = 1,858). Linear mixed model analysis was applied. There was no time shift in the severity of apathy, psychosis, and affective symptoms, but agitation did exhibit a time shift. Agitation was less severe in 2010/2011 than in 2004/2005 in residents with a Clinical Dementia Rating (CDR) sum of boxes score ≤4, and more severe in residents with a CDR sum of boxes score >16. Higher CDR sum of boxes scores and use of psychotropic medication were associated with more severe apathy, agitation, psychosis, and affective symptoms. Poor physical health was associated with more severe apathy, psychosis, and affective symptoms. Women had more severe agitation and less severe affective symptoms than men. A longer stay in a nursing home was associated with more severe agitation and less severe affective symptoms. In conclusion, agitation was less severe in 2010/2011 than in 2004/2005 among nursing home residents with a milder degree of dementia, and more severe in residents with severe dementia. PMID:26933438

  4. Severity of Neuropsychiatric Symptoms in Nursing Home Residents.

    PubMed

    Helvik, Anne-Sofie; Engedal, Knut; Wu, Bei; Benth, Jūratė Šaltytė; Corazzini, Kirsten; Røen, Irene; Selbæk, Geir

    2016-01-01

    We aimed at assessing time shift in the severity of neuropsychiatric symptoms (NPS) in nursing home residents between 2004/2005 and 2010/2011 and associations between NPS and socio-demographic variables, physical health status, dementia severity, and the use of psychotropic drugs. The Neuropsychiatric Inventory Nursing Home Version was used in 2004/2005 (n = 1,163) and 2010/2011 (n = 1,858). Linear mixed model analysis was applied. There was no time shift in the severity of apathy, psychosis, and affective symptoms, but agitation did exhibit a time shift. Agitation was less severe in 2010/2011 than in 2004/2005 in residents with a Clinical Dementia Rating (CDR) sum of boxes score ≤4, and more severe in residents with a CDR sum of boxes score >16. Higher CDR sum of boxes scores and use of psychotropic medication were associated with more severe apathy, agitation, psychosis, and affective symptoms. Poor physical health was associated with more severe apathy, psychosis, and affective symptoms. Women had more severe agitation and less severe affective symptoms than men. A longer stay in a nursing home was associated with more severe agitation and less severe affective symptoms. In conclusion, agitation was less severe in 2010/2011 than in 2004/2005 among nursing home residents with a milder degree of dementia, and more severe in residents with severe dementia. PMID:26933438

  5. New classification scheme for atrial fibrillation symptom severity and burden.

    PubMed

    Koci, Florian; Forbes, Peter; Mansour, Moussa C; Heist, E Kevin; Singh, Jagmeet P; Ellinor, Patrick T; Ruskin, Jeremy N

    2014-07-15

    Although atrial fibrillation (AF) symptom severity is used to guide clinical care, a simple, standardized assessment tool is not available for routine clinical use. We sought to develop and validate a patient-generated score and classification scheme for AF-related symptom severity and burden. Atrial Fibrillation Symptom and Burden, a simple 2-part questionnaire, was designed to assess (1) AF symptom severity using 8 questions to determine how symptoms affect daily life and (2) AF burden using 6 questions to measure AF frequency, duration, and health-care utilization. The resulting score was used to classify patients into 4 classes of symptom and burden severity. Patients were asked to complete the questionnaire, a survey evaluating the questionnaire, and an Short Form-12v2 generic health-related quality-of-life form. Validation of the questionnaire included assessments of its reliability and construct and known groups validity. The strength of interrater agreement between patient-generated and blinded provider-generated classifications of AF symptom severity was also assessed. The survey had good internal consistency (Cronbach α>0.82) and reproducibility (intraclass correlation coefficient=0.93). There was a good linear correlation with health-related quality-of-life aggregates measured by Pearson correlation coefficient (r=0.62 and 0.42 vs physical component summary and mental component summary, respectively). Compared with physical and mental component summary scores, the patient-generated symptom severity classification scheme showed robust discrimination between mild and moderate severity (p<0.0001 and p=0.0009) and between moderate and severe groups (p=0.0001 and p=0.012). In conclusion, this simple patient-generated AF classification scheme is robust, internally consistent, reproducible, and highly correlated with standardized quality-of-life measures. PMID:24878121

  6. Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity?

    ERIC Educational Resources Information Center

    Anholt, Gideon E.; Cath, Danielle C.; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H.; van Megen, Harold; van Balkom, Anton J. L. M.

    2010-01-01

    In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and…

  7. Characterizing individual painDETECT symptoms by average pain severity

    PubMed Central

    Sadosky, Alesia; Koduru, Vijaya; Bienen, E Jay; Cappelleri, Joseph C

    2016-01-01

    Background painDETECT is a screening measure for neuropathic pain. The nine-item version consists of seven sensory items (burning, tingling/prickling, light touching, sudden pain attacks/electric shock-type pain, cold/heat, numbness, and slight pressure), a pain course pattern item, and a pain radiation item. The seven-item version consists only of the sensory items. Total scores of both versions discriminate average pain-severity levels (mild, moderate, and severe), but their ability to discriminate individual item severity has not been evaluated. Methods Data were from a cross-sectional, observational study of six neuropathic pain conditions (N=624). Average pain severity was evaluated using the Brief Pain Inventory-Short Form, with severity levels defined using established cut points for distinguishing mild, moderate, and severe pain. The Wilcoxon rank sum test was followed by ridit analysis to represent the probability that a randomly selected subject from one average pain-severity level had a more favorable outcome on the specific painDETECT item relative to a randomly selected subject from a comparator severity level. Results A probability >50% for a better outcome (less severe pain) was significantly observed for each pain symptom item. The lowest probability was 56.3% (on numbness for mild vs moderate pain) and highest probability was 76.4% (on cold/heat for mild vs severe pain). The pain radiation item was significant (P<0.05) and consistent with pain symptoms, as well as with total scores for both painDETECT versions; only the pain course item did not differ. Conclusion painDETECT differentiates severity such that the ability to discriminate average pain also distinguishes individual pain item severity in an interpretable manner. Pain-severity levels can serve as proxies to determine treatment effects, thus indicating probabilities for more favorable outcomes on pain symptoms. PMID:27555789

  8. Caregiver Life Satisfaction: Relationship to Youth Symptom Severity through Treatment

    ERIC Educational Resources Information Center

    Athay, M. Michele

    2012-01-01

    This study utilized the Satisfaction with Life Scale to investigate the life satisfaction of caregivers for youth receiving mental health services (N = 383). Specifically, this study assessed how caregiver life satisfaction relates to youth symptom severity throughout treatment. Hierarchical linear modeling with a time-varying covariate was used…

  9. Linguistic Correlates of Asymmetric Motor Symptom Severity in Parkinson's Disease

    ERIC Educational Resources Information Center

    Holtgraves, Thomas; McNamara, Patrick; Cappaert, Kevin; Durso, Raymond

    2010-01-01

    Asymmetric motor severity is common in Parkinson's Disease (PD) and provides a method for examining the neurobiologic mechanisms underlying cognitive and linguistic deficits associated with the disorder. In the present research, PD participants (N = 31) were assessed in terms of the asymmetry of their motor symptoms. Interviews with the…

  10. Linguistic Correlates of Asymmetric Motor Symptom Severity in Parkinson's Disease

    PubMed Central

    Holtgraves, Thomas; McNamara, Patrick; Cappaert, Kevin; Durso, Raymond

    2009-01-01

    Asymmetric motor severity is common in Parkinson's Disease (PD) and provides a method for examining the neurobiologic mechanisms underlying cognitive and linguistic deficits associated with the disorder. In the present research, PD participants (N = 31) were assessed in terms of the asymmetry of their motor symptoms. Interviews with the participants were analyzed with the Linguistic Inquiry and Word Count (LIWC) program. Three measures of linguistic complexity – the proportion of verbs, proportion of function words, and sentence length – were found to be affected by symptom asymmetry. Greater left-side motor severity (and hence greater right hemisphere dysfunction) was associated with the production of significantly fewer verbs, function words, and shorter sentences. Hence, the production of linguistic complexity in a natural language context was associated with relatively greater right hemisphere involvement. The potential neurobiological mechanisms underlying this effect are discussed. PMID:19751960

  11. Walking reduces cue-elicited cigarette cravings and withdrawal symptoms, and delays ad libitum smoking.

    PubMed

    Taylor, Adrian; Katomeri, Magdalena

    2007-11-01

    Stress and exposure to smoking cues influence smoking cravings and behavior. Exercise appears to reduce cigarette cravings and withdrawal symptoms, but no study has investigated the effects of exercise on cue-elicited cravings and withdrawal symptoms, or ad libitum smoking behavior. In this study, 60 regular smokers, invited by public advertisements, were assessed at baseline following 2 hr of abstinence, and randomized to a 15-min brisk walk or passive condition. Both groups then completed three tasks (Stroop color-word interference task, speech task, and handling a lit cigarette). Cravings were assessed with two single items, and withdrawal symptoms were assessed using the seven-item Mood and Physical Symptoms Scale. After the laboratory session, ad libitum smoking was determined from the subject's cell phone text message. Exercise (mean heart rate reserve = 24%) attenuated increases in strength of desire to smoke, tension, poor concentration, and stress, in response to a lit cigarette, but had minimal effects on increases in cravings and withdrawal symptoms in response to the stressors. Absolute levels of cravings and withdrawal symptoms were reduced during and following exercise. Exercisers engaged in ad libitum smoking a net 57 min (CI = 31-83) later than those in the passive condition. A 15-min brisk walk not only reduced cigarette cravings and withdrawal symptoms but also could attenuate increases in cue-elicited cravings and withdrawal symptoms, and increase the time between cigarettes smoked.

  12. Endocannabinoid concentrations in hair are associated with PTSD symptom severity.

    PubMed

    Wilker, Sarah; Pfeiffer, Anett; Elbert, Thomas; Ovuga, Emilio; Karabatsiakis, Alexander; Krumbholz, Aniko; Thieme, Detlef; Schelling, Gustav; Kolassa, Iris-Tatjana

    2016-05-01

    The endocannabinoid system has been implicated in the regulation of the stress response, fear memory formation, and inflammatory processes. Posttraumatic stress disorder (PTSD) can result from exposure to extreme stress and is characterized by strong, associative memories for the traumatic events experienced. Furthermore, an elevated physical disease risk has been observed in PTSD, likely to be mediated by inflammatory processes. Therefore, altered endocannabinoid regulation can be expected in individuals with PTSD. However, attempts to assess PTSD-associated differences in the endocannabinoid system from human blood samples have provided inconsistent results, possibly due to fluctuating levels of endocannabinoids. In hair, these neuromodulators are accumulated over time and thus give access to a more stable and reliable assessment. We therefore investigated PTSD-associated differences in hair concentrations of endocannabinoids (N-acyl-ethanolamides palmitoylethanolamide [PEA], oleoylethanolamide [OEA] and stearoylethanolamide [SEA]) in 38 rebel war survivors from Northern Uganda suffering from PTSD and N=38 healthy rebel war survivors without current and lifetime PTSD. PTSD diagnosis and symptom severity were assessed in structured clinical interviews employing the Posttraumatic Diagnostic Scale (PDS). A significant group difference was observed for OEA, with PTSD patients showing reduced hair concentrations. Regression analyses further revealed strong negative relationships between all investigated N-acyl-ethanolamides and symptom severity of PTSD. The observed reductions in endocannabinoids might account for the increased inflammatory state as well as for the failure to extinguish fear memories observed in PTSD. Our findings add to the accumulating evidence suggesting the endocannabinoid system as a target for pharmacological enhancement of exposure-based psychotherapy for PTSD. PMID:26923850

  13. Psychometric properties of the modified Symptom Severity Index (SSI)

    PubMed Central

    Nixdorf, Donald R.; John, Mike T.; Wall, Melanie M.; Fricton, James R.; Schiffman, Eric L.

    2010-01-01

    The psychometric properties of the modified Symptom Severity Index were investigated to assess the relationships among dimensions of pain in temporomandibular disorders. The 15-item instrument is composed of ordinal scales assessing five pain dimensions (intensity, frequency, duration, unpleasantness, and difficulty to endure) as experienced in three locations (temple, temporomandibular joint, masseter). In 108 closed-lock subjects, Cronbach’s alpha was used to measure internal consistency resulting in 31 of the 105 pair-wise comparisons ≥0.71. Multilevel exploratory factor analysis was used to assess dimensionality between items. Two factors emerged, termed temple pain and jaw pain. The jaw pain factor comprised the temporomandibular joint and masseter locations, indicating that subjects did not differentiate between these two locations. With further analysis, the jaw pain factor could be separated into temporal aspects of pain (frequency, duration) and affective dimensions (intensity, unpleasantness, endurability). Temple pain could not be further reduced; this may have been influenced by concurrent orofacial pains such as headache. Internal consistency was high, with alphas ≥0.92 for scales associated with all factors. Excellent test-retest reliability was found for repeat testing at 2–48 hours in 55 subjects (ICC=0.97, 95%CI 0.96–0.99). In conclusion, the modified Symptom Severity Index has excellent psychometric properties for use as an instrument to measure pain in subjects with temporomandibular disorders. The most important characteristic of this pain is location, while the temporal dimensions are important for jaw pain. Further research is needed to confirm these findings and assess relationships between dimensions of pain as experienced in other chronic pain disorders. PMID:19889036

  14. Relationship between imaging biomarkers, age, progression and symptom severity in Alzheimer's disease.

    PubMed

    Dukart, Juergen; Mueller, Karsten; Villringer, Arno; Kherif, Ferath; Draganski, Bogdan; Frackowiak, Richard; Schroeter, Matthias L

    2013-01-01

    The early diagnostic value of glucose hypometabolism and atrophy as potential neuroimaging biomarkers of mild cognitive impairment (MCI) and Alzheimer's disease (AD) have been extensively explored using [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) and structural magnetic resonance imaging (MRI). The vast majority of previous imaging studies neglected the effects of single factors, such as age, symptom severity or time to conversion in MCI thus limiting generalisability of results across studies. Here, we investigated the impact of these factors on metabolic and structural differences. FDG-PET and MRI data from AD patients (n = 80), MCI converters (n = 65) and MCI non-converters (n = 64) were compared to data of healthy subjects (n = 79). All patient groups were split into subgroups by age, time to conversion (for MCI), or symptom severity and compared to the control group. AD patients showed a strongly age-dependent pattern, with younger patients showing significantly more extensive reductions in gray matter volume and glucose utilisation. In the MCI converter group, the amount of glucose utilisation reduction was linked to the time to conversion but not to atrophy. Our findings indicate that FDG-PET might be more closely linked to future cognitive decline whilst MRI being more closely related to the current cognitive state reflects potentially irreversible damage.

  15. AD/HD Symptoms and Conduct Problems: Similarities and Differences in Maternal Perceptions

    ERIC Educational Resources Information Center

    Maniadaki, Katerina; Sonuga-Barke, Edmund; Kakouros, Efthymios; Karaba, Rania

    2006-01-01

    Several theories attempt to explain the high co-occurrence of Attention Deficit/ Hyperactivity Disorder (AD/HD) and Conduct Problems (CP). A strong possibility is that AD/HD behaviours lead to the development of CP, due to family coercive interaction patterns, maintained through parental false beliefs regarding child problem behaviour. We compared…

  16. Differences of Behavioral and Psychological Symptoms of Dementia in Disease Severity in Four Major Dementias

    PubMed Central

    Kazui, Hiroaki; Yoshiyama, Kenji; Kanemoto, Hideki; Suzuki, Yukiko; Sato, Shunsuke; Hashimoto, Mamoru; Ikeda, Manabu; Tanaka, Hibiki; Hatada, Yutaka; Matsushita, Masateru; Nishio, Yoshiyuki; Mori, Etsuro; Tanimukai, Satoshi; Komori, Kenjiro; Yoshida, Taku; Shimizu, Hideaki; Matsumoto, Teruhisa; Mori, Takaaki; Kashibayashi, Tetsuo; Yokoyama, Kazumasa; Shimomura, Tatsuo; Kabeshita, Yasunobu; Adachi, Hiroyoshi; Tanaka, Toshihisa

    2016-01-01

    Background/Aims Behavioral and psychological symptoms of dementia (BPSDs) negatively impact the prognosis of dementia patients and increase caregiver distress. The aims of this study were to clarify the differences of trajectories of 12 kinds of BPSDs by disease severity in four major dementias and to develop charts showing the frequency, severity, and associated caregiver distress (ACD) of BPSDs using the data of a Japan multicenter study (J-BIRD). Methods We gathered Neuropsychiatric Inventory (NPI) data of patients with Alzheimer’s disease (AD; n = 1091), dementia with Lewy bodies (DLB; n = 249), vascular dementia (VaD; n = 156), and frontotemporal lobar degeneration (FTLD; n = 102) collected during a 5-year period up to July 31, 2013 in seven centers for dementia in Japan. The NPI composite scores (frequency × severity) of 12 kinds of items were analyzed using a principal component analysis (PCA) in each dementia. The factor scores of the PCA were compared in each dementia by disease severity, which was determined with Clinical Dementia Rating (CDR). Results Significant increases with higher CDR scores were observed in 1) two of the three factor scores which were loaded for all items except euphoria in AD, 2) two of the four factor scores for apathy, aberrant motor behavior (AMB), sleep disturbances, agitation, irritability, disinhibition, and euphoria in DLB, and 3) one of the four factor scores for apathy, depression, anxiety, and sleep disturbances in VaD. However, no increases were observed in any of the five factor scores in FTLD. Conclusions As dementia progresses, several BPSDs become more severe, including 1) apathy and sleep disturbances in AD, DLB, and VaD, 2) all of the BPSDs except euphoria in AD, 3) AMB, agitation, irritability, disinhibition, and euphoria in DLB, and 4) depression and anxiety in VaD. Trajectories of BPSDs in FTLD were unclear. PMID:27536962

  17. Symptom Variability, Not Severity, Predicts Rehospitalization and Mortality in Patients with Heart Failure

    PubMed Central

    Moser, Debra K.; Frazier, Susan K.; Worrall-Carter, Linda; Biddle, Martha J.; Chung, Misook L.; Lee, Kyoung Suk; Lennie, Terry A.

    2010-01-01

    Background Inability of heart failure (HF) patients to recognize worsening symptoms that herald an exacerbation is a common reason for HF readmissions. Aims To examine the relationship between patterns of HF symptom variability, and HF event-free survival. Methods Patients with HF (N = 71) rated HF symptoms daily for 30 days. Symptoms were rated on a 10 point scale anchored at the extreme ends by “worst symptom could be” and “best symptom could be”. Patients were followed for an average of 1 year to track HF and cardiac rehospitalizations and all-cause mortality. Results Cox regression comparing event-free survival between patients who had highly variable symptom ratings across the 30-days and those whose symptoms were less variable revealed worse event-free survival in patients with more variable symptoms of shortness of breath or edema. Symptom variability predicted event-free survival independently of severity of symptoms, ejection fraction, comorbidities, age and gender. Symptom severity did not predict rehospitalization or mortality. Conclusion Regardless of symptom severity, patients whose symptoms fluctuated in an improving and worsening pattern were at substantially greater risk for poorer event-free survival. These patients may become accustomed to this pattern such that they expect symptoms to improve and thus do not seek treatment with worsening symptoms. PMID:20637697

  18. Donepezil delays progression to AD in MCI subjects with depressive symptoms

    PubMed Central

    Lu, P H.; Edland, S D.; Teng, E; Tingus, K; Petersen, R C.; Cummings, J L.

    2009-01-01

    Objective: To determine whether the presence of depression predicts higher rate of progression to Alzheimer disease (AD) in patients with amnestic mild cognitive impairment (aMCI) and whether donepezil treatment beneficially affect this relationship. Methods: The study sample was composed of 756 participants with aMCI from the 3-year, double-blind, placebo-controlled Alzheimer's Disease Cooperative Study drug trial of donepezil and vitamin E. Beck Depression Inventory (BDI) was used to assess depressive symptoms at baseline and participants were followed either to the end of study or to the primary endpoint of progression to probable or possible AD. Results: Cox proportional hazards regression, adjusted for age at baseline, gender, apolipoprotein genotype, and NYU paragraph delayed recall score, showed that higher BDI scores were associated with progression to AD (p = 0.03). The sample was stratified into depressed (BDI score ≥10; n = 208) and nondepressed (BDI <10; n = 548) groups. Kaplan-Meier analysis showed that among the depressed subjects, the proportion progressing to AD was lower for the donepezil group than the combined vitamin E and placebo groups at 1.7 years (p = 0.023), at 2.2 years (p = 0.025), and remained marginally lower at 2.7 years (p = 0.070). The survival curves among the three treatment groups did not differ within the nondepressed participants. Conclusions: Results suggest that depression is predictive of progression from amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD) and treatment with donepezil delayed progression to AD among depressed subjects with aMCI. Donepezil appears to modulate the increased risk of AD conferred by the presence of depressive symptoms. GLOSSARY AD = Alzheimer disease; ADCS = Alzheimer's Disease Cooperative Study; aMCI = amnestic mild cognitive impairment; BDI = Beck Depression Inventory; CDR = Clinical Dementia Rating; ChEI = cholinesterase inhibitors; DSM-IV = Diagnostic and Statistical Manual

  19. Children with Autism: Sleep Problems and Symptom Severity

    ERIC Educational Resources Information Center

    Tudor, Megan E.; Hoffman, Charles D.; Sweeney, Dwight P.

    2012-01-01

    Relationships between the specific sleep problems and specific behavioral problems of children with autism were evaluated. Mothers' reports of sleep habits and autism symptoms were collected for 109 children with autism. Unlike previous research in this area, only children diagnosed with autism without any commonly comorbid diagnoses (e.g.,…

  20. Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients.

    PubMed

    Weisbord, Steven D; Fried, Linda F; Arnold, Robert M; Fine, Michael J; Levenson, David J; Peterson, Rolf A; Switzer, Galen E

    2005-08-01

    The prevalence, severity, and clinical significance of physical and emotional symptoms in patients who are on maintenance hemodialysis remain incompletely characterized. This study sought to assess symptoms and their relationship to quality of life and depression. The recently developed Dialysis Symptom Index was used to assess the presence and the severity of 30 symptoms. The Illness Effects Questionnaire and Beck Depression Inventory were used to evaluate quality of life and depression, respectively. Correlations among symptom burden, symptom severity, quality of life, and depression were assessed using Spearman correlation coefficient. A total of 162 patients from three dialysis units were enrolled. Mean age was 62 y, 48% were black, 62% were men, and 48% had diabetes. The median number of symptoms was 9.0 (interquartile range 6 to 13). Dry skin, fatigue, itching, and bone/joint pain each were reported by > or =50% of patients. Seven additional symptoms were reported by >33% of patients. Sixteen individual symptoms were described as being more than "somewhat bothersome." Overall symptom burden and severity each were correlated directly with impaired quality of life and depression. In multivariable analyses adjusting for demographic and clinical variables including depression, associations between symptoms and quality of life remained robust. Physical and emotional symptoms are prevalent, can be severe, and are correlated directly with impaired quality of life and depression in maintenance hemodialysis patients. Incorporating a standard assessment of symptoms into the care provided to maintenance hemodialysis patients may provide a means to improve quality of life in this patient population.

  1. Symptom severity of depressive symptoms impacts on social cognition performance in current but not remitted major depressive disorder.

    PubMed

    Air, Tracy; Weightman, Michael J; Baune, Bernhard T

    2015-01-01

    The aim of the present study was to investigate the social cognitive functioning of participants with depression when compared with healthy controls, and to assess the impact of symptom severity. One hundred and eight patients with depression (66 remitted and 42 current) and 52 healthy controls were assessed using the Wechsler Advanced Clinical Solutions: Social Perception Subtest, measuring facial affect recognition in isolation and in combination with prosody and body language interpretation. When healthy controls, remitted depression and currently depressed groups were compared, no associations were found on any of the social cognition subscales. Severity of depressive and anxious symptoms predicted performance on all social cognition subscales in currently depressed participants, controlling for age, gender, education and psychotropic medication. Affective depressive symptoms were inversely related to ACS Pairs and Prosody subscales, while somatic symptoms were inversely related to the ACS Affect Recognition and Total scores. There was no association between severity and the WAIS ACS in remitted depression participants. People with MDD exhibiting more severe depressive and anxious symptoms and a cluster of affective symptoms have greater difficulty undertaking complex social cognitive tasks. Given the state like nature to these deficits, these impairments may cause problems with day to day functioning and have implications in targeted therapeutic interventions.

  2. Symptom severity of depressive symptoms impacts on social cognition performance in current but not remitted major depressive disorder

    PubMed Central

    Air, Tracy; Weightman, Michael J.; Baune, Bernhard T.

    2015-01-01

    The aim of the present study was to investigate the social cognitive functioning of participants with depression when compared with healthy controls, and to assess the impact of symptom severity. One hundred and eight patients with depression (66 remitted and 42 current) and 52 healthy controls were assessed using the Wechsler Advanced Clinical Solutions: Social Perception Subtest, measuring facial affect recognition in isolation and in combination with prosody and body language interpretation. When healthy controls, remitted depression and currently depressed groups were compared, no associations were found on any of the social cognition subscales. Severity of depressive and anxious symptoms predicted performance on all social cognition subscales in currently depressed participants, controlling for age, gender, education and psychotropic medication. Affective depressive symptoms were inversely related to ACS Pairs and Prosody subscales, while somatic symptoms were inversely related to the ACS Affect Recognition and Total scores. There was no association between severity and the WAIS ACS in remitted depression participants. People with MDD exhibiting more severe depressive and anxious symptoms and a cluster of affective symptoms have greater difficulty undertaking complex social cognitive tasks. Given the state like nature to these deficits, these impairments may cause problems with day to day functioning and have implications in targeted therapeutic interventions. PMID:26300814

  3. Symptom severity of depressive symptoms impacts on social cognition performance in current but not remitted major depressive disorder.

    PubMed

    Air, Tracy; Weightman, Michael J; Baune, Bernhard T

    2015-01-01

    The aim of the present study was to investigate the social cognitive functioning of participants with depression when compared with healthy controls, and to assess the impact of symptom severity. One hundred and eight patients with depression (66 remitted and 42 current) and 52 healthy controls were assessed using the Wechsler Advanced Clinical Solutions: Social Perception Subtest, measuring facial affect recognition in isolation and in combination with prosody and body language interpretation. When healthy controls, remitted depression and currently depressed groups were compared, no associations were found on any of the social cognition subscales. Severity of depressive and anxious symptoms predicted performance on all social cognition subscales in currently depressed participants, controlling for age, gender, education and psychotropic medication. Affective depressive symptoms were inversely related to ACS Pairs and Prosody subscales, while somatic symptoms were inversely related to the ACS Affect Recognition and Total scores. There was no association between severity and the WAIS ACS in remitted depression participants. People with MDD exhibiting more severe depressive and anxious symptoms and a cluster of affective symptoms have greater difficulty undertaking complex social cognitive tasks. Given the state like nature to these deficits, these impairments may cause problems with day to day functioning and have implications in targeted therapeutic interventions. PMID:26300814

  4. Psychological Symptoms and Drug Use Severity among Israeli Adolescents Presenting for Outpatient Drug Abuse Treatment

    ERIC Educational Resources Information Center

    Diamond, G.M.; Izzard, M.C.; Kedar, T.; Hutlzer, A.; Mell, H.

    2005-01-01

    The objective of this study was to assess the rates of externalizing and internalizing symptoms, and the relation between psychological symptoms and drug use severity, among 117 Israeli adolescents presenting for outpatient drug abuse treatment. Psychological symptoms were assessed via both adolescent self-report and parent report. Drug use was…

  5. Brief Report: Concurrent Validity of Autism Symptom Severity Measures

    ERIC Educational Resources Information Center

    Reszka, Stephanie S.; Boyd, Brian A.; McBee, Matthew; Hume, Kara A.; Odom, Samuel L.

    2014-01-01

    The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation schedule (ADOS), Childhood Autism Rating Scale (CARS) and social responsiveness scale (SRS) (teacher and parent versions), include an…

  6. Brainstem White Matter Predicts Individual Differences in Manual Motor Difficulties and Symptom Severity in Autism

    PubMed Central

    Travers, Brittany G.; Bigler, Erin D.; Tromp, Do P. M.; Adluru, Nagesh; Destiche, Dan; Samsin, Danica; Froehlich, Alyson; Prigge, Molly D. B.; Duffield, Tyler; Lange, Nicholas; Alexander, Andrew L.; Lainhart, Janet E.

    2015-01-01

    Mounting evidence suggests that poorer motor skills may be related to more severe autism symptoms. This study investigated if atypical white matter microstructure in the brain mediated the relationship between motor skills and ASD symptom severity. Sixty-seven males with ASD and 42 males with typical development (5-33 years old) completed a diffusion tensor imaging scan and measures of grip strength, finger tapping, and autism symptom severity. Within the ASD group, weaker grip strength predicted more severe autism symptoms. Fractional anisotropy of the brainstem's corticospinal tract predicted both grip strength and autism symptom severity and mediated the relationship between the two. These findings suggest that brainstem white matter may contribute to autism symptoms and grip strength in ASD. PMID:26001365

  7. Brainstem White Matter Predicts Individual Differences in Manual Motor Difficulties and Symptom Severity in Autism.

    PubMed

    Travers, Brittany G; Bigler, Erin D; Tromp, Do P M; Adluru, Nagesh; Destiche, Dan; Samsin, Danica; Froehlich, Alyson; Prigge, Molly D B; Duffield, Tyler C; Lange, Nicholas; Alexander, Andrew L; Lainhart, Janet E

    2015-09-01

    Mounting evidence suggests that poorer motor skills may be related to more severe autism symptoms. This study investigated if atypical white matter microstructure in the brain mediated the relationship between motor skills and ASD symptom severity. Sixty-seven males with ASD and 42 males with typical development (5-33 years old) completed a diffusion tensor imaging scan and measures of grip strength, finger tapping, and autism symptom severity. Within the ASD group, weaker grip strength predicted more severe autism symptoms. Fractional anisotropy of the brainstem's corticospinal tract predicted both grip strength and autism symptom severity and mediated the relationship between the two. These findings suggest that brainstem white matter may contribute to autism symptoms and grip strength in ASD.

  8. DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer's disease – a multicentre RCT

    PubMed Central

    Jones, Rob; Sheehan, Bart; Phillips, Patrick; Juszczak, Ed; Adams, Jessica; Baldwin, Ashley; Ballard, Clive; Banerjee, Sube; Barber, Bob; Bentham, Peter; Brown, Richard; Burns, Alistair; Dening, Tom; Findlay, David; Gray, Richard; Griffin, Mary; Holmes, Clive; Hughes, Alan; Jacoby, Robin; Johnson, Tony; Jones, Roy; Knapp, Martin; Lindesay, James; McKeith, Ian; McShane, Rupert; Macharouthu, Ajay; O'Brien, John; Onions, Caroline; Passmore, Peter; Raftery, James; Ritchie, Craig; Howard, Rob

    2009-01-01

    Background Alzheimer's disease (AD) is the commonest cause of dementia. Cholinesterase inhibitors, such as donepezil, are the drug class with the best evidence of efficacy, licensed for mild to moderate AD, while the glutamate antagonist memantine has been widely prescribed, often in the later stages of AD. Memantine is licensed for moderate to severe dementia in AD but is not recommended by the England and Wales National Institute for Health and Clinical Excellence. However, there is little evidence to guide clinicians as to what to prescribe as AD advances; in particular, what to do as the condition progresses from moderate to severe. Options include continuing cholinesterase inhibitors irrespective of decline, adding memantine to cholinesterase inhibitors, or prescribing memantine instead of cholinesterase inhibitors. The aim of this trial is to establish the most effective drug option for people with AD who are progressing from moderate to severe dementia despite treatment with donepezil. Method DOMINO-AD is a pragmatic, 15 centre, double-blind, randomized, placebo controlled trial. Patients with AD, currently living at home, receiving donepezil 10 mg daily, and with Standardized Mini-Mental State Examination (SMMSE) scores between 5 and 13 are being recruited. Each is randomized to one of four treatment options: continuation of donepezil with memantine placebo added; switch to memantine with donepezil placebo added; donepezil and memantine together; or donepezil placebo with memantine placebo. 800 participants are being recruited and treatment continues for one year. Primary outcome measures are cognition (SMMSE) and activities of daily living (Bristol Activities of Daily Living Scale). Secondary outcomes are non-cognitive dementia symptoms (Neuropsychiatric Inventory), health related quality of life (EQ-5D and DEMQOL-proxy), carer burden (General Health Questionnaire-12), cost effectiveness (using Client Service Receipt Inventory) and institutionalization

  9. PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: a latent class analysis.

    PubMed

    Hruska, Bryce; Irish, Leah A; Pacella, Maria L; Sledjeski, Eve M; Delahanty, Douglas L

    2014-10-01

    We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA. PMID:25124501

  10. Brainstem White Matter Predicts Individual Differences in Manual Motor Difficulties and Symptom Severity in Autism

    ERIC Educational Resources Information Center

    Travers, Brittany G.; Bigler, Erin D.; Tromp, Do P. M.; Adluru, Nagesh; Destiche, Dan; Samsin, Danica; Froehlich, Alyson; Prigge, Molly D. B.; Duffield, Tyler C.; Lange, Nicholas; Alexander, Andrew L.; Lainhart, Janet E.

    2015-01-01

    Mounting evidence suggests that poorer motor skills may be related to more severe autism symptoms. This study investigated if atypical white matter microstructure in the brain mediated the relationship between motor skills and ASD symptom severity. Sixty-seven males with ASD and 42 males with typical development (5-33 years old) completed a…

  11. Quality of life, social support, and severity of psychiatric symptoms in Jordanian patients with schizophrenia.

    PubMed

    Hamaideh, S; Al-Magaireh, D; Abu-Farsakh, B; Al-Omari, H

    2014-06-01

    The major purposes of this study were to examine levels and correlations of quality of life (QOL), social support, and severity of psychiatric symptoms as well as to identify the variables that best predict QOL among Jordanian patients with schizophrenia. Descriptive cross-sectional design was used to collect data from 160 patients selected through systematic random sampling from two psychiatric outpatient clinics. Results showed that the highest domain of QOL was the social relationship domain, and the highest source of social support was perceived from significant others. Severity of affective symptoms was the highest, and severity of positive symptoms was the lowest. QOL correlated positively with social support, patients' educational and income level, and employment; and negatively with severity of psychiatric symptoms, duration of untreated illness, and duration of treatment. Support from friends, duration of untreated illness, income level, and severity of affective symptoms predicted QOL and accounting for 47.3% of the variance.

  12. Obsessive-compulsive symptom severity in schizophrenia: a Janus Bifrons effect on functioning.

    PubMed

    Tonna, Matteo; Ottoni, Rebecca; Paglia, Francesca; Ossola, Paolo; De Panfilis, Chiara; Marchesi, Carlo

    2016-02-01

    The impact of obsessive-compulsive symptoms on functioning in schizophrenia is still debated. This study investigated the relationship between OC symptoms and functioning along a severity gradient of obsessive-compulsive dimension. Sixty patients affected by schizophrenia completed the SCID-IV, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale and the Social and Occupational Functioning Assessment Scale. The relationship between functioning and obsessive-compulsive dimension was described by a reverse U-shaped curve; functioning was positively related to the presence of mild obsessive-compulsive symptoms and inversely related to moderate and severe symptoms, after controlling for the severity of positive, negative, disorganization and general psychopathological symptoms. The role of obsessive-compulsive symptoms on social functioning in schizophrenia occurs along a severity continuum with a gradual transition from a positive correlation (from absent to mild symptoms) to an inverse correlation (for symptoms ranging from moderate to severe) and independently from schizophrenia symptom dimensions.

  13. Prospectively assessed incidence, severity, and determinants of respiratory symptoms in the first year of life.

    PubMed

    Latzin, P; Frey, U; Roiha, H L; Baldwin, D N; Regamey, N; Strippoli, M P F; Zwahlen, M; Kuehni, C E

    2007-01-01

    Respiratory symptoms are common in infancy. Nevertheless, few prospective birth cohort studies have studied the epidemiology of respiratory symptoms in normal infants. The aim of this study was to prospectively obtain reliable data on incidence, severity, and determinants of common respiratory symptoms (including cough and wheeze) in normal infants and to determine factors associated with these symptoms. In a prospective population-based birth cohort, we assessed respiratory symptoms during the first year of life by weekly phone calls to the mothers. Poisson regression was used to examine the association between symptoms and various risk factors. In the first year of life, respiratory symptoms occurred in 181/195 infants (93%), more severe symptoms in 89 (46%). The average infant had respiratory symptoms for 4 weeks and 90% had symptoms for less than 12 weeks (range 0 to 23). Male sex, higher birth weight, maternal asthma, having older siblings and nursery care were associated with more, maternal hay fever with fewer respiratory symptoms. The association with prenatal maternal smoking decreased with time since birth. This study provides reliable data on the frequency of cough and wheeze during the first year of life in healthy infants; this may help in the interpretation of published hospital and community-based studies. The apparently reduced risk in children of mothers with hayfever but no asthma, and the decreasing effect of prenatal smoke exposure over time illustrate the complexity of respiratory pathology in the first year of life.

  14. Symptom cluster, healthcare use and mortality in patients with severe chronic obstructive pulmonary disease

    PubMed Central

    Park, Soo Kyung; Larson, Janet L

    2014-01-01

    Aims and objectives To examine how subgroups of patients with chronic obstructive pulmonary disease, identified by ratings of symptoms (dyspnoea, anxiety, depression and fatigue), affect healthcare use and mortality. Background People with chronic obstructive pulmonary disease often experience multiple symptoms. The importance of multiple symptoms and symptom clusters has received increased attention. However, little is known about symptom clusters and their effect on healthcare use and mortality in this population. Design Descriptive cross-sectional study. Methods This secondary data analysis used data from the National Emphysema Treatment Trial. Participants (n = 597) had severe chronic obstructive pulmonary disease. Descriptive and inferential statistics were used to analyse the data that were drawn from structured interviews, questionnaires and clinical measures. Results Three subgroup clusters emerged based on four symptom ratings. Mean age, proportion with higher education, proportion using oxygen, disease severity, exercise capacity and quality of life differed significantly between subgroups. Participants with high levels of symptoms used healthcare services more and were more likely to have died at the five-year follow-up than those with low levels of symptoms. Symptom cluster subgroups had more significant relationship with mortality than single symptoms. Conclusion Patients with high levels of symptoms require greater clinical attention. Relevance to clinical practice Understanding subgroups of patients, based on symptom ratings and their adverse effect on outcomes, may enable healthcare providers to assess multiple symptoms and identify subgroups of patients at risk of increased healthcare use and mortality. Targeting modifiable symptoms within the cluster may be more beneficial than focusing on a single symptom for certain health-related outcome. PMID:24460846

  15. A Controlled Examination of Two Coping Skills for Daily Alcohol Use and PTSD Symptom Severity Among Dually Diagnosed Individuals

    PubMed Central

    Stappenbeck, Cynthia A.; Luterek, Jane A.; Kaysen, Debra; Rosenthal, Christina F.; Gurrad, Bethann; Simpson, Tracy L.

    2015-01-01

    Investigations of targeted coping skills could help guide initial treatment decisions for individuals with co-occurring posttraumatic stress disorder (PTSD) and alcohol dependence (AD) who often endorse worse coping skills than those with AD but not PTSD. Although improvement in coping skills is associated with enhanced alcohol use outcomes, no study has evaluated the utility of teaching specific coping skills in the context of comorbid PTSD/AD. We compared the effects of teaching two coping skills (cognitive restructuring [CR] and experiential acceptance [EA]) or an attention control condition on drinking and PTSD symptoms among 78 men and women with comorbid PTSD/AD during a 5-week daily follow-up assessment. Both CR and EA skills were associated with decreased drinking compared to control, and that change in drinking over time did not significantly differ between those who received CR and EA. Individuals who received CR skills, however, consumed less alcohol on a given day than those who received EA skills. Neither CR nor EA was associated with a decrease in PTSD symptom severity. These results provide preliminary support for clinicians to prioritize CR and EA skills during initial treatment sessions when working with individuals with PTSD/AD, and offer ideas for continued investigation and intervention refinement. PMID:25617814

  16. Validity of symptom and clinical measures of asthma severity for primary outpatient assessment of adult asthma.

    PubMed Central

    Ng, T P

    2000-01-01

    BACKGROUND: Symptom and pulmonary function measures of asthma severity are used for severity classification in practice guidelines. However, there is limited methodological evidence in support of their validity and utility. AIM: To validate initial symptom and forced expiratory volume (FEV1) measures of asthma severity with the subsequent risks of exacerbations resulting in emergency room (ER) visits, hospitalisation, and sickness absence from work. In addition, symptom-based measures of change in asthma severity were also evaluated against the concurrent risks of asthma exacerbations. METHOD: A cohort of 361 adult asthmatic patients in general outpatient clinics was studied. At initial interview, frequencies of asthmatic symptoms and nocturnal exacerbations, FEV1, and a severity score combining these measures, were recorded. At re-interview in the third year, the frequencies of asthma exacerbations resulting in ER visits, hospitalisation, and sickness absence, and a self-assessed global measure of change in severity and serially-assessed change in symptom frequencies, were measured. RESULTS: All individual symptom and FEV1 measures were strongly related to the subsequent risks of ER visits, hospitalisation, and sick absence. A severity score of more than 3 (moderate to severe asthma) and self-assessed change in asthma severity were most strongly and significantly associated with greatly increased risks of all outcomes. Individual symptoms and FEV1 measures alone did not show high sensitivities, but the severity score combining these measures gave much more satisfactory validity. Perhaps not surprisingly, self-assessed change in asthma appeared to give the most satisfactory validity. CONCLUSION: These results support the validity and clinical utility of a simple clinical score based on symptom and FEV1 measures, and self-assessed measure of change in severity, for risk classification in contemporary clinical practice guidelines. PMID:10695059

  17. [Episodic manifestation of hemiparkinson syndrome with severe dementia personality change and precursors of paranoid hallucination symptoms].

    PubMed

    Postrach, F

    1989-09-01

    A case of episodic manifestation of semiparalysis agitans is described, accompanied by severe demential personality change and precursory hallucinatory symptoms, which is made the basis for the discussion of aspects of mental disorders, notably dementia and symptoms resembling schizophrenia, in Parkinsonian patients. By way of allusion to Glass, a diagnosis including a very extensive, complex, symptomatology is made of a Parkinsonian syndrome.

  18. Men With Severe Lower Urinary Tract Symptoms Are at Increased Risk of Depression

    PubMed Central

    Choi, Hong Yong; Nam, Ji Won; Kim, Shin Ah; Choi, Bo Youl; Moon, Hong Sang

    2015-01-01

    Purpose: Lower urinary tract symptoms (LUTS) comprise a set of common, bothersome symptoms in middle-aged and elderly men. Recent research suggests that depressive symptoms may influence the symptoms of benign prostatic hyperplasia (BPH). We performed a community-based cross-sectional study to evaluate the correlation between LUTS and depression. Methods: The survey was conducted in a rural community during four periods in August 2009, 2010, 2011, and 2012. Two validated questionnaires were used to examine LUTS and depressive symptoms. These included the International Prostate Symptom Score/quality of life (IPSS/QoL) and the Korean version of the Center for Epidemiological Studies-Depression scale (CES-D-K). Patients were categorized in the depressive symptom group if their CES-D-K score was >16 points. Results: A total of 711 men were included in this study. Thirty-five participants (4.92%) were found to have depressive symptoms. There was a positive correlation between depressive symptoms and LUTS severity (P<0.001). As compared to the mild LUTS group, the odds ratio (OR) of depression was 2.868 (95% confidence interval [CI], 1.293–6.362; P for trend<0.001) in the moderate LUTS group, and 4.133 (95% CI, 1.510–11.313; P for trend<0.001) in the severe LUTS group. In a model considering multiple variables such as age, education level, smoking, and exercise, the OR in the moderate LUTS group was 2.534 (1.125–5.708, 95% CI, P for trend=0.005), while that in the severe LUTS group was 3.910 (95% CI, 5.708–11.154; P for trend=0.005). In addition, depression was related to voiding symptoms. Conclusions: Men with severe LUTS are at higher risk of depression than those with less severe urinary symptoms. The severity of voiding symptoms worsens depression. More aggressive urological diagnosis and treatment is needed in patients with severe LUTS, due to the impact on depressive symptoms and QoL. PMID:26739184

  19. PTSD symptom severity as a predictor of cue-elicited drug craving in victims of violent crime.

    PubMed

    Saladin, Michael E; Drobes, David J; Coffey, Scott F; Dansky, Bonnie S; Brady, Kathleen T; Kilpatrick, Dean G

    2003-12-01

    This study examined posttraumatic stress disorder (PTSD) symptom severity as a predictor of cue-elicited craving among alcohol- and cocaine-dependent individuals with a history of at least one physical and/or sexual assault. Approximately half of the sample had current PTSD. Severity of PTSD symptoms was measured via the Impact of Events Scale-Revised (IES-R) total severity score. Subjects listened to four trials of a brief narrative imagery script followed by the presentation of an in vivo cue. The script presentation consisted of a description of either the subject's worst traumatic event or a neutral scene. The in vivo cues consisted of the presentation of either the subject's preferred drug or neutral cues. Craving was measured in response to both the script and in vivo cues. Results indicated a high degree of correlation between self-report craving and (a) PTSD symptom severity, (b) type of substance use disorder (SUD) [alcohol dependence (AD) vs. cocaine dependence (CD)], and (c) sex and race of participant. A series of stepwise multiple regressions indicated that PTSD severity was significantly predictive of trauma cue-elicited craving and drug cue-elicited craving. The results are discussed in the context of current research, theory, and clinical practice.

  20. Fear of anxiety as a partial mediator of the relation between trauma severity and PTSD symptoms.

    PubMed

    Reuther, Erin T; Davis, Thompson E; Matthews, Russell A; Munson, Melissa S; Grills-Taquechel, Amie E

    2010-08-01

    Fear of anxiety has previously been found to be a predictor of overall symptoms of posttraumatic stress disorder (PTSD). The current exploratory study examines the relationship between fear of anxiety and symptoms of PTSD in a sample of adults exposed to Hurricane Katrina. Fear of anxiety was found to partially mediate the relationship between the severity of trauma and the severity of PTSD. Further, this mediation was found to operate differently by gender, with the mediation holding true for men but not for women. For both men and women, fear of anxiety was positively correlated with PTSD symptoms.

  1. Predictors of Symptoms Are Different From Predictors of Severe Exacerbations From Asthma in Children

    PubMed Central

    Tantisira, Kelan; Li, Lingling; Schuemann, Brooke; Weiss, Scott T.; Fuhlbrigge, Anne L.

    2011-01-01

    Background: Asthma therapy is typically prescribed and titrated based on patient or parent self-report of symptoms. No longitudinal studies have assessed the relationship between symptoms and severe asthma exacerbations in children. The goal of our study was (1) to assess the association of asthma symptoms with severe asthma exacerbations and (2) to compare predictors of persistent asthma symptoms and predictors of severe asthma exacerbations. Methods: The Childhood Asthma Management Program was a multicenter clinical trial of 1,041 children randomized to receive budesonide, nedocromil, or placebo (as-needed β-agonist). We conducted a post hoc analysis of diary cards that were completed by subjects on a daily basis to categorize subjects as having persistent vs intermittent symptoms. We defined a severe asthma exacerbation as an episode requiring ≥ 3 days use of oral corticosteroids, hospitalization, or ED visit due to asthma based on self-report at study visits every 4 months. Results: While accounting for longitudinal measures, having persistent symptoms from asthma was significantly associated with having severe asthma exacerbations. Predictors of having persistent symptoms compared with intermittent symptoms included not being treated with inhaled corticosteroids, lower FEV1/FVC ratio, and a lower natural logarithm of provocative concentration of methacholine producing a 20% decline in FEV1 (lnPC20). Predictors of having one or more severe asthma exacerbations included younger age, history of hospitalization or ED visit in the prior year, ≥ 3 days use of oral corticosteroids in the prior 3 months, lower FEV1/FVC ratio, lower lnPC20, and higher logarithm to the base 10 eosinophil count; treatment with inhaled corticosteroids was predictive of having no severe asthma exacerbations. Conclusions: Patients with persistent symptoms from asthma were more likely to experience severe asthma exacerbations. Nevertheless, demographic and laboratory predictors of

  2. Emotionally biased cognitive processes: the weakest link predicts prospective changes in depressive symptom severity.

    PubMed

    Everaert, Jonas; Duyck, Wouter; Koster, Ernst H W

    2015-01-01

    Emotional biases in attention, interpretation, and memory are predictive of future depressive symptoms. It remains unknown, however, how these biased cognitive processes interact to predict depressive symptom levels in the long-term. In the present study, we tested the predictive value of two integrative approaches to model relations between multiple biased cognitive processes, namely the additive (i.e., cognitive processes have a cumulative effect) vs. the weakest link (i.e., the dominant pathogenic process is important) model. We also tested whether these integrative models interacted with perceived stress to predict prospective changes in depressive symptom severity. At Time 1, participants completed measures of depressive symptom severity and emotional biases in attention, interpretation, and memory. At Time 2, one year later, participants were reassessed to determine depressive symptom levels and perceived stress. Results revealed that the weakest link model had incremental validity over the additive model in predicting prospective changes in depressive symptoms, though both models explained a significant proportion of variance in the change in depressive symptoms from Time 1 to Time 2. None of the integrative models interacted with perceived stress to predict changes in depressive symptomatology. These findings suggest that the best cognitive marker of the evolution in depressive symptoms is the cognitive process that is dominantly biased toward negative material, which operates independent from experienced stress. This highlights the importance of considering idiographic cognitive profiles with multiple cognitive processes for understanding and modifying effects of cognitive biases in depression.

  3. Urinary symptoms: prevalence and severity in British men aged 55 and over.

    PubMed Central

    Hunter, D J; McKee, C M; Black, N A; Sanderson, C F

    1994-01-01

    OBJECTIVE--To measure the prevalence and severity of urinary symptoms among men aged 55 and over in the British population. DESIGN--Cross sectional population survey using a postal questionnaire. SETTING--North West Thames health region. SUBJECTS--1480 men aged 55 years and over randomly selected from 8 general practices. MAIN OUTCOME MEASURES--Self reported frequency and severity of urinary symptoms, their bothersomeness and previous prostate surgery. RESULTS--The response rate among eligible subjects was 78%. The prevalence of moderate and severe symptoms was 204 per 1000, rising from 160 per 1000 in the 55-59 age group to 259 per 1000 in the 70-74 age group and declining after the age of 80 to 119 per thousand in the 85+ age group. Twelve per cent of men reported previous prostate surgery, and the probability of having had surgery increases steadily with age. About a third of those undergoing surgery have recurrence or persistence of symptoms after surgery. Of men with moderate and severe symptoms, 27.9% reported that their symptoms were a medium or big problem, 36.9% reported that their symptoms interfered with their daily activities at least some of the time, and 43.1% were unhappy or 'felt terrible' about the prospect of a future with their current symptoms. CONCLUSION--The prevalence of urinary symptoms in men is lower than previously reported, although there is a substantial number of men who are bothered by, or who find their lives adversely effected by them. PMID:7830011

  4. High prevalence of symptoms in a severely abused “non-patient” women population

    PubMed Central

    Pallotta, N; Piacentino, D; Ciccantelli, B; Rivera, M; Golini, N; Spagnoli, A; Vincoli, G; Farchi, S

    2014-01-01

    Objective The objective of this article is to assess the prevalence of somatic symptoms and of gastrointestinal (GI) syndromes in abused “non-patient” women and the association with the time of perpetration, type, and severity of abuse. Methods Sixty-seven women, 18–58 years, receiving shelter in anti-violence associations were invited to fill out an anonymous questionnaire with a medical and an abuse section. The severity of abuse was expressed as the 0–6 Abuse Severity Measure (ASM). The association between abuse characteristics and the number of symptoms, and GI syndromes was assessed by Poisson regression model. Results Most women suffered from childhood and adulthood sexual and physical abuse. They reported a mean of 5.1 GI symptoms (range 0–13; median 5; IQR 6) and of 1.3 extra-GI symptoms (range 0–6; median 1; IQR 2); 30% of women matched the Rome II Criteria for one, 36% for two, and 4.4% for three or more syndromes, respectively. Women with an ASM of 5–6, having suffered from both sexual and physical abuse, reported significantly (p = 0.02) more GI symptoms, but not extra-GI ones (p = 0.07), and met criteria for more GI syndromes than women with an ASM ≤4 and those reporting only one type of abuse. No association was found between the time of perpetration of the abuse and the number of GI and extra-GI symptoms. Conclusions Symptoms in abused “non-patient” women mainly concern the abdomen and the GI tract. A history of severe, combined physical and sexual abuse is associated with a higher number of GI symptoms. PMID:25452847

  5. Understanding the Relationship Between Co-occurring PTSD and MDD: Symptom Severity and Affect

    PubMed Central

    Post, Loren M.; Zoellner, Lori A.; Youngstrom, Eric; Feeny, Norah C.

    2011-01-01

    How to best understand theoretically the nature of the relationship between co-occurring PTSD and MDD (PTSD+MDD) is unclear. In a sample of 173 individuals with chronic PTSD, we examined whether the data were more consistent with current co-occurring MDD as a separate construct or as a marker of posttraumatic stress severity, and whether the relationship between PTSD and MDD is a function of shared symptom clusters and affect components. Results showed that the more severe depressive symptoms found in PTSD+MDD as compared to PTSD remained after controlling for PTSD symptom severity. Additionally, depressive symptom severity significantly predicted co-occurring MDD even when controlling for PTSD severity. In comparison to PTSD, PTSD+MDD had elevated dysphoria and re-experiencing – but not avoidance and hyperarousal – PTSD symptom cluster scores, higher levels of negative affect, and lower levels of positive affect. These findings provide support for PTSD and MDD as two distinct constructs with overlapping distress components. PMID:21899984

  6. Public mental health clients with severe mental illness and probable posttraumatic stress disorder: trauma exposure and correlates of symptom severity.

    PubMed

    Lu, Weili; Yanos, Philip T; Silverstein, Steven M; Mueser, Kim T; Rosenberg, Stanley D; Gottlieb, Jennifer D; Duva, Stephanie Marcello; Kularatne, Thanuja; Dove-Williams, Stephanie; Paterno, Danielle; Hawthorne, Danielle; Giacobbe, Giovanna

    2013-04-01

    Individuals with severe mental illness (SMI) are at greatly increased risk for trauma exposure and for the development of posttraumatic stress disorder (PTSD). This study reports findings from a large, comprehensive screening of trauma and PTSD symptoms among public mental health clients in a statewide community mental health system. In 851 individuals with SMI and probable PTSD, childhood sexual abuse was the most commonly endorsed index trauma, followed closely by the sudden death of a loved one. Participants had typically experienced an average of 7 types of traumatic events in their lifetime. The number of types of traumatic events experienced and Hispanic ethnicity were significantly associated with PTSD symptom severity. Clients reported experiencing PTSD in relation to events that occurred on average 20 years earlier, suggesting the clinical need to address trauma and loss throughout the lifespan, including their prolonged after-effects.

  7. Serotonin transporter polymorphism (5HTTLPR), severe childhood abuse and depressive symptom trajectories in adulthood

    PubMed Central

    Nguyen, Timothy B.; Gunn, Jane M.; Potiriadis, Maria; Everall, Ian P.

    2015-01-01

    Background Cross-sectional studies suggest that the serotonin transporter promoter region polymorphism (5-HTT gene-linked polymorphic region, 5HTTLPR) moderates the relationship between childhood abuse and major depressive disorder. Aims To examine whether the 5HTTLPR polymorphism moderates the effect childhood abuse has on 5-year depressive symptom severity trajectories in adulthood. Method At 5-year follow-up, DNA from 333 adult primary care attendees was obtained and genotyped for the 5HTTLPR polymorphism. Linear mixed models were used to test for a genotype × childhood abuse interaction effect on 5-year depressive symptom severity trajectories. Results After covariate adjustment, homozygous s allele carriers with a history of severe childhood abuse had significantly greater depressive symptom severity at baseline compared with those without a history of severe childhood abuse and this effect persisted throughout the 5-year period of observation. Conclusions The 5HTTLPR s/s genotype robustly moderates the effects of severe childhood abuse on depressive symptom severity trajectories in adulthood. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703731

  8. Does the severity of psychopathological symptoms mediate the relationship between patient personality and therapist response?

    PubMed

    Lingiardi, Vittorio; Tanzilli, Annalisa; Colli, Antonello

    2015-06-01

    Countertransference can be viewed as a source of valuable diagnostic and therapeutic information and plays a crucial role in psychotherapy process and outcome. Some empirical researches have showed that patients' specific personality characteristics tend to evoke distinct patterns of emotional response in clinicians. However, to date there have been no studies examining the impact of patients' symptomatology on the association between their personality and therapists' responses. This research aimed to (a) investigate the relationship between patients' symptom severity and clinicians' emotional responses; and (b) explore the possible mediated effect of symptom severity on the relationship between patients' personality pathology and countertransference responses. A sample of psychiatrists and clinical psychologists (N = 198) of different theoretical orientations completed the Shedler-Westen Assessment Procedure-200 and the Therapist Response Questionnaire on a patient currently in their care, who then completed the Symptom Checklist-90-Revised. The findings showed that patients' symptomatology partially mediates the relationship between their specific personality disorders (in particular, schizotypal, borderline, histrionic, and avoidant) and therapists' emotional responses, but in general, the impact of symptom severity is less sizable than one aroused by patients' personality style. Higher levels of patients' symptom severity are most associated with an intense feeling of being overwhelmed, disorganization, helplessness, and frustration in clinicians. These countertransference reactions are not accounted for by therapists' different therapeutic approaches and other variables (as gender, age, profession, and experience). The clinical implications of these results are addressed.

  9. Predicting posttraumatic stress disorder symptoms and pain intensity following severe injury: the role of catastrophizing

    PubMed Central

    Carty, Jessica; O'Donnell, Meaghan; Evans, Lynette; Kazantzis, Nikolaos; Creamer, Mark

    2011-01-01

    Background A number of theories have proposed possible mechanisms that may explain the high rates of comorbidity between posttraumatic stress disorder (PTSD) and persistent pain; however, there has been limited research investigating these factors. Objective The present study sought to prospectively examine whether catastrophizing predicted the development of PTSD symptoms and persistent pain following physical injury. Design Participants (N=208) completed measures of PTSD symptomatology, pain intensity and catastrophizing during hospitalization following severe injury, and 3 and 12 months postinjury. Cross-lagged path analysis explored the longitudinal relationship between these variables. Results Acute catastrophizing significantly predicted PTSD symptoms but not pain intensity 3 months postinjury. In turn, 3-month catastrophizing predicted pain intensity, but not PTSD symptoms 12 months postinjury. Indirect relations were also found between acute catastrophizing and 12-month PTSD symptoms and pain intensity. Relations were mediated via 3-month PTSD symptoms and 3-month catastrophizing, respectively. Acute symptoms did not predict 3-month catastrophizing and catastrophizing did not fully account for the relationship between PTSD symptoms and pain intensity. Conclusions Findings partially support theories that propose a role for catastrophizing processes in understanding vulnerability to pain and posttrauma symptomatology and, thus, a possible mechanism for comorbidity between these conditions. PMID:22893804

  10. Among Inpatients, Posttraumatic Stress Disorder Symptom Severity Is Negatively Associated With Time Spent Walking.

    PubMed

    Rosenbaum, Simon; Vancampfort, Davy; Tiedemann, Anne; Stubbs, Brendon; Steel, Zachary; Ward, Philip B; Berle, David; Sherrington, Catherine

    2016-01-01

    This study aimed to determine whether posttraumatic stress disorder (PTSD) symptom severity and psychological and functional variables were associated with physical activity (PA) upon admission to an inpatient facility. PTSD symptoms, depression, anxiety and stress, sleep quality, and PA participation were assessed among 76 participants (age, 47.6 ± 11.9 years; 83% male). Backward stepwise regression analyses identified variables independently associated with time spent walking and engaging in moderate-vigorous PA (MVPA). No significant correlations were found between any of the variables and MVPA. Total PTSD symptoms (r = -0.39, p < 0.001), combined symptoms of depression, anxiety, and stress (r = -0.31, p < 0.01), and sleep behavior (r = -0.24, p < 0.05) were significantly and negatively associated with total walking time. Total PTSD symptoms were the only significant predictor of walking time (B = -0.03, SE = 0.008, β = -0.4; t = -3.4; p < 0.001). Results indicate that increased PTSD symptoms are associated with lower levels of walking. Results highlight the importance of considering symptoms when designing PA programs for people with PTSD. PMID:26558500

  11. Correlates of depressive symptom severity in problem and pathological gamblers in couple relationships.

    PubMed

    Poirier-Arbour, Alisson; Trudel, Gilles; Boyer, Richard; Harvey, Pascale; Goldfarb, Maria Rocio

    2014-03-01

    Problem and pathological gamblers (PPG) often suffer from depressive symptoms. Gambling problems have negative consequences on multiple aspects of gamblers' lives, including family and marital relationships. The objectives of the current study were to (1) replicate the results of studies that have suggested a stronger and more significant relationship between gambling and depression in PPG than in non-problem gamblers (NPG) and (2) explore specific correlates of depressive symptom severity in PPG in couple relationships. Variables demonstrated to be significantly correlated with depressive symptoms in the general population were selected. It was hypothesized that gender, age, gambler's mean annual income, perceived poverty, employment status, clinical status (i.e., problem or pathological gambler versus non-problem gambler), trait anxiety, alcoholism, problem-solving skills, and dyadic adjustment would be significant predictors of depressive symptoms. Sixty-seven PPG were recruited, primarily from an addiction treatment center; 40 NPG were recruited, primarily through the media. Results revealed that PPG reported significantly greater depressive symptoms than did NPG. Further, elevated trait anxiety and poor dyadic adjustment were demonstrated to be significant and specific correlates of depressive symptom severity in PPG. These findings contribute to the literature on depressive symptomatology in PPG in relationships, and highlight the importance of the influence of the couple relationship on PPG.

  12. Prevalence and Severity of Symptoms in a Sample of African Americans and White Participants.

    PubMed

    Taneja, Indu; So, Suzanna; Stewart, Julian M; Evans, Meredyth; Jason, Leonard A

    2015-01-01

    According to the Centers for Disease Control and Prevention (2013), African Americans have a substantially greater prevalence of a range of health conditions when compared to other racial or ethnic groups. Many of these conditions have been attributed to the historical and contemporary social and economic disparities faced by the African American community. While many health conditions occur at a higher rate in African Americans, it is unclear whether there are specific symptom clusters that may also be more prevalent in African Americans as a result of these disparities. Potential differences in symptomology have not been thoroughly examined between African Americans and White populations. The current study compares the prevalence and pain severity of symptoms among a sample of African Americans and White participants. Significant differences in symptom prevalence were found in disturbed sleep and reproductive areas. African Americans also experience more pain due to symptoms related to orthostatic intolerance. Implications of this finding are discussed.

  13. Prevalence and Severity of Symptoms in a Sample of African Americans and White Participants

    PubMed Central

    Taneja, Indu; So, Suzanna; Stewart, Julian M.; Evans, Meredyth; Jason, Leonard A.

    2016-01-01

    According to the Centers for Disease Control and Prevention (2013), African Americans have a substantially greater prevalence of a range of health conditions when compared to other racial or ethnic groups. Many of these conditions have been attributed to the historical and contemporary social and economic disparities faced by the African American community. While many health conditions occur at a higher rate in African Americans, it is unclear whether there are specific symptom clusters that may also be more prevalent in African Americans as a result of these disparities. Potential differences in symptomology have not been thoroughly examined between African Americans and White populations. The current study compares the prevalence and pain severity of symptoms among a sample of African Americans and White participants. Significant differences in symptom prevalence were found in disturbed sleep and reproductive areas. African Americans also experience more pain due to symptoms related to orthostatic intolerance. Implications of this finding are discussed. PMID:26245010

  14. Clustering symptoms of non-severe malaria in semi-immune Amazonian patients.

    PubMed

    Martins, Antonio C; Araújo, Felipe M; Braga, Cássio B; Guimarães, Maria G S; Nogueira, Rudi; Arruda, Rayanne A; Fernandes, Lícia N; Correa, Livia R; Malafronte, Rosely Dos S; Cruz, Oswaldo G; Codeço, Cláudia T; da Silva-Nunes, Mônica

    2015-01-01

    age, past exposure to malaria, and parasitemia. Understanding the full spectrum of nonsevere malaria is important in endemic areas to guide both passive and active case detection, for the diagnosis of malaria in travelers returning to non-endemic areas, and for the development of vaccines aimed to decrease symptom severity. PMID:26500831

  15. Clustering symptoms of non-severe malaria in semi-immune Amazonian patients

    PubMed Central

    Martins, Antonio C.; Araújo, Felipe M.; Braga, Cássio B.; Guimarães, Maria G.S.; Nogueira, Rudi; Arruda, Rayanne A.; Fernandes, Lícia N.; Correa, Livia R.; Malafronte, Rosely dos S.; Cruz, Oswaldo G.; Codeço, Cláudia T.

    2015-01-01

    , past exposure to malaria, and parasitemia. Understanding the full spectrum of nonsevere malaria is important in endemic areas to guide both passive and active case detection, for the diagnosis of malaria in travelers returning to non-endemic areas, and for the development of vaccines aimed to decrease symptom severity. PMID:26500831

  16. Co-occurring prescription opioid use problems and posttraumatic stress disorder symptom severity

    PubMed Central

    Meier, Andrea; Lambert-Harris, Chantal; McGovern, Mark P.; Xie, Haiyi; An, Melissa; McLeman, Bethany

    2016-01-01

    Background Prescription opioids are the most rapidly growing category of abused substances, and result in significant morbidity, mortality and healthcare costs. Co-occurring with psychiatric disorders, persons with prescription opioid problems have negative treatment outcomes. Data are needed on the prevalence of co-occurring prescription opioid abuse and specific disorders, such as posttraumatic stress disorder (PTSD), to better inform clinical practice. Objective: To determine prevalence rates of current co-occurring prescription opioid use problems and PTSD symptom severity among patients in community addiction treatment settings. Methods We abstracted administrative and chart information on 573 new admissions to three addictive treatment agencies during 2011. Systematic data were collected on PTSD symptoms, substance use, and patient demographics. Results Prescription opioid use was significantly associated with co-occurring PTSD symptom severity (OR: 1.42, p < 0.05). Use of prescription opioids in combination with sedatives (OR: 3.81, p < 0.01) or cocaine (OR: 2.24, p < 0.001) also were associated with PTSD severity. The odds of having co-occurring PTSD symptoms and prescription opioid use problem were nearly three times greater among females versus males (OR: 2.63, p < 0.001). Younger patients (18–34 years old) also were at higher risk (OR: 1.86, p < 0.01). Conclusions Prescription opioid use problems are a risk factor for co-occurring PTSD symptom severity. Being female or younger increase the likelihood of this co-morbidity. Further research is needed to confirm these finding, particularly using more rigorous diagnostic procedures. These data suggest that patients with prescription opioid use problems should be carefully evaluated for PTSD symptoms. PMID:24809229

  17. Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes

    PubMed Central

    Fullerton, Carol S.; Ursano, Robert J.; Liu, Xian; McKibben, Jodi B. A.; Wang, Leming; Reissman, Dori B.

    2015-01-01

    There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH) personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%), and ages ranged from 20 to 78 years (median = 49 years). The majority of participants (73.4%) were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively) even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities. PMID:26125567

  18. Longitudinal Study of Symptom Severity and Language in Minimally Verbal Children with Autism

    ERIC Educational Resources Information Center

    Thurm, Audrey; Manwaring, Stacy S.; Swineford, Lauren; Farmer, Cristan

    2015-01-01

    Background: A significant minority of children with autism spectrum disorder (ASD) are considered "minimally verbal" due to language development stagnating at a few words. Recent developments allow for the severity of ASD symptoms to be examined using Autism Diagnostic Observation Schedule (ADOS) Social Affect (SA) and Restricted and…

  19. Severity of children's ADHD symptoms and parenting stress: a multiple mediation model of self-regulation.

    PubMed

    Graziano, Paulo A; McNamara, Joseph P; Geffken, Gary R; Reid, Adam

    2011-10-01

    The goal of the current study was to determine the extent to which the perceived self-regulation deficits across behavioral, cognitive, and emotional domains seen in children with ADHD explain the association between the severity of ADHD symptoms and parenting stress. Participants for this study included 80 children (mean age = 10 years, 9 months) with a DSM-IV diagnosis of ADHD confirmed by a comprehensive clinical diagnostic assessment. Parents reported their own stress levels as well as the severity of their children's ADHD symptoms, aggression, emotional lability, and executive functioning difficulties. Results indicated that the severity of children's hyperactivity/impulsivity symptoms but not their inattention related to parenting stress. Multiple mediational analyses indicated that the association between hyperactivity/impulsivity and parenting stress was explained by children's perceived comorbid aggression levels, emotional lability, and executive functioning difficulties. No significant differences in the strength of the mediators were found. The current study provides initial data showing that the perceived impairments in children's self-regulation across emotional, cognitive, and behavioral domains are what parents report as stressful, not simply the severity of ADHD symptoms. Due to the cross-sectional nature of this study and shared variance from relying solely on parent report, it will be critical for future research to replicate our findings using longitudinal and multi-informant data such as teacher reports and standardized assessments.

  20. Severity of Children's ADHD Symptoms and Parenting Stress: A Multiple Mediation Model of Self-Regulation

    ERIC Educational Resources Information Center

    Graziano, Paulo A.; McNamara, Joseph P.; Geffken, Gary R.; Reid, Adam

    2011-01-01

    The goal of the current study was to determine the extent to which the perceived self-regulation deficits across behavioral, cognitive, and emotional domains seen in children with ADHD explain the association between the severity of ADHD symptoms and parenting stress. Participants for this study included 80 children (mean age = 10 years, 9 months)…

  1. Salivary Melatonin in Relation to Depressive Symptom Severity in Young Adults.

    PubMed

    Sundberg, Isak; Ramklint, Mia; Stridsberg, Mats; Papadopoulos, Fotios C; Ekselius, Lisa; Cunningham, Janet L

    2016-01-01

    Reduced levels of melatonin have been associated with severe depression. The aim was to investigate the correlation between salivary melatonin and dimensional measures of depressive symptom severity in young adult psychiatric patients. Levels of melatonin were analyzed in six saliva samples during waking hours from 119 young adult patients under outpatient psychiatric care. Melatonin levels were tested for association with the severity of depressive symptoms using the self-rating version of the Montgomery Åsberg Depression Rating Scale (MADRS-S). Where possible, depressive symptoms were assessed again after 6±2 months of treatment. Response was defined as decrease in MADRS-S by ≥50% between baseline and follow-up. Patients with levels of melatonin in the lowest quartile at bedtime had an increased probability of a high MADRS-S score compared to those with the highest levels of melatonin (odds ratio 1.39, 95% CI 1.15-1.69, p<0.01). A post hoc regression analysis found that bedtime melatonin levels predicted response (odds ratio 4.4, 95% CI 1.06-18.43, p<0.05). A negative relationship between salivary melatonin and dimensional measures of depressive symptom severity was found in young patients under outpatient psychiatric care. Bedtime salivary melatonin levels may have prognostic implications. PMID:27042858

  2. Toward an Improved Scale for Assessing Symptom Severity in Children With Acute Otitis Media.

    PubMed

    Shaikh, Nader; Hoberman, Alejandro; Rockette, Howard E; Kurs-Lasky, Marcia; Paradise, Jack L

    2015-12-01

    The objective of the present study was to determine whether changes in the previously developed 7-item Acute Otitis Media Severity of Symptoms scale could improve its responsiveness and its longitudinal construct validity. The items "diminished activity" and "diminished appetite" had low or borderline levels of responsiveness and longitudinal construct validity. Dropping these items seems to be potentially advantageous.

  3. Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes.

    PubMed

    Fullerton, Carol S; Ursano, Robert J; Liu, Xian; McKibben, Jodi B A; Wang, Leming; Reissman, Dori B

    2015-01-01

    There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH) personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%), and ages ranged from 20 to 78 years (median = 49 years). The majority of participants (73.4%) were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively) even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities.

  4. Case Series of an Intraoral Balancing Appliance Therapy on Subjective Symptom Severity and Cervical Spine Alignment

    PubMed Central

    Lee, Young Jun; Lee, Joo Kang; Jung, Soo Chang; Lee, Hwang-woo; Yin, Chang Shik; Lee, Young Jin

    2013-01-01

    Objective. The objective of this study was to investigate the effect of a holistic intraoral appliance (OA) on cervical spine alignment and subjective symptom severity. Design. An observational study on case series with holistic OA therapy. Setting. An outpatient clinic for holistic temporomandibular joint (TMJ) therapy under the supervision of the Pain Center, CHA Biomedical center, CHA University. Subjects. Ambulatory patients presenting with diverse chief complaints in the holistic TMJ clinic. Main Measures. Any immediate change in the curvature of cervical spine and the degree of atlantoaxial rotation was investigated in the images of simple X-ray and computed tomography of cervical spine with or without OA. Changes of subjective symptom severity were also analyzed for the holistic OA therapy cases. Results. A total of 59 cases were reviewed. Alignment of upper cervical spine rotation showed an immediate improvement (P < 0.001). Changes of subjective symptom severity also showed significant improvement (P < 0.05). Conclusion. These cases revealed rudimentary clinical evidence that holistic OA therapy may be related to an alleviated symptom severity and an improved cervical spinal alignment. These results show that further researches may warrant for the holistic TMJ therapy. PMID:23935655

  5. Validating the Posttraumatic Stress Disorder Symptom Scale with Persons Who Have Severe Mental Illnesses

    ERIC Educational Resources Information Center

    O'Hare, Thomas; Shen, Ce; Sherrer, Margaret

    2007-01-01

    Objective: Interview data collected from 275 clients with severe mental illnesses are used to test the construct and criterion validity of the Posttraumatic Stress Disorder Symptom Scale (PSS). Method: First, exploratory and confirmatory factor analyses are used to test whether the scale reflects the posttraumatic stress disorder (PTSD) symptom…

  6. The effect of Valerian root extract on the severity of pre menstrual syndrome symptoms.

    PubMed

    Behboodi Moghadam, Zahra; Rezaei, Elham; Shirood Gholami, Roghaieh; Kheirkhah, Masomeh; Haghani, Hamid

    2016-07-01

    Premenstrual syndrome (PMS) is a common disorder. Due to the knowledge lack of the precise etiology of this syndrome, different treatment methods are recommended, one of them is the use of medicinal herbs. This study aimed to investigate the effect of Valerian ( xié cǎo) root extract on the intensity of PMS symptoms. In this double-blind clinical trial, 100 female students of Islamic Azad University, Tonekabon Branch, Mazandaran Province, Iran, with PMS were randomly divided into groups receiving Valerian (scientific name: Valeriana officinalis) and placebo in 2013. The participants received 2 pills daily in the last seven days of their menstrual cycle for 3 cycles and recorded their symptoms. The data collection tools included demographic information questionnaire, daily symptom severity questionnaire, and a provisional diagnosis of premenstrual syndrome questionnaire. Data were compared previous, one, two, and three cycles after student's intervention using and analyzed by independent t-test, paired t-test, chi-squared test, and repeated measures ANOVA in SPSS 16. A significant difference was seen in mean emotional, behavioral and physical premenstrual symptom severity in the intervention group before and after the intervention (P < 0.001). However, this difference was not statistically significant in the control group. The results of this study showed that Valerian root extract may reduce emotional, physical, and behavioral symptoms of premenstrual syndrome. PMID:27419099

  7. The effects of childhood abuse on self-reported psychotic symptoms in severe mental illness: Mediating effects of posttraumatic stress symptoms.

    PubMed

    Choi, Ji Young; Choi, Young Min; Kim, Bongseog; Lee, Dong Woo; Gim, Min Sook; Park, Soo Hyun

    2015-09-30

    The present study examined the role of posttraumatic stress symptoms in the relationship between childhood abuse and self-reported psychotic symptoms in severe mental illness. A total of 126 patients diagnosed with major psychiatric conditions with comorbid symptoms of psychosis participated in the present study. The representative psychiatric diagnoses included schizophrenia, bipolar disorder with psychotic features, major depressive disorder with psychotic features, schizoaffective disorder, schizophreniform disorder, and delusional disorder. The Korean Child Trauma Questionnaire measured the type and degree of childhood abuse including emotional, physical, and sexual abuse. Korean version of the Impact of Event Scale-Revised assessed posttraumatic stress symptoms, and PSYC subscale of the PSY-5 Factor Scale of the MMPI-2 was used as a measure of self-reported psychotic symptoms. There was a significant relationship between childhood physical, emotional, sexual abuse and psychotic symptoms. Posttraumatic stress symptoms partially mediated the relationship between childhood abuse and psychotic symptoms. This implies that childhood abuse is significantly associated with the experience of chronic posttraumatic stress symptoms, and that such symptoms in turn increases the likelihood of experiencing psychotic symptoms. The results highlight the need for appropriate assessment and intervention concerning childhood abuse and posttraumatic stress symptoms in severe mental illness.

  8. The effects of childhood abuse on self-reported psychotic symptoms in severe mental illness: Mediating effects of posttraumatic stress symptoms.

    PubMed

    Choi, Ji Young; Choi, Young Min; Kim, Bongseog; Lee, Dong Woo; Gim, Min Sook; Park, Soo Hyun

    2015-09-30

    The present study examined the role of posttraumatic stress symptoms in the relationship between childhood abuse and self-reported psychotic symptoms in severe mental illness. A total of 126 patients diagnosed with major psychiatric conditions with comorbid symptoms of psychosis participated in the present study. The representative psychiatric diagnoses included schizophrenia, bipolar disorder with psychotic features, major depressive disorder with psychotic features, schizoaffective disorder, schizophreniform disorder, and delusional disorder. The Korean Child Trauma Questionnaire measured the type and degree of childhood abuse including emotional, physical, and sexual abuse. Korean version of the Impact of Event Scale-Revised assessed posttraumatic stress symptoms, and PSYC subscale of the PSY-5 Factor Scale of the MMPI-2 was used as a measure of self-reported psychotic symptoms. There was a significant relationship between childhood physical, emotional, sexual abuse and psychotic symptoms. Posttraumatic stress symptoms partially mediated the relationship between childhood abuse and psychotic symptoms. This implies that childhood abuse is significantly associated with the experience of chronic posttraumatic stress symptoms, and that such symptoms in turn increases the likelihood of experiencing psychotic symptoms. The results highlight the need for appropriate assessment and intervention concerning childhood abuse and posttraumatic stress symptoms in severe mental illness. PMID:26144585

  9. Are respiratory viruses involved in preseasonal symptoms or severity in Japanese cedar pollinosis?

    PubMed Central

    Tsukagoshi, Hiroyuki; Kimura, Hirokazu; Takanashi, Ikuo; Okubo, Kimihiro

    2016-01-01

    Background: Respiratory virus infections are involved in asthma exacerbations. However, there are no reports of the relationship between respiratory virus infections and Japanese cedar pollinosis. Objective: We studied the relationship between respiratory viral infection and the appearance of preseasonal symptoms and the severity of seasonal symptoms in Japanese cedar pollinosis. Methods: In 36 patients with asthma and with no symptoms (PreAsyP) and 54 patients with asthma and with symptoms (PreSyP) before the cedar pollen shedding commenced (preseason), and 37 patients with mild-to-moderate severity (InMild/Mod) and 45 patients with severe to extreme severity (InSev/Ext) after cedar shedding commenced (in season), the occurrence of respiratory viruses and nasal smear cytology were examined. Results: In total, seven infections with respiratory viruses were detected among the subjects. Human rhinovirus (HRV) C infection was detected in one subject in each of the PreAsyP and PreSyP groups, and one HRVA infection occurred in the InMild/Mod group. In the InSev/Ext group, one HRVA, one HRVC, one respiratory syncytial virus, and one human metapneumovirus were detected. There was no significant difference in the rate of detection of viral infections between the PreAsyP and the PreSyP groups (p = 0.077), and between the InMild/Mod group and the InSev/Ext group (p = 0.24, Wilcoxon rank sum test). When cells types in nasal smears were identified and their abundance examined, the rate of neutrophilia in the subjects in the PreSyP group was 54%, which was statistically higher (p < 0.01) than the subjects in the PreAsyP group (25%). Interestingly, in the subjects in the InSev/Ext group, the proportion of eosinophils (40%) was larger (p < 0.05) than in the subjects in the InMild/Mod group (19%). Conclusion: These results provided no evidence that respiratory virus infections contributed to preseasonal symptoms and severity in season of Japanese cedar pollinosis. Nasal

  10. Severe osteopenia in symptom-free adults with a childhood diagnosis of coeliac disease.

    PubMed

    Cellier, C; Flobert, C; Cormier, C; Roux, C; Schmitz, J

    2000-03-01

    The frequency of osteopenia in symptom-free adults diagnosed with coeliac disease during childhood and who resumed a normal diet during adolescence is unknown. Severe osteopenia (a bone mineral density below two standard deviations of the mean) was found in up to a third of symptom-free young adults on a normal diet. These patients should not be thought to be disease-free but should receive long-term follow-up and most of them should be advised to resume a gluten-free diet. PMID:10711931

  11. Vilazodone in the treatment of major depressive disorder: efficacy across symptoms and severity of depression.

    PubMed

    Khan, Arif; Sambunaris, Angelo; Edwards, John; Ruth, Adam; Robinson, Donald S

    2014-03-01

    Vilazodone is a potent selective serotonin reuptake inhibitor and serotonin 1A receptor partial agonist approved for the treatment of major depressive disorder in adults. To assess the efficacy of vilazodone across a range of symptoms and severities of depression, data from two phase III, 8-week, randomized, double-blind, placebo-controlled trials were pooled for analysis. Overall improvement in depressive symptoms measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) and the 17-item Hamilton Depression Rating Scale was statistically significant (P<0.05) for vilazodone treatment compared with placebo as early as Week 1 and continued throughout double-blind treatment. Vilazodone treatment compared with placebo showed significant improvement on all 10 individual MADRS symptom items at end of treatment (P<0.01). Rates of response and remission were significantly greater in the vilazodone group relative to the placebo group, with numbers needed to treat ranging from eight to nine for response and 12-17 for remission. Between-group treatment differences in MADRS and the other outcome measures were similar among all depression subgroups, with no consistent pattern associated with depression severity. These findings support the efficacy of vilazodone across a broad range of depressive symptoms and severities for the treatment of major depressive disorder.

  12. Severity and clustering of menopausal symptoms among obese and nonobese postmenopausal women in India

    PubMed Central

    Sharanya Shre, E. S.; Trout, Kate; Singh, Sonia Pant; Singh, Awnish Kumar; Mohan, Surapaneni Krishna; Joshi, Ashish

    2016-01-01

    Background: The symptoms of menopause have a negative impact on quality of life, especially in women transitioning to menopause and earlier transitions. This study was conducted with the objective of assessing the effect of obesity on the severity of menopausal symptoms and the clustering of symptoms in postmenopausal women in India. Methodology: The Menopausal Rating Scale (MRS) was used to assess the severity of menopausal symptoms of postmenopausal women of Chennai, visiting Saveetha Medical College, Chennai, India. This cross-sectional study was conducted from August to November 2013 in Chennai, India. Sociodemographic characteristics, anthropometric measurements, blood pressure level, menopausal history, personal health history, and hormonal disorder issues were investigated. Results: The results have shown that 24% of the participants had complaint of mild to severe hot flushes, half of them had reported heart ailments (49%; n = 74), and disturbed sleep (48%; n = 72). The proportion of overweight/obese participants was higher in married (64%) than widows (41%), and this difference was found statistically significant (P = 0.005). There were no significant differences in MRS scores of obese and nonobese postmenopausal participants. Conclusion: There is a need of developing interactive, user friendly, technology based education module for addressing the chronic ailments of postmenopausal women. PMID:27134461

  13. Effect of Treatment with Ginger on the Severity of Premenstrual Syndrome Symptoms

    PubMed Central

    Khayat, Samira; Kheirkhah, Masoomeh; Behboodi Moghadam, Zahra; Fanaei, Hamed; Kasaeian, Amir; Javadimehr, Mani

    2014-01-01

    Premenstrual syndrome (PMS) is a common disorder. Although the etiology of PMS is not clear, to relieve from this syndrome different methods are recommended. One of them is use of medicinal herbs. This study was carried out to evaluate effects of ginger on severity of symptoms of PMS. This study was a clinical trial, double-blinded work, and participants were randomly allocated to intervention (n = 35) and control (n = 35) groups. To determine persons suffering from PMS, participants completed daily record scale questionnaire for two consecutive cycles. After identification, each participant received two ginger capsules daily from seven days before menstruation to three days after menstruation for three cycles and they recorded severity of the symptoms by daily record scale questionnaire. Data before intervention were compared with date 1, 2, and 3 months after intervention. Before intervention, there were no significant differences between the mean scores of PMS symptoms in the two groups, but after 1, 2, and 3 months of treatment, there was a significant difference between the two groups (P < 0.0001). Based on the results of this study, maybe ginger is effective in the reduction of severity of mood and physical and behavioral symptoms of PMS and we suggest ginger as treatment for PMS. PMID:24944825

  14. Childhood Maltreatment and Social Anxiety Disorder: Implications for Symptom Severity and Response to Pharmacotherapy

    PubMed Central

    Bruce, Laura C.; Heimberg, Richard G.; Blanco, Carlos; Schneier, Franklin R.; Liebowitz, Michael R.

    2011-01-01

    Background Childhood maltreatment has been associated with symptom severity, reduced quality of life, and impaired functioning in adults with social anxiety disorder (SAD). No study has investigated how childhood maltreatment impacts pharmacotherapy outcomes in this population, despite evidence for such a link in depression. The current study replicates previous work on childhood maltreatment within SAD and examines its impact on response to pharmacotherapy. Methods 156 individuals seeking treatment for SAD completed the Childhood Trauma Questionnaire, which measures various types of abuse and neglect, along with measures of symptom severity, quality of life, and disability. Data from a subset of patients enrolled in a paroxetine trial (N=127) were analyzed to gauge the impact of childhood maltreatment on attrition and treatment response. Results All types of maltreatment except for sexual abuse and physical abuse were related to greater symptom severity. Emotional abuse and neglect were related to greater disability, and emotional abuse, emotional neglect, and physical abuse were related to decreased quality of life. Emotional abuse significantly predicted attrition. A time by emotional abuse interaction suggests that for those who stayed the course, the impact of emotional abuse on severity of social anxiety weakened significantly over time. Conclusions Emotional maltreatment was most strongly linked to dysfunction in SAD, despite a tendency in the anxiety literature to focus on the effects of sexual and physical abuse. Additionally, individuals reporting emotional abuse were more likely to dropout from pharmacotherapy, but those who stayed the course displayed similar outcomes to those without such a history. PMID:22065560

  15. Neurological Symptom Severity after a Recent Non-cardioembolic Stroke and Recurrent Vascular Risk

    PubMed Central

    Park, Jong-Ho; Ovbiagele, Bruce

    2015-01-01

    Background There is a well-established relation of symptom severity with functional status and mortality after an index stroke. However, little is known about the impact of symptom severity of a recent index stroke on risk of recurrent vascular events. Methods We reviewed the dataset of a multicenter trial involving 3680 recent non-cardioembolic stroke patients aged ≥35 years and followed for 2 years. Independent associations of stroke severity (as measured by National Institutes of Health Stroke Scale [NIHSS] score) with recurrent stroke (primary outcome) and stroke/coronary heart disease (CHD)/vascular death (secondary outcome) were analyzed. NIHSS score was analyzed as a dichotomous (<4 vs. ≥4) and a continuous variable. Results Among study subjects, 550 (15%) had NIHSS scores ≥4 (overall scores ranged from 0 to 18, median score was 1 [25th to 75th percentile 0 to 2]). NIHSS was measured at a median 35 days after the index stroke. After adjusting for multiple covariates, NIHSS ≥4 was independently linked to higher risk of recurrent stroke (HR 1.37, 95% CI: 1.01–1.84) and risk of stroke/CHD/vascular death (HR 1.32, 95% CI: 1.07–1.64). Analysis of NIHSS score as a continuous variable also showed a higher risk of recurrent stroke (HR 1.06, 95% CI: 1.00–1.12) and stroke/CHD/vascular death (HR 1.05, 95% CI: 1.01–1.09) with increasing index stroke symptom severity. Conclusions Greater residual symptom severity after a recent stroke is associated with higher risk of recurrent vascular events. Future studies are needed to confirm this relationship and to clarify its underlying mechanisms. PMID:25817617

  16. Age and Adaptive Functioning in Children and Adolescents with ASD: The Effects of Intellectual Functioning and ASD Symptom Severity.

    PubMed

    Hill, Trenesha L; Gray, Sarah A O; Kamps, Jodi L; Enrique Varela, R

    2015-12-01

    The present study examined the moderating effects of intellectual functioning and ASD symptom severity on the relation between age and adaptive functioning in 220 youth with autism spectrum disorder (ASD). Regression analysis indicated that intellectual functioning and ASD symptom severity moderated the relation between age and adaptive functioning. For younger children with lower intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Similarly, for older children with higher intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Analyses by subscales suggest that this pattern is driven by the Conceptual subscale. Clinical and research implications are discussed.

  17. Age and Adaptive Functioning in Children and Adolescents with ASD: The Effects of Intellectual Functioning and ASD Symptom Severity.

    PubMed

    Hill, Trenesha L; Gray, Sarah A O; Kamps, Jodi L; Enrique Varela, R

    2015-12-01

    The present study examined the moderating effects of intellectual functioning and ASD symptom severity on the relation between age and adaptive functioning in 220 youth with autism spectrum disorder (ASD). Regression analysis indicated that intellectual functioning and ASD symptom severity moderated the relation between age and adaptive functioning. For younger children with lower intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Similarly, for older children with higher intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Analyses by subscales suggest that this pattern is driven by the Conceptual subscale. Clinical and research implications are discussed. PMID:26174048

  18. The Relationship between Symptom Severity and Low Vitamin D Levels in Patients with Schizophrenia

    PubMed Central

    Doğan Bulut, Süheyla; Bulut, Serdar; Görkem Atalan, Dicle; Berkol, Tonguç; Gürçay, Eda; Türker, Türker; Aydemir, Çiğdem

    2016-01-01

    Background In recent years, the relationship between schizophrenia and environmental factors has come into prominence. This study investigated the relationship between vitamin D levels and the positive and negative symptoms of schizophrenia by comparing vitamin D levels between patients with schizophrenia and a healthy control group. Methods The study included 80 patients diagnosed with schizophrenia and 74 age- and sex-matched controls. The Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS) were used to evaluate symptom severity. The 25-hydroxyvitamin D (25OHD) levels of all subjects both patients and healthy controls were analyzed in relation to measurements of symptom severity. Results There were no significant differences between the groups in terms of age, sex, or physical activity. Their mean 25OHD levels were also similar (23.46±13.98ng/mL for the patient group and 23.69±9.61ng/mL for the control group). But when patients with schizophrenia were grouped based on their vitamin D levels, the results indicated a statistically significant differences between their vitamin D levels and their total SANS, affective flattening, and total SAPS, bizarre behavior and positive formal thought disorder scores (p = 0.019, p = 0.004, p = 0.015, p = 0.009 and p = 0.019, respectively). There is a negative correlation between 25OHD levels and SANS total points (r = -0.232, p = 0.038); a negative correlation for attention points (r = -0.227, p = 0.044) and negative correlation with positive formal thoughts (r = -0.257, p = 0.021). Conclusion The results of this study show a relationship between lower levels of vitamin D and the occurrence of positive and negative symptoms, along with increased severity of symptoms at lower levels of vitamin D, suggesting that treatment for schizophrenia should include assessment of patients’ vitamin D levels. We recommend that patients with schizophrenia should be assessed with

  19. Is ideology a risk factor for PTSD symptom severity among Israeli political evacuees?

    PubMed

    Oren, Lior; Possick, Chaya

    2010-08-01

    To study the role of ideology in situations of extreme stress, a research questionnaire, measuring posttraumatic stress disorder (PTSD), settlement ideology (the importance of Jewish settlement in Gaza), and type of evacuation was administered to 326 Jewish residents who were evacuated from Gaza settlements by the Israeli government. Forty percent of the participants met the criteria of probable PTSD. Forcibly evicted individuals reported higher levels of settlement ideology and higher levels of PTSD symptom severity compared to voluntarily evacuated individuals. Contrary to previous studies, ideology was found to be positively associated with PTSD symptom severity. The results are explained by the conservation of resources and terror management theories. Theoretical and practical implications are discussed.

  20. When Parents with Severe Mental Illness Lose Contact with Their Children: Are Psychiatric Symptoms or Substance Use to Blame?

    ERIC Educational Resources Information Center

    Jones, Danson; Macias, Rosemarie Lillianne; Gold, Paul B.; Barreira, Paul; Fisher, William

    2008-01-01

    This study compared parental psychiatric symptom severity, and the absence or presence of severe substance abuse, as predictors of contact with minor children for a representative sample of adults with diagnoses of serious mental illness (N = 45). Child contact and psychiatric symptom severity were measured during regularly scheduled 6-month…

  1. Progesterone for hot flush and night sweat treatment--effectiveness for severe vasomotor symptoms and lack of withdrawal rebound.

    PubMed

    Prior, Jerilynn C; Hitchcock, Christine L

    2012-10-01

    A controlled trial recently showed that oral micronized progesterone (Progesterone, 300 mg at h.s. daily) was effective for vasomotor symptoms (VMS) in 133 healthy early postmenopausal women. Here, we present subgroup data in women with severe VMS (50 VMS of moderate-severe intensity/wk) and also 1-mo withdrawal study outcomes. Women with severe VMS (n = 46) resembled the full cohort but experienced 10 VMS/d of 3 of 4 intensity. On therapy, the progesterone VMS number (#) decreased significantly more than placebo # to 5.5/day (d) versus 8/d (ANCOVA -2.0 95% CI: -3.5 to -0.4). Just after trial mid-point, a withdrawal substudy (D/C) was added--56 women were invited and 34 (61%) took part (progesterone 17; placebo 17). Those in the D/C cohort resembled the whole cohort. On stopping, VMS gradually increased--at D/C week 4, on progesterone, VMS daily # reached 78% and significantly less than baseline (-3.0 to -0.8) but placebo VMS # did not differ from run-in. In summary, progesterone is effective for severe VMS and does not cause a rebound increase in VMS when stopped. That progesterone may be used alone for severe VMS and unlike estrogen does not appear to cause a withdrawal rebound increases VMS treatment options.

  2. Mobile Phone Sensor Correlates of Depressive Symptom Severity in Daily-Life Behavior: An Exploratory Study

    PubMed Central

    Saeb, Sohrab; Zhang, Mi; Karr, Christopher J; Schueller, Stephen M; Corden, Marya E; Kording, Konrad P

    2015-01-01

    Background Depression is a common, burdensome, often recurring mental health disorder that frequently goes undetected and untreated. Mobile phones are ubiquitous and have an increasingly large complement of sensors that can potentially be useful in monitoring behavioral patterns that might be indicative of depressive symptoms. Objective The objective of this study was to explore the detection of daily-life behavioral markers using mobile phone global positioning systems (GPS) and usage sensors, and their use in identifying depressive symptom severity. Methods A total of 40 adult participants were recruited from the general community to carry a mobile phone with a sensor data acquisition app (Purple Robot) for 2 weeks. Of these participants, 28 had sufficient sensor data received to conduct analysis. At the beginning of the 2-week period, participants completed a self-reported depression survey (PHQ-9). Behavioral features were developed and extracted from GPS location and phone usage data. Results A number of features from GPS data were related to depressive symptom severity, including circadian movement (regularity in 24-hour rhythm; r=-.63, P=.005), normalized entropy (mobility between favorite locations; r=-.58, P=.012), and location variance (GPS mobility independent of location; r=-.58, P=.012). Phone usage features, usage duration, and usage frequency were also correlated (r=.54, P=.011, and r=.52, P=.015, respectively). Using the normalized entropy feature and a classifier that distinguished participants with depressive symptoms (PHQ-9 score ≥5) from those without (PHQ-9 score <5), we achieved an accuracy of 86.5%. Furthermore, a regression model that used the same feature to estimate the participants’ PHQ-9 scores obtained an average error of 23.5%. Conclusions Features extracted from mobile phone sensor data, including GPS and phone usage, provided behavioral markers that were strongly related to depressive symptom severity. While these findings must

  3. DUF1220 dosage is linearly associated with increasing severity of the three primary symptoms of autism.

    PubMed

    Davis, Jonathan M; Searles, Veronica B; Anderson, Nathan; Keeney, Jonathon; Dumas, Laura; Sikela, James M

    2014-03-01

    One of the three most frequently documented copy number variations associated with autism spectrum disorder (ASD) is a 1q21.1 duplication that encompasses sequences encoding DUF1220 protein domains, the dosage of which we previously implicated in increased human brain size. Further, individuals with ASD frequently display accelerated brain growth and a larger brain size that is also associated with increased symptom severity. Given these findings, we investigated the relationship between DUF1220 copy number and ASD severity, and here show that in individuals with ASD (n = 170), the copy number (dosage) of DUF1220 subtype CON1 is highly variable, ranging from 56 to 88 copies following a Gaussian distribution. More remarkably, in individuals with ASD CON1 copy number is also linearly associated, in a dose-response manner, with increased severity of each of the three primary symptoms of ASD: social deficits (p = 0.021), communicative impairments (p = 0.030), and repetitive behaviors (p = 0.047). These data indicate that DUF1220 protein domain (CON1) dosage has an ASD-wide effect and, as such, is likely to be a key component of a major pathway underlying ASD severity. Finally, these findings, by implicating the dosage of a previously unexamined, copy number polymorphic and brain evolution-related gene coding sequence in ASD severity, provide an important new direction for further research into the genetic factors underlying ASD. PMID:24651471

  4. DUF1220 Dosage Is Linearly Associated with Increasing Severity of the Three Primary Symptoms of Autism

    PubMed Central

    Davis, Jonathan M.; Searles, Veronica B.; Anderson, Nathan; Keeney, Jonathon; Dumas, Laura; Sikela, James M.

    2014-01-01

    One of the three most frequently documented copy number variations associated with autism spectrum disorder (ASD) is a 1q21.1 duplication that encompasses sequences encoding DUF1220 protein domains, the dosage of which we previously implicated in increased human brain size. Further, individuals with ASD frequently display accelerated brain growth and a larger brain size that is also associated with increased symptom severity. Given these findings, we investigated the relationship between DUF1220 copy number and ASD severity, and here show that in individuals with ASD (n = 170), the copy number (dosage) of DUF1220 subtype CON1 is highly variable, ranging from 56 to 88 copies following a Gaussian distribution. More remarkably, in individuals with ASD CON1 copy number is also linearly associated, in a dose-response manner, with increased severity of each of the three primary symptoms of ASD: social deficits (p = 0.021), communicative impairments (p = 0.030), and repetitive behaviors (p = 0.047). These data indicate that DUF1220 protein domain (CON1) dosage has an ASD-wide effect and, as such, is likely to be a key component of a major pathway underlying ASD severity. Finally, these findings, by implicating the dosage of a previously unexamined, copy number polymorphic and brain evolution-related gene coding sequence in ASD severity, provide an important new direction for further research into the genetic factors underlying ASD. PMID:24651471

  5. Hormonal determinants of the severity of andropausal and depressive symptoms in middle-aged and elderly men with prediabetes.

    PubMed

    Rabijewski, Michał; Papierska, Lucyna; Kuczerowski, Roman; Piątkiewicz, Paweł

    2015-01-01

    Andropausal and depressive symptoms are common in aging males and may be associated with hormone deficiency. We investigated the severity of andropausal and depressive symptoms, as well as their hormonal determinants, in 196 middle-aged and elderly men (age range: 40-80 years) with prediabetes (PD) and in 184 healthy peers. PD was diagnosed according to the definition of the American Diabetes Association. The severity of andropausal and depressive symptoms was assessed using the Aging Males' Symptoms Rating Scale and the Self-Rating Depression Scale. Total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) were measured. The prevalence of andropausal syndrome in men with PD was significantly higher than that in healthy men (35% vs 11%, respectively). In men with PD aged 40-59 years, the severity of sexual, psychological, and all andropausal symptoms was greater than in healthy peers, while in elderly men (60-80 years), only the severity of psychological symptoms was greater than in healthy peers. The severity of depressive symptoms in the middle-aged men with PD was greater than in healthy peers, while the severity of depressive symptoms in elderly men with PD and healthy peers was similar. The higher prevalence of andropausal symptoms was independently associated with cFT and IGF-1 in middle-aged men and with TT and DHEAS in elderly men with PD. The more severe depression symptoms were associated with low TT and DHEAS in middle-aged men and with low cFT and DHEAS in elderly men with PD. In conclusion, the prevalence of andropausal symptoms, especially psychological, was higher in prediabetic patients as compared to healthy men, while the severity of depressive symptoms was higher only in middle-aged men with PD. Hormonal determinants of andropausal and depressive symptoms are different in middle-aged and elderly patients, but endocrine tests are necessary in all men with PD.

  6. Severity of eating disorder symptoms related to oxytocin receptor polymorphisms in anorexia nervosa

    PubMed Central

    Acevedo, Summer F.; Valencia, Celeste; Lutter, Michael; McAdams, Carrie J.

    2015-01-01

    Oxytocin is a peptide hormone important for social behavior, and differences in psychological traits have been associated with variants of the oxytocin receptor gene in healthy people. We examined whether small nucleotide polymorphisms (SNPs) of the oxytocin receptor gene (OXTR) correlated with clinical symptoms in women with anorexia nervosa, bulimia nervosa, and healthy comparison (HC) women. Subjects completed clinical assessments and provided DNA for analysis. Subjects were divided into four groups: HC, subjects currently with anorexia nervosa (AN-C), subjects with a history of anorexia nervosa but in long-term weight recovery (AN-WR), and subjects with bulimia nervosa (BN). Five SNPs of the oxytocin receptor were examined. Minor allele carriers showed greater severity in most of the psychiatric symptoms. Importantly, the combination of having had anorexia and carrying either of the A alleles for two SNPS in the OXTR gene (rs53576, rs2254298) was associated with increased severity specifically for ED symptoms including cognitions and behaviors associated both with eating and appearance. A review of psychosocial data related to the OXTR polymorphisms examined is included in the discussion. OXTR polymorphisms may be a useful intermediate endophenotype to consider in the treatment of patients with anorexia nervosa. PMID:26106053

  7. Spontaneous neuronal activity in insula predicts symptom severity of unmedicated obsessive compulsive disorder adults.

    PubMed

    Zhu, Y; Fan, Q; Zhang, Z; Zhang, H; Tong, S; Li, Y

    2015-01-01

    Emerging evidence has suggested that the pathophysiology of obsessive compulsive disorder (OCD) might involve widely distributed large-scale brain systems. The dysfunction within salience network, which is comprised of dorsal anterior cingulated cortex (dACC) and bilateral insular areas, has been proposed to contribute to OCD onset. The mechanism underlying salience network abnormality remains unclear and it is worthwhile to investigate its clinical relevance using functional neuroimaging approaches. In this study, we performed the spontaneous brain activity measurement using resting-state functional magnetic resonance imaging (fMRI) on unmedicated OCD patients (n=23). Specifically, the amplitude of low frequency (0.01-0.08 Hz) fluctuations (ALFF) was calculated for regions in salience network. The voxel-based Pearson's correlative analysis was conducted to explore the relationship beween ALFF measures and symptom severity for OCD patients. The results showed that the spontaneous neuronal activity in insula was significantly correlated to OCD clinical symptoms, especially compulsive behaviors. Our findings consolidated that the salience network played an important role in the pathogenesis of OCD and the intensity of intrinsic brain activity in insula provided a predictive biomarker for OCD symptom severity. PMID:26737523

  8. Associations of emotional arousal, dissociation and symptom severity with operant conditioning in borderline personality disorder.

    PubMed

    Paret, Christian; Hoesterey, Steffen; Kleindienst, Nikolaus; Schmahl, Christian

    2016-10-30

    Those with borderline personality disorder (BPD) display altered evaluations regarding reward and punishment compared to others. The processing of rewards is basal for operant conditioning. However, studies addressing operant conditioning in BPD patients are rare. In the current study, an operant conditioning task combining learning acquisition and reversal was used. BPD patients and matched healthy controls (HCs) were exposed to aversive and neutral stimuli to assess the influence of emotion on learning. Picture content, dissociation, aversive tension and symptom severity were rated. Error rates were measured. Results showed no group interactions between aversive versus neutral scenes. The higher emotional arousal, dissociation and tension, the worse the acquisition, but not reversal, scores were for BPD patients. Scores from the Borderline Symptom List were associated with more errors in the reversal, but not the acquisition phase. The results are preliminary evidence for impaired acquisition learning due to increased emotional arousal, dissociation and tension in BPD patients. A failure to process punishment in the reversal phase was associated with symptom severity and may be related to neuropsychological dysfunctioning involving the ventromedial prefrontal cortex. Conclusions are limited due to the correlational study design and the small sample size. PMID:27491014

  9. Severity of eating disorder symptoms related to oxytocin receptor polymorphisms in anorexia nervosa

    PubMed Central

    Acevedo, Summer F.; Valencia, Celeste; Lutter, Michael; McAdams, Carrie J.

    2015-01-01

    Oxytocin is a peptide hormone important for social behavior, and differences in psychological traits have been associated with variants of the oxytocin receptor gene in healthy people. We examined whether small nucleotide polymorphisms (SNPs) of the oxytocin receptor gene (OXTR) correlated with clinical symptoms in women with anorexia nervosa, bulimia nervosa, and healthy comparison (HC) women. Subjects completed clinical assessments and provided DNA for analysis. Subjects were divided into four groups: HC, subjects currently with anorexia nervosa (AN-C), subjects with a history of anorexia nervosa but in long-term weight recovery (AN-WR), and subjects with bulimia nervosa (BN). Five SNPs of the oxytocin receptor were examined. Minor allele carriers showed greater severity in most of the psychiatric symptoms. Importantly, the combination of having had anorexia and carrying either of the A alleles for two SNPS in the OXTR gene (rs53576, rs2254298) was associated with increased severity specifically for ED symptoms including cognitions and behaviors associated both with eating and appearance. A review of psychosocial data related to the OXTR polymorphisms examined is included in the discussion. OXTR polymorphisms may be a useful intermediate endophenotype to consider in the treatment of patients with anorexia nervosa. PMID:26106053

  10. Severity of eating disorder symptoms related to oxytocin receptor polymorphisms in anorexia nervosa.

    PubMed

    Acevedo, Summer F; Valencia, Celeste; Lutter, Michael; McAdams, Carrie J

    2015-08-30

    Oxytocin is a peptide hormone important for social behavior and differences in psychological traits have been associated with variants of the oxytocin receptor gene in healthy people. We examined whether single nucleotide polymorphisms (SNPs) of the oxytocin receptor gene (OXTR) correlated with clinical symptoms in women with anorexia nervosa, bulimia nervosa, and healthy comparison (HC) women. Subjects completed clinical assessments and provided DNA for analysis. Subjects were divided into four groups: HC, subjects currently with anorexia nervosa (AN-C), subjects with a history of anorexia nervosa but in long-term weight recovery (AN-WR), and subjects with bulimia nervosa (BN). Five SNPs of the oxytocin receptor were examined. Minor allele carriers showed greater severity in most of the psychiatric symptoms. Importantly, the combination of having had anorexia and carrying either of the A alleles for two SNPS in the OXTR gene (rs53576, rs2254298) was associated with increased severity specifically for ED symptoms including cognitions and behaviors associated both with eating and appearance. A review of psychosocial data related to the OXTR polymorphisms examined is included in the discussion. OXTR polymorphisms may be a useful intermediate endophenotype to consider in the treatment of patients with anorexia nervosa.

  11. Associations of emotional arousal, dissociation and symptom severity with operant conditioning in borderline personality disorder.

    PubMed

    Paret, Christian; Hoesterey, Steffen; Kleindienst, Nikolaus; Schmahl, Christian

    2016-10-30

    Those with borderline personality disorder (BPD) display altered evaluations regarding reward and punishment compared to others. The processing of rewards is basal for operant conditioning. However, studies addressing operant conditioning in BPD patients are rare. In the current study, an operant conditioning task combining learning acquisition and reversal was used. BPD patients and matched healthy controls (HCs) were exposed to aversive and neutral stimuli to assess the influence of emotion on learning. Picture content, dissociation, aversive tension and symptom severity were rated. Error rates were measured. Results showed no group interactions between aversive versus neutral scenes. The higher emotional arousal, dissociation and tension, the worse the acquisition, but not reversal, scores were for BPD patients. Scores from the Borderline Symptom List were associated with more errors in the reversal, but not the acquisition phase. The results are preliminary evidence for impaired acquisition learning due to increased emotional arousal, dissociation and tension in BPD patients. A failure to process punishment in the reversal phase was associated with symptom severity and may be related to neuropsychological dysfunctioning involving the ventromedial prefrontal cortex. Conclusions are limited due to the correlational study design and the small sample size.

  12. Better fear conditioning is associated with reduced symptom severity in autism spectrum disorders.

    PubMed

    South, Mikle; Larson, Michael J; White, Sarah E; Dana, Julianne; Crowley, Michael J

    2011-12-01

    Evidence from behavioral and neuroimaging studies suggest that atypical amygdala function plays a critical role in the development of autism spectrum disorders (ASD). The handful of psychophysiological studies examining amygdala function in ASD using classical fear conditioning paradigms have yielded discordant results. We recorded skin conductance response (SCR) during a simple discrimination conditioning task in 30 children and adolescents (ages 8-18) diagnosed with high-functioning ASD and 30 age- and IQ-matched, typically developing controls. SCR response in the ASD group was uniquely and positively associated with social anxiety; and negatively correlated with autism symptom severity, in particular with social functioning. Fear conditioning studies have tremendous potential to aid understanding regarding the amygdale's role in the varied symptom profile of ASD. Our data demonstrate that such studies require careful attention to task-specific factors, including task complexity; and also to contributions of dimensional, within-group factors that contribute to ASD heterogeneity.

  13. Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report

    PubMed Central

    Igata, Ryohei; Hori, Hikaru; Atake, Kiyokazu; Katsuki, Asuka; Nakamura, Jun

    2016-01-01

    A 54-year-old Japanese woman was diagnosed with major depressive disorder and prescribed paroxetine 20 mg/day. In around May 2013, the patient experienced gastric discomfort, so metoclopramide was prescribed. Beginning on June 4, 2013, the patient was given metoclopramide, 10 mg intravenously, twice per week. On the seventh day after beginning metoclopramide, facial hot flushes, increased sweating, muscle rigidity, and galactorrhea were noted. Extrapyramidal symptoms (EPS) rapidly subsided in response to an intramuscular injection of biperiden. Blood biochemical tests revealed an elevated serum prolactin level of 44 ng/mL. After stopping metoclopramide, EPS disappeared. Serum prolactin level decreased to 15 ng/mL after 4 weeks. In our case, although no adverse reactions had previously occurred following the administration of metoclopramide, the patient developed EPS and hyperprolactinemia following the administration of this antiemetic in combination with paroxetine. Paroxetine and metoclopramide are mainly metabolized by CYP2D6, and they are inhibitors for CYP2D6. We report a case with EPS and hyperprolactinemia whose plasma paroxetine and metoclopramide level rapidly increased after the addition of metoclopramide. Our experience warrants the issuing of a precaution that adverse reactions may arise following the coadministration of metoclopramide and paroxetine even at their respective standard dose levels.

  14. Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report

    PubMed Central

    Igata, Ryohei; Hori, Hikaru; Atake, Kiyokazu; Katsuki, Asuka; Nakamura, Jun

    2016-01-01

    A 54-year-old Japanese woman was diagnosed with major depressive disorder and prescribed paroxetine 20 mg/day. In around May 2013, the patient experienced gastric discomfort, so metoclopramide was prescribed. Beginning on June 4, 2013, the patient was given metoclopramide, 10 mg intravenously, twice per week. On the seventh day after beginning metoclopramide, facial hot flushes, increased sweating, muscle rigidity, and galactorrhea were noted. Extrapyramidal symptoms (EPS) rapidly subsided in response to an intramuscular injection of biperiden. Blood biochemical tests revealed an elevated serum prolactin level of 44 ng/mL. After stopping metoclopramide, EPS disappeared. Serum prolactin level decreased to 15 ng/mL after 4 weeks. In our case, although no adverse reactions had previously occurred following the administration of metoclopramide, the patient developed EPS and hyperprolactinemia following the administration of this antiemetic in combination with paroxetine. Paroxetine and metoclopramide are mainly metabolized by CYP2D6, and they are inhibitors for CYP2D6. We report a case with EPS and hyperprolactinemia whose plasma paroxetine and metoclopramide level rapidly increased after the addition of metoclopramide. Our experience warrants the issuing of a precaution that adverse reactions may arise following the coadministration of metoclopramide and paroxetine even at their respective standard dose levels. PMID:27621638

  15. Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report.

    PubMed

    Igata, Ryohei; Hori, Hikaru; Atake, Kiyokazu; Katsuki, Asuka; Nakamura, Jun

    2016-01-01

    A 54-year-old Japanese woman was diagnosed with major depressive disorder and prescribed paroxetine 20 mg/day. In around May 2013, the patient experienced gastric discomfort, so metoclopramide was prescribed. Beginning on June 4, 2013, the patient was given metoclopramide, 10 mg intravenously, twice per week. On the seventh day after beginning metoclopramide, facial hot flushes, increased sweating, muscle rigidity, and galactorrhea were noted. Extrapyramidal symptoms (EPS) rapidly subsided in response to an intramuscular injection of biperiden. Blood biochemical tests revealed an elevated serum prolactin level of 44 ng/mL. After stopping metoclopramide, EPS disappeared. Serum prolactin level decreased to 15 ng/mL after 4 weeks. In our case, although no adverse reactions had previously occurred following the administration of metoclopramide, the patient developed EPS and hyperprolactinemia following the administration of this antiemetic in combination with paroxetine. Paroxetine and metoclopramide are mainly metabolized by CYP2D6, and they are inhibitors for CYP2D6. We report a case with EPS and hyperprolactinemia whose plasma paroxetine and metoclopramide level rapidly increased after the addition of metoclopramide. Our experience warrants the issuing of a precaution that adverse reactions may arise following the coadministration of metoclopramide and paroxetine even at their respective standard dose levels. PMID:27621638

  16. Gender Differences in the Behavioral Symptom Severity of Prader-Willi Syndrome

    PubMed Central

    Gito, Masao; Ihara, Hiroshi; Ogata, Hiroyuki; Sayama, Masayuki; Murakami, Nobuyuki; Nagai, Toshiro; Ayabe, Tadayuki; Oto, Yuji; Shimoda, Kazutaka

    2015-01-01

    Objectives. This study measured gender differences in Prader-Willi syndrome (PWS) in regard to the severity of behavioral symptoms. Methods. The Food Related Problem Questionnaire (FRPQ), the Aberrant Behavior Checklist Japanese Version, the Childhood Routines Inventory, the Pervasive Developmental Disorders Autism Society Japan Rating Scale, and Japanese ADHD-RS were administered to PWS patients (45 males aged 6 to 58 and 37 females aged 6 to 45). To examine the effects that gender and genotype have on the severity of each symptom, two-way ANOVAs were conducted. Results. Significant interactions were found only in regard to FRPQ scores, such as FRPQ total score (F(1, 78) = 8.43, p < 0.01). The FRPQ of male deletion (DEL) individuals was higher than that of female DEL and male mUPD. The FRPQ of male maternal uniparental disomy (mUPD) was lower than that of female mUPD. Conclusions. In terms of problem behaviors, routines, autistic behaviors, and hyperactivity, no significant differences were found. Food-related behaviors in DEL were more severe in males, although those in mUPD were less severe in males. PMID:26633919

  17. Factors affecting severity of positive and negative symptoms of psychosis in a polysubstance using population with psychostimulant dependence.

    PubMed

    Willi, Taylor S; Honer, William G; Thornton, Allen E; Gicas, Kristina; Procyshyn, Ric M; Vila-Rodriguez, Fidel; Panenka, William J; Aleksic, Ana; Leonova, Olga; Jones, Andrea A; MacEwan, G William; Barr, Alasdair M

    2016-06-30

    Approximately half of psychostimulant users experience psychotic symptoms, which include both positive and negative symptoms. Prior reports have exclusively used positive symptoms to characterize psychostimulant associated psychosis. Symptoms vary dramatically in severity, though most investigations categorize psychosis as a dichotomous occurrence. To explore the association between different substances of abuse and the severity of psychotic symptoms, we investigated 171 individuals meeting DSM-IV-TR criteria for psychostimulant (cocaine or methamphetamine) dependence in an observational cross-sectional study. Participants were predominantly male (72.5%), recruited from a socially disadvantaged neighborhood in Vancouver, Canada, with a mean age of 45.5(±8.8) years. Of the total sample, 85% were dependent on cocaine, and 28.1% were dependent on methamphetamine. Participants had a median total PANSS score of 63, ranging from 37 to 111. Demographic information, current substance use and early substance exposure were used to predict positive and negative psychotic symptom severity in linear regression models. Increased severity of positive psychotic symptoms was significantly related to greater methamphetamine and marijuana use in the past 28 days, and methadone-abstinence. Negative symptom severity was related to increased opioid use in the past 28 days. There was no overlap between predictors of positive and negative symptom severity. PMID:27138828

  18. Efficacy of Atomoxetine in Children with Severe Autistic Disorders and Symptoms of ADHD: An Open-Label Study

    ERIC Educational Resources Information Center

    Charnsil, Chawanun

    2011-01-01

    Objective: This study aims to examine the efficacy of atomoxetine in treating symptoms of attention deficit hyperactivity disorder (ADHD) in children with severe autistic disorder. Method: Children with severe autistic disorder who had symptoms of ADHD were given atomoxetine for 10 weeks. The efficacy of atomoxetine was evaluated by using the…

  19. Age and Adaptive Functioning in Children and Adolescents with ASD: The Effects of Intellectual Functioning and ASD Symptom Severity

    ERIC Educational Resources Information Center

    Hill, Trenesha L.; Gray, Sarah A. O.; Kamps, Jodi L.; Enrique Varela, R.

    2015-01-01

    The present study examined the moderating effects of intellectual functioning and ASD symptom severity on the relation between age and adaptive functioning in 220 youth with autism spectrum disorder (ASD). Regression analysis indicated that intellectual functioning and ASD symptom severity moderated the relation between age and adaptive…

  20. A Preliminary Examination of Trauma History, Locus of Control, and PTSD Symptom Severity in African American Women

    ERIC Educational Resources Information Center

    Hood, Sarah K.; Carter, Michele M.

    2008-01-01

    Prior research has established a relationship between external locus of control and posttraumatic stress disorder (PTSD) symptom severity among Caucasians. There is also evidence that African Americans tend to exhibit an elevated external locus of control. However, the relationship between external control and PTSD symptom severity has not been…

  1. Family composition and symptom severity among Veterans with comorbid PTSD and substance use disorders.

    PubMed

    Jobe-Shields, Lisa; Flanagan, Julianne C; Killeen, Therese; Back, Sudie E

    2015-11-01

    Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur and affect a substantial proportion of military Veterans. Although the impact of parental PTSD and SUD on child development is well-documented, little is known about the influence of family composition on PTSD/SUD symptom severity. The present study investigated children in the home as an independent risk factor for symptom severity in a sample of treatment-seeking Veterans (N = 94; 92% male) with comorbid PTSD/SUD. Twenty-seven percent of the sample had minor children (age 18 or younger) living in the home. Veterans with children in the home evidenced significantly higher PTSD symptomatology as measured by the Clinical Administered PTSD Scale (CAPS; M = 82.65 vs. M = 72.17; t = -2.18; p < .05), and reported using marijuana more frequently than Veterans without children in the home (34% vs. 13% of past 60 days; t = -2.35, p < .05). In a multivariate model, having children in the home accounted for unique variance (ΔR(2) = .07) in PTSD severity after accounting for a range of covariates; however, having children in the home did not account for unique variance in substance use. Directions for future research as well as potential clinical implications for parents seeking treatment for PTSD/SUD are discussed.

  2. Symptom Severity Predicts Degree of T Cell Activation In Adult Women Following Childhood Maltreatment

    PubMed Central

    Lemieux, Andrine; Coe, Christopher L.; Carnes, Molly

    2008-01-01

    Although depression is often associated with a reduction in cellular immune responses, other types of emotional disturbance and psychopathology can activate certain aspects of immunity. Activation markers on T cells, in particular, have been found to be elevated in post-traumatic stress states. However, little is known about the relationship between the severity of PTSD symptoms and the degree of change in T cell phenotypes, or about the potential role of neuroendocrine factors in mediating the association. Twenty-four women with a history of sexual trauma during childhood, including 11 who met diagnostic criteria for PTSD, were compared to 12 age-matched, healthy women without a history of maltreatment. The women provided fasted blood samples for enumeration of cell subsets by immunofluorescence and 24-hour urine samples for analysis of catecholamine and cortisol levels. The percent of T cells expressing CD45RA, an early activation marker, was higher in the PTSD diagnosed women, and the levels correlated positively with intrusive symptoms and negatively with avoidant symptoms. These alterations in cell surface markers did not appear to be mediated by norepinephrine (NE) or cortisol, making them a distinctive and independent biomarker of arousal and disturbance in PTSD. PMID:18396007

  3. Effects of Fenugreek Seed on the Severity and Systemic Symptoms of Dysmenorrhea

    PubMed Central

    Younesy, Sima; Amiraliakbari, Sedigheh; Esmaeili, Somayeh; Alavimajd, Hamid; Nouraei, Soheila

    2014-01-01

    Background Primary dysmenorrhea is a prevalent disorder and its unfavorable effects deteriorates the quality of life in many people across the world. Based on some evidence on the characteristics of fenugreek as a medical plant with anti-inflammato-ry and analgesic properties, this double-blind, randomized, placebo controlled trial was conducted. The main purpose of the study was to evaluate the effects of fenugreek seeds on the severity of primary dysmenorrhea among students. Methods Unmarried Students were randomly assigned to two groups who received fenugreek (n = 51) or placebo (n = 50). For the first 3 days of menstruation, 2–3 capsules containing fenugreek seed powder (900 mg) were given to the subjects three times daily for two consecutive menstrual cycles. Pain severity was evaluated using a visual analog scale and systemic symptoms were assessed using a multidimensional verbal scale. Results Pain severity at baseline did not differ significantly between the two groups. Pain severity was significantly reduced in both groups after the intervention; however, the fenugreek group experienced significantly larger pain reduction (p < 0.001). With respect to the duration of pain, there was no meaningful difference between the two cycles in the placebo group (p = 0.07) but in the fenugreek group, the duration of pain decreased between the two cycles (p < 0.001). Systemic symptoms of dysmenorrhea (fatigue, headache, nausea, vomiting, lack of energy, syncope) decreased in the fenugreek seed group (p < 0.05). No side effects were reported in the fenugreek group. Conclusion These data suggest that prescription of fenugreek seed powder during menstruation can reduce the severity of dysmenorrhea. PMID:24695380

  4. Longitudinal changes in total brain volume in schizophrenia: relation to symptom severity, cognition and antipsychotic medication.

    PubMed

    Veijola, Juha; Guo, Joyce Y; Moilanen, Jani S; Jääskeläinen, Erika; Miettunen, Jouko; Kyllönen, Merja; Haapea, Marianne; Huhtaniska, Sanna; Alaräisänen, Antti; Mäki, Pirjo; Kiviniemi, Vesa; Nikkinen, Juha; Starck, Tuomo; Remes, Jukka J; Tanskanen, Päivikki; Tervonen, Osmo; Wink, Alle-Meije; Kehagia, Angie; Suckling, John; Kobayashi, Hiroyuki; Barnett, Jennifer H; Barnes, Anna; Koponen, Hannu J; Jones, Peter B; Isohanni, Matti; Murray, Graham K

    2014-01-01

    Studies show evidence of longitudinal brain volume decreases in schizophrenia. We studied brain volume changes and their relation to symptom severity, level of function, cognition, and antipsychotic medication in participants with schizophrenia and control participants from a general population based birth cohort sample in a relatively long follow-up period of almost a decade. All members of the Northern Finland Birth Cohort 1966 with any psychotic disorder and a random sample not having psychosis were invited for a MRI brain scan, and clinical and cognitive assessment during 1999-2001 at the age of 33-35 years. A follow-up was conducted 9 years later during 2008-2010. Brain scans at both time points were obtained from 33 participants with schizophrenia and 71 control participants. Regression models were used to examine whether brain volume changes predicted clinical and cognitive changes over time, and whether antipsychotic medication predicted brain volume changes. The mean annual whole brain volume reduction was 0.69% in schizophrenia, and 0.49% in controls (p = 0.003, adjusted for gender, educational level, alcohol use and weight gain). The brain volume reduction in schizophrenia patients was found especially in the temporal lobe and periventricular area. Symptom severity, functioning level, and decline in cognition were not associated with brain volume reduction in schizophrenia. The amount of antipsychotic medication (dose years of equivalent to 100 mg daily chlorpromazine) over the follow-up period predicted brain volume loss (p = 0.003 adjusted for symptom level, alcohol use and weight gain). In this population based sample, brain volume reduction continues in schizophrenia patients after the onset of illness, and antipsychotic medications may contribute to these reductions.

  5. Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia.

    PubMed

    Barry, M J; Cockett, A T; Holtgrewe, H L; McConnell, J D; Sihelnik, S A; Winfield, H N

    1993-08-01

    In previous studies the severity of symptoms of prostatism in men with benign prostatic hyperplasia have not correlated well with prostate size, degree of bladder trabeculation, uroflowmetry or post-void residual volume. As part of a prospective cohort study of benign prostatic hyperplasia treatment effectiveness in 4 university-based urology practices, we correlated symptom severity and these commonly used measures of disease severity. Symptom severity was quantified using the American Urological Association symptom index. Analyses were based on 198 outpatients completing a standardized evaluation (84 of these men have completed 6 months of followup after treatment with prostatectomy, balloon dilation, terazosin or watchful waiting). At baseline, symptom severity was not correlated with uroflowmetry, post-void residual, prostate size and degree of bladder trabeculation. However, symptom severity was much more strongly related to overall health status than the other measures. Reduction in symptoms with treatment did correlate with improvements in uroflowmetry. This poor baseline correlation with symptoms may reflect unreliability in measurement of the physiological/anatomical variables. Alternatively, these parameters may be measuring different pathophysiological phenomena.

  6. Anticipated discrimination is related to symptom severity, functionality and quality of life in schizophrenia.

    PubMed

    Üçok, Alp; Karadayı, Gülşah; Emiroğlu, Birgül; Sartorius, Norman

    2013-10-30

    The aim of this study is to evaluate a possible relationship between the level of anticipated discrimination with severity of symptoms and functionality. We included 103 patients with schizophrenia. Severity of symptoms was measured by PANSS and Calgary Depression Scale for Schizophrenia. Quality of life (QL) and functionality were measured by using QLS, PSP and Functional Remission of General Schizophrenia Scale (FROGS). Anticipated/experienced discrimination was evaluated with four selected items from Discrimination and Stigma Scale. First, variables related to each item were determined by using t-test and later the variables that have an independent contribution to anticipated discrimination subscale of DISC were evaluated with linear regression analysis. Results showed that those who stated that they felt the need to conceal their diagnosis more had shorter duration of illness, lower PANNS scores, higher scores on professional performance subscale of QLS, a lower number of suicide attempts and higher current employment rates. Participants who reported that they had been avoided or shunned more had higher depression scores. While patients with lower level of functionality tended to stop themselves more, patients with high level of functionality tended to conceal their diagnosis.

  7. A determinant of disease symptom severity is located in RNA2 of broad bean wilt virus 2.

    PubMed

    Kwak, Hae-Ryun; Lee, Ye-Ji; Kim, Jaedeok; Kim, Mi-Kyeong; Kim, Jeong-Soo; Choi, Hong-Soo; Seo, Jang-Kyun

    2016-01-01

    Broad bean wilt virus 2 (BBWV2), which belongs to the genus Fabavirus, is a destructive pathogen of many economically important horticultural and ornamental crops. In this study, we constructed infectious full-length cDNA clones of two distinct isolates of BBWV2 under control of the cauliflower mosaic virus 35S promoter. BBWV2-PAP1 isolated from paprika (Capsicum annuum var. gulosum) induces severe disease symptoms in various pepper varieties, whereas BBWV2-RP1 isolated from red pepper (Capsicum annuum L.) causes mild symptoms. Agrobacterium-mediated inoculation of the infectious cDNA clones of BBWV2-PAP1 and RP1 resulted in the same symptoms as the original virus isolates. The infectious cDNA clones of BBWV2-PAP1 and RP1 were used to examine the symptoms induced by pseudorecombinants between the two isolates to localize in which of the two genomic RNAs are the symptom severity determinants in BBWV2. The pseudorecombinant of RP1-RNA1 and PAP1-RNA2 induced severe symptoms, similar to those caused by the parental isolate PAP1, whereas the pseudorecombinant of PAP1-RNA1 and RP1-RNA2 induced mild symptoms, similar to those caused by the parental isolate RP1. Our results suggest that BBWV2 RNA2 contains a symptom determinant(s) capable of enhancing symptom severity.

  8. The Symptom Cluster of Sleep, Fatigue and Depressive Symptoms in Breast Cancer Patients: Severity of the Problem and Treatment Options

    PubMed Central

    Fiorentino, Lavinia; Rissling, Michelle; Liu, Lianqi; Ancoli-Israel, Sonia

    2011-01-01

    Breast cancer is the most commonly diagnosed cancer in women. Insomnia is a significant problem in breast cancer patients, affecting between 20% to 70% of newly diagnosed or recently treated cancer patients. Pain, fatigue, anxiety, and depression are also common conditions in breast cancer and often co-occur with insomnia in symptom clusters, exacerbating one another, and decreasing quality of life (QOL). There have been no clinical trials of drugs for sleep in cancer. Cognitive behavioral psychotherapies on the other hand, have shown some of the most positive results in alleviating the distressing symptoms that often accompany the breast cancer experience, but even these studies have not targeted the symptom cluster. Pharmacological as well as non-pharmacological treatments need to be explored. It might be that a combined pharmacological and behavioral treatment is most efficacious. In short, substantially more research is needed to fully understand and treat the symptom cluster of insomnia, fatigue, pain, depression and anxiety in breast cancer. PMID:22140397

  9. Symptoms of Pain Do Not Correlate with Rotator Cuff Tear Severity

    PubMed Central

    Dunn, Warren R.; Kuhn, John E.; Sanders, Rosemary; An, Qi; Baumgarten, Keith M.; Bishop, Julie Y.; Brophy, Robert H.; Carey, James L.; Holloway, G. Brian; Jones, Grant L.; Ma, C. Benjamin; Marx, Robert G.; McCarty, Eric C.; Poddar, Sourav K.; Smith, Matthew V.; Spencer, Edwin E.; Vidal, Armando F.; Wolf, Brian R.; Wright, Rick W.

    2014-01-01

    Background: For many orthopaedic disorders, symptoms correlate with disease severity. The objective of this study was to determine if pain level is related to the severity of rotator cuff disorders. Methods: A cohort of 393 subjects with an atraumatic symptomatic full-thickness rotator-cuff tear treated with physical therapy was studied. Baseline pretreatment data were used to examine the relationship between the severity of rotator cuff disease and pain. Disease severity was determined by evaluating tear size, retraction, superior humeral head migration, and rotator cuff muscle atrophy. Pain was measured on the 10-point visual analog scale (VAS) in the patient-reported American Shoulder and Elbow Surgeons (ASES) score. A linear multiple regression model was constructed with use of the continuous VAS score as the dependent variable and measures of rotator cuff tear severity and other nonanatomic patient factors as the independent variables. Forty-eight percent of the patients were female, and the median age was sixty-one years. The dominant shoulder was involved in 69% of the patients. The duration of symptoms was less than one month for 8% of the patients, one to three months for 22%, four to six months for 20%, seven to twelve months for 15%, and more than a year for 36%. The tear involved only the supraspinatus in 72% of the patients; the supraspinatus and infraspinatus, with or without the teres minor, in 21%; and only the subscapularis in 7%. Humeral head migration was noted in 16%. Tendon retraction was minimal in 48%, midhumeral in 34%, glenohumeral in 13%, and to the glenoid in 5%. The median baseline VAS pain score was 4.4. Results: Multivariable modeling, controlling for other baseline factors, identified increased comorbidities (p = 0.002), lower education level (p = 0.004), and race (p = 0.041) as the only significant factors associated with pain on presentation. No measure of rotator cuff tear severity correlated with pain (p > 0.25). Conclusions

  10. Relationship of attention-deficit/hyperactivity disorder symptom severity with severity of alcohol-related problems in a sample of inpatients with alcohol use disorder

    PubMed Central

    Bozkurt, Muge; Evren, Cuneyt; Umut, Gokhan; Evren, Bilge

    2016-01-01

    Purpose Attention-deficit/hyperactivity disorder (ADHD) has been shown to be related to a higher risk of developing psychiatric problems such as depressive disorders, substance use disorder, and impulsivity. Adults who have comorbid ADHD and alcohol use disorder (AUD) are at greater risk of negative outcomes. Thus, it is important to evaluate the relationship of ADHD symptoms and the severity of alcohol-related problems among patients with AUD. The aim of the present study was to evaluate the effect of ADHD symptoms on severity of alcohol-related problems, while controlling the effects of depression and impulsivity in a sample of inpatients with AUD. Patients and methods Participants (n=190) were evaluated with the Beck Depression Inventory, the Short Form Barratt Impulsiveness Scale, the Michigan Alcohol Screening Test, and the Adult ADHD Self-Report Scale. Results Severity of the scale scores was positively correlated with each other. Although severity of depression and impulsivity (particularly non-planning impulsivity) predicted the severity of alcohol-related problems in a linear regression model, when severity of ADHD symptoms was included in the analysis, the inattentive subscale score, in particular, predicted the severity of alcohol-related problems together with non-planning impulsivity, whereas depression was no longer a predictor. Conclusion These findings suggest that, together with non-planning impulsivity, symptoms of ADHD (particularly inattentive factor) are an important factor that predict alcohol-related problems, while controlling the severity of depressive symptoms among inpatients with AUD. PMID:27462159

  11. Severity of borderline personality symptoms in adolescence: relationship with maternal parenting stress, maternal psychopathology, and rearing styles.

    PubMed

    Schuppert, H Marieke; Albers, Casper J; Minderaa, Ruud B; Emmelkamp, Paul M G; Nauta, Maaike H

    2015-06-01

    The development of borderline personality disorder (BPD) has been associated with parenting styles and parental psychopathology. Only a few studies have examined current parental rearing styles and parental psychopathology in relationship to BPD symptoms in adolescents. Moreover, parenting stress has not been examined in this group. The current study examined 101 adolescents (14-19 years old) with BPD symptoms and their mothers. Assessments were made on severity of BPD symptoms, youth-perceived maternal rearing styles, and psychopathology and parenting stress in mothers. Multiple regression analyses were used to examine potential predictors of borderline severity. No correlation was found between severity of BPD symptoms in adolescents and parenting stress. Only youth-perceived maternal overprotection was significantly related to BPD severity. The combination of perceived maternal rejection with cluster B traits in mothers was significantly related to BPD severity in adolescents. This study provides a contribution to the disentanglement of the developmental pathways that lead to BPD.

  12. Severity of borderline personality symptoms in adolescence: relationship with maternal parenting stress, maternal psychopathology, and rearing styles.

    PubMed

    Schuppert, H Marieke; Albers, Casper J; Minderaa, Ruud B; Emmelkamp, Paul M G; Nauta, Maaike H

    2015-06-01

    The development of borderline personality disorder (BPD) has been associated with parenting styles and parental psychopathology. Only a few studies have examined current parental rearing styles and parental psychopathology in relationship to BPD symptoms in adolescents. Moreover, parenting stress has not been examined in this group. The current study examined 101 adolescents (14-19 years old) with BPD symptoms and their mothers. Assessments were made on severity of BPD symptoms, youth-perceived maternal rearing styles, and psychopathology and parenting stress in mothers. Multiple regression analyses were used to examine potential predictors of borderline severity. No correlation was found between severity of BPD symptoms in adolescents and parenting stress. Only youth-perceived maternal overprotection was significantly related to BPD severity. The combination of perceived maternal rejection with cluster B traits in mothers was significantly related to BPD severity in adolescents. This study provides a contribution to the disentanglement of the developmental pathways that lead to BPD. PMID:25102082

  13. Influenza-Like Illness among University Students: Symptom Severity and Duration Due to Influenza Virus Infection Compared to Other Etiologies

    ERIC Educational Resources Information Center

    Mullins, Jocelyn; Cook, Robert; Rinaldo, Charles; Yablonsky, Eric; Hess, Rachel; Piazza, Paolo

    2011-01-01

    Objective: University students with influenza-like illness (ILI) were assessed to determine whether symptom severity, duration, or missed days of school or work varied according to etiology. Participants: Sixty persons presenting to a university health clinic with ILI symptoms during 3 consecutive influenza seasons completed baseline survey and…

  14. Psychometric Evaluation of the Symptoms and Functioning Severity Scale (SFSS) Short Forms with Out-of-Home Care Youth

    ERIC Educational Resources Information Center

    Gross, Thomas J.; Duppong Hurley, Kristin; Lambert, Matthew C.; Epstein, Michael H.; Stevens, Amy L.

    2015-01-01

    Background: There is a need for brief progress monitoring measures of behavioral and emotional symptoms for youth in out-of-home care. The Symptoms and Functioning Severity Scale (SFSS; Bickman et al. in Manual of the peabody treatment progress battery. Vanderbilt University, Nashville, 2010) is one measure that has clinician and youth short forms…

  15. Inflammatory Cytokine Expression Is Associated with Chikungunya Virus Resolution and Symptom Severity

    PubMed Central

    Kelvin, Alyson A.; Banner, David; Silvi, Giuliano; Moro, Maria Luisa; Spataro, Nadir; Gaibani, Paolo; Cavrini, Francesca; Pierro, Anna; Rossini, Giada; Cameron, Mark J.; Bermejo-Martin, Jesus F.; Paquette, Stéphane G.; Xu, Luoling; Danesh, Ali; Farooqui, Amber; Borghetto, Ilaria; Kelvin, David J.; Sambri, Vittorio; Rubino, Salvatore

    2011-01-01

    The Chikungunya virus infection zones have now quickly spread from Africa to parts of Asia, North America and Europe. Originally thought to trigger a disease of only mild symptoms, recently Chikungunya virus caused large-scale fatalities and widespread economic loss that was linked to recent virus genetic mutation and evolution. Due to the paucity of information on Chikungunya immunological progression, we investigated the serum levels of 13 cytokines/chemokines during the acute phase of Chikungunya disease and 6- and 12-month post-infection follow-up from patients of the Italian outbreak. We found that CXCL9/MIG, CCL2/MCP-1, IL-6 and CXCL10/IP-10 were significantly raised in the acute phase compared to follow-up samples. Furthermore, IL-1β, TNF-α, Il-12, IL-10, IFN-γ and IL-5 had low initial acute phase levels that significantly increased at later time points. Analysis of symptom severity showed association with CXCL9/MIG, CXCL10/IP-10 and IgG levels. These data give insight into Chikungunya disease establishment and subsequent convalescence, which is imperative to the treatment and containment of this quickly evolving and frequently re-emerging disease. PMID:21858242

  16. Nonophthalmic symptoms secondary to ocular torticollis from severe blepharoptosis: an underappreciated but treatable condition.

    PubMed

    Bohnsack, Brenda L; Bhatt, Rina; Kahana, Alon

    2012-01-01

    The purpose of this case report is to describe reversible systemic symptoms associated with ocular torticollis due to blepharoptosis. A retrospective chart review identified patients with symptomatic ocular torticollis due to bilateral congenital or acquired blepharoptosis who underwent surgical correction (levator resection or frontalis sling). Preoperative and postoperative assessment of systemic symptoms in adults and developmental milestones are reported. The authors present 4 cases, 1 adult and 3 young children, all with severe bilateral upper eyelid ptosis. In the adult patient, it caused debilitating back pain that required orthopedic evaluation but was completely relieved with ptosis repair surgery. In the toddlers, subjective developmental motor delay was rapidly reversed following ptosis repair surgery. The authors suggest that primary care physicians, and spine and neuromuscular specialists, consider the possibility of ocular torticollis due to eyelid ptosis in the evaluation of patients with unexplained back and/or neck pain or with gross motor developmental delay. The authors propose that symptomatic ocular torticollis is an indication for ptosis repair.

  17. Nonophthalmic symptoms secondary to ocular torticollis from severe blepharoptosis: an underappreciated but treatable condition.

    PubMed

    Bohnsack, Brenda L; Bhatt, Rina; Kahana, Alon

    2012-01-01

    The purpose of this case report is to describe reversible systemic symptoms associated with ocular torticollis due to blepharoptosis. A retrospective chart review identified patients with symptomatic ocular torticollis due to bilateral congenital or acquired blepharoptosis who underwent surgical correction (levator resection or frontalis sling). Preoperative and postoperative assessment of systemic symptoms in adults and developmental milestones are reported. The authors present 4 cases, 1 adult and 3 young children, all with severe bilateral upper eyelid ptosis. In the adult patient, it caused debilitating back pain that required orthopedic evaluation but was completely relieved with ptosis repair surgery. In the toddlers, subjective developmental motor delay was rapidly reversed following ptosis repair surgery. The authors suggest that primary care physicians, and spine and neuromuscular specialists, consider the possibility of ocular torticollis due to eyelid ptosis in the evaluation of patients with unexplained back and/or neck pain or with gross motor developmental delay. The authors propose that symptomatic ocular torticollis is an indication for ptosis repair. PMID:21562438

  18. Interdisciplinary Residential Treatment of Posttraumatic Stress Disorder and Traumatic Brain Injury: Effects on Symptom Severity and Occupational Performance and Satisfaction

    PubMed Central

    Speicher, Sarah M.; Walter, Kristen H.

    2014-01-01

    OBJECTIVE. This study examined outcomes of an 8-wk residential treatment program for veterans with posttraumatic stress disorder (PTSD) and a history of traumatic brain injury (TBI). METHOD. Twenty-six veterans completed the Canadian Occupational Performance Measure, Clinician-Administered PTSD Scale, Beck Depression Inventory–2nd Edition, and PTSD Checklist before and after treatment. RESULTS. Veterans demonstrated significant improvements in occupational performance and satisfaction with their performance, as well as in PTSD and depression symptom severity after residential PTSD/TBI treatment. Additionally, improvements in occupational performance and satisfaction were associated with decreases in depression symptom severity. CONCLUSION. Although preliminary, results suggest that veterans with PTSD and a history of TBI experienced significant decreases in PTSD and depression symptom severity and improvement in self-perception of performance and satisfaction in problematic occupational areas. Changes in occupational areas and depression symptom severity were related, highlighting the importance of interdisciplinary treatment. PMID:25005504

  19. Parent Alcoholism Impacts the Severity and Timing of Children's Externalizing Symptoms

    ERIC Educational Resources Information Center

    Hussong, Andrea M.; Huang, Wenjing; Curran, Patrick J.; Chassin, Laurie; Zucker, Robert A.

    2010-01-01

    Although previous studies show that children of alcoholic parents have higher rates of externalizing symptoms compared to their peers, it remains unclear whether the timing of children's externalizing symptoms is linked to that of their parent's alcohol-related symptoms. Using a multilevel modeling approach, we tested whether children aged 2…

  20. Multi-domain patient reported outcomes of irritable bowel syndrome: exploring person centered perspectives to better understand symptom severity scores

    PubMed Central

    Lackner, Jeffrey M.; Jaccard, James; Baum, Charles

    2012-01-01

    Objectives Patient reported outcomes (PRO) assessing multiple gastrointestinal symptoms are central to characterizing the therapeutic benefit of novel agents for irritable bowel syndrome (IBS). Common approaches that sum or average responses across different illness components must be unidimensional and have small unique variances to avoid aggregation bias and misinterpretation of clinical data. This study sought to evaluate the unidimensionality of the IBS Symptom Severity Scale (IBS-SSS) and to explore person centered cluster analytic methods for characterizing multivariate-based patient profiles. Methods Ninety-eight Rome-diagnosed IBS patients completed the IBS-SSS and a single, global item of symptom severity (UCLA Symptom Severity Scale) at pretreatment baseline of an NIH funded clinical trial. A k-means cluster analyses were performed on participants symptom severity scores. Results The IBS-SSS was not unidimensional. Exploratory cluster analyses revealed four common symptom profiles across five items of the IBS-SSS. One cluster of patients (25%) had elevated scores on pain frequency and bowel dissatisfaction, with less elevated but still high scores on life interference and low pain severity ratings. A second cluster (19%) was characterized by intermediate scores on both pain dimensions, but more elevated scores on bowel dissatisfaction. A third cluster (18%) was elevated across all IBS-SSS sub-components. The fourth and most common cluster (37%) had relatively low scores on all dimensions except bowel dissatisfaction and life interference due to IBS symptoms. Conclusions PRO endpoints and research on IBS more generally relying on multicomponent assessments of symptom severity should take into account the multidimensional structure of symptoms to avoid aggregation bias and to optimize the sensitivity of detecting treatment effects. PMID:23337220

  1. Processing of facial and nonsocial information is differentially associated with severity of symptoms in patients with multiepisode schizophrenia.

    PubMed

    Barkhof, Emile; de Sonneville, Leo M J; Meijer, Carin J; de Haan, Lieuwe

    2015-02-01

    Patients with schizophrenia show impairments in social cognitive abilities, such as recognizing facial emotions. However, the relation to symptoms remains unclear. The goal of this study was to explore whether facial emotion recognition and face identity recognition are associated with severity of symptoms and to which extent associations with symptoms differ for processing of social versus nonsocial information. Facial emotion recognition, face recognition, and abstract pattern recognition were evaluated in 98 patients with multiepisode schizophrenia. Severity of symptoms was measured using a five-factor model of the Positive and Negative Syndrome Scale. Results show that facial emotion recognition and, to a lesser extent, face recognition were predominantly associated with severity of disorganization symptoms. In contrast, recognition of nonsocial patterns was associated with negative symptoms, excitement, and emotional distress. Reaction time rather than accuracy of social cognition explained variance in symptomatology. These results lead to the conclusion that facial emotion processing in schizophrenia appears to be associated with severity of symptoms, especially disorganization. PMID:25594793

  2. Determinants of symptom profile and severity of conduct disorder in a tertiary level pediatric care set up: A pilot study

    PubMed Central

    Jayaprakash, R.; Rajamohanan, K.; Anil, P.

    2014-01-01

    Background: Conduct disorders (CDs) are one of the most common causes for referral to child and adolescent mental health centers. CD varies in its environmental factors, symptom profile, severity, co-morbidity, and functional impairment. Aims: The aim was to analyze the determinants of symptom profile and severity among childhood and adolescent onset CD. Settings and Design: Clinic based study with 60 consecutive children between 6 and 18 years of age satisfying International Classification of Disease-10 Development Control Rules guidelines for CD, attending behavioral pediatrics unit outpatient. Materials and Methods: The family psychopathology, symptom severity, and functional level were assessed using parent interview schedule, revised behavioral problem checklist and Children's Global Assessment Scale. Statistical Analysis: The correlation and predictive power of the variables were analyzed using SPSS 16.0 version. Results: There was significant male dominance (88.3%) with boy girl ratio 7.5:1. Most common comorbidity noticed was hyperkinetic disorders (45%). Childhood onset group was more predominant (70%). Prevalence of comorbidity was more among early onset group (66.7%) than the late-onset group (33.3%). The family psychopathology, symptom severity, and the functional impairment were significantly higher in the childhood onset group. Conclusion: The determinants of symptom profile and severity are early onset (childhood onset CD), nature, and quantity of family psychopathology, prevalence, and type of comorbidity and nature of symptom profile itself. The family psychopathology is positively correlated with the symptom severity and negatively correlated with the functional level of the children with CD. The symptom severity was negatively correlated with the functional level of the child with CD. PMID:25568472

  3. Validation of the symptoms and functioning severity scale in residential group care.

    PubMed

    Lambert, Matthew C; Hurley, Kristin Duppong; Gross, Thomas J; Epstein, Michael H; Stevens, Amy L

    2015-05-01

    Tests that measure the emotional and behavioral problems of children and youth are typically not normed and standardized on youth diagnosed with disruptive behavior, particularly those youth in residential care. Yet professional standards mandate that before instruments are used with a specific population the psychometric properties need to be studied and re-established: specifically, psychometric properties, including validity, need to be evaluated (AERA, APA, and NCME, The standards for educational and psychological testing. AERA, Washington, DC, 1999). The purpose of the present study was to assess the validity characteristics of the Symptoms and Functioning Severity Scale (SFSS; Bickman et al., Manual of the Peabody Treatment Progress Battery, Vanderbilt University, Nashville, TN, 2010), a widely used test developed for use in outpatient clinics, with youth in a residential care program. The convergent validity of the SFSS was established with the large correlations (0.78-0.86) with the CBCL. Several binary classification analyses including specificity, area under the receiver operating characteristic curve, positive and negative likelihood ratios, and the Youden Index supported the validity of the SFSS. However, the sensitivity index was somewhat low indicating the test may produce a high level of false negatives. Limitations, future research and implications are discussed.

  4. Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with seasonal affective disorder.

    PubMed

    Mc Mahon, Brenda; Andersen, Sofie B; Madsen, Martin K; Hjordt, Liv V; Hageman, Ida; Dam, Henrik; Svarer, Claus; da Cunha-Bang, Sofi; Baaré, William; Madsen, Jacob; Hasholt, Lis; Holst, Klaus; Frokjaer, Vibe G; Knudsen, Gitte M

    2016-05-01

    Cross-sectional neuroimaging studies in non-depressed individuals have demonstrated an inverse relationship between daylight minutes and cerebral serotonin transporter; this relationship is modified by serotonin-transporter-linked polymorphic region short allele carrier status. We here present data from the first longitudinal investigation of seasonal serotonin transporter fluctuations in both patients with seasonal affective disorder and in healthy individuals. Eighty (11)C-DASB positron emission tomography scans were conducted to quantify cerebral serotonin transporter binding; 23 healthy controls with low seasonality scores and 17 patients diagnosed with seasonal affective disorder were scanned in both summer and winter to investigate differences in cerebral serotonin transporter binding across groups and across seasons. The two groups had similar cerebral serotonin transporter binding in the summer but in their symptomatic phase during winter, patients with seasonal affective disorder had higher serotonin transporter than the healthy control subjects (P = 0.01). Compared to the healthy controls, patients with seasonal affective disorder changed their serotonin transporter significantly less between summer and winter (P < 0.001). Further, the change in serotonin transporter was sex- (P = 0.02) and genotype- (P = 0.04) dependent. In the patients with seasonal affective disorder, the seasonal change in serotonin transporter binding was positively associated with change in depressive symptom severity, as indexed by Hamilton Rating Scale for Depression - Seasonal Affective Disorder version scores (P = 0.01). Our findings suggest that the development of depressive symptoms in winter is associated with a failure to downregulate serotonin transporter levels appropriately during exposure to the environmental stress of winter, especially in individuals with high predisposition to affective disorders.media-1vid110.1093/brain/aww043_video_abstractaww043_video

  5. Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with seasonal affective disorder.

    PubMed

    Mc Mahon, Brenda; Andersen, Sofie B; Madsen, Martin K; Hjordt, Liv V; Hageman, Ida; Dam, Henrik; Svarer, Claus; da Cunha-Bang, Sofi; Baaré, William; Madsen, Jacob; Hasholt, Lis; Holst, Klaus; Frokjaer, Vibe G; Knudsen, Gitte M

    2016-05-01

    Cross-sectional neuroimaging studies in non-depressed individuals have demonstrated an inverse relationship between daylight minutes and cerebral serotonin transporter; this relationship is modified by serotonin-transporter-linked polymorphic region short allele carrier status. We here present data from the first longitudinal investigation of seasonal serotonin transporter fluctuations in both patients with seasonal affective disorder and in healthy individuals. Eighty (11)C-DASB positron emission tomography scans were conducted to quantify cerebral serotonin transporter binding; 23 healthy controls with low seasonality scores and 17 patients diagnosed with seasonal affective disorder were scanned in both summer and winter to investigate differences in cerebral serotonin transporter binding across groups and across seasons. The two groups had similar cerebral serotonin transporter binding in the summer but in their symptomatic phase during winter, patients with seasonal affective disorder had higher serotonin transporter than the healthy control subjects (P = 0.01). Compared to the healthy controls, patients with seasonal affective disorder changed their serotonin transporter significantly less between summer and winter (P < 0.001). Further, the change in serotonin transporter was sex- (P = 0.02) and genotype- (P = 0.04) dependent. In the patients with seasonal affective disorder, the seasonal change in serotonin transporter binding was positively associated with change in depressive symptom severity, as indexed by Hamilton Rating Scale for Depression - Seasonal Affective Disorder version scores (P = 0.01). Our findings suggest that the development of depressive symptoms in winter is associated with a failure to downregulate serotonin transporter levels appropriately during exposure to the environmental stress of winter, especially in individuals with high predisposition to affective disorders.media-1vid110.1093/brain/aww043_video_abstractaww043_video_abstract.

  6. The Impact of Dyspepsia on Symptom Severity and Quality of Life in Adults with Headache

    PubMed Central

    Tai, Mei-Ling Sharon; Norhatta, Norbelinda; Goh, Khean Jin; Moy, Foong Ming; Sujarita, Ramanujam; Asraff, Azman Ahmad; Lee, Qin Zhi; Ng, Jiun Hoong; Tan, Eugene Choon Li; Mahadeva, Sanjiv

    2015-01-01

    Background Dyspepsia and headache frequently co-exist, but the clinical implication of this association is uncertain. We planned to examine the prevalence and impact of dyspepsia in adults with headache. Methods A cross-sectional study was conducted in a secondary care setting. Clinical, psychological and health-related quality of life (HRQOL) data were compared between subjects with headache and controls (non-headache subjects). The impact of dyspepsia was analysed further in subjects with headache alone. Results 280 subjects (93 cases with headache and 187 matched controls) were recruited. The following baseline characteristics of subjects were as follows: mean age 45.0±17.3 years, 57.0% females and ethnic distribution—Malaysian = 45 (48.4%), Chinese n = 24 (25.8%) and Indians n = 24 (25.8%). Headache sub-types among cases with headache were as follows: tension-type headache (TTH) n = 53 (57.0%) and migraine n = 40 (43.0%). Dyspepsia was more prevalent in cases with headache compared to controls (25.8% vs 12.8%, p = 0.011), and headache was independently associated with dyspepsia (OR 2.75, 95% CI 1.39–5.43). Among cases with headache, there was a trend towards a higher prevalence of dyspepsia in those with migraine (27.5%) compared to TTH (24.5%). Subjects with headache and dyspepsia, compared to those with headache alone, had a greater severity of headache symptoms (63.67±22.85 mm vs 51.20 ±24.0 mm VAS, p = 0.029). Overall HRQOL scores were lower in headache subjects with dyspepsia (EQ-5D summary score 0.82±0.18 vs 0.90 ±0.16, p = 0.037 and EQ-5D VAS 62.08±17.50 mm vs 72.62 ±18.85 mm, p = 0.018), compared to those without dyspepsia. Conclusion Dyspepsia is associated with more severe headache symptoms and results in a lower HRQOL in patients with headache. PMID:25629323

  7. Severity and correlates of depressive symptoms among recipients of meals on wheels: age, gender, and racial/ethnic difference.

    PubMed

    Choi, Namkee G; Teeters, Mary; Perez, Linda; Farar, Bart; Thompson, David

    2010-03-01

    In this study, we briefly described a large urban Meals on Wheels program's adoption of the Patient Health Questionnaire-9 (PHQ-9) as its depression-screening tool. Then we reported the assessment outcomes with respect to the rates, severity, and correlates of depressive symptoms. The sample consisted of 736 MOW clients. Bivariate analysis, with chi(2) statistics, was performed to examine differences in the rates and severity of depressive symptoms by age group, gender, race/ethnicity, and cognitive status. Negative binomial regression analysis was used to determine the correlates of depression symptom severity. Of the sample, 17.5% had clinically significant depressive symptoms (PHQ-9 > or = 10), and 8.8% had probable major depressive disorder (MDD). A significantly higher proportion of those under age 60 years was found to have clinically significant depressive symptoms and probable MDD. The multivariate regression results show that age, gender, race/ethnicity, income, cognitive impairment, number of chronic medical conditions, and the nutritional risk score were significant predictors of the severity of depression symptoms. Implications of and recommendations for incorporating a valid depression-screening tool into social service agencies' existing assessment process are discussed.

  8. [Difficulties in the differential diagnosis of hyponatremia presenting with severe neuropsychiatric symptoms].

    PubMed

    Steiner, Tamás; Oláh, Roland; Németh, Attila; Winkler, Gábor

    2013-08-01

    Hyponatremia is the most frequent eletrolyte imbalance in hospitalized geriatric patient. The accompanying signs and symptoms can run a wide range and, therefore, these patients are usually admitted to various departments, i.e. neurology and/or traumatology first. Directed laboratory investigations demonstrate severe hyponatremia. Differential diagnosis can be very difficult and complex in the clinical settings. Firstly, spurious forms of hyponatremia have to be excluded, then the underlying cause should elucidated based on the patients hydration status and serum osmolarity. Hyponatremia can be divided into hyper-, hypo- and normovolemic forms. Moreover, it can be further classified as hypo-, iso- and hyperosmolar hyponatremias. The differentiation between renal and extrarenal salt wasting forms is hinged on the urine sodium concentration. Syndrome of inappropriate antidiuretic hormone secretion is the most common cause of normovolemic, hypoosmolar forms (named also as Schwartz-Bartter syndrome). The authors aimed to shed light on the often insurmountable difficulties of the diagnosis, differential diagnosis and appropriate treatment of this very frequent electrolyte imbalance by presenting a clinical case report. Their purported aim reflects upon the wide array of ethiopathogenesis of hyponatremia: various endocrine, renal diseases, inappropriateness of antidiuretic hormone secretion as well as the role of different medications (e.g. diuretics). This fine-tuned and intricate physiology of sodium metabolism could fortuitously be overturned by these mechanisms. PMID:23895992

  9. Incidence and Trends in Psychopathology Symptoms over Time in Adults with Severe to Profound Intellectual Disability

    ERIC Educational Resources Information Center

    Horovitz, Max; Matson, Johnny L.; Sipes, Megan; Shoemaker, Mary; Belva, Brian; Bamburg, Jay W.

    2011-01-01

    Individuals with intellectual disability (ID) have a high risk for developing comorbid psychopathology. While researchers have shown that symptoms of psychopathology remain relatively stable in children with ID over time, little research has been conducted to demonstrate symptom stability for adults with ID. Incidence of psychopathology symptoms…

  10. The association of quality of social relations, symptom severity and intelligence with anxiety in children with autism spectrum disorders.

    PubMed

    Eussen, Mart L J M; Van Gool, Arthur R; Verheij, Fop; De Nijs, Pieter F A; Verhulst, Frank C; Greaves-Lord, Kirstin

    2013-11-01

    Limited quality of social relations, milder symptom severity and higher intelligence were shown to account for higher anxiety levels in autism spectrum disorders. The current study replicated and extended earlier findings by combining these three determinants of anxiety in autism spectrum disorders in one study. The sample consisted of 134 school-aged children with autism spectrum disorders, of whom 58 (43%) had a co-morbid anxiety disorder according to the Diagnostic Interview Schedule for Children-Parent version. In this sample, we tested associations between these determinants and anxiety univariately and multivariately to clarify the unique contribution of all determinants. Since we hypothesized that the association between limited quality of social relations and anxiety would be amplified by low symptom severity and/or high intelligence, we additionally tested for moderating effects. We found that higher anxiety levels were associated with a lower quality of social relations and lower symptom severity. In this mainly high-functioning sample, intelligence was not related to anxiety levels. No moderation effects were found. Since lower quality of social relations and lower symptom severity are associated with higher anxiety levels in children with autism spectrum disorders, therapeutic interventions aimed at reducing anxiety in autism spectrum disorders should pay attention to improving social relations, and presumably children with a lower symptom severity could benefit most from such interventions.

  11. Child AD/HD Severity and Psychological Functioning in Relation to Divorce, Remarriage, Multiple Transitions and the Quality of Family Relationships

    ERIC Educational Resources Information Center

    Heckel, Leila; Clarke, Adam R.; Barry, Robert J.; McCarthy, Rory; Selikowitz, Mark

    2013-01-01

    Both Attention-Deficit/Hyperactivity Disorder (AD/HD) and divorce are very prevalent in western societies, and they may occur together. AD/HD is generally viewed as a neurobiological disorder, which has led to a commonly held belief that social-environmental factors play little role in the symptom profile of children diagnosed with the disorder.…

  12. College students with depressive symptoms with and without fatigue: Differences in functioning, suicidality, anxiety, and depressive severity

    PubMed Central

    Nyer, Maren; Mischoulon, David; Alpert, Jonathan E.; Holt, Daphne J.; Brill, Charlotte D.; Yeung, Albert; Pedrelli, Paola; Baer, Lee; Dording, Christina; Huz, Ilana; Fisher, Lauren; Fava, Maurizio; Farabaugh, Amy

    2015-01-01

    BACKGROUND We examined whether fatigue was associated with greater symptomatic burden and functional impairment in college students with depressive symptoms. METHODS Using data from the self-report Beck Depression Inventory (BDI), we stratified a group of 287 students endorsing significant symptoms of depression (BDI score ≥13) into 3 levels: no fatigue, mild fatigue, or moderate/severe fatigue. We then compared the 3 levels of fatigue across a battery of psychiatric and functional outcome measures. RESULTS Approximately 87% of students endorsed at least mild fatigue. Students with moderate/severe fatigue had significantly greater depressive symptom severity compared with those with mild or no fatigue and scored higher on a suicide risk measure than those with mild fatigue. Students with severe fatigue evidenced greater frequency and intensity of anxiety than those with mild or no fatigue. Reported cognitive and functional impairment increased significantly as fatigue worsened. CONCLUSIONS Depressed college students with symptoms of fatigue demonstrated functional impairment and symptomatic burden that worsened with increasing levels of fatigue. Assessing and treating symptoms of fatigue appears warranted within this population. PMID:25954936

  13. Serum Vitamin D Status in Iranian Fibromyalgia Patients: according to the Symptom Severity and Illness Invalidation

    PubMed Central

    Maafi, Alireza Amir; Haghdoost, Afrooz; Aarabi, Yasaman; Hajiabbasi, Asghar; Shenavar Masooleh, Irandokht; Zayeni, Habib; Ghalebaghi, Babak; Hassankhani, Amir; Bidari, Ali

    2016-01-01

    Background This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group (17.24 ± 13.50 and 9.91 ± 6.47 respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95–19.87, P = 0.05). Conclusions This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM. PMID:27413482

  14. Withdrawal Symptoms and Nicotine Dependence Severity Predict Virtual Reality Craving in Cigarette-Deprived Smokers

    PubMed Central

    Cooper, Kim N.; Mahoney, James J.; Bordnick, Patrick S.; Salas, Ramiro; Kosten, Thomas R.; Dani, John A.; De La Garza, Richard

    2015-01-01

    Introduction: Virtual reality (VR) has been shown to be effective in eliciting responses to nicotine cues in cigarette smokers. The primary aim of this study was to investigate whether cigarette-deprived smokers would exhibit increased craving and changes in heart rate when viewing cigarette related cues as compared to non-smoking cues in a VR environment, and the secondary aim was to assess the extent to which self-assessed measures of withdrawal and dependence correlated with VR craving. Methods: Nicotine-dependent cigarette smokers were recruited for a 2 day study. On Day 1, participants smoked as usual and on Day 2 were deprived from smoking overnight. On both days, participants completed self-assessment questionnaires on withdrawal, craving, and nicotine-dependence. Participants completed a VR session during the cigarette deprivation condition only (Day 2). During this session, they were exposed to active smoking and placebo (non-smoking) cues. Results: The data show that self-reported levels of “craving” (p < .01) and “thinking about cigarettes” (p < .0001) were significantly greater after exposure to the active cues versus non-smoking cues. Significant increases in heart rate were found for 3 of 4 active cues when compared to non-smoking cues (p < .05). Finally, significant positive correlations were found between self-reported craving prior to the VR session and craving induced by active VR cues (p < .01). Conclusions: In this report, active VR cues elicited craving during cigarette deprivation. This is the first study to demonstrate that self-reported craving, withdrawal symptoms, and nicotine dependence severity predict cue-induced craving in the VR setting. PMID:25475087

  15. Bleeding symptoms and laboratory correlation in patients with severe von Willebrand disease.

    PubMed

    Metjian, A D; Wang, C; Sood, S L; Cuker, A; Peterson, S M; Soucie, J M; Konkle, B A

    2009-07-01

    Type 3 von Willebrand disease (VWD) is a rare bleeding disorder with markedly decreased or absent von Willebrand factor (VWF) protein, accompanied by a parallel decrease in VWF function and factor VIII (FVIII) activity. The goal of this study was to describe the population of patients enrolled in the USA Centers for Disease Control Universal Data Collection (UDC) study with type 3 VWD, defined as a VWF:Ag of <10%, and to correlate bleeding symptoms with VWF and FVIII levels. Data on 150 patients were analysed. Almost all patients experienced bleeding episodes (98%) and required blood and/or factor product treatment (92%). While oral mucosal bleeding (the site of first bleed in 54%) was most common, subsequent muscle and joint bleeds were also seen (28%, 45%, respectively), and intracranial haemorrhage occurred in 8% of individuals. Mean age of first bleed was lower in those with either a FVIII < or =5% or a VWF:Ag <1%. Univariate marginal model analysis showed lower levels of FVIII and VWF:Ag both predicted a higher risk of joint bleeding. Longitudinal multivariate analysis found a lower FVIII level (P = 0.03), increasing age (P < 0.0001), history of joint bleeding (P = 0.001), higher body mass index (BMI) (P < 0.0001), and use of home infusion (P = 0.02) were all negatively associated with joint mobility. Low levels of VWF:Ag (P = 0.003) and male sex (P = 0.007) were also negatively associated with joint function. This study documents the strong bleeding phenotype in severe VWD and provides data to help target therapy, including prophylaxis, for patients most at risk of bleeding complications.

  16. WHEN PARENTS WITH SEVERE MENTAL ILLNESS LOSE CONTACT WITH THEIR CHILDREN: ARE PSYCHIATRIC SYMPTOMS OR SUBSTANCE USE TO BLAME?

    PubMed Central

    Jones, Danson; Macias, Rosemarie Lillianne; Gold, Paul B.; Barreira, Paul; Fisher, William

    2009-01-01

    This study compared parental psychiatric symptom severity, and the absence or presence of severe substance abuse, as predictors of contact with minor children for a representative sample of adults with diagnoses of serious mental illness (N = 45). Child contact and psychiatric symptom severity were measured during regularly scheduled 6-month research interviews over a total 30-month period following each participant’s entry into the project. Severe substance abuse was documented as present or absent for the 6-month interval preceding each interview. Results revealed that incidence of severe substance abuse was repeatedly associated with less frequent parent-child contact, even after controlling for psychiatric symptoms, diagnosis, gender, age, ethnicity, and socioeconomic status. Neither psychiatric diagnosis nor symptom severity predicted frequency of child contact when substance abuse was taken into account. Mental health agencies offering parenting classes for adults with serious mental illness should incorporate substance use interventions to reduce loss of child custody and strengthen parent-child relationships. PMID:20011665

  17. Effect of Body Weight and Esophageal Damage on the Severity of Gastroesophageal Reflux Symptoms. Mexican GERD Working Group

    PubMed Central

    Lopez-Alvarenga, Juan Carlos; Vargas, José Antonio; Lopez, Luis Humberto; Fass, Ronnie; Sobrino-Cossio, Sergio; Higgins, Paul; Comuzzie, Anthony

    2010-01-01

    Background and Aims Several studies have demonstrated overweight and obesity are strong independent risk factor of GERD symptoms and esophageal erosions. Our aim was to analyze the joint effect of BMI with the grade of esophageal damage over symptoms’ intensity of GERD. Methods We used a questionnaire with a Likert scale for severity of symptoms related to GERD. The distal portion of the esophagus was evaluated to determine the presence of mucosal injury, classified by Los Angeles criteria (LA). Results We included 917 subjects (53.76% females) with average age 36.8 ± 7 years. Males had higher BMI than females (26.8 ± 3.5 vs. 25.2 ± 4.5, p <0.001). Severe damage (C–D ulcers) was associated with overweight (BMI 25–30), severity of heartburn, retching, halitosis, regurgitation, and chest oppression. BMI >30 had high score for heartburn and retching, but low score for nausea, compared with lower weight. The model with interaction showed a non-linear association between BMI and LA. Overweight (but not obese) patients with damage scored C–D had the highest score for intensity of heartburn and retching. Conclusions BMI and LA do not have additive effects on the severity of symptoms of GERD. Those with BMI between 25 and 30 had severe symptoms score, but those with BMI >30 showed lower scores. These findings could explain controversial results found in other studies. PMID:20082872

  18. Acute and maintenance electroconvulsive therapy for treatment of severely disabling obsessive-compulsive symptoms in a patient with Asperger syndrome.

    PubMed

    Nilsson, Björn M; Ekselius, Lisa

    2009-09-01

    We report successful treatment with electroconvulsive therapy of a comorbid condition including severe obsessive-compulsive symptoms and hypochondriacal delusions in a 38-year-old man with Asperger syndrome. His condition deteriorated into a severely disabled chronic state that was refractory to different pharmacological and psychological treatments but was completely reversed after electroconvulsive therapy. Although typical obsessive-compulsive symptoms were predominant, the case also exhibits differences compared with regular obsessive-compulsive disorder regarding onset and course that are discussed in the report.

  19. The severity of Internet addiction risk and its relationship with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students.

    PubMed

    Dalbudak, Ercan; Evren, Cuneyt; Aldemir, Secil; Evren, Bilge

    2014-11-30

    The aim of this study was to investigate the relationship of Internet addiction (IA) risk with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students. A total of 271 Turkish university students participated in this study. The students were assessed through the Internet Addiction Scale (IAS), the Borderline Personality Inventory (BPI), the Dissociative Experiences Scale (DES), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The rates of students were 19.9% (n=54) in the high IA risk group, 38.7% (n=105) in the mild IA risk group and 41.3% (n=112) in the group without IA risk. Correlation analyses revealed that the severity of IA risk was related with BPI, DES, emotional abuse, CTQ-28, depression and anxiety scores. Univariate covariance analysis (ANCOVA) indicated that the severity of borderline personality features, emotional abuse, depression and anxiety symptoms were the predictors of IAS score, while gender had no effect on IAS score. Among childhood trauma types, emotional abuse seems to be the main predictor of IA risk severity. Borderline personality features predicted the severity of IA risk together with emotional abuse, depression and anxiety symptoms among Turkish university students.

  20. The severity of Internet addiction risk and its relationship with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students.

    PubMed

    Dalbudak, Ercan; Evren, Cuneyt; Aldemir, Secil; Evren, Bilge

    2014-11-30

    The aim of this study was to investigate the relationship of Internet addiction (IA) risk with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students. A total of 271 Turkish university students participated in this study. The students were assessed through the Internet Addiction Scale (IAS), the Borderline Personality Inventory (BPI), the Dissociative Experiences Scale (DES), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The rates of students were 19.9% (n=54) in the high IA risk group, 38.7% (n=105) in the mild IA risk group and 41.3% (n=112) in the group without IA risk. Correlation analyses revealed that the severity of IA risk was related with BPI, DES, emotional abuse, CTQ-28, depression and anxiety scores. Univariate covariance analysis (ANCOVA) indicated that the severity of borderline personality features, emotional abuse, depression and anxiety symptoms were the predictors of IAS score, while gender had no effect on IAS score. Among childhood trauma types, emotional abuse seems to be the main predictor of IA risk severity. Borderline personality features predicted the severity of IA risk together with emotional abuse, depression and anxiety symptoms among Turkish university students. PMID:25023365

  1. Functional Correlates of childhood maltreatment and symptom severity during affective theory of mind tasks in chronic depression.

    PubMed

    Hentze, Charlotte; Walter, Henrik; Schramm, Elisabeth; Drost, Sarah; Schoepf, Dieter; Fangmeier, Thomas; Mattern, Margarete; Normann, Claus; Zobel, Ingo; Schnell, Knut

    2016-04-30

    Among multiple etiological factors of depressive disorders, childhood maltreatment (CM) gains increasing attention as it confers susceptibility for depression and predisposes to chronicity. CM assumedly inhibits social-cognitive development, entailing interactional problems as observed in chronic depression (CD), especially in affective theory of mind (ToM). However, the extent of CM among CD patients varies notably as does the severity of depressive symptoms. We tested whether the extent of CM or depressive symptoms correlates with affective ToM functions in CD patients. Regional brain activation measured by functional magnetic resonance imaging during an affective ToM task was tested for correlation with CM, assessed by the Childhood Trauma Questionnaire (CTQ), and symptom severity, assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS), in 25 unmedicated CD patients (mean age 41.52, SD 11.13). Amygdala activation during affective ToM correlated positively with CTQ total scores, while (para)hippocampal response correlated negatively with MADRS scores. Our findings suggest that differential amygdala activation in affective ToM in CD is substantially modulated by previous CM and not by the pathophysiological equivalents of current depressive symptoms. This illustrates the amygdala's role in the mediation of CM effects. The negative correlation of differential (para)hippocampal activation and depressive symptom severity indicates reduced integration of interactional experiences during depressive states.

  2. Linguistic characteristics in a non-trauma-related narrative task are associated with PTSD diagnosis and symptom severity.

    PubMed

    Papini, Santiago; Yoon, Patricia; Rubin, Mikael; Lopez-Castro, Teresa; Hien, Denise A

    2015-05-01

    Linguistic characteristics of trauma narratives have been linked to the development and severity of posttraumatic stress disorder (PTSD). However, it remains unclear if linguistic markers of PTSD exist beyond the scope of trauma narratives. This study used ambiguous visual prompts to elicit spontaneous narratives from trauma-exposed individuals with (n = 23) and without PTSD (n = 30). Individuals with PTSD used more singular pronouns and death-related words, and fewer plural pronouns. Within the PTSD group, increased severity of reexperiencing symptoms was associated with greater use of singular pronouns and lower use of cognitive words; increased severity of avoidance symptoms was associated with lower use of death words; and increased severity of hyperarousal symptoms was associated with less frequent use of anxiety words. Together, these linguistic variables accounted for 53% of the variance in total PTSD symptom severity. These findings are consistent with previous research suggesting that language use is a strong predictor of PTSD psychopathology, and extend the evidence to include the linguistic characteristics of non-trauma-related narratives. PMID:25961121

  3. The Association of Quality of Social Relations, Symptom Severity and Intelligence with Anxiety in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Eussen, Mart L. J. M.; Van Gool, Arthur R.; Verheij, Fop; De Nijs, Pieter F. A.; Verhulst, Frank C.; Greaves-Lord, Kirstin

    2013-01-01

    Limited quality of social relations, milder symptom severity and higher intelligence were shown to account for higher anxiety levels in autism spectrum disorders. The current study replicated and extended earlier findings by combining these three determinants of anxiety in autism spectrum disorders in one study. The sample consisted of 134…

  4. The Impact of Child Symptom Severity on Stress among Parents of Children with ASD: The Moderating Role of Coping Styles

    ERIC Educational Resources Information Center

    Lyons, Amy M.; Leon, Scott C.; Roecker Phelps, Carolyn E.; Dunleavy, Alison M.

    2010-01-01

    We examined the impact of autism severity and parental coping strategies on stress in parents of children with ASD. Children's autism symptoms and parental coping strategies (task-oriented, emotion-oriented, social diversion, and distraction) were evaluated as predictors of four types of parental stress (parent and family problems, pessimism,…

  5. Emergency Medical Service and In-Hospital Vital Signs as Predictors of Subsequent PTSD Symptom Severity in Pediatric Injury Patients

    ERIC Educational Resources Information Center

    Nugent, Nicole R.; Christopher, Norman C.; Delahanty, Douglas L.

    2006-01-01

    Background: The present study investigated the extent to which heart rate (HR) levels soon after a traumatic event predicted posttraumatic stress disorder (PTSD) symptom severity assessed 6 weeks and 6 months later in child trauma victims. Methods: Participants consisted of 82 children (56 boys, 26 girls) aged 8-18 who were admitted to a…

  6. Lifetime Traumatic Events and High-Risk Behaviors as Predictors of PTSD Symptoms in People with Severe Mental Illnesses

    ERIC Educational Resources Information Center

    O'Hare, Thomas; Sherrer, Margaret V.

    2009-01-01

    Research is limited regarding the role of high-risk behaviors, trauma, and posttraumatic stress disorder (PTSD) symptoms in people with severe mental illnesses (SMI). The current survey of 276 community mental health clients diagnosed with either a schizophrenia spectrum disorder or a major mood disorder examined the mediating role of lifetime…

  7. Impact of Cognitive Behavioral Therapy on Observed Autism Symptom Severity during School Recess: A Preliminary Randomized, Controlled Trial

    ERIC Educational Resources Information Center

    Wood, Jeffrey J.; Fujii, Cori; Renno, Patricia; Van Dyke, Marilyn

    2014-01-01

    This study compared cognitive behavioral therapy (CBT) and treatment-as-usual (TAU) in terms of effects on observed social communication-related autism symptom severity during unstructured play time at school for children with autism spectrum disorders (ASD). Thirteen children with ASD (7-11 years old) were randomly assigned to 32 sessions of CBT…

  8. Predictors of Posttraumatic Distress 1 Year after Exposure to Community Violence: The Importance of Acute Symptom Severity

    ERIC Educational Resources Information Center

    Denson, Thomas F.; Marshall, Grant N.; Schell, Terry L.; Jaycox, Lisa H.

    2007-01-01

    In this longitudinal study of 333 primarily male, Hispanic survivors of community violence, the authors investigated the effects of 4 categories of risk factors on posttraumatic stress disorder (PTSD) symptom severity: demographic characteristics, pretraumatic psychological factors, characteristics of the trauma, and reactions to the trauma.…

  9. The Use of Complementary and Alternative Medicine by Korean Breast Cancer Women: Is It Associated with Severity of Symptoms?

    PubMed Central

    Hwang, Jung Hye; Kim, Woon-Yong; Ahmed, Mansoor; Choi, Soojeung; Kim, Jiwoo; Han, Dong Woon

    2015-01-01

    Background. Use of complementary and alternative medicine (CAM) among patients with breast cancer could be associated with severity of the cancer symptoms experienced, but there is little evidence to prove this. This study tried to investigate any difference in the severity of breast cancer symptoms between CAM users and nonusers. Methods. The study followed cross-sectional design using structured survey questionnaire. Survey participants were recruited from four different healthcare settings in Seoul, South Korea. The survey instrument comprised 39 items including questions on demographics, use of CAM, and six main symptoms associated with breast cancer and cancer treatment. Results. Out of 288 participants, 67% stated using one or more modalities of CAM. Age, education, and time duration since diagnosis of cancer were significantly associated with use of CAM. About 90% of the CAM users experienced side effects of cancer treatment. CAM users reported more severe anxiety and skin/hair changes than nonusers. Conclusions. CAM was used by those breast cancer patients who experience more severe symptoms to alleviate the conditions associated with breast cancer and cancer treatment. Our findings revealed motivation behind the CAM use, which has profound implications for clinicians to recognize patient-perceived needs. PMID:26770251

  10. Association of Symptoms and Severity of Rift Valley Fever with Genetic Polymorphisms in Human Innate Immune Pathways

    PubMed Central

    Hise, Amy G.; Traylor, Zachary; Hall, Noémi B.; Sutherland, Laura J.; Dahir, Saidi; Ermler, Megan E.; Muiruri, Samuel; Muchiri, Eric M.; Kazura, James W.; LaBeaud, A. Desirée; King, Charles H.; Stein, Catherine M.

    2015-01-01

    Background Multiple recent outbreaks of Rift Valley Fever (RVF) in Africa, Madagascar, and the Arabian Peninsula have resulted in significant morbidity, mortality, and financial loss due to related livestock epizootics. Presentation of human RVF varies from mild febrile illness to meningoencephalitis, hemorrhagic diathesis, and/or ophthalmitis with residual retinal scarring, but the determinants for severe disease are not understood. The aim of the present study was to identify human genes associated with RVF clinical disease in a high-risk population in Northeastern Province, Kenya. Methodology/Principal Findings We conducted a cross-sectional survey among residents (N = 1,080; 1–85 yrs) in 6 villages in the Sangailu Division of Ijara District. Participants completed questionnaires on past symptoms and exposures, physical exam, vision testing, and blood collection. Single nucleotide polymorphism (SNP) genotyping was performed on a subset of individuals who reported past clinical symptoms consistent with RVF and unrelated subjects. Four symptom clusters were defined: meningoencephalitis, hemorrhagic fever, eye disease, and RVF-not otherwise specified. SNPs in 46 viral sensing and response genes were investigated. Association was analyzed between SNP genotype, serology and RVF symptom clusters. The meningoencephalitis symptom phenotype cluster among seropositive patients was associated with polymorphisms in DDX58/RIG-I and TLR8. Having three or more RVF-related symptoms was significantly associated with polymorphisms in TICAM1/TRIF, MAVS, IFNAR1 and DDX58/RIG-I. SNPs significantly associated with eye disease included three different polymorphisms TLR8 and hemorrhagic fever symptoms associated with TLR3, TLR7, TLR8 and MyD88. Conclusions/Significance Of the 46 SNPs tested, TLR3, TLR7, TLR8, MyD88, TRIF, MAVS, and RIG-I were repeatedly associated with severe symptomatology, suggesting that these genes may have a robust association with RVFV-associated clinical

  11. Severity of depressive symptoms and accuracy of dietary reporting among obese women with major depressive disorder seeking weight loss treatment.

    PubMed

    Whited, Matthew C; Schneider, Kristin L; Appelhans, Bradley M; Ma, Yunsheng; Waring, Molly E; DeBiasse, Michele A; Busch, Andrew M; Oleski, Jessica L; Merriam, Philip A; Olendzki, Barbara C; Crawford, Sybil L; Ockene, Ira S; Lemon, Stephenie C; Pagoto, Sherry L

    2014-01-01

    An elevation in symptoms of depression has previously been associated with greater accuracy of reported dietary intake, however this association has not been investigated among individuals with a diagnosis of major depressive disorder. The purpose of this study was to investigate reporting accuracy of dietary intake among a group of women with major depressive disorder in order to determine if reporting accuracy is similarly associated with depressive symptoms among depressed women. Reporting accuracy of dietary intake was calculated based on three 24-hour phone-delivered dietary recalls from the baseline phase of a randomized trial of weight loss treatment for 161 obese women with major depressive disorder. Regression models indicated that higher severity of depressive symptoms was associated with greater reporting accuracy, even when controlling for other factors traditionally associated with reporting accuracy (coefficient  =  0.01 95% CI = 0.01 - 0.02). Seventeen percent of the sample was classified as low energy reporters. Reporting accuracy of dietary intake increases along with depressive symptoms, even among individuals with major depressive disorder. These results suggest that any study investigating associations between diet quality and depression should also include an index of reporting accuracy of dietary intake as accuracy varies with the severity of depressive symptoms.

  12. Severity of Child Sexual Abuse and Revictimization: The Mediating Role of Coping and Trauma Symptoms

    ERIC Educational Resources Information Center

    Fortier, Michelle A.; DiLillo, David; Messman-Moore, Terri L.; Peugh, James; DeNardi, Kathleen A.; Gaffey, Kathryn J.

    2009-01-01

    Child sexual abuse (CSA) has consistently been associated with the use of avoidant coping; these coping methods have been associated with increased trauma symptoms, which have, in turn, been linked to increased risk for adult sexual revictimization. Given these previous findings, the purpose of the current study was to test a model that…

  13. Neurophysiological Indices of Atypical Auditory Processing and Multisensory Integration Are Associated with Symptom Severity in Autism

    ERIC Educational Resources Information Center

    Brandwein, Alice B.; Foxe, John J.; Butler, John S.; Frey, Hans-Peter; Bates, Juliana C.; Shulman, Lisa H.; Molholm, Sophie

    2015-01-01

    Atypical processing and integration of sensory inputs are hypothesized to play a role in unusual sensory reactions and social-cognitive deficits in autism spectrum disorder (ASD). Reports on the relationship between objective metrics of sensory processing and clinical symptoms, however, are surprisingly sparse. Here we examined the relationship…

  14. Posttraumatic Stress Symptoms Are Associated with the Frequency and Severity of Delinquency among Detained Boys

    ERIC Educational Resources Information Center

    Becker, Stephen P.; Kerig, Patricia K.

    2011-01-01

    Trauma and posttraumatic stress symptoms increasingly are recognized as risk factors for involvement with the juvenile justice system, and detained youth evidence higher rates of trauma exposure and posttraumatic stress disorder (PTSD) compared to their nondetained peers. Using a sample of 83 detained boys aged 12 to 17, we tested the hypothesis…

  15. The Impact of Physical Complaints, Social Environment, and Psychological Functioning on IBS Patients’ Health Perceptions: Looking Beyond GI Symptom Severity

    PubMed Central

    Lackner, Jeffrey M.; Gudleski, Gregory D.; Thakur, Elyse R.; Stewart, Travis J.; Iacobucci, Gary J.; Spiegel, Brennan M.R.

    2016-01-01

    OBJECTIVES In the absence of a reliable biomarker, clinical decisions for a functional gastrointestinal (GI) disorder like irritable bowel syndrome (IBS) depend on asking patients to appraise and communicate their health status. Self-ratings of health (SRH) have proven a powerful and consistent predictor of health outcomes, but little is known about how they relate to those relevant to IBS (e.g., quality of life (QOL), IBS symptom severity). This study examined what psychosocial factors, if any, predict SRH among a cohort of more severe IBS patients. METHODS Subjects included 234 Rome III-positive IBS patients (mean age = 41 years, female = 78%) without comorbid organic GI disease. Subjects were administered a test battery that included the IBS Symptom Severity Scale, Screening for Somatoform Symptoms, IBS Medical Comorbidity Inventory, SF-12 Vitality Scale, Perceived Stress Scale, Beck Depression Inventory, Trait Anxiety Inventory, and Negative Interactions Scale. RESULTS Partial correlations identified somatization, depression, fatigue, stress, anxiety, and medical comorbidities as variables with the strongest correlations with SRH (r values = 0.36–0.41, P values < 0.05). IBS symptom severity was weakly associated with SRH (r = 0.18, P < 0.05). The final regression model explained 41.3% of the variance in SRH scores (F = 8.49, P < 0.001) with significant predictors including fatigue, medical comorbidities, somatization, and negative social interactions. CONCLUSIONS SRH are associated with psychological (anxiety, stress, depression), social (negative interactions), and extraintestinal somatic factors (fatigue, somatization, medical comorbidities). The severity of IBS symptoms appears to have a relatively modest role in how IBS patients describe their health in general. PMID:24419481

  16. Depression and Its Severity Are Strongly Associated with Both Storage and Voiding Lower Urinary Tract Symptoms Independently of Prostate Volume.

    PubMed

    Jeong, Su-Min; Suh, Beomseok; Jang, Soo Hyun; Jin, Ho Seong; Kim, Nakhyun; Kwon, Hyuktae; Cho, Belong; Park, Jin-Ho

    2015-11-01

    Depression is related to various functional medical conditions. Its association with lower urinary tract symptoms (LUTS) is also expected. We evaluated whether depression and its severity are associated with LUTS when LUTS risk factors including prostate volume (PV) are taken into account in a large population of Korean men. Study subjects included 10,275 men who underwent routine health check-ups at the Healthcare System Gangnam Center of Seoul National University Hospital. Depression was assessed using Beck Depression Inventory-II and LUTS using international prostate symptom score. PV was measured using transrectal ultrasonography by a radiologist. Effect sizes of depression severity on total, storage, and voiding symptoms were assessed. In multivariate logistic regression analysis, mild, moderate and severe depression were associated with total (adjusted odds ratio: aOR = 2.99, 3.86 and 8.99; all P < 0.001), voiding (aOR = 3.04, 3.28 and 5.58; all P < 0.001) and storage symptoms (aOR = 2.43, 3.43 and 2.89; all P < 0.05) showing dose response relationships (all P trend < 0.001). In a subgroup analysis for participants with PV data (n = 1,925), mild and moderate-severe depression were also associated with LUTS (aOR = 3.29, 2.84; P < 0.001 and 0.018, respectively). In conclusion, depression and its severity are strongly associated with total, voiding, and storage symptoms independently of PV state. PMID:26539010

  17. PTSD symptom severity is associated with increased recruitment of top-down attentional control in a trauma-exposed sample☆

    PubMed Central

    White, Stuart F.; Costanzo, Michelle E.; Blair, James R.; Roy, Michael J.

    2014-01-01

    Background Recent neuroimaging work suggests that increased amygdala responses to emotional stimuli and dysfunction within regions mediating top down attentional control (dorsomedial frontal, lateral frontal and parietal cortices) may be associated with the emergence of anxiety disorders, including posttraumatic stress disorder (PTSD). This report examines amygdala responsiveness to emotional stimuli and the recruitment of top down attention systems as a function of task demands in a population of U.S. military service members who had recently returned from combat deployment in Afghanistan/Iraq. Given current interest in dimensional aspects of pathophysiology, it is worthwhile examining patients who, while not meeting full PTSD criteria, show clinically significant functional impairment. Methods Fifty-seven participants with sub-threshold levels of PTSD symptoms completed the affective Stroop task while undergoing fMRI. Participants with PTSD or depression at baseline were excluded. Results Greater PTSD symptom severity scores were associated with increased amygdala activation to emotional, particularly positive, stimuli relative to neutral stimuli. Furthermore, greater PTSD symptom severity was associated with increased superior/middle frontal cortex response during task conditions relative to passive viewing conditions. In addition, greater PTSD symptom severity scores were associated with: (i) increased activation in the dorsolateral prefrontal, lateral frontal, inferior parietal cortices and dorsomedial frontal cortex/dorsal anterior cingulate cortex (dmFC/dACC) in response to emotional relative to neutral stimuli; and (ii) increased functional connectivity during emotional trials, particularly positive trials, relative to neutral trials between the right amygdala and dmFC/dACC, left caudate/anterior insula cortex, right lentiform nucleus/caudate, bilateral inferior parietal cortex and left middle temporal cortex. Conclusions We suggest that these data may

  18. Family Functioning in First-Episode and Chronic Psychosis: The Role of Patient's Symptom Severity and Psychosocial Functioning.

    PubMed

    Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Basta, Maria; Lionis, Christos; Vgontzas, Alexandros N

    2016-08-01

    The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Patients' symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers' assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient -0.13; 95 % CI -0.23, -0.03), increased caregivers' EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient's functioning (β coefficient -2.04; 95 % CI -3.55, -0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient's low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families.

  19. The Effects of Aggression on Symptom Severity and Treatment Response in a Trial of Cognitive Behavioral Therapy for Panic Disorder

    PubMed Central

    Cassiello-Robbins, Clair; Conklin, Laren R.; Anakwenze, Ujunwa; Gorman, Jack M.; Woods, Scott W.; Shear, M. Katherine; Barlow, David H.

    2015-01-01

    Background Previous research suggests that patients with panic disorder exhibit higher levels of aggression than patients with other anxiety disorders. This aggression is associated with more severe symptomatology and interpersonal problems. However, few studies have examined whether higher levels of aggression are associated with a worse treatment response in this population. Methods The present study sought to examine the association of aggression with panic disorder symptom severity in a sample of 379 patients who participated in a trial examining long-term strategies for the treatment of panic disorder. Results We found that aggression was significantly associated with higher baseline levels of panic disorder symptoms, anxiety, depression, and functional impairment. Further, we found that patients higher in aggression did not achieve the same level of improvement in general anxiety symptoms during treatment compared to patients lower in aggression, even when controlling for baseline anxiety symptom severity. Conclusion These results suggest that more research is needed concerning patients with anxiety disorders with higher aggression, as they may be a group in need of additional treatment considerations. PMID:25987198

  20. Metacognitive Reflection and Insight Therapy (MERIT) With a Patient With Severe Symptoms of Disorganization.

    PubMed

    de Jong, Steven; van Donkersgoed, Rozanne; Pijnenborg, G H M; Lysaker, Paul H

    2016-02-01

    One recent development within the realm of psychotherapeutic interventions for schizophrenia has been a shift in focus from symptom management to consideration of metacognition, or the processes by which people synthesize information about themselves and others in an integrated manner. One such approach, metacognitive reflection and insight therapy (MERIT); in particular, offers a description of 8 therapeutic activities that should occur in each session, resulting in the stimulation and growth of metacognitive capacity. In this report, we present a description of 12 sessions with a patient suffering from schizophrenia manifesting significantly disorganized symptoms. Each MERIT element is described along with observed clinical and metacognitive gains. As illustrated in this report, these procedures helped the patient move from a state of having no complex ideas about himself or others, to one in which he could begin to develop integrated and realistic ideas about himself and others and use that capacity to think about life challenges.

  1. Acute posttraumatic stress symptoms but not generalized anxiety symptoms are associated with severity of exposure to war trauma: A study of civilians under fire

    PubMed Central

    Helpman, Liat; Besser, Avi; Neria, Yuval

    2015-01-01

    Posttraumatic stress (PTSS) and generalized anxiety symptoms (GAS) may ensue following trauma. While they are now thought to represent different psychopathological entities, it is not clear whether both GAS and PTSS show a dose–response to trauma exposure. The current study aimed to address this gap in knowledge and to investigate the moderating role of subjects’ demographics in the exposure-outcome associations. The sample included 249 civilian adults, assessed during the 2014 Israel–Gaza military conflict. The survey probed demographic information, trauma exposure, and symptoms. PTSS but not GAS was associated with exposure severity. Women were at higher risk for both PTSS and GAS than men. In addition, several demographic variables were only associated with PTSS levels. PTSS dose-response effect was moderated by education. These findings are in line with emerging neurobiological and cognitive research, suggesting that although PTSS and GAS have shared risk factors they represent two different psychopathological entities. Clinical and theoretical implications are discussed. PMID:26343559

  2. Antigen exposure in the late light period induces severe symptoms of food allergy in an OVA-allergic mouse model.

    PubMed

    Tanabe, Kana; Kitagawa, Eri; Wada, Misaki; Haraguchi, Atsushi; Orihara, Kanami; Tahara, Yu; Nakao, Atsuhito; Shibata, Shigenobu

    2015-09-30

    The mammalian circadian clock controls many physiological processes that include immune responses and allergic reactions. Several studies have investigated the circadian regulation of intestinal permeability and tight junctions known to be affected by cytokines. However, the contribution of circadian clock to food allergy symptoms remains unclear. Therefore, we investigated the role of the circadian clock in determining the severity of food allergies. We prepared an ovalbumin food allergy mouse model, and orally administered ovalbumin either late in the light or late in the dark period under light-dark cycle. The light period group showed higher allergic diarrhea and weight loss than the dark period group. The production of type 2 cytokines, IL-13 and IL-5, from the mesenteric lymph nodes and ovalbumin absorption was higher in the light period group than in the dark period group. Compared to the dark period group, the mRNA expression levels of the tight junction proteins were lower in the light period group. We have demonstrated that increased production of type 2 cytokines and intestinal permeability in the light period induced severe food allergy symptoms. Our results suggest that the time of food antigen intake might affect the determination of the severity of food allergy symptoms.

  3. Severe depression as the sole symptom of affective focal status epilepticus.

    PubMed

    Dimitriadis, Konstantinos; Pfefferkorn, Thomas; Noachtar, Soheyl

    2014-05-14

    Depression as well as fear, joy and anger have been described as the semiological features of focal epileptic seizures. When emotions present as the sole symptoms of epileptic seizures, they may easily be misdiagnosed as a psychiatric disorder. We describe a patient with affective focal status epilepticus, secondary to limbic encephalitis, in which depression was the only clinical manifestation. Through EEG correlates the epileptic nature of depression could be proven. Furthermore, we discuss the association between epilepsy and depression, as well as the link between ictal depression and suicidal rates.

  4. Severe depression as the sole symptom of affective focal status epilepticus

    PubMed Central

    Dimitriadis, Konstantinos; Pfefferkorn, Thomas; Noachtar, Soheyl

    2014-01-01

    Depression as well as fear, joy and anger have been described as the semiological features of focal epileptic seizures. When emotions present as the sole symptoms of epileptic seizures, they may easily be misdiagnosed as a psychiatric disorder. We describe a patient with affective focal status epilepticus, secondary to limbic encephalitis, in which depression was the only clinical manifestation. Through EEG correlates the epileptic nature of depression could be proven. Furthermore, we discuss the association between epilepsy and depression, as well as the link between ictal depression and suicidal rates. PMID:24827645

  5. Severity of symptom flare after moderate exercise is linked to cytokine activity in chronic fatigue syndrome.

    PubMed

    White, Andrea T; Light, Alan R; Hughen, Ronald W; Bateman, Lucinda; Martins, Thomas B; Hill, Harry R; Light, Kathleen C

    2010-07-01

    Chronic fatigue syndrome (CFS) patients often report symptom flare (SF) for >24 h after moderate exercise (post-ex). We hypothesized that SF is linked to increases in circulating cytokines and CD40 Ligand (CD40L). In 19 CFS patients and 17 controls, mental and physical fatigue and pain symptom ratings were obtained together with serum for 11 cytokines and CD40L before and at 0.5, 8, 24, and 48 h post-ex. Before exercise, CFS had lower CD40L (p<.05) but similar cytokines versus controls. In subgroups based on SF at 48 h, high SF patients (n=11) increased in IL-1beta, IL-12, IL-6, IL-8, IL-10, and IL-13 (p<.05) 8 h post-ex. Low SF patients (n=8) showed post-ex decreases in IL-10, IL-13, and CD40L, and controls decreased in IL-10, CD40L, and TNFalpha (p<.05). Thus, in CFS, cytokine activity may vary directly with SF, which may explain prior inconsistent findings.

  6. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep.

    PubMed

    Gore, Mugdha; Brandenburg, Nancy A; Dukes, Ellen; Hoffman, Deborah L; Tai, Kei-Sing; Stacey, Brett

    2005-10-01

    Our goal was to evaluate pain severity, pain-related interference with function, sleep impairment, symptom levels of anxiety and depression, and quality of life among patients with painful diabetic peripheral neuropathy (DPN). Participants in a burden of illness survey (n = 255) completed the modified Brief Pain Inventory-DPN (BPI-DPN), MOS Sleep Scale, Hospital Anxiety and Depression Scale (HADS), Short Form Health Survey-12v2 (SF-12v2), and the EuroQoL (EQ-5D). Patients were 61 +/- 12.8 years old (51.4% female), had diabetes for 12 +/- 10.3 years and painful DPN for 6.4 +/- 6.4 years. Average and Worst Pain scores (BPI-DPN, 0-10 scales) were 5.0 +/- 2.5 and 5.6 +/- 2.8. Pain substantially interfered (>or=4 on 0-10 scales) with walking ability, normal work, sleep, enjoyment of life, mood, and general activity. Moderate to severe symptom levels of anxiety and depression (HADS-A and HADS-D scores >or=11 on 0-21 scales) occurred in 35% and 28% of patients, respectively. Patients reported greater sleep problems compared with the general U.S. population and significant impairment in both physical and mental functioning (SF-12v2) compared with subjects with diabetes. The mean EQ-5D utility score was 0.5 +/- 0.3. Greater pain levels in DPN (mild to moderate to severe) corresponded with higher symptom levels of anxiety and depression, more sleep problems, and lower utility ratings and physical and mental functioning, (all Ps < 0.01). Painful DPN is associated with decrements in many aspects of patients' lives: physical and emotional functioning, affective symptoms, and sleep problems. The negative impact is higher in patients with greater pain severity. PMID:16256902

  7. The Moderating Role of Experiential Avoidance in the Relationship between Posttraumatic Stress Disorder Symptom Severity and Cannabis Dependence.

    PubMed

    Bordieri, Michael J; Tull, Matthew T; McDermott, Michael J; Gratz, Kim L

    2014-10-01

    The relationship between cannabis use and posttraumatic stress disorder (PTSD) has received increased scientific scrutiny in recent years. Consistent with this research, studies provide evidence that many individuals with PTSD use cannabis to reduce negative affect and other unpleasant internal experiences associated with PTSD. However, no research to date has explored factors that may be associated with an increased likelihood of cannabis misuse among individuals with PTSD. Consequently, this study explored the moderating role of experiential avoidance (EA; defined as the tendency to engage in strategies to reduce unpleasant private experiences) in the PTSD-cannabis dependence relationship among a sample of 123 Criterion A trauma-exposed patients in residential substance abuse treatment. Moderation analyses indicated an interactive effect of PTSD symptom severity and EA on current cannabis dependence. Specifically, results revealed a conditional effect of PTSD symptom severity on cannabis dependence only when EA was average or higher, with higher levels of PTSD symptom severity associated with a greater risk of cannabis dependence. These findings are consistent with evidence that cannabis use may serve an avoidant function among some individuals with PTSD and suggest that acceptance-based behavioral approaches might be effective in targeting both cannabis use and PTSD-related impairment.

  8. Adding to the Education Debt: Depressive Symptoms Mediate the Association between Racial Discrimination and Academic Performance in African Americans.

    PubMed

    English, Devin; Lambert, Sharon F; Ialongo, Nicholas S

    2016-08-01

    Although the United States faces a seemingly intractable divide between white and African American academic performance, there remains a dearth of longitudinal research investigating factors that work to maintain this gap. The present study examined whether racial discrimination predicted the academic performance of African American students through its effect on depressive symptoms. Participants were a community sample of African American adolescents (N=495) attending urban public schools from grade 7 to grade 9 (Mage=12.5). Structural equation modeling revealed that experienced racial discrimination predicted increases in depressive symptoms 1year later, which, in turn, predicted decreases in academic performance the following year. These results suggest that racial discrimination continues to play a critical role in the academic performance of African American students and, as such, contributes to the maintenance of the race-based academic achievement gap in the United States. PMID:27425564

  9. Mental Health Literacy for Anxiety Disorders: How perceptions of symptom severity might relate to recognition of psychological distress

    PubMed Central

    Paulus, Daniel J.; Wadsworth, Lauren Page; Hayes-Skelton, Sarah A.

    2015-01-01

    Purpose Improving mental health literacy is an important consideration when promoting expedient and effective treatment seeking for psychological disorders. Low recognition serves as a barrier to treatment (Coles and Coleman, 2010), and this article examines recognition by lay individuals of severity for three psychological disorders: social anxiety, generalized anxiety, and major depression using a dimensional approach. Design Vignettes of mild/subclinical, moderate, and severe cases of each disorder were rated for severity by a team of expert assessors and 270 participants (mean age = 26.8; 76.7% women). Findings Difference ratings were calculated comparing participants’ responses to scores from the assessors. A within-groups factorial ANOVA with LSD follow-up was performed to examine the effects of Diagnosis and Severity on difference ratings. Both main effects [Diagnosis, F(2, 536)=35.26, Mse=1.24; Severity, F(2, 536)=9.44, Mse=1.93] and the interaction were significant [F(4, 1072)=13.70, Mse=1.13] all p’s < 0.001. Social anxiety cases were underrated in the mild/subclinical and moderate cases, generalized anxiety cases were underrated at all three severities, and major depression cases were overrated at all three severities. Social implications Judgments of severity may underlie the low recognition rates for social anxiety disorder and generalized anxiety disorder. Future efforts should focus on improved recognition and education regarding anxiety disorders in the population, particularly before they become severe. Value This project demonstrates the importance of considering judgments of symptom severity on a continuum, and in a range of cases, rather than just the ability to correctly label symptoms, when determining whether or not people recognize psychological disorders. PMID:26893607

  10. Severity of Anxiety Symptoms Reported by Borderline Patients and Axis II Comparison Subjects: Description and Prediction over 16 Years of Prospective Follow-Up

    PubMed Central

    Zanarini, Mary C.; Frankenburg, Frances R.; Fitzmaurice, Garrett M.

    2014-01-01

    The first purpose of this study was to determine the severity of anxiety symptoms reported by borderline patients and axis II comparison subjects over 16 years of follow-up. The second was to determine the most salient predictors of the severity of anxiety symptoms of borderline patients. Initially, 290 borderline inpatients and 72 comparison subjects were assessed using measures of anxiety, childhood adversity, and normal personality. The severity of anxiety symptoms was reassessed every two years. Borderline patients reported approximately twice as severe symptoms of anxiety as comparison subjects. However, these symptoms decreased significantly over time for those in both groups. Among borderline patients, two variables were found to be significant multivariate predictors of severity of overall anxiety: non-sexual childhood abuse and trait neuroticism. The results of this study suggest that anxiety symptoms form a distinct profile for borderline patients--a profile related to both childhood adversity and a vulnerable temperament. PMID:24932876

  11. Nicotinic Mechanisms Modulate Ethanol Withdrawal and Modify Time Course and Symptoms Severity of Simultaneous Withdrawal from Alcohol and Nicotine.

    PubMed

    Perez, Erika; Quijano-Cardé, Natalia; De Biasi, Mariella

    2015-09-01

    Alcohol and nicotine are among the top causes of preventable death in the United States. Unfortunately, people who are dependent on alcohol are more likely to smoke than individuals in the general population. Similarly, smokers are more likely to abuse alcohol. Alcohol and nicotine codependence affects health in many ways and leads to poorer treatment outcomes in subjects who want to quit. This study examined the interaction of alcohol and nicotine during withdrawal and compared abstinence symptoms during withdrawal from one of the two drugs only vs both. Our results indicate that simultaneous withdrawal from alcohol and nicotine produces physical symptoms that are more severe and last longer than those experienced during withdrawal from one of the two drugs alone. In animals experiencing withdrawal after chronic ethanol treatment, acute nicotine exposure was sufficient to prevent abstinence symptoms. Similarly, symptoms were prevented when alcohol was injected acutely in mice undergoing nicotine withdrawal. These experiments provide evidence for the involvement of the nicotinic cholinergic system in alcohol withdrawal. Furthermore, the outcomes of intracranial microinfusions of mecamylamine, a nonselective nicotinic receptor antagonist, highlight a major role for the nicotinic receptors expressed in medial habenula and interpeduncular nucleus during withdrawal. Overall, the data support the notion that modulating the nicotinic cholinergic system might help to maintain long-term abstinence from alcohol.

  12. Comparison of intranasal azelastine to intranasal fluticasone propionate for symptom control in moderate-to-severe seasonal allergic rhinitis.

    PubMed

    Carr, Warner W; Ratner, Paul; Munzel, Ullrich; Murray, Ruth; Price, David; Canonica, G Walter; Mullol, Joaquim; Virchow, J Christian; Lieberman, Phil; Meltzer, Eli; Bachert, Claus

    2012-01-01

    Intranasal corticosteroids are considered the most effective therapy for moderate-to-severe seasonal allergic rhinitis (SAR) and recommended first line in guidelines. It is uncertain whether intranasal antihistamines have comparable efficacy. This study was designed to compare the efficacy of azelastine (AZE; 137 μg/spray) and fluticasone propionate (FP; 50 μg/spray), both given as 1 spray/nostril bid (i.e., approved dosing regimen in the United States), in SAR via a post hoc analysis of data from a previously published direct-comparison study. Six hundred ten moderate-to-severe SAR patients (≥12 years old) were randomized into a double-blind, placebo-controlled, parallel-group trial. The primary efficacy variable was change from baseline in reflective total nasal symptom score (rTNSS (morning and evening), over 14 days. Reflective total ocular symptom score (rTOSS) was a key secondary variable. Reflective total of seven symptom scores (rT7SS [nasal plus ocular symptoms]) and time to ≥50% reduction from baseline in these key parameters were also analyzed. AZE and FP reduced rTNSS from baseline by a similar degree (-3.25 versus -3.84; p = 0.2014). Patients experienced comparable improvement in rTOSS (-2.62 versus -2.17; p = 0.2371) and rT7SS (-5.83 versus -6.05; p = 0.7820). FP was superior to AZE in alleviating rhinorrhea (-1.15 versus -0.87; p = 0.0433), but AZE showed comparable efficacy for all other nasal and ocular symptoms. There was no clinically or statistically significant difference between AZE (-1.17) and FP (-1.43) for reduction in the overall rhinitis quality of life questionnaire score (although FP, but not AZE, significantly differed from placebo). A similar proportion of patients in the AZE and FP groups achieved a 50% reduction in rTNSS. However, more AZE patients (53.0%) exhibited a 50% reduction in rTOSS by day 14 versus FP (39.6%), and ≤3 days faster (p = 0.028). Intranasal AZE (137 micrograms/spray) and intranasal FP (50 micrograms

  13. Dissociative, depressive, and PTSD symptom severity as correlates of nonsuicidal self-injury and suicidality in dissociative disorder patients.

    PubMed

    Webermann, Aliya R; Myrick, Amie C; Taylor, Christina L; Chasson, Gregory S; Brand, Bethany L

    2016-01-01

    The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise specified with a recent history of nonsuicidal self-injury (NSSI) and suicide attempts from those patients without recent self-harm. A total of 241 clinicians reported on recent history of patient NSSI and suicide attempts. Of these clinicians' patients, 221 completed dissociative, depressive, and posttraumatic stress disorder symptomatology measures. Baseline cross-sectional data from a naturalistic and prospective study of dissociative disorder patients receiving community treatment were utilized. Analyses evaluated dissociative, depressive, and posttraumatic stress disorder symptom severity as methods of classifying patients into NSSI and suicide attempt groupings. Results indicated that dissociation severity accurately classified patients into NSSI and suicidality groups, whereas depression severity accurately classified patients into NSSI groups. These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment. PMID:26211678

  14. Dissociative, depressive, and PTSD symptom severity as correlates of nonsuicidal self-injury and suicidality in dissociative disorder patients.

    PubMed

    Webermann, Aliya R; Myrick, Amie C; Taylor, Christina L; Chasson, Gregory S; Brand, Bethany L

    2016-01-01

    The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise specified with a recent history of nonsuicidal self-injury (NSSI) and suicide attempts from those patients without recent self-harm. A total of 241 clinicians reported on recent history of patient NSSI and suicide attempts. Of these clinicians' patients, 221 completed dissociative, depressive, and posttraumatic stress disorder symptomatology measures. Baseline cross-sectional data from a naturalistic and prospective study of dissociative disorder patients receiving community treatment were utilized. Analyses evaluated dissociative, depressive, and posttraumatic stress disorder symptom severity as methods of classifying patients into NSSI and suicide attempt groupings. Results indicated that dissociation severity accurately classified patients into NSSI and suicidality groups, whereas depression severity accurately classified patients into NSSI groups. These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment.

  15. Gender Differences in Severity and Correlates of Depression Symptoms in People Living with HIV in Ontario, Canada.

    PubMed

    Aljassem, Kinda; Raboud, Janet M; Hart, Trevor A; Benoit, Anita; Su, DeSheng; Margolese, Shari L; Rourke, Sean B; Rueda, Sergio; Burchell, Ann; Cairney, John; Shuper, Paul; Loutfy, Mona R

    2016-01-01

    This study investigates the differences in severity and correlates of depression symptoms among 1069 men and 267 women living with HIV in Ontario, Canada, who completed the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Women had higher CES-D scores than that of men (median [interquartile range]: 13 [5-26] versus 9 [3-20], P=.0004). More women had total CES-D scores>15 (mild-moderate depression; 44% versus 33%, P=.002) and >21 (severe depression; 31% versus 23%, P=.003). Unlike men, at age 40, women's scores increased yearly (0.4 per increased year, P=.005). The distribution of scores differed by gender: There was no difference in the 10th percentile of depression scores, 0 (95% confidence interval [CI]: 1.0-1.0) but the 75th percentile of depression scores for women was 6 (95% CI: 2.0-10.0) points higher than that of men. Important gender differences exist in depression symptoms and in correlates of symptoms in people living with HIV.

  16. Experience of insomnia, symptom attribution and treatment preferences in individuals with moderate to severe COPD: a qualitative study

    PubMed Central

    Kauffman, Karen S; Doede, Megan; Diaz-Abad, Montserrat; Scharf, Steven M; Bell-Farrell, Wanda; Rogers, Valerie E; Geiger-Brown, Jeanne

    2014-01-01

    Persons with chronic obstructive pulmonary disease (COPD) are known to have poor sleep quality. Acceptance of and adherence to therapies for sleep problems may depend on how the person with COPD regards the source of his sleep problem, yet little is known about their attribution as to the cause of these sleep symptoms. The objective of this study was to describe the subjective sleep complaints of individuals with COPD along with their attributions as to the cause of these symptoms, and their treatment preferences for insomnia. Three focus groups were conducted (N=18) with participants who have moderate to severe COPD. Focus group data were transcribed, compared and contrasted to identify themes of attribution. Participants reported difficulty falling asleep, staying asleep, and daytime sleepiness. They attributed their sleep problems primarily to their pulmonary symptoms, but also poor air quality (thick humid air) and death anxiety when awake during the night. There was no clear preference for type of treatment to remedy this problem (medication, cognitive therapy), although they indicated that traveling to the clinic was difficult and should be avoided as much as possible. These data suggest that environmental manipulation to improve air quality (eg, air conditioning) and modifications to reduce death anxiety could be beneficial to persons with COPD. In-person multi-session therapy may not be acceptable to persons with moderate to severe COPD, however internet-based therapy might make treatment more accessible. PMID:25525346

  17. Severe low back pain as the initial symptom of venous thrombosis of the inferior vena cava

    PubMed Central

    Tabatabai, Mohsen Abdul Wahab; Butros, Victor Mikhaeel; Mahdi, Shihab Ahmed; Ahmad, Mohammad Javad

    2014-01-01

    A 45-year-old previously well male truck driver presented to the emergency department with severe low back pain; lumbosacral X-ray was normal and he was given analgaesics and discharged. The following day, he presented to the emergency department again, his pain had not responded to the analgaesics; this time he also presented with massive bilateral swelling of lower limbs and left testicle that started 3 h earlier. The pain was severe, dull and interfered with the patient's ability to walk. An urgent workup revealed extensive thrombosis of the inferior vena cava. PMID:25155491

  18. Association of metacognitive beliefs, obsessive beliefs and symptom severity with quality of life in obsessive-compulsive patients.

    PubMed

    Barahmand, Usha; Tavakolian, Ehsan; Alaei, Sarah

    2014-10-01

    The aim of this study was to evaluate the association of obsessive beliefs, obsessive-compulsive disorder severity and metacognitive beliefs to the quality of life in patients with obsessive-compulsive disorder (OCD). Sixty one adults with a principal diagnosis of OCD were recruited for the study. Participants were assessed by trained clinicians using an unstructured clinical interview, the Obsessive Beliefs Questionnaire, the Yale-Brown Obsessive-Compulsive Scale, the Metacognitive Beliefs Questionnaire and the WHO Quality of Life Questionnaire. Data were analyzed using Pearson's of correlation coefficients and multiple regression analyses. Findings indicate that obsessive beliefs, severity total OCD and metacognitive beliefs were associated with total quality of life scores. Regression analysis revealed that while OCD total severity explained 40.1% of the variance in total quality of life, obsessive beliefs (perfectionism/certainty domain) and metacognitions (cognitive self-consciousness and negative beliefs about thoughts in general) explained an additional 13.7%, 7.7% and 5.4% of the variance in QoL. Findings indicate that the metacognitive beliefs associated with OCD symptom severity are different from that associated with quality of life. The implications are that metacognitive therapy aimed at symptom reduction may not necessarily result in improved QoL in OCD patients.

  19. The impact of sensation seeking on the relationship between attention deficit/hyperactivity symptoms and severity of Internet addiction risk.

    PubMed

    Dalbudak, Ercan; Evren, Cuneyt; Aldemir, Secil; Taymur, Ibrahim; Evren, Bilge; Topcu, Merve

    2015-07-30

    The aim of this study was to investigate the relationship of attention deficit/hyperactivity symptoms (ADHS) with severity of Internet addiction risk (SIAR), while controlling the effects of variables such as depression, anxiety, anger, sensation seeking and lack of assertiveness among university students. Cross-sectional online self-report survey was conducted in two universities among a representative sample of 582 Turkish university students. The students were assessed through the Addiction Profile Index Internet Addiction Form Screening Version (BAPINT-SV), the Psychological Screening Test for Adolescents (PSTA) and the Adult Attention deficit/hyperactivity disorder Self-Report Scale (ASRS). The participants were classified into the two groups as those with high risk of Internet addiction (HRIA) (11%) and those with low risk of Internet addiction (IA) (89%). The mean age was lower in the group with HRIA, whereas depression, anxiety, sensation seeking, anger, lack of assertiveness and ADHS scores were higher in this group. Lastly, a hierarchical regression analysis suggested that severity of sensation seeking and ADHS, particularly attention deficiency, predicted SIAR. The severity of sensation seeking and ADHS, particularly attention deficit symptoms, are important for SIAR. Awareness of sensation seeking among those with high ADHS may be important in prevention and management of IA among university students.

  20. Impact of psychotic symptoms on cognitive functioning in child and adolescent psychiatric inpatients with severe mood disorders.

    PubMed

    McCarthy, James B; Weiss, Shira R; Segovich, Kristin T; Barbot, Baptiste

    2016-10-30

    Despite established differences in cognitive functioning of adults with mood disorder-related psychosis and those with non-affective psychotic disorders, there is limited evidence of the impact of psychotic symptoms on the cognitive functioning of children and adolescents with mood disorders. This study investigates IQ, working memory, and processing speed scores in 80 child and adolescent inpatients discharged from an intermediate care state psychiatric hospital, using a retrospective chart review. Associations between diagnosis based on DSM-IV criteria (7 with Major Depression- MDD; 43 with Bipolar Disorders-BD, and 30 with Mood Disorders Not Otherwise Specified-NOS), presence of current psychotic features, and cognitive functioning (WISC-IV IQ, Coding, Symbol Search, and Digit Span) were investigated using Multivariate Analyses of Variance. No differences were found in cognitive functioning between patients with MDD and BD, or between those with severe Mood Disorders (MDD or BD) and those with NOS, when controlling for age, gender, and presence of psychotic features. However, patients with severe mood disorders and psychotic features showed lower IQs and greater working memory deficits than those without psychotic features or NOS. Results are discussed in terms of treatment planning for children and adolescents at risk for developing psychotic symptoms and severe mood disorders.

  1. The impact of sensation seeking on the relationship between attention deficit/hyperactivity symptoms and severity of Internet addiction risk.

    PubMed

    Dalbudak, Ercan; Evren, Cuneyt; Aldemir, Secil; Taymur, Ibrahim; Evren, Bilge; Topcu, Merve

    2015-07-30

    The aim of this study was to investigate the relationship of attention deficit/hyperactivity symptoms (ADHS) with severity of Internet addiction risk (SIAR), while controlling the effects of variables such as depression, anxiety, anger, sensation seeking and lack of assertiveness among university students. Cross-sectional online self-report survey was conducted in two universities among a representative sample of 582 Turkish university students. The students were assessed through the Addiction Profile Index Internet Addiction Form Screening Version (BAPINT-SV), the Psychological Screening Test for Adolescents (PSTA) and the Adult Attention deficit/hyperactivity disorder Self-Report Scale (ASRS). The participants were classified into the two groups as those with high risk of Internet addiction (HRIA) (11%) and those with low risk of Internet addiction (IA) (89%). The mean age was lower in the group with HRIA, whereas depression, anxiety, sensation seeking, anger, lack of assertiveness and ADHS scores were higher in this group. Lastly, a hierarchical regression analysis suggested that severity of sensation seeking and ADHS, particularly attention deficiency, predicted SIAR. The severity of sensation seeking and ADHS, particularly attention deficit symptoms, are important for SIAR. Awareness of sensation seeking among those with high ADHS may be important in prevention and management of IA among university students. PMID:25962354

  2. Quantitative characterization of disease severity in diseases with complex symptom profiles.

    PubMed

    Kondraske, George V; Stewart, R Malcolm

    2006-01-01

    A number of clinical and research situations arise that require the integration of complex, multi-dimensional, performance-related information to determine a single quantity such as "disease severity" or "risk level" (for subsequent development of a disease). This process is generally carried out either by relying on a subjective gestalt approach or by using rating scales that combine scores for component measures using an additive process without justification. Concepts from general systems performance theory have provided insights into this problem, teaching that a fundamentally multiplicative method of integrating components is often appropriate. In this paper, concepts and previous supportive experimental work are reviewed in the context of the quantitative characterization of disease severity. A Parkinson's disease study (n=114) is presented that mimics the "two-condition" situation encountered in the clinical trial of a new drug or other therapy. Traditional and performance theory-based composite scores are computed for each condition ("on" and "off" medications) and compared, with emphasis on the different quantitative "pictures" conveyed by each approach. It is concluded that performance theory based composites are not only more sensitive to therapeutic agents experimentally, but also have superior conceptual validity compared to traditional forms of single-number composites. PMID:17946592

  3. [ Symptom Severity and the Role of Friendship in Children at a Child Guidance Center from Parents' Point of View].

    PubMed

    Brüggemann, Kai

    2016-01-01

    By means of the Child Behavior Checklist (CBCL) it was assessed how much children who are attended to a child guidance center suffer from behavior problems and emotional distress. Furthermore, the interaction between straining and supporting influences was examined. Results show that symptom severity lies in the range of clinical significance. Children of divorced parents show more internalizing as well as externalizing problems than children of nuclear families. High social integration is correlated with lower psychic symptomatic - yet, this finding was dependent on family situation: While frequency to meet friends in children from nuclear families was correlated with lower symptomatic, this effect could not be found in children of divorced parents.

  4. [ Symptom Severity and the Role of Friendship in Children at a Child Guidance Center from Parents' Point of View].

    PubMed

    Brüggemann, Kai

    2016-01-01

    By means of the Child Behavior Checklist (CBCL) it was assessed how much children who are attended to a child guidance center suffer from behavior problems and emotional distress. Furthermore, the interaction between straining and supporting influences was examined. Results show that symptom severity lies in the range of clinical significance. Children of divorced parents show more internalizing as well as externalizing problems than children of nuclear families. High social integration is correlated with lower psychic symptomatic - yet, this finding was dependent on family situation: While frequency to meet friends in children from nuclear families was correlated with lower symptomatic, this effect could not be found in children of divorced parents. PMID:26904930

  5. Harm Avoidance and Self-Directedness Characterize Fibromyalgic Patients and the Symptom Severity

    PubMed Central

    Leombruni, Paolo; Zizzi, Francesca; Miniotti, Marco; Colonna, Fabrizio; Castelli, Lorys; Fusaro, Enrico; Torta, Riccardo

    2016-01-01

    Objective: Evidence in the literature suggests peculiar personality traits for fibromyalgic (FM) patients, and it has been suggested that personality characteristics may be involved in patients’ different symptomatic events and responses to treatment. The aim of the study is to investigate the personality characteristics of Italian FM patients and to explore the possibility of clustering them considering both personality traits and clinical characteristics. Design: The study used a cross-sectional methodology and involved a control group. A self-assessment procedure was used for data gathering. The study included 87 female FM patients and 83 healthy females. Patients were approached and interviewed in person during a psychiatric consultation. Healthy people were recruited from general practices with previous telephone contact. Main Outcome Measures: Participants responded to the Hospital Anxiety and Depression Scale, the Temperament and Character Inventory, the Fibromyalgia Impact Questionnaire and the Short-Form-36 Health Survey. Results: FM patients scored significantly different from healthy participants on the Harm avoidance (HA), Novelty seeking (NS) and Self-directedness (SD). Two clusters were identified: patients in Cluster1 (n = 37) had higher scores on HA and lower scores on RD, SD, and Cooperativeness and reported more serious fibromyalgia and more severe anxious–depressive symptomatology than did patients in Cluster2 (n = 46). Conclusion: This study confirms the presence of certain personality traits in the FM population. In particular, high levels of HA and low levels of SD characterize a subgroup of FM patients with more severe anxious–depressive symptomatology. According to these findings, personality assessment could be useful in the diagnostic process to tailor therapeutic interventions to the personality characteristics. PMID:27199814

  6. Associations of pineal volume, chronotype and symptom severity in adults with attention deficit hyperactivity disorder and healthy controls.

    PubMed

    Bumb, Jan Malte; Mier, Daniela; Noelte, Ingo; Schredl, Michael; Kirsch, Peter; Hennig, Oliver; Liebrich, Luisa; Fenske, Sabrina; Alm, Barbara; Sauer, Carina; Leweke, Franz Markus; Sobanski, Esther

    2016-07-01

    The pineal gland, as part of the human epithalamus, is the main production site of peripheral melatonin, which promotes the modulation of sleep patterns, circadian rhythms and circadian preferences (morningness vs. eveningness). The present study analyses the pineal gland volume (PGV) and its association with circadian preferences and symptom severity in adult ADHD patients compared to healthy controls. PGV was determined manually using high-resolution 3T MRI (T1-magnetization prepared rapid gradient echo) in medication free adult ADHD patients (N=74) compared to healthy controls (N=86). Moreover, the Morningness-Eveningness Questionnaire (MEQ), the ADHD Diagnostic Checklist and the Wender-Utah Rating Scale were conducted. PGV differed between both groups (patients: 59.9±33.8mm(3); healthy controls: 71.4±27.2mm(3), P=0.04). In ADHD patients, more eveningness types were revealed (patients: 29%; healthy controls: 17%; P=0.05) and sum scores of the MEQ were lower (patients: 45.8±11.5; healthy controls 67.2±10.1; P<0.001). Multiple regression analyses indicated a positive correlation of PGV and MEQ scores in ADHD (β=0.856, P=0.003) but not in healthy controls (β=0.054, P=0.688). Patients' MEQ scores (β=-0.473, P=0.003) were negatively correlated to ADHD symptoms. The present results suggest a linkage between the PGV and circadian preference in adults with ADHD and an association of the circadian preference to symptom severity. This may facilitate the development of new chronobiological treatment approaches for the add-on treatment in ADHD. PMID:27150337

  7. Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans.

    PubMed

    Myers, Catherine E; Vanmeenen, Kirsten M; McAuley, J Devin; Beck, Kevin D; Pang, Kevin C H; Servatius, Richard J

    2012-01-01

    Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R(2) = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.

  8. Escitalopram is associated with reductions in pain severity and pain interference in opioid dependent patients with depressive symptoms.

    PubMed

    Tsui, Judith I; Herman, Debra S; Kettavong, Malyna; Anderson, Bradley J; Stein, Michael D

    2011-11-01

    Pain is common among opioid-dependent patients, yet pharmacologic strategies are limited. The aim of this study was to explore whether escitalopram, a selective serotonin reuptake inhibitor, was associated with reductions in pain. The study used longitudinal data from a randomized, controlled trial that evaluated the effects of escitalopram on treatment retention in patients with depressive symptoms who were initiating buprenorphine/naloxone for treatment of opioid dependence. Participants were randomized to receive escitalopram 10 mg or placebo daily. Changes in pain severity, pain interference, and depression were assessed at 1-, 2-, and 3-month visits with the visual analog scale, Brief Pain Inventory, and the Beck Depression Inventory II, respectively. Fixed-effects estimators for panel regression models were used to assess the effects of intervention on changes in outcomes over time. Additional models were estimated to explore whether the intervention effect was mediated by within-person changes in depression. In this sample of 147 adults, we found that participants randomized to escitalopram had significantly larger reductions on both pain severity (b=-14.34, t=-2.66, P<.01) and pain interference (b=-1.20, t=-2.23, P<.05) between baseline and follow-up. After adjusting for within-subject changes in depression, the estimated effects of escitalopram on pain severity and pain interference were virtually identical to the unadjusted effects. This study of opioid-dependent patients with depressive symptoms found that treatment with escitalopram was associated with clinically meaningful reductions in pain severity and pain interference during the first 3 months of therapy.

  9. Cluster Analysis of the Yale Global Tic Severity Scale (YGTSS): Symptom Dimensions and Clinical Correlates in an Outpatient Youth Sample

    ERIC Educational Resources Information Center

    Kircanski, Katharina; Woods, Douglas W.; Chang, Susanna W.; Ricketts, Emily J.; Piacentini, John C.

    2010-01-01

    Tic disorders are heterogeneous, with symptoms varying widely both within and across patients. Exploration of symptom clusters may aid in the identification of symptom dimensions of empirical and treatment import. This article presents the results of two studies investigating tic symptom clusters using a sample of 99 youth (M age = 10.7, 81% male,…

  10. An Investigation of Depression, Trauma History, and Symptom Severity in Individuals Enrolled in a Treatment Trial for Chronic PTSD

    PubMed Central

    Bedard-Gilligan, Michele; Duax Jakob, Jeanne M.; Doane, Lisa Stines; Jaeger, Jeff; Eftekhari, Afsoon; Feeny, Norah; Zoellner, Lori A.

    2015-01-01

    Objectives To explore how factors such as major depressive disorder (MDD) and trauma history, including the presence of childhood abuse, influence diverse clinical outcomes such as severity and functioning in a sample with posttraumatic stress disorder (PTSD). Method In this study, 200 men and women seeking treatment for chronic PTSD in a clinical trial were assessed for trauma history and major depressive disorder and compared on symptom severity, psychosocial functioning, dissociation, treatment history, and extent of diagnostic co-occurrence. Results Overall, childhood abuse did not consistently predict clinical severity. However, co-occurring MDD, and to a lesser extent a high level of trauma exposure, did predict greater severity, worse functioning, greater dissociation, more extensive treatment history, and additional co-occurring disorders. Conclusions These findings suggest that presence of co-occurring depression may be a more critical marker of severity and impairment than history of childhood abuse or repeated trauma exposure. Furthermore, they emphasize the importance of assessing MDD and its impact on treatment seeking and treatment response for those with PTSD. PMID:25900026

  11. Severity of Lower Urinary Tract Symptoms among Middle Aged and Elderly Nigerian Men: Impact on Quality of Life

    PubMed Central

    Adebayo, Philip Babatunde

    2016-01-01

    Objectives. To compare the severity of LUTS among middle aged and elderly Nigerian men and determine the influence of LUTS severity on QoL. Methods. This cross-sectional study was conducted among new patients presenting with LUTS attending Urology clinic between 2011 and 2015. Assessment of symptoms was based on IPSS and bother score completed by the eligible subjects on the same day of their clinic visits. Results. Four hundred patients were studied comprising 229 middle aged and 171 elderly men. Interquartile range (IQR) of IPSS scores for men <65 years and those ≥65 years was 14.0 (16.0) and 19 (15.0), respectively (p < 0.001). Mild LUTS was significantly associated with best, good, and poor quality of life while moderate LUTS was associated with poor QoL. Severe LUTS was significantly associated with all the categories of QoL (Best-Worst). Among the cohort of subjects with poor QoL, elderly patients had a significantly higher median IPSS score (p < 0.05). Conclusions. There is no level of severity of LUTS in which patients' QoL is not impaired although mild symptomatology may be associated with better QoL and severe symptomatology with poor QoL. Careful attention to QoL may help identify patients who require early and prompt treatment irrespective of the IPSS. PMID:27413368

  12. Elevated corticosterone levels and severe weather conditions decrease parental investment of incubating Adélie penguins.

    PubMed

    Thierry, Anne-Mathilde; Massemin, Sylvie; Handrich, Yves; Raclot, Thierry

    2013-03-01

    Corticosterone, the main stress hormone in birds, mediates resource allocation, allowing animals to adjust their physiology and behaviour to changes in the environment. Incubation is a time and energy-consuming phase of the avian reproductive cycle. It may be terminated prematurely, when the parents' energy stores are depleted or when environmental conditions are severe. In this study, the effects of experimentally elevated baseline corticosterone levels on the parental investment of incubating male Adélie penguins were investigated. Incubation duration and reproductive success of 60 penguins were recorded. The clutches of some birds were replaced by dummy eggs, which recorded egg temperatures and rotation rates, enabling a detailed investigation of incubation behaviour. Corticosterone levels of treated birds were 2.4-fold higher than those of controls 18 days post treatment. Exogenous corticosterone triggered nest desertion in 61% of the treated birds; consequently reducing reproductive success, indicating that corticosterone can reduce or disrupt parental investment. Regarding egg temperatures, hypothermic events became more frequent and more pronounced in treated birds, before these birds eventually abandoned their nest. The treatment also significantly decreased incubation temperatures by 1.3°C and lengthened the incubation period by 2.1 days. However, the number of chicks at hatching was similar among successful nests, regardless of treatment. Weather conditions appeared to be particularly important in determining the extent to which corticosterone levels affected the behaviour of penguins, as treated penguins were more sensitive to severe weather conditions. This underlines the importance of considering the interactions of organisms with their environment in studies of animal behaviour and ecophysiology.

  13. No association between the serotonin transporter linked polymorphic region polymorphism and severity of posttraumatic stress disorder symptoms in combat veterans with or without comorbid depression.

    PubMed

    Kovacic Petrovic, Zrnka; Nedic Erjavec, Gordana; Nikolac Perkovic, Matea; Peraica, Tina; Pivac, Nela

    2016-10-30

    Since both posttraumatic stress disorder (PTSD) and depression are associated with disturbances in the serotoninergic system, the aim of the study was to determine the association between severity of PTSD symptoms, serotonin transporter polymorphism (5-HTTLPR) and platelet serotonin (5-HT) concentration, in male combat veterans with PTSD (n = 325), who were subdivided according to presence of comorbid depression. The methodological approach included the psychiatric diagnostic interviews and rating scales (SCID for DSM-IV, HDRS, CAPS), polymerase chain reaction for 5-HTTLPR genotyping and spectrophotofluorometric method for measuring the platelet 5-HT concentration. PTSD veterans without depression had more severe PTSD symptoms, and less severe depressive symptoms, than PTSD veterans with depression. 5-HTTLPR genotype frequencies did not differ between veterans with mild, moderate and severe PTSD symptoms, and between depressed and non-depressed PTSD veterans. No significant association was found between the severity of PTSD symptoms and 5-HTTLPR genotype. Platelet 5-HT concentration was similar in PTSD veterans, with or without comorbid depression, and between two groups subdivided according to the severity of PTSD symptoms or 5-HTTLPR genotype. The study confirmed, on ethnically homogenous groups of veterans with matched combat experience, a lack of association between the PTSD symptoms severity and 5-HTTLPR or platelet 5-HT concentration. PMID:27525827

  14. Effect of the Interplay between Trauma Severity and Trait Neuroticism on Posttraumatic Stress Disorder Symptoms among Adolescents Exposed to a Pipeline Explosion

    PubMed Central

    Guo, Wei; Xue, Jiao-Mei; Shao, Di; Long, Zhou-Ting; Cao, Feng-Lin

    2015-01-01

    Background While numerous studies have explored relevant factors of posttraumatic stress disorder (PTSD) symptoms, there have been few joint investigations of trauma severity and trait neuroticism on the development of PTSD symptoms. This study aims to assess the involvement and interrelationship of trauma severity and neuroticism in the expression of PTSD symptoms among adolescents exposed to an accidental explosion. Methods Six hundred and sixty-two adolescents were recruited from a junior middle school closest to the 2013 pipeline explosion site in China and were assessed using the Explosion Exposure Questionnaire, the NEO Five Factor Inventory-Neuroticism Subscale (FFI-N), and the PTSD Checklist-Civilian (PCL-C). A battery of hierarchical multiple regression analyses and two-way ANOVAs were performed to examine the effect of trauma severity and trait neuroticism on adolescent PTSD symptoms. Results Eighty-seven adolescents (13.1%) showed PTSD symptoms after the pipeline explosion. Correlation analysis showed that all the factors of explosion exposure and trait neuroticism were positively associated with adolescent PTSD symptoms. Being male and younger was linked to lower risk for PTSD symptoms. The regression models identified explosion exposure and neuroticism as independent risk factors for PTSD symptoms, and the interactions between trait neuroticism and trauma exposure (personal casualty, degree of influence, total traumatic severity) were related to PTSD symptoms. Conclusions The results highlight the role of trauma exposure and trait neuroticism as risk factors for PTSD symptoms. Therefore, the combination of these two factors should be investigated in clinical settings due to an augmented risk for more severe PTSD symptoms. PMID:25793606

  15. Non-Motor Symptoms of Essential Tremor Are Independent of Tremor Severity and Have an Impact on Quality of Life

    PubMed Central

    Musacchio, Thomas; Purrer, Veronika; Papagianni, Aikaterini; Fleischer, Anna; Mackenrodt, Daniel; Malsch, Carolin; Gelbrich, Götz; Steigerwald, Frank; Volkmann, Jens; Klebe, Stephan

    2016-01-01

    Background Several publications have focused on accompanying non-motor symptoms (NMS) in essential tremor (ET) patients; however, it remains unclear if NMS are an intrinsic part of the disease or secondary phenomena. We present the results of several neuropsychiatric tests and their impact on quality of life (QoL) in community-dwelling patients with ET. Methods Participants were recruited via a newspaper article about ET published in the local media and on the internet. All participants completed several standard neuropsychiatric tests, including those that assess QoL. To compare differences between cases and controls, Student’s t-tests with Bonferroni-Holm post hoc tests were performed. Spearman’s correlation coefficients were also calculated. Results We enrolled 110 patients with definite or probable ET. Highly significant changes were observed for apathy, anxiety, and cognition and negatively impacted QoL. Most aberrations were independent of tremor severity and duration. Discussion The significant neuropsychiatric deficits and reduced QoL demonstrate a degree of illness that appears to be a non-motor phenotype rather than a secondary effect of ET. In the future, NMS should carefully be explored in ET patients as they may have an impact on QoL and treatment. PMID:26989573

  16. Prospective study of the influence of psychological and medical factors on quality of life and severity of symptoms among patients with oral squamous cell carcinoma.

    PubMed

    Rana, M; Kanatas, A; Herzberg, P Y; Khoschdell, M; Kokemueller, H; Gellrich, N-C; Rana, M

    2015-04-01

    About 400,000 people worldwide are diagnosed with oral squamous cell carcinoma (SCC) annually, and the incidence is increasing. Many advanced carcinomas of the oral cavity require radical surgical treatment that can impair patient's quality of life (QoL) and severity of symptoms. We therefore aimed to identify coping strategies and disease-specific medical factors that affect QoL and severity of symptoms. Patients with oral SCC were asked to complete the Freiburg Questionnaire on Coping with Illness (FQCI), the University of Washington Quality of life Questionnaire (UW-QOL version 4), and the Brief Symptom Inventory (BSI) to measure psychological stress. We also assessed the impact of various factors on QoL and severity of symptoms, including stage and site of tumour, method of reconstruction, time of diagnosis, and social structure (age, sex, marital status, living arrangements, level of education, and employment). We enrolled a consecutive sample of 104 patients over a period of one year. Stepwise linear regression analyses indicated that both depressive coping and size of tumour had an adverse effect on QoL and severity of symptoms. Patients with high educational attainment and those who lived alone reported impaired QoL, and women experienced increased severity of symptoms. Impaired QoL and increased severity of symptoms were associated with a depressive style of coping, size of tumour, educational attainment, and living arrangements. It is important to identify these patients during treatment as they could benefit from psycho-oncological counselling.

  17. Traumatic Severity and Trait Resilience as Predictors of Posttraumatic Stress Disorder and Depressive Symptoms among Adolescent Survivors of the Wenchuan Earthquake

    PubMed Central

    Ying, Liuhua; Wu, Xinchun; Lin, Chongde; Jiang, Lina

    2014-01-01

    Purpose To examine the associations between trauma severity, trait resilience, and posttraumatic stress disorder (PTSD) and depressive symptoms among adolescent survivors of the Wenchuan earthquake, China. Methods 788 participants were randomly selected from secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the earthquake. Participants completed four main questionnaires including the Child PTSD Symptom Scale, the Center for Epidemiologic Studies Depression Scale for Children, the Connor and Davidson’s Resilience Scale, and the Severity of Exposure to Earthquake Scale. Results After adjusting for the effect of age and gender, four aspects of trauma severity (i.e., direct exposure, indirect exposure, worry about others, and house damage) were positively associated with the severity of PTSD and depressive symptoms, whereas trait resilience was negatively associated with PTSD and depressive symptoms and moderated the relationship between subjective experience (i.e., worry about others) and PTSD and depressive symptoms. Conclusions Several aspects (i.e., direct exposure, indirect exposure, worry about others, and house damage) of earthquake experiences may be important risk factors for the development and maintenance of PTSD and depression. Additionally, trait resilience exhibits the beneficial impact on PTSD and depressive symptoms and buffers the effect of subjective experience (i.e., worry about others) on PTSD and depressive symptoms. PMID:24586751

  18. Differences in the Prevalence, Severity and Symptom Profiles of Depression in Boys and Adolescents with an Autism Spectrum Disorder versus Normally Developing Controls

    ERIC Educational Resources Information Center

    Bitsika, Vicki; Sharpley, Christopher F.

    2015-01-01

    The prevalence, severity and symptom profiles for major depressive disorder (MDD) were compared in samples of boys and adolescents with and without an autism spectrum disorder (ASD). Self-reports were obtained on the Depression subscale of the Child and Adolescent Symptoms Inventory (CASI-D) with 70 ASD and 50 non-ASD male participants between the…

  19. Physical health symptoms reported by trafficked women receiving post-trafficking support in Moldova: prevalence, severity and associated factors

    PubMed Central

    2012-01-01

    Background Many trafficked people suffer high levels of physical, sexual and psychological abuse. Yet, there has been limited research on the physical health problems associated with human trafficking or how the health needs of women in post-trafficking support settings vary according to socio-demographic or trafficking characteristics. Methods We analysed the prevalence and severity of 15 health symptoms reported by 120 trafficked women who had returned to Moldova between December 2007 and December 2008 and were registered with the International Organisation for Migration Assistance and Protection Programme. Women had returned to Moldova an average of 5.9 months prior to interview (range 2-12 months). Results Headaches (61.7%), stomach pain (60.9%), memory problems (44.2%), back pain (42.5%), loss of appetite (35%), and tooth pain (35%) were amongst the most commonly reported symptoms amongst both women trafficked for sexual exploitation and women trafficked for labour exploitation. The prevalence of headache and memory problems was strongly associated with duration of exploitation. Conclusions Trafficked women who register for post-trafficking support services after returning to their country of origin are likely to have long-term physical and dental health needs and should be provided with access to comprehensive medical services. Health problems among women who register for post-trafficking support services after returning to their country of origin are not limited to women trafficked for sexual exploitation but are also experienced by victims of labour exploitation. PMID:22834807

  20. Failure to use corollary discharge to remap visual target locations is associated with psychotic symptom severity in schizophrenia

    PubMed Central

    Rösler, Lara; Rolfs, Martin; van der Stigchel, Stefan; Neggers, Sebastiaan F. W.; Cahn, Wiepke; Kahn, René S.

    2015-01-01

    Corollary discharge (CD) refers to “copies” of motor signals sent to sensory areas, allowing prediction of future sensory states. They enable the putative mechanisms supporting the distinction between self-generated and externally generated sensations. Accordingly, many authors have suggested that disturbed CD engenders psychotic symptoms of schizophrenia, which are characterized by agency distortions. CD also supports perceived visual stability across saccadic eye movements and is used to predict the postsaccadic retinal coordinates of visual stimuli, a process called remapping. We tested whether schizophrenia patients (SZP) show remapping disturbances as evidenced by systematic transsaccadic mislocalizations of visual targets. SZP and healthy controls (HC) performed a task in which a saccadic target disappeared upon saccade initiation and, after a brief delay, reappeared at a horizontally displaced position. HC judged the direction of this displacement accurately, despite spatial errors in saccade landing site, indicating that their comparison of the actual to predicted postsaccadic target location relied on accurate CD. SZP performed worse and relied more on saccade landing site as a proxy for the presaccadic target, consistent with disturbed CD. This remapping failure was strongest in patients with more severe psychotic symptoms, consistent with the theoretical link between disturbed CD and phenomenological experiences in schizophrenia. PMID:26108951

  1. Association between severity of behavioral phenotype and comorbid attention deficit hyperactivity disorder symptoms in children with autism spectrum disorders.

    PubMed

    Rao, Patricia A; Landa, Rebecca J

    2014-04-01

    Autism spectrum disorder and attention deficit hyperactivity disorder are neurodevelopmental disorders that cannot be codiagnosed under existing diagnostic guidelines (Diagnostic and Statistical Manual of the American Psychiatric Association, 4th ed., text rev.). However, reports are emerging that attention deficit hyperactivity disorder is sometimes comorbid with autism spectrum disorder. In the current study, we examined rates of parent-reported clinically significant symptoms of attention deficit hyperactivity disorder in school-aged children (4-8 years) with autism spectrum disorder, most of whom were first enrolled in our research protocols as toddlers. Results revealed that children with autism spectrum disorder and attention deficit hyperactivity disorder had lower cognitive functioning, more severe social impairment, and greater delays in adaptive functioning than children with autism spectrum disorder only. Implications for clinical practice include the need to assess for attention deficit hyperactivity disorder symptoms at an early age in children diagnosed with autism spectrum disorder. Research is needed to determine efficacious interventions for young children with autism spectrum disorder with comorbid attention deficit hyperactivity disorder to optimize outcomes.

  2. Impact of cognitive behavioral therapy on observed autism symptom severity during school recess: a preliminary randomized, controlled trial.

    PubMed

    Wood, Jeffrey J; Fujii, Cori; Renno, Patricia; Van Dyke, Marilyn

    2014-09-01

    This study compared cognitive behavioral therapy (CBT) and treatment-as-usual (TAU) in terms of effects on observed social communication-related autism symptom severity during unstructured play time at school for children with autism spectrum disorders (ASD). Thirteen children with ASD (7-11 years old) were randomly assigned to 32 sessions of CBT or community-based psychosocial treatment (TAU) for 16 weeks. The CBT program is based on the memory retrieval competition model and emphasizes the development of perspective-taking through guided behavioral experimentation supplemented with reflective Socratic discussion and supported by parent training and school consultation to promote generalization of social communication and emotion regulation skills. Trained observers blind to treatment condition observed each child during recess on two separate days at baseline and again at posttreatment, using a structured behavioral observation system that generates frequency scores for observed social communication-related autism symptoms. CBT outperformed TAU at posttreatment on the frequency of self-isolation, the proportion of time spent with peers, the frequency of positive or appropriate interaction with peers, and the frequency of positive or appropriate peer responses to the target child (d effect size range 1.34-1.62). On average, children in CBT were engaged in positive or appropriate social interaction with peers in 68.6% of observed intervals at posttreatment, compared to 25% of intervals for children in TAU. Further investigation of this intervention modality with larger samples and follow-up assessments is warranted. PMID:24671750

  3. Can impairment in memory, language and executive functions predict neuropsychiatric symptoms in Alzheimer's disease (AD)? Findings from a cross-sectional study.

    PubMed

    García-Alberca, José María; Lara, José Pablo; Berthier, Marcelo Luis; Cruz, Belén; Barbancho, Miguel Ángel; Green, Cristina; González-Barón, Salvador

    2011-01-01

    The authors performed a cross-sectional study to examine the relationship between specific cognitive domains and behavioral and psychological symptoms in dementia (BPSD) in 125 patients with probable AD. Cognitive deficits were evaluated with the mini mental state examination (MMSE), trail-making test (TMT), Rey auditory verbal learning test (RAVLT), and semantic fluency test (SFT) and phonemic fluency test (PhFT), whereas the neuropsychiatric inventory (NPI) was used to rate BPSD. Patients' performance in cognitive tests significantly correlated with total NPI scores (p<0.0001). After controlling for demographic and clinical characteristics, cognitive impairments in memory, executive function, and language (RAVLT, TMT, PhFT, SFT) importantly estimated total NPI scores (p<0.001, multivariate regression models). These findings suggest that the evaluation of cognitive domains may have a predictive value for the occurrence of BPSD.

  4. Dizziness symptom severity and impact on daily living as perceived by patients suffering from peripheral vestibular disorder.

    PubMed

    Mendel, B; Bergenius, J; Langius, A

    1999-08-01

    The purpose of this study was to describe quality-of-life aspects in a group of patients (n = 99) suffering from peripheral vestibular disorder, using three different self-rated instruments, the Vertigo Symptom Scale (VSS), the Vertigo Handicap Questionnaire (VHQ) and the Sickness Impact Profile (SIP). The results showed that the type of dizziness that most influenced the quality-of-life aspects were: frequent short- or long-term dizziness, nausea, and the feeling that the ground was distant or as though the patient were walking on clouds. However, several of the impairments in daily life were neither related to the disease itself nor the demographic data. This verifies the necessity of investigating other factors such as personality and coping capacity. The results of this study also demonstrate the patients' need of psychosocial support. A comprehensive assessment and evaluation is important in order to identify each patient's needs.

  5. Effect of cigarette smoke from the mother on bronchial responsiveness and severity of symptoms in children with asthma

    SciTech Connect

    Murray, A.B.; Morrison, B.J.

    1986-04-01

    The effect of parental smoking was assessed in 94 consecutively observed children, aged 7 to 17 years, who had a history of asthmatic wheezing. The 24 children whose mothers smoked, when they were compared with children whose mothers did not smoke, had 47% more symptoms, a 13% lower mean FEV1 percent, a 23% lower mean FEF25-75%, and fourfold greater responsiveness to aerosolized histamine. A dose response was evident. There was a highly significant correlation between the results of the tests and the number of cigarettes the mother smoked while she was in the house. The differences between the children of smoking and nonsmoking mothers were greater in older than in younger subjects. The smoking habits of the father were not correlated with the severity of the child's asthma.

  6. Severity of Lyme disease with persistent symptoms. Insights from a double-blind placebo-controlled clinical trial.

    PubMed

    Cameron, D

    2008-10-01

    Lyme disease is a global health concern and is the world's leading tick borne infection caused by the spirochete, Borrelia burgdorferi, that has been associated with numerous neurologic, rheumatologic and psychiatric manifestations. The symptoms of Lyme disease have been characterized as either severe or ''related to the aches and pains of daily living.'' A randomized double-blind, placebo-controlled clinical trial (RCT) was conducted in a primary internal medicine practice in Westchester County, New York, USA. A total of 84 adults with Lyme disease with persistent symptoms (LDPS) were studied; 52 received amoxicillin and 34 received placebo. The subjects received either placebo or amoxicillin 3 g per day orally for 3 months. The SF-36 was used as the outcome measure of the patient's perceived Quality of Life (QOL). For subjects enrolling in this RCT, the average SF-36 physical component summary (PCS) of QOL (40+/-9, range 29-44) and mental component summary (MCS) of QOL (39+/-14, range 23-46) were worse than the general USA population and worse than individuals with diabetes, heart disease, depression, osteoarthritis or rheumatoid arthritis. The improvements in the SF-36 measure of QOL for subjects randomized to amoxicillin vs. placebo was significant (46% vs 18%, P=0.007). It is important for clinicians to be aware that LDPS can be severe. A significant gain in the QOL for subjects randomized to amoxicillin in this RCT without serious adverse events is consistent with the goal of improving patient's QOL and consequently worthy of further study. PMID:18971914

  7. Initial Severity Effects on Residual Symptoms in Response and Remission: A STAR*D Study During and After Failed Citalopram Treatment.

    PubMed

    Madhoo, Manisha; Levine, Stephen Z

    2015-08-01

    The effects of initial severity on the time to and course of residual symptoms based on response or remission periods, and during and after failed response to citalopram in major depressive disorder are unknown. STAR*D data during and after failed citalopram treatment were reanalyzed to examine the effect of initial severity on the time to and course of residual symptoms using the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR). During and after failed citalopram treatment, Cox regression and Generalized Estimating Equation models were computed to examine mild and moderate residual symptoms during (1) response based on at least a 50% QIDS-SR reduction, as well as (2) remission based on a QIDS-SR score below 6. Generally, initial severity significantly (P < 0.05) increased the time to and course of residual symptoms at the time of response and remission. The course of select mild and moderate residual symptoms was significantly (P < 0.05) more likely to persist in the presence of initial severity during response than remission (eg, energy) across treatment levels. It is concluded that initial severity is a predictor of the time to and course of residual symptoms. The presence of residual symptoms is more likely during response than remission, thereby directing their definition as a treatment target. PMID:26066336

  8. PTSD Symptom Severities, Interpersonal Traumas, and Benzodiazepines Are Associated with Substance-Related Problems in Trauma Patients

    PubMed Central

    Guina, Jeffrey; Nahhas, Ramzi W.; Goldberg, Adam J.; Farnsworth, Seth

    2016-01-01

    Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors were significantly associated with substance-related problems, particularly benzodiazepines (AOR = 2.78; 1.99 for alcohol, 2.42 for tobacco, 8.02 for illicit drugs), DSM-5 PTSD diagnosis (AOR = 1.92; 2.38 for alcohol, 2.00 for tobacco, 2.14 for illicit drugs), most PTSSs (especially negative beliefs, recklessness, and avoidance), and interpersonal traumas (e.g., assaults and child abuse). Conclusion: In this clinical sample, there were consistent and strong associations between several trauma-related variables and substance-related problems, consistent with our hypotheses. We discuss possible explanations and implications of these findings, which we hope will stimulate further research, and improve screening and treatment. PMID:27517964

  9. The association of pain severity and pain interference levels with abuse experiences and mental health symptoms among 300 mothers: baseline data analysis for a 7-year prospective study.

    PubMed

    Symes, Lene; McFarlane, Judith; Nava, Angeles; Gilroy, Heidi; Maddoux, John

    2013-01-01

    Women who experience interpersonal violence are at increased risk for anxiety, depression, posttraumatic stress symptoms, and chronic pain and other physical disorders. Although the effects of mental health disorders on women's functioning and well-being are well established, less is known about the effects of pain. We examined participants' (n = 300 mothers) experiences of pain severity and pain interference. Higher levels of pain severity and pain interference were significantly associated with anxiety, PTSD, and depression symptoms. Mental health symptoms compounded by pain, may leave abused women less able to access resources or practice safety behaviors to protect themselves and their children. PMID:23301564

  10. A Prospective Investigation of Emotion Dysregulation as a Moderator of the Relation between Posttraumatic Stress Symptoms and Substance Use Severity

    PubMed Central

    Tull, Matthew T.; Bardeen, Joseph R.; DiLillo, David; Messman-Moore, Terri; Gratz, Kim L.

    2014-01-01

    Despite strong evidence for an association between the experience of posttraumatic stress (PTS) symptoms and substance use, little is known about the particular individuals most at-risk for problematic substance use in response to PTS symptoms. Consequently, the goal of this study was to conduct a prospective investigation of the moderating role of emotion dysregulation (assessed through self-report and behavioral measures) in the relation between PTS symptoms and substance use 8-months later within a sample of 106 young adult women. No main effect of PTS symptoms on substance use was found. Instead, PTS symptoms were only associated with later substance use in the context of heightened emotion dysregulation. Results provide support for emotion dysregulation as a key factor that may increase risk for substance use among women experiencing PTS symptoms and highlight a target for future interventions aimed at reducing risk for the development of maladaptive behaviors stemming from PTS symptoms. PMID:25483275

  11. A Comparison of Symptom Severity and Bolus Retention to Chicago Classification Esophageal Pressure Topography Metrics in Patients with Achalasia

    PubMed Central

    Nicodème, Frédéric; de Ruigh, Annemijn; Xiao, Yinglian; Rajeswaran, Shankar; Teitelbaum, Ezra N.; Hungness, Eric S.; Kahrilas, Peter J.; Pandolfino, John E.

    2012-01-01

    Background & Aims We compared findings from timed barium esophagrams (TBEs) and esophageal pressure topography (EPT) studies among achalasia subtypes and in relation to symptom severity. Method We analyzed data from 50 patients with achalasia (31 male, 20–79 years old) who underwent high-resolution manometry (HRM), had TBE following a 200ml barium swallow, and completed questionnaires that determine Eckardt Scores (ES). Twenty-five were not treated and 25 were treated (11 by pneumatic dilation, 14 by myotomy). Non-parametric testing was used to assess differences among groups of treated patients (10 had type-1 achalasia and 15 had type-2 achalasia), and the Pearson correlation was used to assess their relationship. Results There were no significant differences in TBE measurements between patient groups. Of the 25 patients who received treatment, 10 had a manometric pattern consistent with persistent achalasia after treatment (6 with type 1 and 4 with type 2 achalasia), whereas 15 appeared to have resolved the achalasia pattern (peristalsis was absent in 8 and weak in 7). The height of the barium column at 5 minutes and ES were significantly reduced in patients that had resolved their achalasia pattern, based on HRM. The integrated relaxation pressure (IRP) and the TBE column height correlated at 5 minutes (r=0.422; p<0.05). Discussion Patients that resolve their achalasia pattern, based on HRM, demonstrated improved emptying based on TBE measurements and improved symptom scores. There was no significant difference between patients with type-1 or 2 achalasia in TBEs. These findings indicate that normalization of the IRP on HRM is a clinically relevant objective of treatment for achalasia. PMID:23078890

  12. Psychological Dysfunction Is Associated With Symptom Severity but Not Disease Etiology or Degree of Gastric Retention in Patients With Gastroparesis

    PubMed Central

    Hasler, William L.; Parkman, Henry P.; Wilson, Laura A.; Pasricha, Pankaj J.; Koch, Kenneth L.; Abell, Thomas L.; Snape, William J.; Farrugia, Gianrico; Lee, Linda; Tonascia, James; Unalp-Arida, Aynur; Hamilton, Frank

    2011-01-01

    OBJECTIVES Gastroparesis patients may have associated psychological distress. This study aimed to measure depression and anxiety in gastroparesis in relation to disease severity, etiology, and gastric retention. METHODS Beck Depression Inventory (BDI) and State–Trait Anxiety Inventory (STAI) scores for state (Y1) and trait (Y2) anxiety were obtained from 299 gastroparesis patients from 6 centers of the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium. Severity was investigator graded as grades 1, 2, or 3 and patient reported by Gastroparesis Cardinal Symptom Index (GCSI) scores. Antiemetic/prokinetic medication use, anxiolytic and antidepressant medication use, supplemental feedings, and hospitalizations were recorded. BDI, Y1, and Y2 scores were compared in diabetic vs. idiopathic etiologies and mild (≤20%) vs. moderate (>20–35%) vs. severe (>35–50%) vs. very severe (>50%) gastric retention at 4h. RESULTS BDI, Y1, and Y2 scores were greater with increasing degrees of investigator-rated gastroparesis severity (P<0.05). BDI, Y1, and Y2 scores were higher for GCSI >3.1 vs. π3.1 (P<0.05). Antiemetic and prokinetic use and ≥6 hospitalizations/year were more common with BDI ≥20 vs. <20 (P<0.05). Anxiolytic use was more common with Y1 ≥46; antidepressant use and ≥6 hospitalizations/year were more common with Y2 ≥44 (P<0.05). BDI, Y1, and Y2 scores were not different in diabetic and idiopathic gastroparesis and did not relate to degree of gastric retention. On logistic regression, GCSI >3.1 was associated with BDI ≥20 and Y1 ≥46; antiemetic/prokinetic use was associated with BDI ≥20; anxiolytic use was associated with Y1 ≥46; and antidepressant use was associated with Y2 ≥44. CONCLUSIONS Higher depression and anxiety scores are associated with gastroparesis severity on investigator- and patient-reported assessments. Psychological dysfunction does not vary by etiology or degree of

  13. A longitudinal study of several potential mediators of the relationship between child maltreatment and posttraumatic stress disorder symptoms.

    PubMed

    Shenk, Chad E; Putnam, Frank W; Rausch, Joseph R; Peugh, James L; Noll, Jennie G

    2014-02-01

    Child maltreatment is a reliable predictor of posttraumatic stress disorder (PTSD) symptoms. However, not all maltreated children develop PTSD symptoms, suggesting that additional mediating variables explain how certain maltreated children develop PTSD symptoms and others do not. The current study tested three potential mediators of the relationship between child maltreatment and subsequent PTSD symptoms: (a) respiratory sinus arrhythmia reactivity, (b) cortisol reactivity, and (c) experiential avoidance, or the unwillingness to experience painful private events, such as thoughts and memories. Maltreated (n = 51) and nonmaltreated groups (n = 59) completed a stressor paradigm, a measure of experiential avoidance, and a semistructured interview of PTSD symptoms. One year later, participants were readministered the PTSD symptoms interview. Results of a multiple mediator model showed the set of potential mediators mediated the relationship between child maltreatment and subsequent PTSD symptoms. However, experiential avoidance was the only significant, specific indirect effect, demonstrating that maltreated children avoiding painful private events after the abuse were more likely to develop a range of PTSD symptoms 1 year later. These results highlight the importance of experiential avoidance in the development of PTSD symptoms for maltreated children, and implications for secondary prevention and clinical intervention models are discussed. PMID:24444173

  14. Alcohol use severity and depressive symptoms among late adolescent Hispanics: Testing associations of acculturation and enculturation in a bicultural transaction model.

    PubMed

    Cano, Miguel Ángel; de Dios, Marcel A; Castro, Yessenia; Vaughan, Ellen L; Castillo, Linda G; Lorenzo-Blanco, Elma I; Piña-Watson, Brandy; Berger Cardoso, Jodi; Ojeda, Lizette; Cruz, Rick A; Correa-Fernandez, Virmarie; Ibañez, Gladys; Auf, Rehab; Molleda, Lourdes M

    2015-10-01

    Research has indicated that Hispanics have high rates of heavy drinking and depressive symptoms during late adolescence. The purpose of this study was to test a bicultural transaction model composed of two enthnocultural orientations (acculturation and enculturation); and stressful cultural transactions with both the U.S. culture (perceived ethnic discrimination) and Hispanic culture (perceived intragroup marginalization) to predict alcohol use severity and depressive symptoms among a sample of 129 (men=39, women=90) late adolescent Hispanics (ages 18-21) enrolled in college. Results from a path analysis indicated that the model accounted for 18.2% of the variance in alcohol use severity and 24.3% of the variance in depressive symptoms. None of the acculturation or enculturation domains had statistically significant direct effects with alcohol use severity or depressive symptoms. However, higher reports of ethnic discrimination were associated with higher reports of alcohol use severity and depressive symptoms. Similarly, higher reports of intragroup marginalization were associated with higher depressive symptoms. Further, both ethnic discrimination and intragroup marginalization functioned as mediators of multiple domains of acculturation and enculturation. These findings highlight the need to consider the indirect effects of enthnocultural orientations in relation to health-related outcomes. PMID:26092776

  15. Alcohol use severity and depressive symptoms among late adolescent Hispanics: Testing associations of acculturation and enculturation in a bicultural transaction model.

    PubMed

    Cano, Miguel Ángel; de Dios, Marcel A; Castro, Yessenia; Vaughan, Ellen L; Castillo, Linda G; Lorenzo-Blanco, Elma I; Piña-Watson, Brandy; Berger Cardoso, Jodi; Ojeda, Lizette; Cruz, Rick A; Correa-Fernandez, Virmarie; Ibañez, Gladys; Auf, Rehab; Molleda, Lourdes M

    2015-10-01

    Research has indicated that Hispanics have high rates of heavy drinking and depressive symptoms during late adolescence. The purpose of this study was to test a bicultural transaction model composed of two enthnocultural orientations (acculturation and enculturation); and stressful cultural transactions with both the U.S. culture (perceived ethnic discrimination) and Hispanic culture (perceived intragroup marginalization) to predict alcohol use severity and depressive symptoms among a sample of 129 (men=39, women=90) late adolescent Hispanics (ages 18-21) enrolled in college. Results from a path analysis indicated that the model accounted for 18.2% of the variance in alcohol use severity and 24.3% of the variance in depressive symptoms. None of the acculturation or enculturation domains had statistically significant direct effects with alcohol use severity or depressive symptoms. However, higher reports of ethnic discrimination were associated with higher reports of alcohol use severity and depressive symptoms. Similarly, higher reports of intragroup marginalization were associated with higher depressive symptoms. Further, both ethnic discrimination and intragroup marginalization functioned as mediators of multiple domains of acculturation and enculturation. These findings highlight the need to consider the indirect effects of enthnocultural orientations in relation to health-related outcomes.

  16. White matter volume change and its correlation with symptom severity in patients with schizophrenia: a VBM-DARTEL study.

    PubMed

    Kim, Gwang-Won; Jeong, Gwang-Woo

    2015-12-16

    The aim of this study was to evaluate the white matter (WM) volume change and its correlation with symptom severity in patients with schizophrenia using voxel-based morphometry. A total of 20 patients with schizophrenia and 20 age-matched healthy controls participated in this study. MR image data were processed using SPM8 software with diffeomorphic anatomical registration through an exponentiated Lie algebra (DARTEL) algorithm. The patients with schizophrenia showed significant decreases (P=0.042) in the WM volumes of the temporal lobe and superior frontal gyrus compared with the healthy controls. The WM volumes of the middle temporal gyrus were negatively correlated with the scores of both the Positive Subscale (Pearson's ρ=-0.68, P=0.001) and the Negative Subscale (ρ=-0.71, P=0.0005) in the Positive and Negative Syndrome Scale. In addition, the scores of the General Psychopathology Subscale were negatively correlated with the WM volumes of the superior frontal gyrus (ρ=-0.68, P=0.0009). This study evaluated the WM volume of patients with schizophrenia compared with healthy controls using DARTEI-based voxel-based morphometry and also assessed the correlation of the localized WM volume changes with the Positive and Negative Syndrome Scale. These findings will be useful to understand the neuropathology associated with WM abnormality in schizophrenia. PMID:26485094

  17. Nonlinear speech analysis algorithms mapped to a standard metric achieve clinically useful quantification of average Parkinson's disease symptom severity

    PubMed Central

    Tsanas, Athanasios; Little, Max A.; McSharry, Patrick E.; Ramig, Lorraine O.

    2011-01-01

    The standard reference clinical score quantifying average Parkinson's disease (PD) symptom severity is the Unified Parkinson's Disease Rating Scale (UPDRS). At present, UPDRS is determined by the subjective clinical evaluation of the patient's ability to adequately cope with a range of tasks. In this study, we extend recent findings that UPDRS can be objectively assessed to clinically useful accuracy using simple, self-administered speech tests, without requiring the patient's physical presence in the clinic. We apply a wide range of known speech signal processing algorithms to a large database (approx. 6000 recordings from 42 PD patients, recruited to a six-month, multi-centre trial) and propose a number of novel, nonlinear signal processing algorithms which reveal pathological characteristics in PD more accurately than existing approaches. Robust feature selection algorithms select the optimal subset of these algorithms, which is fed into non-parametric regression and classification algorithms, mapping the signal processing algorithm outputs to UPDRS. We demonstrate rapid, accurate replication of the UPDRS assessment with clinically useful accuracy (about 2 UPDRS points difference from the clinicians' estimates, p < 0.001). This study supports the viability of frequent, remote, cost-effective, objective, accurate UPDRS telemonitoring based on self-administered speech tests. This technology could facilitate large-scale clinical trials into novel PD treatments. PMID:21084338

  18. Patient satisfaction with treatment for alcohol use disorders: comparing patients with and without severe mental health symptoms

    PubMed Central

    McCallum, Stacey L; Andrews, Jane M; Gaughwin, Matthew D; Turnbull, Deborah A; Mikocka-Walus, Antonina A

    2016-01-01

    Background Previous studies suggest patients with co-occurring alcohol use disorders (AUDs) and severe mental health symptoms (SMHS) are less satisfied with standard AUD treatment when compared to patients with an AUD alone. This study compared patient satisfaction with standard AUD treatment among patients with and without SMHS and explored how standard treatment might be improved to better address the needs of these patients. Methods Eighty-nine patients receiving treatment for an AUD either at an inpatient hospital, outpatient clinic, inpatient detoxification, or residential/therapeutic community services were surveyed. Patient satisfaction with treatment was assessed using the Treatment Perception Questionnaire (range: 0–40). Patients were stratified according to their score on the Depression Anxiety Stress Scale. Forty patients scored in the extremely severe range of depression (score >14) and/or anxiety (score >10) (indicating SMHS) and 49 patients did not. An inductive content analysis was also conducted on qualitative data relating to areas of service improvement. Results Patients with SMHS were found to be equally satisfied with treatment (mean =25.10, standard deviation =8.12) as patients with an AUD alone (mean =25.43, standard deviation =6.91). Analysis revealed that being an inpatient in hospital was associated with reduced treatment satisfaction. Patients with SMHS were found to be significantly less satisfied with staffs’ understanding of the type of help they wanted in treatment, when compared to patients with AUDs alone. Five areas for service improvement were identified, including staff qualities, informed care, treatment access and continuity, issues relating to inpatient stay, and addressing patients’ mental health needs. Conclusion While findings suggest that AUD treatment services adequately meet the needs of patients with SMHS in treatment, patients with SMHS do feel that staff lack understanding of their treatment needs. Findings have

  19. Main and Interactive Effects of a Nonclinical Panic Attack History and Distress Tolerance in Relation to PTSD Symptom Severity

    PubMed Central

    Marshall-Berenz, Erin C.; Vujanovic, Anka A.; Zvolensky, Michael J.

    2010-01-01

    The current study investigated the main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptoms. The sample consisted of 91 adults (62.6% women; Mage = 23.45, SD = 9.56) who met DSM-IV criteria for trauma exposure, 53.8% of whom met criteria for a recent (past two years) history of nonclinical panic attacks. Results indicated that distress tolerance, as measured by the Distress Tolerance Scale (Simons & Gaher, 2005), was significantly related to all PTSD symptom clusters, and a nonclinical panic attack history was significantly related to PTSD re-experiencing and hyperarousal symptoms. The interaction of a nonclinical panic attack history and distress tolerance significantly predicted unique variance in only PTSD hyperarousal symptoms. Implications and future directions are discussed for the role of nonclinical panic attacks and distress tolerance in PTSD symptom expression. PMID:20888732

  20. Measuring the prevalence of current, severe symptoms of mental health problems in a canadian correctional population: implications for delivery of mental health services for inmates.

    PubMed

    Brown, Gregory P; Hirdes, John P; Fries, Brant E

    2015-01-01

    This study measured the prevalence of current, severe symptoms of a mental health problem in an adult population of inmates in Ontario, Canada. The Resident Assessment Instrument-Mental Health was used to measure the prevalence of symptoms among a sample of 522 inmates. Propensity score weighting was used to adjust for nonrandom selection into the sample. Prevalence estimates were derived for the total inmate population, remand and sentenced, males and females, and Aboriginal and non-Aboriginal inmates. It is estimated that 41.1% of Ontario inmates will have at least one current, severe symptom of a mental health problem; of this group, 13.0%, will evidence two or more symptoms. The number of symptoms is strongly associated with presence of a psychiatric diagnosis and level of mental health care needs. Female (35.1%) and Aboriginal (18.7%) inmates are more likely to demonstrate two or more current, severe symptoms. Greater efforts must be made to bridge the gap between correctional and mental health care systems to ensure inmates in correctional facilities can access and receive appropriate mental health care services.

  1. Cross-sectional study of the severity of self-reported depressive symptoms in heroin users who participate in a methadone maintenance treatment program

    PubMed Central

    WU, Yafei; YAN, Shiyan; BAO, Yanping; LIAN, Zhi; QU, Zhi; LIU, Zhimin

    2016-01-01

    Background Methadone maintenance treatment (MMT) is widely recognized as an effective method of combatting narcotic addiction. MMT reduces heroin withdrawal symptoms and, thus, makes it possible to provide the psychological and social support that is essential to the rehabilitation of drug users. Aim Compare the severity of depressive symptoms in heroin users who are currently receiving MMT to that of heroin users who are not receiving MMT. Methods We administered the 13-item version of the Beck Depression Inventory (BDI-13) and a demographic history form to 929 heroin users who had been receiving MMT at nine methadone treatment clinics in three Chinese cities for an average of 9 months and to 238 heroin users who had enrolled in a MMT program at the centers but had not yet begun MMT. Results Seventy-nine percent (188/238) of the untreated individuals reported depressive symptoms compared to 68% (628/929) of the individuals receiving MMT (χ2=11.69, p<0.001). The median (interquartile range) BDI score in the untreated group was 10.4 (7.9-11.4) compared to 8.0 (5.7-11.6) in the MMT group (Z=2.75, p=0.006). In the MMT group, there was a negative correlation between the severity of reported depressive symptoms and the duration of participation in the MMT program (rs=-0.24, Z=2.88, p=0.004). Multivariate linear regression analysis showed that after adjusting for all demographic variables the treated group still had less severe depressive symptoms than the untreated group. After adjusting for the effect of MMT treatment, depressive symptoms were more severe in heroin users who self-reported poor family relationships (standardized regression coefficient β=0.118, t=6.56, p<0.001) and in those who were divorced (β=0.120, t=3.73, p<0.001). Conclusions Moderate to severe depressive symptoms are common in heroin users. MMT is associated with lower levels of depressive symptoms in heroin users, but prospective randomized controlled trials are needed to determine whether or

  2. Cross-sectional study of the severity of self-reported depressive symptoms in heroin users who participate in a methadone maintenance treatment program

    PubMed Central

    WU, Yafei; YAN, Shiyan; BAO, Yanping; LIAN, Zhi; QU, Zhi; LIU, Zhimin

    2016-01-01

    Background Methadone maintenance treatment (MMT) is widely recognized as an effective method of combatting narcotic addiction. MMT reduces heroin withdrawal symptoms and, thus, makes it possible to provide the psychological and social support that is essential to the rehabilitation of drug users. Aim Compare the severity of depressive symptoms in heroin users who are currently receiving MMT to that of heroin users who are not receiving MMT. Methods We administered the 13-item version of the Beck Depression Inventory (BDI-13) and a demographic history form to 929 heroin users who had been receiving MMT at nine methadone treatment clinics in three Chinese cities for an average of 9 months and to 238 heroin users who had enrolled in a MMT program at the centers but had not yet begun MMT. Results Seventy-nine percent (188/238) of the untreated individuals reported depressive symptoms compared to 68% (628/929) of the individuals receiving MMT (χ2=11.69, p<0.001). The median (interquartile range) BDI score in the untreated group was 10.4 (7.9-11.4) compared to 8.0 (5.7-11.6) in the MMT group (Z=2.75, p=0.006). In the MMT group, there was a negative correlation between the severity of reported depressive symptoms and the duration of participation in the MMT program (rs=-0.24, Z=2.88, p=0.004). Multivariate linear regression analysis showed that after adjusting for all demographic variables the treated group still had less severe depressive symptoms than the untreated group. After adjusting for the effect of MMT treatment, depressive symptoms were more severe in heroin users who self-reported poor family relationships (standardized regression coefficient β=0.118, t=6.56, p<0.001) and in those who were divorced (β=0.120, t=3.73, p<0.001). Conclusions Moderate to severe depressive symptoms are common in heroin users. MMT is associated with lower levels of depressive symptoms in heroin users, but prospective randomized controlled trials are needed to determine whether or

  3. Self-Compassion as a Prospective Predictor of PTSD Symptom Severity Among Trauma-Exposed U.S. Iraq and Afghanistan War Veterans

    PubMed Central

    Hiraoka, Regina; Meyer, Eric C.; Kimbrel, Nathan A.; DeBeer, Bryann B.; Gulliver, Suzy Bird; Morissette, Sandra B.

    2016-01-01

    U. S. combat veterans of the Iraq and Afghanistan wars have elevated rates of posttraumatic stress disorder (PTSD) compared to the general population. Self-compassion, characterized by self-kindness, a sense of common humanity when faced with suffering, and mindful awareness of suffering, is a potentially modifiable factor implicated in the development and maintenance of PTSD. We examined the concurrent and prospective relationship between self-compassion and PTSD symptom severity after accounting for level of combat exposure and baseline PTSD severity. Participants at baseline assessment were 115 Iraq and Afghanistan war veterans exposed to 1 or more traumatic events during deployment (n = 101 at follow-up). PTSD symptoms were assessed using the Clinician Administered PTSD Scale for DSM-IV at baseline and 12 months. Self-compassion and combat exposure were assessed at baseline via self-report. Self-compassion was associated with baseline PTSD symptoms after accounting for combat exposure (β = −.59; p < .001; ΔR2 = .34; f2 = .67; large effect) and predicted 12-month PTSD symptom severity after accounting for combat exposure and baseline PTSD severity (β = −.24; p = .008; ΔR2 = .03; f2 = .08; small effect). Findings suggest that interventions that increase self-compassion may be beneficial for treating chronic PTSD symptoms among some Iraq and Afghanistan war veterans. PMID:25808565

  4. Self-Compassion as a prospective predictor of PTSD symptom severity among trauma-exposed U.S. Iraq and Afghanistan war veterans.

    PubMed

    Hiraoka, Regina; Meyer, Eric C; Kimbrel, Nathan A; DeBeer, Bryann B; Gulliver, Suzy Bird; Morissette, Sandra B

    2015-04-01

    U.S. combat veterans of the Iraq and Afghanistan wars have elevated rates of posttraumatic stress disorder (PTSD) compared to the general population. Self-compassion, characterized by self-kindness, a sense of common humanity when faced with suffering, and mindful awareness of suffering, is a potentially modifiable factor implicated in the development and maintenance of PTSD. We examined the concurrent and prospective relationship between self-compassion and PTSD symptom severity after accounting for level of combat exposure and baseline PTSD severity in 115 Iraq and Afghanistan war veterans exposed to 1 or more traumatic events during deployment. PTSD symptoms were assessed using the Clinician Administered PTSD Scale for DSM-IV (CAPS-IV) at baseline and 12 months (n =101). Self-compassion and combat exposure were assessed at baseline via self-report. Self-compassion was associated with baseline PTSD symptoms after accounting for combat exposure (β = -.59; p < .001; ΔR(2) = .34; f(2) = .67; large effect) and predicted 12-month PTSD symptom severity after accounting for combat exposure and baseline PTSD severity (β = -.24; p = .008; ΔR(2) = .03; f(2) = .08; small effect). Findings suggest that interventions that increase self-compassion may be beneficial for treating chronic PTSD symptoms among some Iraq and Afghanistan war veterans.

  5. Serum SNTF Increases in Concussed Professional Ice Hockey Players and Relates to the Severity of Postconcussion Symptoms

    PubMed Central

    Shahim, Pashtun; Tegner, Yelverton; Blennow, Kaj; Zetterberg, Henrik; Smith, Douglas H.

    2015-01-01

    Abstract Biomarkers for diffuse axonal injury could have utilities for the acute diagnosis and clinical care of concussion, including those related to sports. The calpain-derived αII-spectrin N-terminal fragment (SNTF) accumulates in axons after traumatic injury and increases in human blood after mild traumatic brain injury (mTBI) in relation to white matter abnormalities and persistent cognitive dysfunction. However, SNTF has never been evaluated as a biomarker for sports-related concussion. Here, we conducted longitudinal analysis of serum SNTF in professional ice hockey players, 28 of whom had a concussion, along with 45 players evaluated during the preseason, 17 of whom were also tested after a concussion-free training game. Compared with preseason levels, serum SNTF increased at 1 h after concussion and remained significantly elevated from 12 h to 6 days, before declining to preseason baseline. In contrast, serum SNTF levels were unchanged after training. In 8 players, postconcussion symptoms resolved within a few days, and in these cases serum SNTF levels were at baseline. On the other hand, for the 20 players withheld from play for 6 days or longer, serum SNTF levels rose from 1 h to 6 days postconcussion, and at 12–36 h differed significantly from the less-severe concussions (p=0.004). Serum SNTF exhibited diagnostic accuracy for concussion, especially so with delayed return to play (area under the curve=0.87). Multi-variate analyses of serum SNTF and tau improved the diagnostic accuracy, the relationship with the delay in return to play, and the temporal window beyond tau alone. These results provide evidence that blood SNTF, a biomarker for axonal injury after mTBI, may be useful for diagnosis and prognosis of sports-related concussion, as well as for guiding neurobiologically informed decisions on return to play. PMID:25419578

  6. Serum SNTF Increases in Concussed Professional Ice Hockey Players and Relates to the Severity of Postconcussion Symptoms.

    PubMed

    Siman, Robert; Shahim, Pashtun; Tegner, Yelverton; Blennow, Kaj; Zetterberg, Henrik; Smith, Douglas H

    2015-09-01

    Biomarkers for diffuse axonal injury could have utilities for the acute diagnosis and clinical care of concussion, including those related to sports. The calpain-derived αII-spectrin N-terminal fragment (SNTF) accumulates in axons after traumatic injury and increases in human blood after mild traumatic brain injury (mTBI) in relation to white matter abnormalities and persistent cognitive dysfunction. However, SNTF has never been evaluated as a biomarker for sports-related concussion. Here, we conducted longitudinal analysis of serum SNTF in professional ice hockey players, 28 of whom had a concussion, along with 45 players evaluated during the preseason, 17 of whom were also tested after a concussion-free training game. Compared with preseason levels, serum SNTF increased at 1 h after concussion and remained significantly elevated from 12 h to 6 days, before declining to preseason baseline. In contrast, serum SNTF levels were unchanged after training. In 8 players, postconcussion symptoms resolved within a few days, and in these cases serum SNTF levels were at baseline. On the other hand, for the 20 players withheld from play for 6 days or longer, serum SNTF levels rose from 1 h to 6 days postconcussion, and at 12-36 h differed significantly from the less-severe concussions (p=0.004). Serum SNTF exhibited diagnostic accuracy for concussion, especially so with delayed return to play (area under the curve=0.87). Multi-variate analyses of serum SNTF and tau improved the diagnostic accuracy, the relationship with the delay in return to play, and the temporal window beyond tau alone. These results provide evidence that blood SNTF, a biomarker for axonal injury after mTBI, may be useful for diagnosis and prognosis of sports-related concussion, as well as for guiding neurobiologically informed decisions on return to play. PMID:25419578

  7. Altered inflammatory activity associated with reduced hippocampal volume and more severe posttraumatic stress symptoms in Gulf War veterans

    PubMed Central

    O’Donovan, Aoife; Chao, Linda L.; Paulson, Jennifer; Samuelson, Kristin W.; Shigenaga, Judy K.; Grunfeld, Carl; Weiner, Mike W.; Neylan, Thomas C.

    2014-01-01

    SUMMARY Background Inflammation may reduce hippocampal volume by blocking neurogenesis and promoting neurodegeneration. Posttraumatic stress disorder (PTSD) has been linked with both elevated inflammation and reduced hippocampal volume. However, few studies have examined associations between inflammatory markers and hippocampal volume, and none have examined these associations in the context of PTSD. Methods We measured levels of the inflammatory markers interleukin-6 (IL-6) and soluble receptor II for tumor necrosis factor (sTNF-RII) as well as hippocampal volume in 246 Gulf War veterans with and without current and past PTSD as assessed with the Clinician Administered PTSD Scale (CAPS). Enzyme-linked immunosorbent assays were used to measure inflammatory markers, and 1.5 Tesla magnetic resonance imaging (MRI) and Freesurfer version 4.5 were used to quantify hippocampal volume. Hierarchical linear regression and analysis of covariance models were used to examine if hippocampal volume and PTSD status would be associated with elevated levels of IL-6 and sTNF-RII. Results Increased sTNF-RII, but not IL-6, was significantly associated with reduced hippocampal volume (β = −.14, p = .01). The relationship between sTNF-RII and hippocampal volume was independent of potential confounds and covariates, including PTSD status. Although we observed no PTSD diagnosis-related differences in either IL-6 or sTNF-RII, higher PTSD severity was associated with significantly increased sTNF-RII (β = .24, p = .04) and reduced IL-6 levels (β = −.24, p = .04). Conclusions Our results indicate that specific inflammatory proteins may be associated with brain structure and function as indexed by hippocampal volume and PTSD symptoms. PMID:25465168

  8. Influence of Deep Breathing on Heart Rate Variability in Parkinson’s Disease: Co-relation with Severity of Disease and Non-Motor Symptom Scale Score

    PubMed Central

    Jagtap, Gayatri J; Chakor, Rahul T

    2014-01-01

    Context: Dysautonomia and non-motor symptoms (NMS) in Parkinson’s disease (PD) are frequent, disabling and reduce quality of life of patient. Aims and Objective: There is a paucity of studies on autonomic dysfunction in PD in Indian population. The study aimed to evaluate autonomic dysfunction in PD patients and co-relate the findings with severity of PD and Non-Motor Symptoms Scale (NMSS) score. Materials and Methods: We evaluated autonomic function in 30 diagnosed patients of PD (age 55-70 years) and 30 healthy age-matched controls by 3 min deep breathing test (DBT). NMSS was used to identify non-motor symptoms and Hoehn and Yahr (HY) Scale to grade severity of PD. The DBT findings were co-related with severity of PD (HY staging) and NMSS score. Results: DBT was found to be abnormal in 40% while it was on borderline in 33.3% of PD patients. There was a statistically significant difference (p<0.01) between patients and control group for the DBT. NMS were reported across all the stages of PD but with variable frequency and severity for individual symptom. A negative co-relation was found between results of deep breathing test and clinical severity of disease and NMSS score. Conclusion: Abnormalities of autonomic function and NMS were integral and present across all the stages of PD patients. Early recognition and treatment of these may decrease morbidity and improve quality of life of PD patients. PMID:25177554

  9. Severity of negative symptoms in schizophrenia correlated to hyperactivity of the left globus pallidus and the right claustrum. A PET study.

    PubMed

    Galeno, Roxana; Molina, Mario; Guirao, Manuel; Isoardi, Roberto

    2004-01-01

    Schizophrenia has been characterized as a complex disease, in which various cerebral regions may be affected. The purpose of this study was to compare the cerebral regions that are involved in mild and severe negative symptoms, and to determine whether the degree of severity can be related to specific dysfunctional areas of the brain. The PANS Scale was used to form two groups of patients with prevalence of negative symptoms: Mildly Affected (MA), and Severely Affected (SA). Brain PETs were obtained in resting conditions, and SPM (Statistical Parametric Mapping) was used to perform statistical comparisons. The MA-group showed increased activity in: posterior cingulate gyrus, middle frontal gyrus, precentral gyrus, middle occipital gyrus, cuneus and post-central gyrus; decreased activity in inferior frontal gyrus, orbitofrontal and fusiform gyrus. The SA-group showed increased activity in: globus pallidus, insular cortex, cuneus, claustrum, post-central gyrus and pre-central gyrus; decreased activity in fusiform gyrus and superior temporal gyri. These results permit correlation of negative symptomatology with abnormalities in the cortico-striato-pallido-thalamic neural circuit. Severity of negative symptoms is clearly correlated to abnormal left external pallidal activation, evidencing the relevance of this nucleus for cognitive, planning and social capabilities. Specific therapeutic strategies might be derived from pallidal neurotransmitter systems studies. Key words: schizophrenia, negative symptoms, severity, PET, globus pallidus, claustrum.

  10. Does Autism Diagnosis Age or Symptom Severity Differ among Children According to Whether Assisted Reproductive Technology Was Used to Achieve Pregnancy?

    ERIC Educational Resources Information Center

    Schieve, Laura A.; Fountain, Christine; Boulet, Sheree L.; Yeargin-Allsopp, Marshalyn; Kissin, Dmitry M.; Jamieson, Denise J.; Rice, Catherine; Bearman, Peter

    2015-01-01

    Previous studies report associations between conception with assisted reproductive technology (ART) and autism. Whether these associations reflect an ascertainment or biologic effect is undetermined. We assessed diagnosis age and initial autism symptom severity among >30,000 children with autism from a linkage study of California Department of…

  11. Trait Mindfulness, Reasons For Living and General Symptom Severity as Predictors of Suicide Probability in Males with Substance Abuse or Dependence

    PubMed Central

    Mohammadkhani, Parvaneh; Azadmehr, Hedieh; Mobramm, Ardeshir; Naseri, Esmaeil

    2015-01-01

    Objective: The aim of this study was to evaluate suicide probability in Iranian males with substance abuse or dependence disorder and to investigate the predictors of suicide probability based on trait mindfulness, reasons for living and severity of general psychiatric symptoms. Method: Participants were 324 individuals with substance abuse or dependence in an outpatient setting and prison. Reasons for living questionnaire, Mindfulness Attention Awareness Scale and Suicide probability Scale were used as instruments. Sample was selected based on convenience sampling method. Data were analyzed using SPSS and AMOS. Results: The life-time prevalence of suicide attempt in the outpatient setting was35% and it was 42% in the prison setting. Suicide probability in the prison setting was significantly higher than in the outpatient setting (p<0.001). The severity of general symptom strongly correlated with suicide probability. Trait mindfulness, not reasons for living beliefs, had a mediating effect in the relationship between the severity of general symptoms and suicide probability. Fear of social disapproval, survival and coping beliefs and child-related concerns significantly predicted suicide probability (p<0.001). Discussion: It could be suggested that trait mindfulness was more effective in preventing suicide probability than beliefs about reasons for living in individuals with substance abuse or dependence disorders. The severity of general symptom should be regarded as an important risk factor of suicide probability. PMID:26005482

  12. The Impact of Child Symptom Severity on Depressed Mood among Parents of Children with ASD: The Mediating Role of Stress Proliferation

    ERIC Educational Resources Information Center

    Benson, Paul R.

    2006-01-01

    "Stress proliferation" (the tendency of stressors to engender additional stressors in other life domains) is explored in a sample of 68 parents of children identified with ASD. Regression analyses showed that parent depression was predicted by both child symptom severity and by stress proliferation and that stress proliferation partially mediated…

  13. Executive functioning in autism spectrum disorders: influence of task and sample characteristics and relation to symptom severity.

    PubMed

    Van Eylen, Lien; Boets, Bart; Steyaert, Jean; Wagemans, Johan; Noens, Ilse

    2015-11-01

    Impaired executive functioning (EF) has been proposed to underlie symptoms of autism spectrum disorders (ASD). However, insight in the EF profile of ASD individuals is hampered due to task impurity and inconsistent findings. To elucidate these inconsistencies, we investigated the influence of task and sample characteristics on EF in ASD, with an extended test battery designed to reduce task impurity. Additionally, we studied the relation between EF and ASD symptoms. EF (inhibition, cognitive flexibility, generativity, working memory and planning) was measured in open-ended versus structured assessment situations, while controlling for possible confounding EF and non-EF variables. The performance of 50 individuals with ASD was compared with that of 50 age, gender and IQ matched typically developing (TD) individuals. The effects of group (ASD versus TD), age (children versus adolescents) and gender were examined, as well as the correlation between age, IQ, ASD symptoms and EF. Individuals with ASD showed impairments in all EF domains, but deficits were more pronounced in open-ended compared to structured settings. Group differences did not depend on gender and only occasionally on participants' age. This suggests that inconsistencies between studies largely result from differences in task characteristics and less from differences in the investigated sample features. However, age and IQ strongly correlated with EF, indicating that group differences in these factors should be controlled for when studying EF. Finally, EF correlated with both social and non-social ASD symptoms, but further research is needed to clarify the nature of this relationship. PMID:25697266

  14. Internalizing Symptoms and Affective Reactivity in Relation to the Severity of Aggression in Clinically Referred, Behavior-Disordered Children

    ERIC Educational Resources Information Center

    Kolko, David J.; Baumann, Barbara L.; Bukstein, Oscar G.; Brown, Elissa J.

    2007-01-01

    We examined the affective correlates of aggression in children referred to a partial hospitalization program for the treatment of behavior disorders who did not have a mood or anxiety disorder. Parent and teacher ratings of the children's impulsivity, internalizing symptoms, affective reactivity, and aggression were examined for their…

  15. Treatment with immunosuppressive and anti-inflammatory agents delays onset of canine genetic narcolepsy and reduces symptom severity.

    PubMed

    Boehmer, L N; Wu, M-F; John, J; Siegel, J M

    2004-08-01

    All Doberman pinschers and Labrador retrievers homozygous for a mutation of the hypocretin (orexin) receptor-2 (hcrtr2) gene develop narcolepsy under normal conditions. Degenerative changes and increased display of major histocompatibility complex class II antigens have been linked to symptom onset in genetically narcoleptic Doberman pinschers. This suggests that the immune system may contribute to neurodegenerative changes and narcoleptic symptomatology in these dogs. We therefore attempted to alter the course of canine genetic narcolepsy, as an initial test of principle, by administering a combination of three immunosuppressive and anti-inflammatory drugs chosen to suppress the immune response globally. Experimental dogs were treated with a combination of methylprednisolone, methotrexate and azathioprine orally starting within 3 weeks after birth, and raised in an environment that minimized pathogen exposure. Symptoms in treated and untreated animals were quantified using the food elicited cataplexy test (FECT), modified FECT and actigraphy. With drug treatment, time to cataplexy onset more than doubled, time spent in cataplexy during tests was reduced by more than 90% and nighttime sleep periods were consolidated. Short-term drug administration to control dogs did not reduce cataplexy symptoms, demonstrating that the drug regimen did not directly affect symptoms. Treatment was stopped at 6 months, after which experimental animals remained less symptomatic than controls until at least 2 years of age. This treatment is the first shown to affect symptom development in animal or human genetic narcolepsy. Our findings show that hcrtr2 mutation is not sufficient for the full symptomatic development of canine genetic narcolepsy and suggest that the immune system may play a role in the development of this disorder.

  16. Coping Self-Efficacy Moderates the Association Between Severity of Partner Violence and PTSD Symptoms Among Incarcerated Women.

    PubMed

    DeCou, Christopher R; Lynch, Shannon M; Cole, Trevor T; Kaplan, Stephanie P

    2015-10-01

    Previous research indicates self-efficacy may function as a protective factor for survivors of partner violence (PV), including coping self-efficacy specific to domestic violence. We hypothesized that domestic violence coping self-efficacy would moderate the association between recent PV and posttraumatic stress disorder (PTSD) symptoms in a sample of incarcerated women, such that the association between PV and PTSD would be strongest at low levels of domestic violence coping self-efficacy. Participants (N = 102) were incarcerated women who reported PV in the year prior to incarceration. They were aged 19-55 years (M = 33.57, SD = 9.32), identified predominantly as European American (84.3%), American Indian (15.7%), and Hispanic (14.7%), with 80.4% completing high school or more in terms of education. Participants responded to self-report measures of PV, trauma history, domestic violence coping self-efficacy, and current PTSD symptoms. In a series of sequential regression analyses, PV (β = .65, sr(2) = .06, p = .017) was significantly associated with current PTSD symptoms above and beyond past trauma history (β = .37, sr(2) = .14, p < .001), and this association was moderated by domestic violence coping self-efficacy (Domestic Violence Coping Self-Efficacy × Partner Violence; β = -.54, sr(2) = .03, p = .044). The relationship between PV and PTSD symptoms was greatest at low and average levels of domestic violence coping self-efficacy and nonsignificant at high levels of domestic violence coping self-efficacy. These findings highlight the importance of assessing domestic violence coping self-efficacy in incarcerated women with recent PV, given that domestic violence coping self-efficacy appeared to be protective against symptoms of PTSD. PMID:26366884

  17. The Effects of a Self-Care Program on the Severity of Symptoms and Quality of Life of Patients With Irritable Bowel Syndrome.

    PubMed

    Ghiyasvandian, Shahrzad; Ghorbani, Mojtaba; Zakerimoghadam, Masoumeh; Purfarzad, Zahra; Kazemnejad, Anoshirvan

    2016-01-01

    Irritable bowel syndrome (IBS) is a chronic disease that needs special self-care strategies. The current study aimed at determining the effects of a self-care program on the severity of symptoms and quality of life of patients with IBS. In this randomized controlled clinical trial, 119 patients were randomly assigned to the experimental (n = 60) and control (n = 59) groups. Patients in both groups received the usual treatment of IBS by a gastroenterologist. The control group did not receive any intervention, whereas the experimental group was trained in the self-care program. The process of implementing the self-care program included designing and determining the content validity of the self-care training package, individual training, the first follow-up call, group training, and the second follow-up call. The instruments for collecting data were IBS-Quality of Life and IBS-Symptom Severity Scale. Two sets of evaluations (before and 2 months after the intervention) were done for both groups. The data were analyzed using SPSS software, Version 16. The results showed that there was not a significant difference between the two groups in the severity of symptoms and quality of life before the intervention (p > .05); however, the 2 groups were significantly different after the intervention (p < .0001). Implementation of the self-care program resulted in the improvement of quality of life and reduction in the symptom severity in the experimental group after the intervention (p < .0001), whereas no significant changes were observed in the control group (p > .05). Hence, the data supports that self-care program was effective in improving the quality of life and reducing the severity of symptoms in patients with IBS. PMID:27684634

  18. Trial of pectin-enriched muffins in patients with severe dumping syndrome after gastric resection. Observations on symptoms and gastric emptying pattern.

    PubMed

    Andersen, J R; Holtug, K; Uhrenholt, A

    1989-01-01

    Pectin is known to delay gastric emptying and alleviate dumping symptoms when ingested with hyperosmolar, glucose-containing meals. As the treatment of dumping syndrome includes frequent, small dry meals, the effect of pectin ingested in muffins was tested in five patients with severe, intractable dumping syndrome after gastric resection. Ingestion of 99mTc-DTPA-labelled muffins containing 5 g pectin did not alleviate dumping symptoms or delay gastric emptying compared with muffins without pectin. Pectin does not seem to be beneficial as a supplement in the conventional dietary management of post-gastrectomy dumping.

  19. Harsh parent-child conflict is associated with decreased anti-inflammatory gene expression and increased symptom severity in children with asthma.

    PubMed

    Ehrlich, Katherine B; Miller, Gregory E; Chen, Edith

    2015-11-01

    Asthma is a chronic respiratory disorder that affects over 7 million children in the United States. Evidence indicates that family stressors are associated with worsening of asthma symptoms, and some research suggests that these stressful experiences engender changes in children's immune systems in ways that exacerbate airway inflammation and contribute to both acute and chronic asthma symptoms. We examined the association between observed experiences of parent-child conflict and the expression of signaling molecules involved in the transduction of anti-inflammatory signals that regulate airway inflammation and obstruction. Fifty-seven children and their parents participated in a conflict task, and coders rated interactions for evidence of harsh and supportive behaviors. Children reported on their perceptions of parental support and reported on their daily asthma symptoms for 2 weeks. We collected peripheral blood in children to measure leukocyte expression of messenger RNA for the glucocorticoid receptor and the β2-adrenergic receptor. Analyses revealed that harsh conflict behaviors were associated with decreased expression of both messenger RNAs and more severe asthma symptoms. Neither supportive behaviors nor perceived parental support was associated with gene expression or asthma symptoms. These findings suggest that harsh interactions with parents are associated with downregulation of key anti-inflammatory signaling molecules and difficulties breathing in children with asthma. Children with asthma who are also victims of maltreatment may be particularly susceptible to transcriptional changes in immune cells that could worsen asthma over time.

  20. Passive coping response to depressive symptoms among low-income homebound older adults: does it affect depression severity and treatment outcome?

    PubMed

    Choi, Namkee G; Hegel, Mark T; Sirrianni, Leslie; Marinucci, Mary Lynn; Bruce, Martha L

    2012-11-01

    Due to their homebound state, lack of financial resources, and/or other life demands, a significant proportion of depressed, low-income homebound older adults experience depression. Because of their limited access to psychotherapy, most of these older adults self-manage their depressive symptoms. The purposes of this study were to examine (1) the relationship between homebound older adults' coping responses to depressed mood and the severity of their depressive symptoms at baseline (n = 121), and (2) the moderating effect of passive coping responses on the relationship between participation in problem-solving therapy (PST: in-person or telehealth delivery) and depressive symptoms at 12- and 24-week follow-ups. Controlling for the effects of demographic and disability characteristics, cognitive passive coping was significantly associated with baseline depressive symptoms, while behavioral passive coping was not. The main effect of baseline cognitive passive coping response was also significant in mixed-effects regression analysis, but the interaction between coping pattern and group was not significant. The results point to a possibility that cognitive passive copers may have benefited as much from PST as the rest of the PST participants. Further research needs to examine the moderating effect of coping responses to depressive symptoms on treatment efficacy of PST and other psychosocial interventions for late-life depression.

  1. The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving.

    PubMed

    Kaczkurkin, Antonia N; Asnaani, Anu; Alpert, Elizabeth; Foa, Edna B

    2016-04-01

    Given the high rates of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD), we investigated an integrated treatment for these disorders. Individuals with comorbid PTSD and alcohol dependence were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants also received BRENDA (supportive counseling). The naltrexone plus PE group showed a greater decline in alcohol craving symptoms than those in the placebo with no PE group. The PE plus placebo and the naltrexone without PE groups did not differ significantly from the placebo with no PE group in terms of alcohol craving. No treatment group differences were found for percentage of drinking days. Alcohol craving was moderated by PTSD severity, with those with higher PTSD symptoms showing faster decreases in alcohol craving. Both PTSD and alcohol use had a lagged effect on alcohol craving, with changes in PTSD symptoms and percentage of days drinking being associated with subsequent changes in craving. These results support the relationship between greater PTSD symptoms leading to greater alcohol craving and suggest that reducing PTSD symptoms may be beneficial to reducing craving in those with co-occurring PTSD/SUD.

  2. Phonetic Measures of Reduced Tongue Movement Correlate with Negative Symptom Severity in Hospitalized Patients with First-Episode Schizophrenia-Spectrum Disorders

    PubMed Central

    Covington, Michael A.; Lunden, S.L. Anya; Cristofaro, Sarah L.; Wan, Claire Ramsay; Bailey, C. Thomas; Broussard, Beth; Fogarty, Robert; Johnson, Stephanie; Zhang, Shayi; Compton, Michael T.

    2012-01-01

    Background Aprosody, or flattened speech intonation, is a recognized negative symptom of schizophrenia, though it has rarely been studied from a linguistic/phonological perspective. To bring the latest advances in computational linguistics to the phenomenology of schizophrenia and related psychotic disorders, a clinical first-episode psychosis research team joined with a phonetics/computational linguistics team to conduct a preliminary, proof-of-concept study. Methods Video recordings from a semi-structured clinical research interview were available from 47 first-episode psychosis patients. Audio tracks of the video recordings were extracted, and after review of quality, 25 recordings were available for phonetic analysis. These files were de-noised and a trained phonologist extracted a 1-minute sample of each patient’s speech. WaveSurfer 1.8.5 was used to create, from each speech sample, a file of formant values (F0, F1, F2, where F0 is the fundamental frequency and F1 and F2 are resonance bands indicating the moment-by-moment shape of the oral cavity). Variability in these phonetic indices was correlated with severity of Positive and Negative Syndrome Scale negative symptom scores using Pearson correlations. Results A measure of variability of tongue front-to-back position—the standard deviation of F2—was statistically significantly correlated with the severity of negative symptoms (r=−0.446, p=0.03). Conclusion This study demonstrates a statistically significant and meaningful correlation between negative symptom severity and phonetically measured reductions in tongue movements during speech in a sample of first-episode patients just initiating treatment. Further studies of negative symptoms, applying computational linguistics methods, are warranted. PMID:23102940

  3. Language and communication skills in preschool children with autism spectrum disorders: contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability.

    PubMed

    Kjellmer, Liselotte; Hedvall, Åsa; Fernell, Elisabeth; Gillberg, Christopher; Norrelgen, Fritjof

    2012-01-01

    This study examined the contribution of cognitive function, severity of autism, and adaptive functioning to the variability in language and communication skills in 129 preschool children (aged 24-63 months) with autism spectrum disorder (ASD). Participants were selected from a representative research cohort of 208 preschool children on the basis of caregiver completion of the MacArthur-Bates Communicative Development Inventories (CDI). The children were classified into three cognitive groups: (a) Normal intelligence; (b) Developmental delay; and (c) Intellectual disability. Autism symptom severity was measured by the Autistic Behavior Checklist (ABC), and adaptive functioning by the Daily Living Skills (DLS) and Socialization (Soc) subscales from the Vineland Adaptive Behavior Scales. For each of five CDI variables (Phrases understood, Words understood, Words produced, Gestures and actions, and Language use), the contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability was examined. Cognition and age explained about half or more of the variance in the four verbal language CDI variables, but only about one fourth of the variance in the non-verbal communication variable Gestures and actions. Severity of autism symptoms and the two adaptive measures (DLS and Soc) each only accounted for a few percent more of the variance in the four CDI language variables; however, for Gestures and actions, an additional 11-21% of the variance was accounted for. In conclusion, for children with ASD, receptive and expressive language is mainly related to cognitive level, whereas non-verbal communication skills seem to also be related to severity of autism symptoms and adaptive functioning.

  4. The Brain-Derived Neurotrophic Factor Val66Met Polymorphism Moderates the Effects of Childhood Abuse on Severity of Depressive Symptoms in a Time-Dependent Manner.

    PubMed

    Webb, Caitlin; Gunn, Jane M; Potiriadis, Maria; Everall, Ian P; Bousman, Chad A

    2016-01-01

    Cross-sectional studies have demonstrated that the brain-derived neurotrophic factor (BDNF) Val66Met single-nucleotide polymorphism moderates the association between exposure to negative life events and depression outcomes. Yet, it is currently unclear whether this moderating effect is applicable to positive life events and if the moderating effect is stable over time. To address these gaps in the literature, we examined clinical and BDNF genotypic data from a 5-year prospective cohort of 310 primary care attendees. Primary care attendees were selected based on existence of depressive symptoms at screening. Depressive symptoms were assessed at baseline and annually for 5 years post-baseline using the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire-9 (PHQ-9). Linear mixed models assessed differences in depressive symptom severity over the 5-year follow-up period by BDNF Val66Met and history of life events, both negative and positive. Analysis identified a novel three-way interaction between the BDNF Val66Met polymorphism, history of severe childhood abuse, and time. Post hoc analysis stratified by time showed a two-way interaction between Val66Met and severe childhood abuse at baseline that was not detectable at any other time point. An interaction between Val66Met and positive life events was not detected. Our longitudinal results suggest that the BDNF Val66Met polymorphism moderates the depressive symptom severity experienced by those with a history of severe childhood abuse but does so in a time-dependent manner. Our results further support the notion that gene-environment-depression interactions are dynamic and highlight the importance of longitudinal assessment of these interactions. Given these novel longitudinal findings; replication is required. PMID:27621711

  5. The Brain-Derived Neurotrophic Factor Val66Met Polymorphism Moderates the Effects of Childhood Abuse on Severity of Depressive Symptoms in a Time-Dependent Manner

    PubMed Central

    Webb, Caitlin; Gunn, Jane M.; Potiriadis, Maria; Everall, Ian P.; Bousman, Chad A.

    2016-01-01

    Cross-sectional studies have demonstrated that the brain-derived neurotrophic factor (BDNF) Val66Met single-nucleotide polymorphism moderates the association between exposure to negative life events and depression outcomes. Yet, it is currently unclear whether this moderating effect is applicable to positive life events and if the moderating effect is stable over time. To address these gaps in the literature, we examined clinical and BDNF genotypic data from a 5-year prospective cohort of 310 primary care attendees. Primary care attendees were selected based on existence of depressive symptoms at screening. Depressive symptoms were assessed at baseline and annually for 5 years post-baseline using the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire-9 (PHQ-9). Linear mixed models assessed differences in depressive symptom severity over the 5-year follow-up period by BDNF Val66Met and history of life events, both negative and positive. Analysis identified a novel three-way interaction between the BDNF Val66Met polymorphism, history of severe childhood abuse, and time. Post hoc analysis stratified by time showed a two-way interaction between Val66Met and severe childhood abuse at baseline that was not detectable at any other time point. An interaction between Val66Met and positive life events was not detected. Our longitudinal results suggest that the BDNF Val66Met polymorphism moderates the depressive symptom severity experienced by those with a history of severe childhood abuse but does so in a time-dependent manner. Our results further support the notion that gene–environment–depression interactions are dynamic and highlight the importance of longitudinal assessment of these interactions. Given these novel longitudinal findings; replication is required. PMID:27621711

  6. The Brain-Derived Neurotrophic Factor Val66Met Polymorphism Moderates the Effects of Childhood Abuse on Severity of Depressive Symptoms in a Time-Dependent Manner

    PubMed Central

    Webb, Caitlin; Gunn, Jane M.; Potiriadis, Maria; Everall, Ian P.; Bousman, Chad A.

    2016-01-01

    Cross-sectional studies have demonstrated that the brain-derived neurotrophic factor (BDNF) Val66Met single-nucleotide polymorphism moderates the association between exposure to negative life events and depression outcomes. Yet, it is currently unclear whether this moderating effect is applicable to positive life events and if the moderating effect is stable over time. To address these gaps in the literature, we examined clinical and BDNF genotypic data from a 5-year prospective cohort of 310 primary care attendees. Primary care attendees were selected based on existence of depressive symptoms at screening. Depressive symptoms were assessed at baseline and annually for 5 years post-baseline using the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire-9 (PHQ-9). Linear mixed models assessed differences in depressive symptom severity over the 5-year follow-up period by BDNF Val66Met and history of life events, both negative and positive. Analysis identified a novel three-way interaction between the BDNF Val66Met polymorphism, history of severe childhood abuse, and time. Post hoc analysis stratified by time showed a two-way interaction between Val66Met and severe childhood abuse at baseline that was not detectable at any other time point. An interaction between Val66Met and positive life events was not detected. Our longitudinal results suggest that the BDNF Val66Met polymorphism moderates the depressive symptom severity experienced by those with a history of severe childhood abuse but does so in a time-dependent manner. Our results further support the notion that gene–environment–depression interactions are dynamic and highlight the importance of longitudinal assessment of these interactions. Given these novel longitudinal findings; replication is required.

  7. Symptoms and impact of COPD assessed by an electronic diary in patients with moderate-to-severe COPD: psychometric results from the SHINE study

    PubMed Central

    Kulich, Károly; Keininger, Dorothy L; Tiplady, Brian; Banerji, Donald

    2015-01-01

    Background Symptoms, particularly dyspnea, and activity limitation, have an impact on the health status and the ability to function normally in patients with chronic obstructive pulmonary disease (COPD). Methods To develop an electronic patient diary (eDiary), qualitative patient interviews were conducted from 2009 to 2010 to identify relevant symptoms and degree of bother due to symptoms. The eDiary was completed by a subset of 209 patients with moderate-to-severe COPD in the 26-week QVA149 SHINE study. Two morning assessments (since awakening and since the last assessment) and one evening assessment were made each day. Assessments covered five symptoms (“shortness of breath,” “phlegm/mucus,” “chest tightness,” “wheezing,” and “coughing”) and two impact items (“bothered by COPD” and “difficulty with activities”) and were scored on a 10-point numeric scale. Results Patient compliance with the eDiary was 90.4% at baseline and 81.3% at week 26. Correlations between shortness of breath and impact items were >0.95. Regression analysis showed that shortness of breath was a highly significant (P<0.0001) predictor of impact items. Exploratory factor analysis gave a single factor comprising all eDiary items, including both symptoms and impact items. Shortness of breath, the total score (including five symptoms and two impact items), and the five-item symptom score from the eDiary performed well, with good consistency and reliability. The eDiary showed good sensitivity to change, with a 0.6 points reduction in the symptoms scores (on a 0–10 point scale) representing a meaningful change. Conclusion The eDiary was found to be valid, reliable, and responsive. The high correlations obtained between “shortness of breath” and the ratings of “bother” and “difficulty with activities” confirmed the relevance of this symptom in patients with COPD. Future studies will be required to explore further psychometric properties and their ability to

  8. Concordance between severity of disease, prevalence of nonmotor symptoms, patient-reported quality of life and disability and use of medication in Parkinson's disease.

    PubMed

    Raggi, Alberto; Leonardi, Matilde; Covelli, Venusia; Albanese, Alberto; Soliveri, Paola; Carella, Francesco; Romito, Luigi

    2012-08-01

    The aim of this study was to test the concordance between disease severity, prevalence of nonmotor symptoms, age, health-related quality of life (HRQoL), disability and medication use in patients with Parkinson's disease (PD). Severity was classified with the Hoehn and Yahr (HY) scale and Levodopa Equivalent Daily Dose (LEDD) calculated. HRQoL was evaluated with the SF-36, disability with the WHO-DAS II and nonmotor symptoms with the NMSQuest. Patients were clustered using SF-36 and WHO-DAS II into three groups covering the continuum from low disability and HRQoL, to severe disability and HRQoL decrement. Contingency Coefficient were used to verify the relationships between clusters and HY stage; ANOVA to evaluate differences in NMS, age and LEDD between clusters; odds ratio to test the likelihood of taking levodopa or dopamine agonist and being member of the three clusters; t test to evaluate differences in LEDD between patients with HY ≥3 or ≤2. Eighty-six patients were clustered: 48 had low disability and HRQoL decrement, 18 intermediate disability and HRQoL decrement and 20 high disability and HRQoL decrement. A significant relationship was found between PD severity groups, HRQoL and disability profiles. No differences for age and LEDD were observed in the three groups, and those with more disability and lower HRQoL reported a higher number of nonmotor symptoms; patients in HY ≥3 were prescribed higher doses of drugs. In conclusion, we found a substantial concordance between PD staging, prevalence of nonmotor symptoms and patient-reported HRQoL and disability measures. In our opinion, the SF-36 and the WHO-DAS II can be used for profiling patients.

  9. Increased Epidermal Growth Factor Receptor (EGFR) Associated with Hepatocyte Growth Factor (HGF) and Symptom Severity in Children with Autism Spectrum Disorders (ASDs)

    PubMed Central

    Russo, Anthony J

    2014-01-01

    BACKGROUND One in 88 children in the US is thought to have one of the autism spectrum disorders (ASDs). ASDs are characterized by social impairments and communication problems. Growth factors and their receptors may play a role in the etiology of ASDs. Research has shown that epidermal growth factor receptor (EGFR) activation is associated with nerve cell development and repair. This study was designed to measure plasma levels of EGFR in autistic children and correlate these levels with its ligand, epidermal growth factor, other related putative biomarkers such as hepatocyte growth factor (HGF), the ligand for MET (MNNG HOS transforming gene) receptor, as well as the symptom severity of 19 different behavioral symptoms. SUBJECTS AND METHODS Plasma EGFR concentration was measured in 33 autistic children and 34 age- and gender-similar neurotypical controls, using an enzyme-linked immunosorbent assay. Plasma EGFR levels were compared to putative biomarkers known to be associated with EGFR and MET and severity levels of 19 autism-related symptoms. RESULTS We found plasma EGFR levels significantly higher in autistic children, when compared to neurotypical controls. EGFR levels correlated with HGF and high-mobility group protein B1 (HMGB1) levels, but not other tested putative biomarkers, and EGFR levels correlated significantly with severity of expressive language, conversational language, focus/attention, hyperactivity, eye contact, and sound sensitivity deficiencies. CONCLUSIONS These results suggest a relationship between increased plasma EGFR levels and designated symptom severity in autistic children. A strong correlation between plasma EGFR and HGF and HMGB1 suggests that increased EGFR levels may be associated with the HGF/Met signaling pathway, as well as inflammation. PMID:25249767

  10. Brief Report: A Preference for Biological Motion Predicts a Reduction in Symptom Severity 1 Year Later in Preschoolers with Autism Spectrum Disorders.

    PubMed

    Franchini, Martina; Wood de Wilde, Hilary; Glaser, Bronwyn; Gentaz, Edouard; Eliez, Stephan; Schaer, Marie

    2016-01-01

    Recent research has consistently demonstrated reduced orienting to social stimuli in samples of young children with autism spectrum disorders (ASD). However, social orienting greatly varies between individual children on the spectrum. Better understanding this heterogeneity in social orienting may contribute to our comprehension of the mechanisms underlying autistic symptoms thereby improving our ability to intervene. Indeed, children on the autism spectrum who show higher levels of interest in social stimuli demonstrate reduced clinical symptoms and increased adaptive functioning. However, longitudinal studies examining the influence of social orienting on subsequent outcome are critically lacking. Here, we aim to explore the relationship between social interest at the age of 3 and changes in severity of autistic symptoms over the subsequent year, in 20 children with ASD and 20 age-matched typically developing (TD) children. A visual preference for social stimuli was measured using an eye-tracking task at baseline, consisting of a previously studied visual preference paradigm presenting biological and geometric motion side-by-side. The task was altered for the current study by alternating presentation side for each type of stimuli to keep visual perseveration from influencing participants' first fixation location. Clinical data were collected both at baseline and 1 year later at follow-up. As a group, we observed reduced interest for biological motion (BIO-M) in children with ASD compared to TD children, corroborating previous findings. We also confirmed that a preference for BIO-M is associated with better adaptive functioning in preschoolers with ASD. Most importantly, our longitudinal results showed that a preference for BIO-M strongly predicted decreased severity of diagnostic symptoms. Participants who preferred social stimuli at the age of 3 showed drastic reductions in their severity level of autistic symptoms 1 year later, whereas participants who

  11. Brief Report: A Preference for Biological Motion Predicts a Reduction in Symptom Severity 1 Year Later in Preschoolers with Autism Spectrum Disorders

    PubMed Central

    Franchini, Martina; Wood de Wilde, Hilary; Glaser, Bronwyn; Gentaz, Edouard; Eliez, Stephan; Schaer, Marie

    2016-01-01

    Recent research has consistently demonstrated reduced orienting to social stimuli in samples of young children with autism spectrum disorders (ASD). However, social orienting greatly varies between individual children on the spectrum. Better understanding this heterogeneity in social orienting may contribute to our comprehension of the mechanisms underlying autistic symptoms thereby improving our ability to intervene. Indeed, children on the autism spectrum who show higher levels of interest in social stimuli demonstrate reduced clinical symptoms and increased adaptive functioning. However, longitudinal studies examining the influence of social orienting on subsequent outcome are critically lacking. Here, we aim to explore the relationship between social interest at the age of 3 and changes in severity of autistic symptoms over the subsequent year, in 20 children with ASD and 20 age-matched typically developing (TD) children. A visual preference for social stimuli was measured using an eye-tracking task at baseline, consisting of a previously studied visual preference paradigm presenting biological and geometric motion side-by-side. The task was altered for the current study by alternating presentation side for each type of stimuli to keep visual perseveration from influencing participants’ first fixation location. Clinical data were collected both at baseline and 1 year later at follow-up. As a group, we observed reduced interest for biological motion (BIO-M) in children with ASD compared to TD children, corroborating previous findings. We also confirmed that a preference for BIO-M is associated with better adaptive functioning in preschoolers with ASD. Most importantly, our longitudinal results showed that a preference for BIO-M strongly predicted decreased severity of diagnostic symptoms. Participants who preferred social stimuli at the age of 3 showed drastic reductions in their severity level of autistic symptoms 1 year later, whereas participants who

  12. Brief Report: A Preference for Biological Motion Predicts a Reduction in Symptom Severity 1 Year Later in Preschoolers with Autism Spectrum Disorders

    PubMed Central

    Franchini, Martina; Wood de Wilde, Hilary; Glaser, Bronwyn; Gentaz, Edouard; Eliez, Stephan; Schaer, Marie

    2016-01-01

    Recent research has consistently demonstrated reduced orienting to social stimuli in samples of young children with autism spectrum disorders (ASD). However, social orienting greatly varies between individual children on the spectrum. Better understanding this heterogeneity in social orienting may contribute to our comprehension of the mechanisms underlying autistic symptoms thereby improving our ability to intervene. Indeed, children on the autism spectrum who show higher levels of interest in social stimuli demonstrate reduced clinical symptoms and increased adaptive functioning. However, longitudinal studies examining the influence of social orienting on subsequent outcome are critically lacking. Here, we aim to explore the relationship between social interest at the age of 3 and changes in severity of autistic symptoms over the subsequent year, in 20 children with ASD and 20 age-matched typically developing (TD) children. A visual preference for social stimuli was measured using an eye-tracking task at baseline, consisting of a previously studied visual preference paradigm presenting biological and geometric motion side-by-side. The task was altered for the current study by alternating presentation side for each type of stimuli to keep visual perseveration from influencing participants’ first fixation location. Clinical data were collected both at baseline and 1 year later at follow-up. As a group, we observed reduced interest for biological motion (BIO-M) in children with ASD compared to TD children, corroborating previous findings. We also confirmed that a preference for BIO-M is associated with better adaptive functioning in preschoolers with ASD. Most importantly, our longitudinal results showed that a preference for BIO-M strongly predicted decreased severity of diagnostic symptoms. Participants who preferred social stimuli at the age of 3 showed drastic reductions in their severity level of autistic symptoms 1 year later, whereas participants who

  13. Predictive Symptoms and Signs of Severe Dengue Disease for Patients with Dengue Fever: A Meta-Analysis

    PubMed Central

    Zhang, H.; Zhou, Y. P.; Peng, H. J.; Zhang, X. H.; Zhou, F. Y.; Liu, Z. H.; Chen, X. G.

    2014-01-01

    The aim of the meta-analysis was to provide more solid evidence for the reliability of the new classification. A systematic literature search was performed using PubMed, Armed Forces Pest Management Board Literature Retrieval System, and Google Scholar up to August 2012. A pooled odds ratio (OR) was calculated using either a random-effect or a fixed-effect model. A total of 16 papers were identified. Among the 11 factors studied, five symptoms demonstrated an increased risk for SDD, including bleeding [OR: 13.617; 95% confidence interval (CI): 3.281, 56.508], vomiting/nausea (OR: 1.692; 95% CI: 1.256, 2.280), abdominal pain (OR: 2.278; 95% CI: 1.631, 3.182), skin rashes (OR: 2.031; 95% CI: 1.269, 3.250), and hepatomegaly (OR: 4.751; 95% CI: 1.769, 12.570). Among the four bleeding-related symptoms including hematemesis, melena, gum bleeding, and epistaxis, only hematemesis (OR: 6.174; 95% CI: 2.66, 14.334; P < 0.001) and melena (OR: 10.351; 95% CI: 3.065, 34.956; P < 0.001) were significantly associated with SDD. No significant associations with SDD were found for gender, lethargy, retroorbital pain, diarrhea, or tourniquet test, whereas headache appeared protective (OR: 0.555; 95% CI: 0.455, 0.676). The meta-analysis suggests that bleeding (hematemesis/melena), vomiting/nausea, abdominal pain, skin rashes, and hepatomegaly may predict the development of SDD in patients with DF, while headache may predict otherwise. PMID:25097856

  14. Acute Mountain Sickness Symptom Severity at the South Pole: The Influence of Self-Selected Prophylaxis with Acetazolamide

    PubMed Central

    Johnson, Jacob B.; Richert, Maile; Miller, Andrew D.

    2016-01-01

    Introduction Acetazolamide, a carbonic anhydrase inhibitor, remains the only FDA approved pharmaceutical prophylaxis for acute mountain sickness (AMS) though its effectiveness after rapid transport in real world conditions is less clear. Methods Over 2 years, 248 healthy adults traveled by airplane from sea level (SL) to the South Pole (ALT, ~3200m) and 226 participants provided Lake Louise Symptom Scores (LLSS) on a daily basis for 1 week; vital signs, blood samples, and urine samples were collected at SL and at ALT. Acetazolamide was available to any participant desiring prophylaxis. Comparisons were made between the acetazolamide with AMS (ACZ/AMS) (n = 42), acetazolamide without AMS (ACZ/No AMS)(n = 49), no acetazolamide with AMS (No ACZ/AMS) (n = 56), and the no acetazolamide without AMS (No ACZ/No AMS) (n = 79) groups. Statistical analysis included Chi-squared and one-way ANOVA with Bonferroni post-hoc tests. Significance was p≤0.05. Results No significant differences were found for between-group characteristics or incidence of AMS between ACZ and No ACZ groups. ACZ/AMS reported greater LLSS, BMI, and red cell distribution width. ACZ/No AMS had the highest oxygen saturation (O2Sat) at ALT. No significant differences were found in serum electrolyte concentrations or PFT results. Discussion Acetazolamide during rapid ascent provided no apparent protection from AMS based on LLSS. However, it is unclear if this lack of effect was directly associated with the drug or if perhaps there was some selection bias with individuals taking ACZ more likely to have symptoms or if there may have been more of perceptual phenomenon related to a constellation of side effects. PMID:26848757

  15. Predictive symptoms and signs of severe dengue disease for patients with dengue fever: a meta-analysis.

    PubMed

    Zhang, H; Zhou, Y P; Peng, H J; Zhang, X H; Zhou, F Y; Liu, Z H; Chen, X G

    2014-01-01

    The aim of the meta-analysis was to provide more solid evidence for the reliability of the new classification. A systematic literature search was performed using PubMed, Armed Forces Pest Management Board Literature Retrieval System, and Google Scholar up to August 2012. A pooled odds ratio (OR) was calculated using either a random-effect or a fixed-effect model. A total of 16 papers were identified. Among the 11 factors studied, five symptoms demonstrated an increased risk for SDD, including bleeding [OR: 13.617; 95% confidence interval (CI): 3.281, 56.508], vomiting/nausea (OR: 1.692; 95% CI: 1.256, 2.280), abdominal pain (OR: 2.278; 95% CI: 1.631, 3.182), skin rashes (OR: 2.031; 95% CI: 1.269, 3.250), and hepatomegaly (OR: 4.751; 95% CI: 1.769, 12.570). Among the four bleeding-related symptoms including hematemesis, melena, gum bleeding, and epistaxis, only hematemesis (OR: 6.174; 95% CI: 2.66, 14.334; P < 0.001) and melena (OR: 10.351; 95% CI: 3.065, 34.956; P < 0.001) were significantly associated with SDD. No significant associations with SDD were found for gender, lethargy, retroorbital pain, diarrhea, or tourniquet test, whereas headache appeared protective (OR: 0.555; 95% CI: 0.455, 0.676). The meta-analysis suggests that bleeding (hematemesis/melena), vomiting/nausea, abdominal pain, skin rashes, and hepatomegaly may predict the development of SDD in patients with DF, while headache may predict otherwise.

  16. Elevated Monoamine Oxidase-A Distribution Volume in Borderline Personality Disorder Is Associated With Severity Across Mood Symptoms, Suicidality, and Cognition

    PubMed Central

    Kolla, Nathan J.; Chiuccariello, Lina; Wilson, Alan A.; Houle, Sylvain; Links, Paul; Bagby, R. Michael; McMain, Shelley; Kellow, Charis; Patel, Jalpa; Rekkas, Paraskevi V.; Pasricha, Suvercha; Meyer, Jeffrey H.

    2016-01-01

    BACKGROUND Monoamine oxidase-A (MAO-A) is a treatment target in neurodegenerative illness and mood disorders that increases oxidative stress and predisposition toward apoptosis. Increased MAO-A levels in prefrontal cortex (PFC) and anterior cingulate cortex (ACC) occur in rodent models of depressive behavior and human studies of depressed moods. Extreme dysphoria is common in borderline personality disorder (BPD), especially when severe, and the molecular underpinnings of severe BPD are largely unknown. We hypothesized that MAO-A levels in PFC and ACC would be highest in severe BPD and would correlate with symptom magnitude. METHODS [11C] Harmine positron emission tomography measured MAO-A total distribution volume (MAO-A VT), an index of MAO-A density, in severe BPD subjects (n = 14), moderate BPD subjects (n = 14), subjects with a major depressive episode (MDE) only (n = 14), and healthy control subjects (n = 14). All subjects were female. RESULTS Severe BPD was associated with greater PFC and ACC MAO-A VT compared with moderate BPD, MDE, and healthy control subjects (multivariate analysis of variance group effect: F6,102 = 5.6, p < .001). In BPD, PFC and ACC MAO-A VT were positively correlated with mood symptoms (PFC: r = .52, p = .005; ACC: r = .53, p = .004) and suicidality (PFC: r = .40, p = .037; ACC: r = .38, p = .046), while hippocampus MAO-A VT was negatively correlated with verbal memory (r = −.44, p = .023). CONCLUSIONS These results suggest that elevated MAO-A VT is associated with multiple indicators of BPD severity, including BPD symptomatology, mood symptoms, suicidality, and neurocognitive impairment. PMID:25698585

  17. Substance abuse and personality disorders in homeless drop-in center clients: symptom severity and psychotherapy retention in a randomized clinical trial.

    PubMed

    Ball, Samuel A; Cobb-Richardson, Patricia; Connolly, Adrian J; Bujosa, Cesar T; O'neall, Thomas W

    2005-01-01

    This study evaluated the psychiatric symptoms, psychosocial problems, and treatment response of personality-disordered substance abusers receiving services within a homeless drop-in center. Fifty-two homeless clients were assessed after program admission and randomly assigned to receive either individual psychotherapy focused on personality disorder and substance abuse relapse prevention (dual-focus schema therapy [DFST]) or standard group substance abuse counseling (SAC). Client functioning was assessed using measures of personality disorder, psychiatric symptoms, early maladaptive schemas, interpersonal problems, and addiction-related psychosocial impairment. Therapy retention (total weeks in treatment) and utilization (number of weeks in which sessions were attended) were the primary outcomes. Although rates of cluster B personality disorders were comparable to other substance dependent samples, clusters A and C disorders were disproportionately more common. Clients reported significant psychiatric symptoms, criminality, and psychosocial impairment, yet made limited lifetime use of mental health services. Overall, there was greater utilization of individual DFST than group SAC. However, clients with more severe personality disorder symptoms demonstrated better utilization of SAC than DFST. PMID:16122538

  18. Substance abuse and personality disorders in homeless drop-in center clients: symptom severity and psychotherapy retention in a randomized clinical trial.

    PubMed

    Ball, Samuel A; Cobb-Richardson, Patricia; Connolly, Adrian J; Bujosa, Cesar T; O'neall, Thomas W

    2005-01-01

    This study evaluated the psychiatric symptoms, psychosocial problems, and treatment response of personality-disordered substance abusers receiving services within a homeless drop-in center. Fifty-two homeless clients were assessed after program admission and randomly assigned to receive either individual psychotherapy focused on personality disorder and substance abuse relapse prevention (dual-focus schema therapy [DFST]) or standard group substance abuse counseling (SAC). Client functioning was assessed using measures of personality disorder, psychiatric symptoms, early maladaptive schemas, interpersonal problems, and addiction-related psychosocial impairment. Therapy retention (total weeks in treatment) and utilization (number of weeks in which sessions were attended) were the primary outcomes. Although rates of cluster B personality disorders were comparable to other substance dependent samples, clusters A and C disorders were disproportionately more common. Clients reported significant psychiatric symptoms, criminality, and psychosocial impairment, yet made limited lifetime use of mental health services. Overall, there was greater utilization of individual DFST than group SAC. However, clients with more severe personality disorder symptoms demonstrated better utilization of SAC than DFST.

  19. Self-perceived symptoms and care needs of patients with severe to very severe chronic obstructive pulmonary disease, congestive heart failure or chronic renal failure and its consequences for their closest relatives: the research protocol

    PubMed Central

    Janssen, Daisy JA; Wouters, Emiel FM; Schols, Jos MGA; Spruit, Martijn A

    2008-01-01

    Background Recent research shows that the prevalence of patients with very severe chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and chronic renal failure (CRF) continues to rise over the next years. Scientific studies concerning self-perceived symptoms and care needs in patients with severe to very severe COPD, CHF and CRF are scarce. Consequently, it will be difficult to develop an optimal patient-centred palliative care program for patients with end-stage COPD, CHF or CRF. The present study has been designed to assess the symptoms, care needs, end-of-life care treatment preferences and communication needs of patients with severe to very severe COPD, CHF or CRF. Additionally, family distress and care giving burden of relatives of these patients will be assessed. Methods/design A cross-sectional comparative and prospective longitudinal study in patients with end-stage COPD, CHF or CRF has been designed. Patients will be recruited by their treating physician specialist. Patients and their closest relatives will be visited at baseline and every 4 months after baseline for a period of 12 months. The following outcomes will be assessed during home visits: self-perceived symptoms and care needs; daily physical functioning; general health status; end-of-life care treatment preferences; end-of-life care communication and care-giver burden of family caregivers. Additionally, end-of-life care communication and prognosis of survival will be assessed with the physician primarily responsible for the management of the chronic organ failure. Finally, if patients decease during the study period, the baseline preferences with regard to life-sustaining treatments will be compared with the real end-of-life care. Discussion To date, the symptoms, care needs, caregiver burden, end-of-life care treatment preferences and communication needs of patients with very severe COPD, CHF or CRF remain unknown. The present study will increase the knowledge about the

  20. Posttraumatic stress symptom severity and cognitive-based smoking processes among trauma-exposed treatment-seeking smokers: The role of perceived stress.

    PubMed

    Garey, Lorra; Bakhshaie, Jafar; Vujanovic, Anka A; Reitzel, Lorraine R; Schmidt, Norman B; Zvolensky, Michael J

    2016-09-01

    Trauma exposure and smoking co-occur at an alarmingly high rate. However, there is little understanding of the mechanisms underlying this clinically significant relation. The present study examined perceived stress as an explanatory mechanism linking posttraumatic stress symptom severity and smoking-specific avoidance/inflexibility, perceived barriers to smoking cessation, and negative affect reduction/negative reinforcement expectancies from smoking among trauma-exposed smokers. Participants were trauma-exposed, treatment-seeking daily cigarette smokers (n=179; 48.0% female; Mage=41.17; SD=12.55). Results indicated that posttraumatic stress symptom severity had an indirect significant effect on each of the dependent variables via perceived stress. The present results provide empirical support that perceived stress may be an underlying mechanism that indirectly explains posttraumatic symptoms relation to smoking-specific avoidance/inflexibility, perceived barriers to smoking cessation, and negative affect reduction/negative reinforcement expectancies among trauma-exposed smokers. These findings suggest that there may be clinical utility in targeting perceived stress among trauma-exposed smokers via stress management psychoeducation and skills training. PMID:27100473

  1. Reduction of leaf area and symptom severity as proxies of disease-induced plant mortality: the example of the Cauliflower mosaic virus infecting two Brassicaceae hosts.

    PubMed

    Doumayrou, Juliette; Leblaye, Sophie; Froissart, Rémy; Michalakis, Yannis

    2013-09-01

    Disease induced effects on host survival are important to understand the evolution of parasitic virulence and host resistance/tolerance. Unfortunately, experiments evaluating such effects are in most cases logistically demanding justifying the measurement of survival proxies. For plant hosts commonly used proxies are leaf area and the nature and severity of visual qualitative disease symptoms. In this study we tested whether these traits are indeed correlated to the host mortality rate induced by viral infection. We infected Brassica rapa and Arabidopsis thaliana plants with different natural isolates of Cauliflower mosaic virus (CaMV) and estimated over time the development of symptoms and the relative reduction of leaf area compared to healthy plants and followed plant mortality. We observed that the mortality of infected plants was correlated with the relative reduction of leaf area of both B. rapa and A. thaliana. Measures of mortality were also correlated with the severity of visual qualitative symptoms but the magnitude of the correlations and the time frame at which they were significant depended on the host plant: stronger and earlier correlations were observed on A. thaliana.

  2. Associations of acoustically measured tongue/jaw movements and portion of time speaking with negative symptom severity in patients with schizophrenia in Italy and the United States.

    PubMed

    Bernardini, Francesco; Lunden, Anya; Covington, Michael; Broussard, Beth; Halpern, Brooke; Alolayan, Yazeed; Crisafio, Anthony; Pauselli, Luca; Balducci, Pierfrancesco M; Capulong, Leslie; Attademo, Luigi; Lucarini, Emanuela; Salierno, Gianfranco; Natalicchi, Luca; Quartesan, Roberto; Compton, Michael T

    2016-05-30

    This is the first cross-language study of the effect of schizophrenia on speech as measured by analyzing phonetic parameters with sound spectrography. We hypothesized that reduced variability in pitch and formants would be correlated with negative symptom severity in two samples of patients with schizophrenia, one from Italy, and one from the United States. Audio recordings of spontaneous speech were available from 40 patients. From each speech sample, a file of F0 (pitch) and formant values (F1 and F2, resonance bands indicating the moment-by-moment shape of the oral cavity), and the portion of the recording in which there was speaking ("fraction voiced," FV), was created. Correlations between variability in the phonetic indices and negative symptom severity were tested and further examined using regression analyses. Meaningful negative correlations between Scale for the Assessment of Negative Symptoms (SANS) total score and standard deviation (SD) of F2, as well as variability in pitch (SD F0) were observed in the Italian sample. We also found meaningful associations of SANS affective flattening and SANS alogia with SD F0, and of SANS avolition/apathy and SD F2 in the Italian sample. In both samples, FV was meaningfully correlated with SANS total score, avolition/apathy, and anhedonia/asociality. PMID:27039009

  3. Reduction of leaf area and symptom severity as proxies of disease-induced plant mortality: the example of the Cauliflower mosaic virus infecting two Brassicaceae hosts.

    PubMed

    Doumayrou, Juliette; Leblaye, Sophie; Froissart, Rémy; Michalakis, Yannis

    2013-09-01

    Disease induced effects on host survival are important to understand the evolution of parasitic virulence and host resistance/tolerance. Unfortunately, experiments evaluating such effects are in most cases logistically demanding justifying the measurement of survival proxies. For plant hosts commonly used proxies are leaf area and the nature and severity of visual qualitative disease symptoms. In this study we tested whether these traits are indeed correlated to the host mortality rate induced by viral infection. We infected Brassica rapa and Arabidopsis thaliana plants with different natural isolates of Cauliflower mosaic virus (CaMV) and estimated over time the development of symptoms and the relative reduction of leaf area compared to healthy plants and followed plant mortality. We observed that the mortality of infected plants was correlated with the relative reduction of leaf area of both B. rapa and A. thaliana. Measures of mortality were also correlated with the severity of visual qualitative symptoms but the magnitude of the correlations and the time frame at which they were significant depended on the host plant: stronger and earlier correlations were observed on A. thaliana. PMID:23742852

  4. Posttraumatic stress symptom severity and cognitive-based smoking processes among trauma-exposed treatment-seeking smokers: The role of perceived stress.

    PubMed

    Garey, Lorra; Bakhshaie, Jafar; Vujanovic, Anka A; Reitzel, Lorraine R; Schmidt, Norman B; Zvolensky, Michael J

    2016-09-01

    Trauma exposure and smoking co-occur at an alarmingly high rate. However, there is little understanding of the mechanisms underlying this clinically significant relation. The present study examined perceived stress as an explanatory mechanism linking posttraumatic stress symptom severity and smoking-specific avoidance/inflexibility, perceived barriers to smoking cessation, and negative affect reduction/negative reinforcement expectancies from smoking among trauma-exposed smokers. Participants were trauma-exposed, treatment-seeking daily cigarette smokers (n=179; 48.0% female; Mage=41.17; SD=12.55). Results indicated that posttraumatic stress symptom severity had an indirect significant effect on each of the dependent variables via perceived stress. The present results provide empirical support that perceived stress may be an underlying mechanism that indirectly explains posttraumatic symptoms relation to smoking-specific avoidance/inflexibility, perceived barriers to smoking cessation, and negative affect reduction/negative reinforcement expectancies among trauma-exposed smokers. These findings suggest that there may be clinical utility in targeting perceived stress among trauma-exposed smokers via stress management psychoeducation and skills training.

  5. Coping Style Use Predicts Posttraumatic Stress and Complicated Grief Symptom Severity Among College Students Reporting a Traumatic Loss

    ERIC Educational Resources Information Center

    Schnider, Kimberly R.; Elhai, Jon D.; Gray, Matt J.

    2007-01-01

    Problem-focused coping, and active and avoidant emotional coping were examined as correlates of grief and posttraumatic stress disorder (PTSD) severity among 123 college students reporting the unexpected death of an immediate family member, romantic partner, or very close friend. The authors administered to participants, via the Internet, 5…

  6. Intimate Partner Violence and Depression Symptom Severity among South African Women during Pregnancy and Postpartum: Population-Based Prospective Cohort Study

    PubMed Central

    Tsai, Alexander C.; Tomlinson, Mark; Comulada, W. Scott; Rotheram-Borus, Mary Jane

    2016-01-01

    Background Violence against women by intimate partners remains unacceptably common worldwide. The evidence base for the assumed psychological impacts of intimate partner violence (IPV) is derived primarily from studies conducted in high-income countries. A recently published systematic review identified 13 studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. To address this gap in the literature, we analyzed longitudinal data collected during the course of a 3-y cluster-randomized trial with the aim of estimating the association between IPV and depression symptom severity. Methods and Findings We conducted a secondary analysis of population-based, longitudinal data collected from 1,238 pregnant women during a 3-y cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 mo, 18 mo, and 36 mo (85% retention). The primary explanatory variable of interest was exposure to four types of physical IPV in the past year. Depression symptom severity was measured using the Xhosa version of the ten-item Edinburgh Postnatal Depression Scale. In a pooled cross-sectional multivariable regression model adjusting for potentially confounding time-fixed and time-varying covariates, lagged IPV intensity had a statistically significant association with depression symptom severity (regression coefficient b = 1.04; 95% CI, 0.61–1.47), with estimates from a quantile regression model showing greater adverse impacts at the upper end of the conditional depression distribution. Fitting a fixed effects regression model accounting for all time-invariant confounding (e.g., history of childhood sexual abuse) yielded similar findings (b = 1.54; 95% CI, 1.13–1.96). The magnitudes of the coefficients indicated that a one–standard-deviation increase in IPV intensity was associated with a 12.3% relative increase in depression symptom severity over the same time period. The most important

  7. Basal ganglia dysfunction in OCD: subthalamic neuronal activity correlates with symptoms severity and predicts high-frequency stimulation efficacy.

    PubMed

    Welter, M-L; Burbaud, P; Fernandez-Vidal, S; Bardinet, E; Coste, J; Piallat, B; Borg, M; Besnard, S; Sauleau, P; Devaux, B; Pidoux, B; Chaynes, P; Tézenas du Montcel, S; Bastian, A; Langbour, N; Teillant, A; Haynes, W; Yelnik, J; Karachi, C; Mallet, L

    2011-05-03

    Functional and connectivity changes in corticostriatal systems have been reported in the brains of patients with obsessive-compulsive disorder (OCD); however, the relationship between basal ganglia activity and OCD severity has never been adequately established. We recently showed that deep brain stimulation of the subthalamic nucleus (STN), a central basal ganglia nucleus, improves OCD. Here, single-unit subthalamic neuronal activity was analysed in 12 OCD patients, in relation to the severity of obsessions and compulsions and response to STN stimulation, and compared with that obtained in 12 patients with Parkinson's disease (PD). STN neurons in OCD patients had lower discharge frequency than those in PD patients, with a similar proportion of burst-type activity (69 vs 67%). Oscillatory activity was present in 46 and 68% of neurons in OCD and PD patients, respectively, predominantly in the low-frequency band (1-8 Hz). In OCD patients, the bursty and oscillatory subthalamic neuronal activity was mainly located in the associative-limbic part. Both OCD severity and clinical improvement following STN stimulation were related to the STN neuronal activity. In patients with the most severe OCD, STN neurons exhibited bursts with shorter duration and interburst interval, but higher intraburst frequency, and more oscillations in the low-frequency bands. In patients with best clinical outcome with STN stimulation, STN neurons displayed higher mean discharge, burst and intraburst frequencies, and lower interburst interval. These findings are consistent with the hypothesis of a dysfunction in the associative-limbic subdivision of the basal ganglia circuitry in OCD's pathophysiology.

  8. Basal ganglia dysfunction in OCD: subthalamic neuronal activity correlates with symptoms severity and predicts high-frequency stimulation efficacy.

    PubMed

    Welter, M-L; Burbaud, P; Fernandez-Vidal, S; Bardinet, E; Coste, J; Piallat, B; Borg, M; Besnard, S; Sauleau, P; Devaux, B; Pidoux, B; Chaynes, P; Tézenas du Montcel, S; Bastian, A; Langbour, N; Teillant, A; Haynes, W; Yelnik, J; Karachi, C; Mallet, L

    2011-01-01

    Functional and connectivity changes in corticostriatal systems have been reported in the brains of patients with obsessive-compulsive disorder (OCD); however, the relationship between basal ganglia activity and OCD severity has never been adequately established. We recently showed that deep brain stimulation of the subthalamic nucleus (STN), a central basal ganglia nucleus, improves OCD. Here, single-unit subthalamic neuronal activity was analysed in 12 OCD patients, in relation to the severity of obsessions and compulsions and response to STN stimulation, and compared with that obtained in 12 patients with Parkinson's disease (PD). STN neurons in OCD patients had lower discharge frequency than those in PD patients, with a similar proportion of burst-type activity (69 vs 67%). Oscillatory activity was present in 46 and 68% of neurons in OCD and PD patients, respectively, predominantly in the low-frequency band (1-8 Hz). In OCD patients, the bursty and oscillatory subthalamic neuronal activity was mainly located in the associative-limbic part. Both OCD severity and clinical improvement following STN stimulation were related to the STN neuronal activity. In patients with the most severe OCD, STN neurons exhibited bursts with shorter duration and interburst interval, but higher intraburst frequency, and more oscillations in the low-frequency bands. In patients with best clinical outcome with STN stimulation, STN neurons displayed higher mean discharge, burst and intraburst frequencies, and lower interburst interval. These findings are consistent with the hypothesis of a dysfunction in the associative-limbic subdivision of the basal ganglia circuitry in OCD's pathophysiology. PMID:22832400

  9. An Examination of the Appropriateness of the Content of the DSM-IV AD/HD Symptom Criteria for Elementary School Girls

    ERIC Educational Resources Information Center

    DeGrass, Lisa Marie

    2009-01-01

    Like many childhood disorders, prevalence rates of AD/HD differ significantly across gender, with male-to-female ratios ranging from 2:1 to 9:1 depending on the sample (APA, 1994). Limited research has been conducted thus far in an effort to better understand these differential prevalence rates. However, it has been proposed that the current…

  10. What patients do to counteract the symptoms of Willis-Ekbom disease (RLS/WED): Effect of gender and severity of illness

    PubMed Central

    Gupta, Ravi; Goel, Deepak; Ahmed, Sohaib; Dhar, Minakshi; Lahan, Vivekananda

    2014-01-01

    Objectives: This study was carried out to assess different counteracting strategies used by patients with idiopathic Willis-Ekbom disease (RLS/WED). Whether these strategies were influenced by gender or disease severity was also assessed. Materials and Methods: A total of 173 patients of idiopathic RLS/WED were included in this study. Their demographic data was recorded. Details regarding the RLS/WED and strategies that they used to counteract the symptoms were asked. The severity of RLS/WED was measured with the help of the Hindi version of international restless legs syndrome severity rating scale. They were asked to provide the details regarding the relief obtained from all the strategies they used on three-point scale: no relief, some relief, and complete relief. Results: Of the patients, 72% were females. Mean age of the subjects in this study was 39.6 ± 12.6 years, and male subjects were older than females. Four common strategies were reported by the patients to counter the sensations of RLS/WED: moving legs while in bed (85.5%), asking somebody to massage their legs or massaging legs themselves (76.9%), walking (53.2%), and tying a cloth/rope tightly on the legs (39.3%). Of all the patients who moved their legs, 6.7% did not experience any relief, 64.2% reported some relief, and 28.4% reported complete relief. Similarly, of all the patients who used “walking” to counteract symptoms, 50% reported complete relief, 44.5% reported some relief, and the rest did not experience any relief. Many of these patients reported that massage and tying a cloth/rope on legs brought greater relief than any of these strategies. Tying cloth on the leg was more common among females as compared to males (45.9% females vs. 23.5% males; χ2 = 7.54; P = 0.006), while patients with moderately severe to severe RLS/WED reported “moving legs in bed” (79.3% in mild to moderate RLS/WED; 91.8% in severe to very severe RLS; χ2 = 5.36; P = 0.02). Conclusion: Patients with RLS

  11. Anger and Posttraumatic Stress Disorder Symptom Severity in a Trauma-Exposed Military Population: Differences by Trauma Context and Gender.

    PubMed

    Worthen, Miranda; Rathod, Sujit D; Cohen, Gregory; Sampson, Laura; Ursano, Robert; Gifford, Robert; Fullerton, Carol; Galea, Sandro; Ahern, Jennifer

    2015-12-01

    Studies have found a stronger association between anger and posttraumatic stress disorder (PTSD) severity in military populations than in nonmilitary populations. Two hypotheses have been proposed to explain this difference: Military populations are more prone to anger than nonmilitary populations, and traumas experienced on deployment create more anger than nondeployment traumas. To examine these hypotheses, we evaluated the association between anger and PTSD severity among never-deployed military service members with nondeployment traumas (n = 226) and deployed service members with deployment traumas (n = 594) using linear regression. We further examined these associations stratified by gender. Bivariate associations between anger and PTSD severity were similar for nondeployment and deployment events; however, gender modified this association. For men, the association for deployment events was stronger than for nondeployment events (β = .18, r = .53 vs. β = .16, r = .37, respectively), whereas the reverse was true for women (deployment: β = .20, r = .42 vs. nondeployment: β = .25, r = .65). Among men, findings supported the hypothesis that deployment traumas produce stronger associations between PTSD and anger and are inconsistent with hypothesized population differences. In women, however, there was not a clear fit with either hypothesis.

  12. Reconstructed summer Palmer Drought Severity Index since 1850 AD based on δ13C of larch tree rings in eastern Siberia

    NASA Astrophysics Data System (ADS)

    Tei, Shunsuke; Yonenobu, Hitoshi; Sugimoto, Atsuko; Ohta, Takeshi; Maximov, Trofim C.

    2015-10-01

    We present a tree-ring reconstruction of Palmer Drought Severity Index (PDSI) in Ust-Maya region (60°00‧N, 133°49‧E), central part of eastern Siberia using total ring (TR) widths and latewood (LW) δ13C chronologies from larch trees (1850-2008 AD). Summer (JJA) PDSI was correlated positively and negatively with the TR widths and LW δ13C, respectively. Using a multiple liner regression approach, we reconstructed summer PDSI using the time series of TR widths and LW δ13C. The reconstruction showed an interannual to decadal wet/dry fluctuation with several moist periods before 1950s and a severe drought event from 1991 to 1993. Comparison of the reconstruction with reconstructed July PDSI for the Yakutsk region, 300 km northwest of Ust-Maya, showed heterogeneous changes in the mean states of soil moisture, but synchronous year-to-year changes. These results indicate that regional studies are quite important to precisely depict the spatio-temporal variability of hydrological changes in the central part of eastern Siberia.

  13. Duplication of the MECP2 region is a frequent cause of severe mental retardation and progressive neurological symptoms in males.

    PubMed

    Van Esch, Hilde; Bauters, Marijke; Ignatius, Jaakko; Jansen, Mieke; Raynaud, Martine; Hollanders, Karen; Lugtenberg, Dorien; Bienvenu, Thierry; Jensen, Lars Riff; Gecz, Jozef; Moraine, Claude; Marynen, Peter; Fryns, Jean-Pierre; Froyen, Guy

    2005-09-01

    Loss-of-function mutations of the MECP2 gene at Xq28 are associated with Rett syndrome in females and with syndromic and nonsyndromic forms of mental retardation (MR) in males. By array comparative genomic hybridization (array-CGH), we identified a small duplication at Xq28 in a large family with a severe form of MR associated with progressive spasticity. Screening by real-time quantitation of 17 additional patients with MR who have similar phenotypes revealed three more duplications. The duplications in the four patients vary in size from 0.4 to 0.8 Mb and harbor several genes, which, for each duplication, include the MR-related L1CAM and MECP2 genes. The proximal breakpoints are located within a 250-kb region centromeric of L1CAM, whereas the distal breakpoints are located in a 300-kb interval telomeric of MECP2. The precise size and location of each duplication is different in the four patients. The duplications segregate with the disease in the families, and asymptomatic carrier females show complete skewing of X inactivation. Comparison of the clinical features in these patients and in a previously reported patient enables refinement of the genotype-phenotype correlation and strongly suggests that increased dosage of MECP2 results in the MR phenotype. Our findings demonstrate that, in humans, not only impaired or abolished gene function but also increased MeCP2 dosage causes a distinct phenotype. Moreover, duplication of the MECP2 region occurs frequently in male patients with a severe form of MR, which justifies quantitative screening of MECP2 in this group of patients.

  14. Duplication of the MECP2 Region Is a Frequent Cause of Severe Mental Retardation and Progressive Neurological Symptoms in Males

    PubMed Central

    Van Esch, Hilde ; Bauters, Marijke ; Ignatius, Jaakko ; Jansen, Mieke ; Raynaud, Martine ; Hollanders, Karen ; Lugtenberg, Dorien ; Bienvenu, Thierry ; Jensen, Lars Riff ; Gécz, Jozef ; Moraine, Claude ; Marynen, Peter ; Fryns, Jean-Pierre ; Froyen, Guy 

    2005-01-01

    Loss-of-function mutations of the MECP2 gene at Xq28 are associated with Rett syndrome in females and with syndromic and nonsyndromic forms of mental retardation (MR) in males. By array comparative genomic hybridization (array-CGH), we identified a small duplication at Xq28 in a large family with a severe form of MR associated with progressive spasticity. Screening by real-time quantitation of 17 additional patients with MR who have similar phenotypes revealed three more duplications. The duplications in the four patients vary in size from 0.4 to 0.8 Mb and harbor several genes, which, for each duplication, include the MR-related L1CAM and MECP2 genes. The proximal breakpoints are located within a 250-kb region centromeric of L1CAM, whereas the distal breakpoints are located in a 300-kb interval telomeric of MECP2. The precise size and location of each duplication is different in the four patients. The duplications segregate with the disease in the families, and asymptomatic carrier females show complete skewing of X inactivation. Comparison of the clinical features in these patients and in a previously reported patient enables refinement of the genotype-phenotype correlation and strongly suggests that increased dosage of MECP2 results in the MR phenotype. Our findings demonstrate that, in humans, not only impaired or abolished gene function but also increased MeCP2 dosage causes a distinct phenotype. Moreover, duplication of the MECP2 region occurs frequently in male patients with a severe form of MR, which justifies quantitative screening of MECP2 in this group of patients. PMID:16080119

  15. CO2 retention with minimal symptoms but severe dysfunction during wet simulated dives to 6.8 atm abs.

    PubMed

    Warkander, D E; Norfleet, W T; Nagasawa, G K; Lundgren, C E

    1990-11-01

    During wet dives in a hyperbaric chamber to 6.8 atm abs (690 kPa), air breathing subjects were experimentally exposed to external breathing resistance. Two of them were, unbeknownst to themselves, severely incapacitated. In the first incident the subject had been exercising for 25 min (end-tidal PCO2 60-65 mmHg, 7.3-8.0 kPa) when the breathing resistance was rapidly increased from low to very high (requiring pressure swings of 80 cmH2O, 8 kPa, peak to peak). He functioned normally (end-tidal PCO2 72 mmHg, 9.6 kPa) for about 100 s but 20 s later he was confused and irrational. After being extracted from the water (end-tidal PCO2 above 90 mmHg, 12 kPa), he lost consciousness for about 60 s. In the second incident the subject was exercising and breathing against a high resistance (pressure swings of 50-55 cmH2O, 5.0-5.6 kPa). His end-tidal PCO2 was high (65-68 mmHg, 8.7-9.3 kPa) throughout the exercise period, and after 24 min he reported mild dyspnea. A few seconds later he became confused. In other experiments both subjects voluntarily terminated experiments when the breathing resistance became overwhelming. These 2 subjects generally had high end-tidal PCO2 levels, but 1 other subject with end-tidal PCO2 levels in the same range never experienced any problems. These incidents indicate that severe hypercapnia does not necessarily correlate with dyspnea and that severe disturbances in mental function due to hypercapnia can develop suddenly when high breathing resistance is encountered in diving.

  16. Fever, rash and systemic symptoms: understanding the role of virus and HLA in severe cutaneous drug allergy

    PubMed Central

    Pavlos, Rebecca; Mallal, Simon; Ostrov, David; Pompeu, Yuri; Phillips, Elizabeth

    2014-01-01

    Drug hypersensitivity syndromes such as abacavir hypersensitivity and the severe cutaneous adverse drug reactions (SCAR) have been associated with significant short and long-term morbidity and mortality. More recently these immunologically mediated and previously unpredictable diseases have been shown to be associated with primarily Class I and also Class II HLA alleles. The case of the association of HLA-B*57:01 and abacavir hypersensitivity has created a translational roadmap for how this knowledge can be utilized in the clinic to prevent severe reactions. Although many hurdles exist to the widespread translation of such HLA screening approaches, our understanding of how drugs interact with the MHC has contributed to the discovery of new models that have provided considerable insights into the immunopathogenesis of SCAR and other T-cell mediated drug hypersensitivity syndromes. Future translation of this knowledge will facilitate the development of pre-clinical toxicity screening to significantly improve efficacy and safety of drug development and design. PMID:24565765

  17. Beyond symptom management: Family relations, unmet needs of persons living with severe mental illnesses, and potential implications for social work in South Africa.

    PubMed

    Tomita, Andrew; Burns, Jonathan K; King, Howard; Baumgartner, Joy Noel; Davis, Glen P; Mtshemla, Sisanda; Nene, Siphumelele; Susser, Ezra

    2016-01-01

    This study examined the quality of family relationships and its associations with the severity of unmet needs of individuals admitted to a tertiary psychiatric hospital in South Africa. The quality of family relations and perceived unmet needs were assessed using the Lehman Quality of Life Interview and Camberwell Assessment of Needs, respectively. The results show that higher total unmet needs were associated with lower quality of family relations. The main areas of serious unmet needs included accessing government benefits and information, and establishing social relations. The results have implications for hospital-based social workers beyond managing psychiatric symptoms in South Africa.

  18. Relationship of early-life trauma, war-related trauma, personality traits, and PTSD symptom severity: a retrospective study on female civilian victims of war

    PubMed Central

    Stevanović, Aleksandra; Frančišković, Tanja; Vermetten, Eric

    2016-01-01

    Background Consequences of war-related traumatisation have mostly been investigated in military and predominant male populations, while research on female civilian victims of war has been neglected. Furthermore, research of post-war posttraumatic stress disorder (PTSD) in women has rarely included early-life trauma in their prediction models, so the contribution of trauma in childhood and early youth is still unexplored. Objective To examine the relationship of early-life trauma, war-related trauma, personality traits, and symptoms of posttraumatic stress among female civilian victims of the recent war in Croatia. Method The cross-sectional study included 394 participants, 293 war-traumatised adult women civilians, and 101 women without war-related trauma. Participants were recruited using the snowball sampling method. The applied instruments included the Clinician-Administrated PTSD Scale (CAPS), the NEO Personality Inventory-Revised (NEO-PI-R), the War Stressors Assessment Questionnaire (WSAQ), and the Early Trauma Inventory Self Report-Short Form (ETISR-SF). A hierarchical multiple regression analysis was performed to assess the prediction model of PTSD symptom severity measured by CAPS score for current PTSD. Results The prevalence of current PTSD (CAPS cut-off score=65) in this cohort was 20.7%. The regression model that included age, early-life trauma, war-related trauma, neuroticism, and extraversion as statistically significant predictors explained 45.8% of variance in PTSD symptoms. Conclusions Older age, exposure to early-life trauma, exposure to war-related traumatic events, high neuroticism, and low extraversion are independent factors associated with higher level of PTSD symptoms among women civilian victims of war. PMID:27056034

  19. High velocity circuit resistance training improves cognition, psychiatric symptoms and neuromuscular performance in overweight outpatients with severe mental illness.

    PubMed

    Strassnig, Martin T; Signorile, Joseph F; Potiaumpai, Melanie; Romero, Matthew A; Gonzalez, Carolina; Czaja, Sara; Harvey, Philip D

    2015-09-30

    We developed a physical exercise intervention aimed at improving multiple determinants of physical performance in severe mental illness. A sample of 12 (9M, 3F) overweight or obese community-dwelling patients with schizophrenia (n=9) and bipolar disorder (n=3) completed an eight-week, high-velocity circuit resistance training, performed twice a week on the computerized Keiser pneumatic exercise machines, including extensive pre/post physical performance testing. Participants showed significant increases in strength and power in all major muscle groups. There were significant positive cognitive changes, objectively measured with the Brief Assessment of Cognition Scale: improvement in composite scores, processing speed and symbol coding. Calgary Depression Scale for Schizophrenia and Positive and Negative Syndrome Scale total scores improved significantly. There were large gains in neuromuscular performance that have functional implications. The cognitive domains that showed the greatest improvements (memory and processing speed) are most highly predictive of disability in schizophrenia. Moreover, the improvements seen in depression suggest this type of exercise intervention may be a valuable add-on therapy for bipolar depression.

  20. How do you feel? Self-esteem predicts affect, stress, social interaction, and symptom severity during daily life in patients with chronic illness.

    PubMed

    Juth, Vanessa; Smyth, Joshua M; Santuzzi, Alecia M

    2008-10-01

    Self-esteem has been demonstrated to predict health and well-being in a number of samples and domains using retrospective reports, but little is known about the effect of self-esteem in daily life. A community sample with asthma (n = 97) or rheumatoid arthritis (n = 31) completed a self-esteem measure and collected Ecological Momentary Assessment (EMA) data 5x/day for one week using a palmtop computer. Low self-esteem predicted more negative affect, less positive affect, greater stress severity, and greater symptom severity in daily life. Naturalistic exploration of mechanisms relating self-esteem to physiological and/or psychological components in illness may clarify causal relationships and inform theoretical models of self-care, well-being, and disease management.

  1. Oil body-associated hazelnut allergens including oleosins are underrepresented in diagnostic extracts but associated with severe symptoms

    PubMed Central

    2014-01-01

    Background Oil body-associated allergens such as oleosins have been reported for important allergenic foods such as peanut, sesame and hazelnut. Here we investigate whether oil body associated proteins (OAPs) are linked with specific clinical phenotypes and whether they are represented in skin prick test (SPT) reagents. Methods A hazelnut OAP fraction was characterized by mass-spectrometry (MS) to identify its major constituents. Polyclonal rabbit antibodies were generated against hazelnut OAPs. The presence of OAPs in commercially available hazelnut SPTs was studied by immunoblot and spiking experiments. OAP-specific IgE antibodies were measured in sera from patients with a convincing history of hazelnut allergy by RAST (n = 91), immunoblot (n = 22) and basophil histamine release (BHR; n = 14). Results Hazelnut OAPs were analysed by MS and found to be dominated by oleosins at ~14 and ~17 kDa, and a 27 kDa band containing oleosin dimers and unidentified protein. In 36/91 sera specific IgE against hazelnut OAPs was detected, and confirmed to be biologically active by BHR (n = 14). The majority (21/22) recognized the oleosin bands at 17 kDa on immunoblot, of which 11 exclusively. These OAP-specific IgE responses dominated by oleosin were associated with systemic reactions to hazelnut (OR 4.24; p = 0.015) and negative SPT (χ2 6.3, p = 0.012). Immunoblot analysis using OAP-specific rabbit antiserum demonstrated that commercial SPT reagents are virtually devoid of OAPs, sometimes (3/9) resulting in false-negative SPT. Spiking of SPT reagents with OAP restored serum IgE binding of these false-negative patients on immunoblot at mainly 17 kDa. Conclusion Hazelnut allergens found in oil bodies dominated by oleosin are associated with more severe systemic reactions and negative SPT. Defatted diagnostic extracts are virtually devoid of these allergens, resulting in poor sensitivity for detection of IgE antibodies against these clinically relevant

  2. Prevalence of pain and association with psychiatric symptom severity in perinatally HIV-infected children as compared to controls living in HIV-affected households.

    PubMed

    Serchuck, Leslie K; Williams, Paige L; Nachman, Sharon; Gadow, Kenneth D; Chernoff, Miriam; Schwartz, Lynnae

    2010-05-01

    This cross-sectional study evaluated the prevalence of pain and psychiatric symptoms in perinatally HIV-infected children at entry into P1055, a multicenter investigation of the prevalence and severity of psychiatric symptoms in HIV-infected children. Subjects 6-17 years of age and their primary caregivers were recruited from 29 International Maternal Pediatric Adolescent AIDS Clinical Trials sites in the USA and Puerto Rico. A total of 576 children (320 HIV and 256 HIV- children) were enrolled from June 2005 to September 2006. Subject self-reports of pain were measured by the Wong-Baker visual analog scale and Short-Form McGill Pain Questionnaire. Symptomatology for anxiety, depression, and dysthymia was assessed through Symptom Inventory instruments. Caregiver's assessment of their child's pain and psychiatric symptomatology was similarly measured. Logistic regression models were used to evaluate predictors of pain. We found that a higher proportion of HIV-infected than uninfected subjects reported pain in the last two months (41% vs 32%, p=0.04), last two weeks (28% vs 19%, p=0.02), and lasting more than one week (20% vs 11%, p=0.03). Among HIV-infected youth, females (OR=1.53, p=0.09), White race (OR=2.15, p=0.04), and Centers for Disease Control (CDC) Class C (OR=1.83, p=0.04) were significantly more likely to report pain. For all subjects, only 52% of caregivers recognized their child's pain and just 22% were aware that pain affected their child's daily activities. The odds of reported pain in HIV increased with higher symptom severity for generalized anxiety (OR=1.14, p=0.03), major depression (OR=1.15, p=0.03), and dysthymia (OR=1.18, p=0.01). This study underscores the importance of queries concerning pain and emotional stressors in the care of HIV and uninfected children exposed to HIV individuals. The discordance between patient and caregiver reports of pain and its impact on activities of daily living highlights that pain in children is under

  3. Use of the Beck Depression Inventory for assessing depression in patients hospitalized with severe burn. Disentangling symptoms of depression from injury and treatment factors.

    PubMed

    Thombs, Brett D

    2007-08-01

    The objective of this study was to assess whether scores on the Beck Depression Inventory (BDI) are biased by injury severity among hospitalized survivors of burn (N=262). A confirmatory factor analysis (CFA) model was developed with a general depression factor that loaded on all items and somatic and cognitive factors that were orthogonal to the general factor and to each other. The model fit the data well and substantially better than an alternative three-factor model with correlated factors. Percent total body surface area burned (TBSA) was significantly associated with the general depression factor (p=.04), but also with the orthogonal somatic factor (p<.001), suggesting biased measurement due to overlap between somatic symptoms of depression and the severity of the burn injury. Analysis of item communalities, however, suggested that only approximately 2% of total predicted item variance was associated with bias related to injury severity. It was concluded that, despite a small amount of bias, the BDI is a reasonably accurate clinical tool even in the context of severe burn. Appropriate adjustments for bias, however, should be made in research with the BDI among patients with acute burn.

  4. Disturbances of spontaneous empathic processing relate with the severity of the negative symptoms in patients with schizophrenia: a behavioural pilot-study using virtual reality technology.

    PubMed

    Thirioux, Bérangère; Tandonnet, Louis; Jaafari, Nematollah; Berthoz, Alain

    2014-10-01

    Behavioural and neuroimaging data have recently pointed out that empathy (feeling into someone else) is associated with mental imagery and transformation related to one's and other's visuo-spatial perspectives. Impairments of both empathic and visuo-spatial abilities have been observed in patients with schizophrenia. Especially, it has been suggested that schizophrenics are altered in spontaneously simulating another individual's first-person experience. However, there is so far only little evidence regarding the relationship between deficits in empathy and disturbances in spontaneous heterocentered coding in schizophrenia. In the present pilot-study, we tested with schizophrenic patients our behavioural paradigm that enables to measure from the bodily postures and movements whether individuals in ecologically more valid conditions are interacting with another individual by using egocentered - as in sympathy (feeling with someone else) - or heterocentered - as in empathy - visuo-spatial mechanisms. For that, ten patients and ten controls, standing and moving, interacted with a virtual tightrope walker, displayed life-sized, standing and moving as well. We show that patients with higher negative symptoms had, in most cases, deficits in spontaneously using heterocentered visuo-spatial mechanisms and employed preferentially an egocentered referencing to interact with the avatar. In contrast, preserved spontaneous heterocentered visuo-spatial strategies were not linked to a prevailing negative or positive symptomatology. Our data suggest that the severity of the negative symptoms in schizophrenia relates with disturbances of spontaneous ("on-line") empathic processing in association with lower scoring self-reported trait cognitive empathy. PMID:25014409

  5. Elderly Patients with Dementia-Related Symptoms of Severe Agitation and Aggression: Consensus Statement on Treatment Options, Clinical Trials Methodology, and Policy

    PubMed Central

    Salzman, C; Jeste, D; Meyer, RE; Cohen-Mansfield, J; Cummings, J; Grossberg, G; Jarvik, L; Kraemer, H; Lebowitz, B; Maslow, K; Pollock, B; Raskind, M; Schultz, S; Wang, P; Zito, JM; Zubenko, GS

    2009-01-01

    Atypical antipsychotic drugs have been used off-label in clinical practice for treatment of serious dementia-associated agitation and aggression. Following reports of cerebrovascular adverse events associated with the use of atypical antipsychotic in elderly patients with dementia, the FDA issued black box warnings for several atypical antipsychotics, titled “Cerebrovascular Adverse Events, including Stroke, in Elderly Patients with Dementia.” Subsequently, the FDA initiated a meta-analysis of safety data from 17 registration trials across six antipsychotic drugs (five atypical antipsychotics and haloperidol). In 2005, the Agency issued a black box warning regarding increased risk of mortality associated with the use of atypical antipsychotic drugs in this patient population. Geriatric mental health experts participating in a 2006 consensus conference reviewed evidence on the safety and efficacy of antipsychotics, as well as nonpharmacologic approaches, in treating dementia-related symptoms of agitation and aggression. They concluded that, while problems in clinical trials design may have been one of the contributors to the failure to find a signal of drug efficacy, the findings related to drug safety should be taken seriously by clinicians in assessing the potential risks and benefits of treatment in a frail population, and in advising families about treatment. Information provided to patients and family members should be documented in the patient’s chart. Drugs should be used only when non-pharmacologic approaches have failed to adequately control behavioral disruption. Participants also agreed that that there is a need for an FDA-approved medication for the treatment of severe, persistent or recurrent dementia-related symptoms of agitation and aggression (even in the absence of psychosis), that are unresponsive to nonpharmacologic intervention. The authors have outlined methodological enhancements to better evaluate treatment approaches in future

  6. Depressive symptoms associated with hereditary Alzheimer's disease: a case description.

    PubMed

    Contreras, Mónica Yicette Sánchez; Vargas, Paula Alejandra Osorio; Ramos, Lucero Rengifo; Velandia, Rafael Alarcón

    The authors describe a family group studied by the Centro de Biología Molecular y Biotecnología, and the Clínica de la Memoria, las Demencias y el Envejecimiento (Universidad Tecnológica de Pereira, Colombia), and evaluate the association of depressive symptoms with Alzheimer's disease (AD). This family presented a hereditary pattern for AD characterized by an early onset of dementia symptoms, a long preclinical depressive course, and, once the first symptoms of dementia appeared, a rapid progression to severe cognitive function impairment. The authors found a high prevalence of depressive symptoms in this family and propose that the symptoms could be an important risk factor for developing AD in the presence of other risk factors such as the APOE E4 allele.

  7. Segmented strings in AdS 3

    NASA Astrophysics Data System (ADS)

    Callebaut, Nele; Gubser, Steven S.; Samberg, Andreas; Toldo, Chiara

    2015-11-01

    We study segmented strings in flat space and in AdS 3. In flat space, these well known classical motions describe strings which at any instant of time are piecewise linear. In AdS 3, the worldsheet is composed of faces each of which is a region bounded by null geodesics in an AdS 2 subspace of AdS 3. The time evolution can be described by specifying the null geodesic motion of kinks in the string at which two segments are joined. The outcome of collisions of kinks on the worldsheet can be worked out essentially using considerations of causality. We study several examples of closed segmented strings in AdS 3 and find an unexpected quasi-periodic behavior. We also work out a WKB analysis of quantum states of yo-yo strings in AdS 5 and find a logarithmic term reminiscent of the logarithmic twist of string states on the leading Regge trajectory.

  8. Influence of the severity and location of bodily injuries on post-concussive and combat stress symptom reporting after military-related concurrent mild traumatic brain injuries and polytrauma.

    PubMed

    French, Louis M; Lange, Rael T; Marshall, Kathryn; Prokhorenko, Olga; Brickell, Tracey A; Bailie, Jason M; Asmussen, Sarah B; Ivins, Brian; Cooper, Douglas B; Kennedy, Jan E

    2014-10-01

    Traumatic brain injuries (TBI) sustained in combat frequently co-occur with significant bodily injuries. Intuitively, more extensive bodily injuries might be associated with increased symptom reporting. In 2012, however, French et al. demonstrated an inverse relation between bodily injury severity and symptom reporting. This study expands on that work by examining the influence of location and severity of bodily injuries on symptom reporting after mild TBI. Participants were 579 US military service members who sustained an uncomplicated mild TBI with concurrent bodily injuries and who were evaluated at two military medical centers. Bodily injury severity was quantified using a modified Injury Severity Score (ISSmod). Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C), on average, 2.5 months post-injury. There was a significant negative association between ISSmod scores and NSI (r=-0.267, p<0.001) and PCL-C (r=-0.273, p<0.001) total scores. Using linear regression to examine the relation between symptom reporting and injury severity across the six ISS body regions, three body regions were significant predictors of the NSI total score (face; p<0.001; abdomen; p=0.003; extremities; p<0.001) and accounted for 9.3% of the variance (p<0.001). For the PCL-C, two body regions were significant predictors of the PCL-C total score (face; p<0.001; extremities; p<0.001) and accounted for 10.5% of the variance. There was an inverse relation between bodily injury severity and symptom reporting in this sample. Hypothesized explanations include underreporting of symptoms, increased peer support, disruption of fear conditioning because of acute morphine use, or delayed expression of symptoms.

  9. The University of Michigan Incontinence Symptom Index (M-ISI): a Clinical Measure for Type, Severity, and Bother related to Urinary Incontinence

    PubMed Central

    Suskind, Anne M.; Dunn, Rodney L.; Morgan, Daniel M.; DeLancey, John O.L.; McGuire, Edward J.; Wei, John T.

    2013-01-01

    Aims To develop a clinically relevant, easy to use, and validated instrument for assessing severity and bother related to urinary incontinence. Methods Survey items were piloted and refined following psychometric principles in five separate patient cohorts. Patient and expert endorsement of items, factor analyses, Spearman rank correlations and response distributions were employed for item selection. Formal reliability and validity evaluation were conducted for the final questionnaire items. Results Expert physicians and patient focus groups confirmed face and content validity for the measure. A 10-item measure called the Michigan Incontinence Symptom Index (M-ISI) was developed with two domains: a Total M-ISI Domain consisting of subdomains for stress urinary incontinence, urgency urinary incontinence, and pad use, and a Bother Domain. High construct validity was demonstrated with a Cronbach’s alpha for the Total M-ISI Domain (items 1–8) of 0.90 and for the Bother Domain (items 9–10) of 0.82. Cronbach’s alpha for the subdomains were all > 0.85. Construct validity, convergent and divergent validity, internal discriminant validity, and predictive validity were all robust. The minimally important difference for the measure was determined to be 4 points (out of 32) for the Total M-ISI Severity Domain, and 1–2 points (out of 8–12) for the individual subdomains. Conclusions The M-ISI is a parsimonious measure that has established reliability and validity on several levels and complements current clinical evaluative methods for patients with urinary incontinence. PMID:23945994

  10. Relationship between the prefrontal function and the severity of the emotional symptoms during a verbal fluency task in patients with major depressive disorder: a multi-channel NIRS study.

    PubMed

    Liu, Xiaomin; Sun, Gaoxiang; Zhang, Xiaoqian; Xu, Bo; Shen, Chenyu; Shi, Lujie; Ma, Xiangyun; Ren, Xiajin; Feng, Kun; Liu, Pozi

    2014-10-01

    Multi-channel near-infrared spectroscopy (NIRS) is a noninvasive and low-cost functional neuroimaging technique in psychiatric research, and it has been wildly used for detecting the spatiotemporal characteristics of brain activity. In order to evaluate the clinical value of NIRS data in the assistant diagnosis of major depressive disorder (MDD), prefrontal cortex (PFC) hemoglobin concentration exchange of 30 MDD patients combined with anxious and obsessive-compulsive symptom was detected by NIRS under voice fluency task (VFT), then the relationship between the severity of depressive, anxious and obsessive-compulsive symptom assessed by Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) with NIRS data in PFC was analyzed. Hypoactivation in lateral and lower PFC of MDD patients was confirmed in this study. Furthermore, Spearman correlation found that oxy-hemoglobin concentration ([oxy-Hb]) exchange in right-lateral PFC was associated with the severity of anxiety, while bilateral PFC and antero-medial PFC were associated with severity of depression. Meanwhile, no statistical correlation was observed on the severity of obsessive-compulsive symptom. The results prompted that MDD patients with anxiety and obsession-compulsion symptom showed a PFC hypoactivation state in NIRS. Furthermore, the function of right-lateral PFC was associated with anxiety symptom, while bilateral PFC and antero-medial PFC were associated with depression symptom. Different from depression and anxiety, obsession-compulsion may have a different biological character in PFC function.

  11. The assessment of the relationship between personality, the presence of the 5HTT and MAO-A polymorphisms, and the severity of climacteric and depressive symptoms in postmenopausal women.

    PubMed

    Jurczak, Anna; Szkup, Małgorzata; Wieder-Huszla, Sylwia; Grzywacz, Anna; Samochowiec, Agnieszka; Karakiewicz, Beata; Samochowiec, Jerzy; Grochans, Elżbieta

    2015-08-01

    The purpose of this study is to determine the relationship between personality, the serotonin transporter (5HTT) and monoamine oxidase A (MAO-A) polymorphisms and the severity of climacteric and depressive symptoms in postmenopausal women. The study involved 272 healthy postmenopausal women from Poland. This survey-based study was performed using the following: the Beck Depression Inventory for depressive symptoms, the Blatt-Kupperman Menopausal Index and the Neuroticism-Extroversion-Openness-Five Factor Inventory for personality. A polymerase chain reaction was employed to identify the DNA polymorphisms. The women were aged 55.4 ± 5.5 years on average. Significant correlations were proved between the allele frequency of the 30-bp variable-number tandem repeat (VNTR) polymorphism in the MAO-A promoter region and the incidence of depressive symptoms in the women analysed (p ≤ 0.05), as well as between the severity of climacteric symptoms in the postmenopausal women and the allele frequency of the polymorphism in the 5HTT gene (the 5HTT 's' variant) (p ≤ 0.05). There was a significant correlation between the severity of climacteric and depressive symptoms (p < 0.001). (1) The severity of climacteric and depressive symptoms depends on personality traits. (2) Personality traits are biologically determined, and the level of their expression is associated with the 5HTT polymorphism. (3) Identification of homogeneous groups of women having predispositions to depressive and severe climacteric symptoms may help to implement early prevention programmes for this group of recipients.

  12. PATIENT-REPORTED OUTCOMES OF QUALITY OF LIFE, FUNCTIONING, AND DEPRESSIVE SYMPTOM SEVERITY IN MAJOR DEPRESSIVE DISORDER COMORBID WITH PANIC DISORDER BEFORE AND AFTER SSRI TREATMENT IN THE STAR*D TRIAL

    PubMed Central

    IsHak, Waguih William; Mirocha, James; Christensen, Scott; Wu, Fan; Kwock, Richard; Behjat, Joseph; Pi, Sarah; Akopyan, A.; Peselow, Eric D.; Cohen, Robert M.; Elashoff, David

    2014-01-01

    Background Panic disorder (PD) is highly comorbid with major depressive disorder (MDD) with potential impact on patient-reported outcomes of quality of life (QOL), functioning, and depressive symptom severity Methods Using data from the sequenced treatment alternatives to relieve depression (STAR*D) trial, we compared entry and post-SSRI-treatment QOL, functioning, and depressive symptom severity scores in MDD patients with comorbid PD (MDD+PD) to MDD patients without PD (MDDnoPD). We also compared pre- and posttreatment proportions of patients with severe impairments in quality of life and functioning. Results MDD+PD patients experienced significantly lower QOL and functioning and more severe depressive symptoms than MDDnoPD patients at entry. Following treatment with citalopram, both groups showed significant improvements, however, nearly 30–60% of patients still suffered from severe quality of life and functioning impairments. MDD+PD patients exited with lower QOL and functioning than MDDnoPD patients, a difference that became statistically insignificant after adjusting for baseline measures of depressive symptom severity, functioning, and QOL, comorbid anxiety disorders (PTSD, GAD, social, and specific phobias), age, and college education. Conclusions Functional outcomes using QOL and functioning measures should be utilized in treating and researching MDD so that shortfalls in traditional treatment can be identified and additional interventions can be designed to address severe baseline QOL and functioning deficits in MDD comorbid with PD. PMID:23861180

  13. Persistent CSF but not plasma HIV RNA is associated with increased risk of new-onset moderate-to-severe depressive symptoms; a prospective cohort study.

    PubMed

    Hammond, Edward R; Crum, Rosa M; Treisman, Glenn J; Mehta, Shruti H; Clifford, David B; Ellis, Ronald J; Gelman, Benjamin B; Grant, Igor; Letendre, Scott L; Marra, Christina M; Morgello, Susan; Simpson, David M; Mcarthur, Justin C

    2016-08-01

    Major depressive disorder is the most common neuropsychiatric complication in human immunodeficiency virus (HIV) infections and is associated with worse clinical outcomes. We determined if detectable cerebrospinal fluid (CSF) HIV ribonucleic acid (RNA) at threshold ≥50 copies/ml is associated with increased risk of depression. The CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) cohort is a six-center US-based prospective cohort with bi-annual follow-up of 674 participants. We fit linear mixed models (N = 233) and discrete-time survival models (N = 154; 832 observations) to evaluate trajectories of Beck Depression Inventory (BDI) II scores and the incidence of new-onset moderate-to-severe depressive symptoms (BDI ≥ 17) among participants on combination antiretroviral therapy (cART), who were free of depression at study entry and received a minimum of three CSF examinations over 2496 person-months follow-up. Detectable CSF HIV RNA (threshold ≥50 copies/ml) at any visit was associated with a 4.7-fold increase in new-onset depression at subsequent visits adjusted for plasma HIV RNA and treatment adherence; hazard ratio (HR) = 4.76, (95 % CI 1.58-14.3); P = 0.006. Depression (BDI) scores were 2.53 points higher (95 % CI 0.47-4.60; P = 0.02) over 6 months if CSF HIV RNA was detectable at a prior study visit in fully adjusted models including age, sex, race, education, plasma HIV RNA, duration and adherence of CART, and lifetime depression diagnosis by Diagnostic Statistical Manual (DSM-IV) criteria. Persistent CSF but not plasma HIV RNA is associated with an increased risk for new-onset depression. Further research evaluating the role of immune activation and inflammatory markers may improve our understanding of this association. PMID:26727907

  14. Persistent CSF but not plasma HIV RNA is associated with increased risk of new-onset moderate-to-severe depressive symptoms; a prospective cohort study.

    PubMed

    Hammond, Edward R; Crum, Rosa M; Treisman, Glenn J; Mehta, Shruti H; Clifford, David B; Ellis, Ronald J; Gelman, Benjamin B; Grant, Igor; Letendre, Scott L; Marra, Christina M; Morgello, Susan; Simpson, David M; Mcarthur, Justin C

    2016-08-01

    Major depressive disorder is the most common neuropsychiatric complication in human immunodeficiency virus (HIV) infections and is associated with worse clinical outcomes. We determined if detectable cerebrospinal fluid (CSF) HIV ribonucleic acid (RNA) at threshold ≥50 copies/ml is associated with increased risk of depression. The CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) cohort is a six-center US-based prospective cohort with bi-annual follow-up of 674 participants. We fit linear mixed models (N = 233) and discrete-time survival models (N = 154; 832 observations) to evaluate trajectories of Beck Depression Inventory (BDI) II scores and the incidence of new-onset moderate-to-severe depressive symptoms (BDI ≥ 17) among participants on combination antiretroviral therapy (cART), who were free of depression at study entry and received a minimum of three CSF examinations over 2496 person-months follow-up. Detectable CSF HIV RNA (threshold ≥50 copies/ml) at any visit was associated with a 4.7-fold increase in new-onset depression at subsequent visits adjusted for plasma HIV RNA and treatment adherence; hazard ratio (HR) = 4.76, (95 % CI 1.58-14.3); P = 0.006. Depression (BDI) scores were 2.53 points higher (95 % CI 0.47-4.60; P = 0.02) over 6 months if CSF HIV RNA was detectable at a prior study visit in fully adjusted models including age, sex, race, education, plasma HIV RNA, duration and adherence of CART, and lifetime depression diagnosis by Diagnostic Statistical Manual (DSM-IV) criteria. Persistent CSF but not plasma HIV RNA is associated with an increased risk for new-onset depression. Further research evaluating the role of immune activation and inflammatory markers may improve our understanding of this association.

  15. Relationship between omalizumab pharmacokinetics, IgE pharmacodynamics and symptoms in patients with severe persistent allergic (IgE-mediated) asthma

    PubMed Central

    Lowe, Philip J; Tannenbaum, Stacey; Gautier, Aurelie; Jimenez, Pablo

    2009-01-01

    AIMS Omalizumab, a subcutaneously administered anti-IgE antibody, is effective for moderate-to-severe persistent allergic asthma. The aims were to (i) describe the population pharmacodynamics of free IgE with a mechanism-based, nonlinear, omalizumab–IgE binding model; (ii) deduce a target-free IgE suppression level by correlation with clinical outcomes; and (iii) check the adequacy of current approved dosing tables and explore potential doses and regimens beyond. METHODS Concentration data (omalizumab, free and total IgE) were obtained from 1781 patients aged 12–79 years, in four sparsely sampled randomized, placebo-controlled studies and 152 subjects in a richly sampled single-dose study. NONMEM predictive performance across the range of bodyweights (39–150 kg) and baseline IgE (19–1055 IU ml−1) was checked by simulation. Predicted free IgE levels were correlated with time-averaged patient diary clinical outcomes. RESULTS The model accurately predicted observed omalizumab, free and total IgE concentrations. Free IgE concentrations correlated well with clinical signs and symptoms, allowing a target concentration of 14 ng ml−1, at the midpoint of 4-week clinical observation periods, to be set for determining the dose and regimen for omalizumab. CONCLUSIONS The omalizumab–IgE binding model is predictive for free IgE and demonstrates a nonlinear time-dependent relationship between free IgE suppression and clinical outcomes in asthma. Although currently approved dosing tables are close to optimal, it should be possible to treat patients with higher levels of baseline IgE if higher doses can be administered. PMID:19660004

  16. Associations between omega-3 poly-unsaturated fatty acids from fish consumption and severity of depressive symptoms: an analysis of the 2005–2008 National Health and Nutrition Examination Survey

    PubMed Central

    Hoffmire, Claire A.; Block, Robert C.; Thevenet-Morrison, Kelly; van Wijngaarden, Edwin

    2012-01-01

    SUMMARY Fish is the primary source of dietary omega-3 poly-unsaturated fatty acids EPA and DHA, which have been reported to reduce depressive symptoms in clinical trials. We assessed the association between fish consumption and depressive symptoms in a nationally representative sample of 10,480 adults from the 2005–2008 National Health and Nutrition Examination Survey. Depressive symptoms were classified by severity using the Patient Health Questionnaire. Fish meal consumption reported in 30-day food frequency questionnaires, and EPA+DHA intake computed from 24-hour dietary recalls were evaluated in relation to depressive symptoms using multivariable ordinal logistic regression. Consumption of breaded fish showed an increased risk of greater depressive symptom severity, while all fish, non-breaded fish, and shell fish were not associated. Any EPA+DHA intake was significantly associated with fewer depressive symptoms. Exposure-response analyses revealed no clear patterns for any intake measures. Inconsistent patterns of associations in our study may be partially explained by exposure misclassification. PMID:22472486

  17. Hairy AdS solitons

    NASA Astrophysics Data System (ADS)

    Anabalón, Andrés; Astefanesei, Dumitru; Choque, David

    2016-11-01

    We construct exact hairy AdS soliton solutions in Einstein-dilaton gravity theory. We examine their thermodynamic properties and discuss the role of these solutions for the existence of first order phase transitions for hairy black holes. The negative energy density associated to hairy AdS solitons can be interpreted as the Casimir energy that is generated in the dual filed theory when the fermions are antiperiodic on the compact coordinate.

  18. Multi-analyte profile analysis of plasma immune proteins: altered expression of peripheral immune factors is associated with neuropsychiatric symptom severity in adults with and without chronic hepatitis C virus infection.

    PubMed

    Huckans, Marilyn; Fuller, Bret E; Olavarria, Hannah; Sasaki, Anna W; Chang, Michael; Flora, Kenneth D; Kolessar, Michael; Kriz, Daniel; Anderson, Jeanne R; Vandenbark, Arthur A; Loftis, Jennifer M

    2014-03-01

    BackgroundThe purpose of this study was to characterize hepatitis C virus (HCV)-associated differences in the expression of 47 inflammatory factors and to evaluate the potential role of peripheral immune activation in HCV-associated neuropsychiatric symptoms-depression, anxiety, fatigue, and pain. An additional objective was to evaluate the role of immune factor dysregulation in the expression of specific neuropsychiatric symptoms to identify biomarkers that may be relevant to the treatment of these neuropsychiatric symptoms in adults with or without HCV. MethodsBlood samples and neuropsychiatric symptom severity scales were collected from HCV-infected adults (HCV+, n = 39) and demographically similar noninfected controls (HCV-, n = 40). Multi-analyte profile analysis was used to evaluate plasma biomarkers. ResultsCompared with HCV- controls, HCV+ adults reported significantly (P < 0.050) greater depression, anxiety, fatigue, and pain, and they were more likely to present with an increased inflammatory profile as indicated by significantly higher plasma levels of 40% (19/47) of the factors assessed (21%, after correcting for multiple comparisons). Within the HCV+ group, but not within the HCV- group, an increased inflammatory profile (indicated by the number of immune factors > the LDC) significantly correlated with depression, anxiety, and pain. Within the total sample, neuropsychiatric symptom severity was significantly predicted by protein signatures consisting of 4-10 plasma immune factors; protein signatures significantly accounted for 19-40% of the variance in depression, anxiety, fatigue, and pain. ConclusionsOverall, the results demonstrate that altered expression of a network of plasma immune factors contributes to neuropsychiatric symptom severity. These findings offer new biomarkers to potentially facilitate pharmacotherapeutic development and to increase our understanding of the molecular pathways associated with neuropsychiatric symptoms in

  19. Multi-analyte profile analysis of plasma immune proteins: altered expression of peripheral immune factors is associated with neuropsychiatric symptom severity in adults with and without chronic hepatitis C virus infection.

    PubMed

    Huckans, Marilyn; Fuller, Bret E; Olavarria, Hannah; Sasaki, Anna W; Chang, Michael; Flora, Kenneth D; Kolessar, Michael; Kriz, Daniel; Anderson, Jeanne R; Vandenbark, Arthur A; Loftis, Jennifer M

    2014-03-01

    BackgroundThe purpose of this study was to characterize hepatitis C virus (HCV)-associated differences in the expression of 47 inflammatory factors and to evaluate the potential role of peripheral immune activation in HCV-associated neuropsychiatric symptoms-depression, anxiety, fatigue, and pain. An additional objective was to evaluate the role of immune factor dysregulation in the expression of specific neuropsychiatric symptoms to identify biomarkers that may be relevant to the treatment of these neuropsychiatric symptoms in adults with or without HCV. MethodsBlood samples and neuropsychiatric symptom severity scales were collected from HCV-infected adults (HCV+, n = 39) and demographically similar noninfected controls (HCV-, n = 40). Multi-analyte profile analysis was used to evaluate plasma biomarkers. ResultsCompared with HCV- controls, HCV+ adults reported significantly (P < 0.050) greater depression, anxiety, fatigue, and pain, and they were more likely to present with an increased inflammatory profile as indicated by significantly higher plasma levels of 40% (19/47) of the factors assessed (21%, after correcting for multiple comparisons). Within the HCV+ group, but not within the HCV- group, an increased inflammatory profile (indicated by the number of immune factors > the LDC) significantly correlated with depression, anxiety, and pain. Within the total sample, neuropsychiatric symptom severity was significantly predicted by protein signatures consisting of 4-10 plasma immune factors; protein signatures significantly accounted for 19-40% of the variance in depression, anxiety, fatigue, and pain. ConclusionsOverall, the results demonstrate that altered expression of a network of plasma immune factors contributes to neuropsychiatric symptom severity. These findings offer new biomarkers to potentially facilitate pharmacotherapeutic development and to increase our understanding of the molecular pathways associated with neuropsychiatric symptoms in

  20. Premenstrual symptoms.

    PubMed

    1973-03-24

    Data is reviewed on premenstrual symptoms which have been related to high suicide and accident rates, employment absentee rates, poor academic performance and acute psychiatric problems. A recent study of healthy young women indicated that 39% had troublesome premenstrual symptoms, 54% passed clots in their menses, 70% had cyclical localized acneiform eruptions and only 17% failed to experience menstrual pain. Common menstrual disorders are classified as either dysmenorrhea or the premenstrual syndrome. Symptoms for the latter usually begin 2-12 days prior to menstruation and include nervous tension, irritability, anxiety, depression, bloated breasts and abdomen, swollen fingers and legs, headaches, dizziness, occasional hypersomia, excessive thirst and appetite. Some women may display an increased susceptibility to migraine, vasomotor rhinitis, asthma, urticaria and epilepsy. Symptoms are usually relieved with the onset of menses. While a definitive etiological theory remains to be substantiated, symptomatic relief has been reported with salt and water restriction and simple diuretics used 7 to 10 days premenstrually. Diazapam or chlordiazepoxide treatment is recommended before oral contraceptive therapy. The premenstrual syndrome may persist after menopause, is unaffected by parity, and sufferers score highly on neuroticism tests. Primary or spasmodic dysmenorrhea occurs in young women, tends to decline with age and parity and has no correlation with premenstrual symptoms or neuroticism. Spasmodic or colicky pain begins and is most severe on the first day of menstruation and may continue for 2-3 days. Treatment of dysmenorrhea with psychotropic drugs or narcotics is discouraged due to the risk of dependence and abuse. Temporary relief for disabling pain may be obtained with oral contraceptives containing synthetic estrogen and progestogen but the inherent risks should be acknowledged. Both disorders have been correlated to menstrual irregularity. Amenorrhea in

  1. A single residue in the 126-kDa protein of pepper mild mottle virus controls the severity of symptoms on infected green bell pepper plants.

    PubMed

    Ichiki, T U; Nagaoka, E N; Hagiwara, K; Sasaya, T; Omura, T

    2009-01-01

    Infectious cDNA clones originally derived from a mild strain of Pepper mild mottle virus were constructed by replacing residue 649, a critical point for attenuation of this virus, with all possible amino acids. All clones were infectious to pepper plants and induced a variety of symptoms, including no visible symptoms. The results of this study showed that a single amino acid mutation at residue 649 could control the function of the 126- and 183-kDa proteins, replicases with multiple roles in the life cycle of this virus.

  2. Value Added?

    ERIC Educational Resources Information Center

    UCLA IDEA, 2012

    2012-01-01

    Value added measures (VAM) uses changes in student test scores to determine how much "value" an individual teacher has "added" to student growth during the school year. Some policymakers, school districts, and educational advocates have applauded VAM as a straightforward measure of teacher effectiveness: the better a teacher, the better students…

  3. Comparison of Work-related Symptoms and Visual Contrast Sensitivity between Employees at a Severely Water-damaged School and a School without Significant Water Damage

    EPA Science Inventory

    NIOSH received a request for a health hazard evaluation at a water-damaged school in New Orleans, Louisiana. Employees submitted the request because of concerns about exposure to mold in their school building. We administered a work history and health symptom questionnaire. We al...

  4. Multi-analyte profile analysis of plasma immune proteins: altered expression of peripheral immune factors is associated with neuropsychiatric symptom severity in adults with and without chronic hepatitis C virus infection

    PubMed Central

    Huckans, Marilyn; Fuller, Bret E; Olavarria, Hannah; Sasaki, Anna W; Chang, Michael; Flora, Kenneth D; Kolessar, Michael; Kriz, Daniel; Anderson, Jeanne R; Vandenbark, Arthur A; Loftis, Jennifer M

    2014-01-01

    Background The purpose of this study was to characterize hepatitis C virus (HCV)-associated differences in the expression of 47 inflammatory factors and to evaluate the potential role of peripheral immune activation in HCV-associated neuropsychiatric symptoms—depression, anxiety, fatigue, and pain. An additional objective was to evaluate the role of immune factor dysregulation in the expression of specific neuropsychiatric symptoms to identify biomarkers that may be relevant to the treatment of these neuropsychiatric symptoms in adults with or without HCV. Methods Blood samples and neuropsychiatric symptom severity scales were collected from HCV-infected adults (HCV+, n = 39) and demographically similar noninfected controls (HCV−, n = 40). Multi-analyte profile analysis was used to evaluate plasma biomarkers. Results Compared with HCV− controls, HCV+ adults reported significantly (P < 0.050) greater depression, anxiety, fatigue, and pain, and they were more likely to present with an increased inflammatory profile as indicated by significantly higher plasma levels of 40% (19/47) of the factors assessed (21%, after correcting for multiple comparisons). Within the HCV+ group, but not within the HCV− group, an increased inflammatory profile (indicated by the number of immune factors > the LDC) significantly correlated with depression, anxiety, and pain. Within the total sample, neuropsychiatric symptom severity was significantly predicted by protein signatures consisting of 4–10 plasma immune factors; protein signatures significantly accounted for 19–40% of the variance in depression, anxiety, fatigue, and pain. Conclusions Overall, the results demonstrate that altered expression of a network of plasma immune factors contributes to neuropsychiatric symptom severity. These findings offer new biomarkers to potentially facilitate pharmacotherapeutic development and to increase our understanding of the molecular pathways associated with neuropsychiatric

  5. Depressive Symptoms Are Associated with Analgesic Use in People with Alzheimer’s Disease: Kuopio ALSOVA Study

    PubMed Central

    Gilmartin, Julia Fiona-Maree; Väätäinen, Saku; Törmälehto, Soili; Bell, J. Simon; Lönnroos, Eija; Salo, Lotta; Hallikainen, Ilona; Martikainen, Janne; Koivisto, Anne M.

    2015-01-01

    Neuropsychiatric symptoms of Alzheimer’s disease (AD) such as depression may be associated with pain, which according to the literature may be inadequately recognized and managed in this population. This study aimed to identify the factors associated with analgesic use in persons with AD; in particular, how AD severity, functional status, neuropsychiatric symptoms of AD, co-morbidities and somatic symptoms are associated with analgesic use. 236 community-dwelling persons with very mild or mild AD at baseline, and their caregivers, were interviewed over five years as part of the prospective ALSOVA study. Generalized Estimating Equations (GEEs) were used to estimate unadjusted and adjusted odds ratios (ORs) for the factors associated with analgesic use over a five year follow-up. The proportion of persons with AD using any analgesic was low (13.6%) at baseline and remained relatively constant during the follow-up (15.3% at Year 5). Over time, the most prevalent analgesic changed from non-steroidal anti-inflammatories (8.1% of persons with AD at Year 1) to acetaminophen (11.1% at Year 5). Depressive symptoms (measured by the Beck Depression Inventory, BDI) were independently associated with analgesic use, after effects of age, gender, education, AD severity, comorbidities and somatic symptoms were taken into account. For every one unit increase in BDI, the odds of analgesic use increased by 4% (OR = 1.04, 95% confidence interval CI = 1.02-1.07). Caregiver depressive symptoms were not statistically significantly associated with analgesic use of the person with AD. Depressive symptoms were significantly associated with analgesic use during the five year follow-up period. Possible explanations warranting investigation are that persons with AD may express depressive symptoms as painful somatic complaints, or untreated pain may cause depressive symptoms. Greater awareness of the association between depressive symptoms and analgesic use may lead to safer and more

  6. Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLADR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures

    PubMed Central

    Gunn, Shelly R.; Gibson Gunn, G.; Mueller, Francis W.

    2016-01-01

    Patient: Male, 25 Final Diagnosis: Ulcerative colitis and chronic fatigue syndrome Symptoms: Colitis • profound fatigue • multi-joint pain • cognitive impairment • corneal keratitis Medication: — Clinical Procedure: VIP replacement therapy Specialty: Family Medicine Objective: Unusual clinical course Background: Patients with multisymptom chronic conditions, such as refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS), present diagnostic and management challenges for clinicians, as well as the opportunity to recognize and treat emerging disease entities. In the current case we report reversal of co-existing RUC and CFS symptoms arising from biotoxin exposures in a genetically susceptible individual. Case Report: A 25-year-old previously healthy male with new-onset refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS) tested negative for autoimmune disease biomarkers. However, urine mycotoxin panel testing was positive for trichothecene group and air filter testing from the patient’s water-damaged rental house identified the toxic mold Stachybotrys chartarum. HLA-DR/DQ testing revealed a multisusceptible haplotype for development of chronic inflammation, and serum chronic inflammatory response syndrome (CIRS) biomarker testing was positive for highly elevated TGF-beta and a clinically undetectable level of vasoactive intestinal peptide (VIP). Following elimination of biotoxin exposures, VIP replacement therapy, dental extractions, and implementation of a mind body intervention-relaxation response (MBI-RR) program, the patient’s symptoms resolved. He is off medications, back to work, and resuming normal exercise. Conclusions: This constellation of RUC and CFS symptoms in an HLA-DR/DQ genetically susceptible individual with biotoxin exposures is consistent with the recently described CIRS disease pathophysiology. Chronic immune disturbance (turbatio immuno) can be identified with clinically available CIRS biomarkers and

  7. The BEHAVE-AD Assessment System: A Perspective, A Commentary on New Findings, and A Historical Review

    PubMed Central

    Reisberg, Barry; Monteiro, Isabel; Torossian, Carol; Auer, Stefanie; Shulman, Melanie B.; Ghimire, Santosh; Boksay, Istvan; BenArous, Francoise Guillo; Osorio, Ricardo; Vengassery, Aninditha; Imran, Sheema; Shaker, Hussam; Noor, Sadaf; Naqvi, Shazia; Kenowsky, Sunnie; Xu, Jinfeng

    2014-01-01

    Background Behavioral and psychological symptoms of dementia (BPSD) and associated disturbances in Alzheimer's disease (AD) are a source of distress and burden for spouses, professional caregivers, and others with responsibilities for the care of individuals with AD. BPSD with behavioral disturbances are also associated with more rapid institutionalization and increased morbidity and mortality for persons with AD. Objectives In this review and commentary, we discuss the history of the development of BPSD and behavioral disturbance assessments, which are distinct from those evaluating cognitive and functional symptoms of AD. In particular, we review the informant-based Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), the related, potentially more sensitive, BEHAVE-AD Frequency-Weighted Severity Scale (BEHAVE-AD-FW), and the direct subject evaluation-based Empirical BEHAVE-AD Rating Scale (E-BEHAVE-AD). The kinds of medications that alleviate behavioral symptoms on these measures as well as the problems and possibilities for further advances with these medications are discussed. Finally, the importance of distinguishing BPSD and behavioral disturbance remediation in AD from the treatment of cognitive decline and other aspects of AD is emphasized in the context of appropriate assessment methodology. The objective of this paper is to provide a framework for further advances in the treatment of BPSD and associated behavioral disturbances in AD and, consequently, a framework for continuing improvements in the lives of individuals with AD and those who share the burden of the disease with the AD person. PMID:24714384

  8. Genome-wide transcriptomic analysis reveals correlation between higher WRKY61 expression and reduced symptom severity in Turnip crinkle virus infected Arabidopsis thaliana

    PubMed Central

    Gao, Ruimin; Liu, Peng; Yong, Yuhan; Wong, Sek-Man

    2016-01-01

    Turnip crinkle virus (TCV) is a carmovirus that infects many Arabidopsis ecotypes. Most studies mainly focused on discovery of resistance genes against TCV infection, and there is no Next Generation Sequencing based comparative genome wide transcriptome analysis reported. In this study, RNA-seq based transcriptome analysis revealed that 238 (155 up-regulated and 83 down-regulated) significant differentially expressed genes with at least 15-fold change were determined. Fifteen genes (including upregulated, unchanged and downregulated) were selected for RNA-seq data validation using quantitative real-time PCR, which showed consistencies between these two sets of data. GO enrichment analysis showed that numerous terms such as stress, immunity, defence and chemical stimulus were affected in TCV-infected plants. One putative plant defence related gene named WRKY61 was selected for further investigation. It showed that WRKY61 overexpression plants displayed reduced symptoms and less virus accumulation, as compared to wild type (WT) and WRKY61 deficient lines, suggesting that higher WRKY61 expression level reduced TCV viral accumulation. In conclusion, our transcriptome analysis showed that global gene expression was detected in TCV-infected Arabidopsis thaliana. WRKY61 gene was shown to be negatively correlated with TCV infection and viral symptoms, which may be connected to plant immunity pathways. PMID:27086702

  9. Toward a Threshold for Subthreshold Depression: An Analysis of Correlates of Depression by Severity of Symptoms Using Data from an Elderly Community Sample.

    ERIC Educational Resources Information Center

    Hybels, Celia F.; Blazer, Dan G.; Pieper, Carl F.

    2001-01-01

    Explored demographic and risk factor profiles of two groups, one with more severe depression and one with less severe depression. Depression appears to exist along a continuum, with demographic, social, and physical health predictors of subthreshold depression similar to predictors of depression as defined by the Center for Epidemiologic…

  10. ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation

    ERIC Educational Resources Information Center

    Louwerse, A.; Eussen, M. L. J. M.; Van der Ende, J.; de Nijs, P. F. A.; Van Gool, A. R.; Dekker, L. P.; Verheij, C.; Verheij, F.; Verhulst, F. C.; Greaves-Lord, K.

    2015-01-01

    The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were…

  11. Extracorporeal Cardiac Shock Wave Therapy Ameliorates Clinical Symptoms and Improves Regional Myocardial Blood Flow in a Patient with Severe Coronary Artery Disease and Refractory Angina

    PubMed Central

    Prinz, Christian; Lindner, Oliver; Bitter, Thomas; Hering, Detlef; Burchert, Wolfgang; Horstkotte, Dieter; Faber, Lothar

    2009-01-01

    Different therapeutic options are being used for chronic coronary artery disease (CAD). We report about a 51-year-old female with CAD and refractory angina pectoris despite maximally tolerated medical therapy and after both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The patient received cardiac shock wave therapy (CSWT) over a period of 6 month. There was no arrhythmia during or after treatment; enzyme levels were normal at all times. PET imaging showed a substantial improvement of myocardial stress perfusion. Since the patient reported that she now was fully capable to deal with her everyday life, further treatment options were postponed. Our case report suggests that ultrasound-guided CSWT is able to improve symptoms and perfusion in ischemic myocardium. PMID:19724656

  12. ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation.

    PubMed

    Louwerse, A; Eussen, M L J M; Van der Ende, J; de Nijs, P F A; Van Gool, A R; Dekker, L P; Verheij, C; Verheij, F; Verhulst, F C; Greaves-Lord, K

    2015-12-01

    The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were administered in childhood (ages 6-12) and in adolescence (ages 12-20) to 72 individuals with a pervasive developmental disorder-not otherwise specified (PDD-NOS). ADOS calibrated severity scores showed a large stability (r = .51). Psychiatric comorbidity in childhood and adolescence were not associated with ASD severity in adolescence. Mental health care use (87 %) and special education needs were high (71 %). Reevaluation of ASD severity and psychiatric comorbidity later in life seem useful when PDD-NOS is diagnosed in childhood. PMID:26395112

  13. Anthrax: Symptoms

    MedlinePlus

    ... hands Inhalation anthrax symptoms can include: Fever and chills Chest Discomfort Shortness of breath Confusion or dizziness ... aches Gastrointestinal anthrax symptoms can include: Fever and chills Swelling of neck or neck glands Sore throat ...

  14. Kynurenine Pathway Pathologies: do Nicotinamide and Other Pathway Co-Factors have a Therapeutic Role in Reduction of Symptom Severity, Including Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

    PubMed Central

    Blankfield, Adele

    2013-01-01

    The definition of dual tryptophan pathways has increased the understanding of the mind-body, body-mind dichotomy. The serotonergic pathway highlights the primary (endogenous) psychiatric disorders. The up-regulation of the kynurenine pathway by physical illnesses can cause neuropathic and immunological disorders1 associated with secondary neuropsychiatric symptoms. Tryptophan and nicotinamide deficiencies fall within the protein energy malnutrition (PEM) spectrum. They can arise if the kynurenine pathway is stressed by primary or secondary inflammatory conditions and the consequent imbalance of available catabolic/anabolic substrates may adversely influence convalescent phase efficiency. The replacement of depleted or reduced NAD+ levels and other cofactors can perhaps improve the clinical management of these disorders. Chronic fatigue syndrome (CFS) and fibromyalgia (FM) appear to meet the criteria of a tryptophan-kynurenine pathway disorder with potential neuroimmunological sequelae. Aspects of some of the putative precipitating factors have been previously outlined.2,3 An analysis of the areas of metabolic dysfunction will focus on future directions for research and management. PMID:23922501

  15. Prevalence and severity of symptoms of asthma, allergic rhinitis, and eczema in 10- to 15-year-old schoolchildren in central Taiwan.

    PubMed

    Chiang, Li-Chi; Chen, Yu-Huan; Hsueh, Kai-Chung; Huang, Jing-Long

    2007-03-01

    The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was distributed through 14 schools and was completed by 11,874 students out of which are parents of 4,167 children aged between 10 and 12 years old and 7,677 older children aged between 13 and 15 years in central Taiwan. The overall cumulative and 12-month prevalence of wheezing, rhinitis, and eczema were 7.4%, 43.0%, and 7.2%, respectively. It was shown that boys had significantly higher prevalence of wheezing and rhinitis (p < 0.001 and p = 0.001) when compared to girls in central Taiwan. The study also found that prevalence rates among younger children with symptoms of wheezing, rhinitis, and recurrent itchy rash in the past 12-month (8.2%, 44.4%, and 8.8%) were higher than that among older children (6.9%, 42.2%, and 6.3%, respectively). In conclusion, boys had significantly higher prevalence of wheezing and rhinitis than girls while younger children tend to have higher prevalence of the disorders than those that are older in age.

  16. Visuospatial memory in healthy elderly, AD and MCI: a review.

    PubMed

    Iachini, Ina; Iavarone, Alessandro; Senese, Vincenzo Paolo; Ruotolo, Francesco; Ruggiero, Gennaro

    2009-03-01

    In the literature it is commonly reported that several spatial abilities decline with normal aging, even though such a decline is not uniform. So far, it is not yet clear which spatial components present a normal age-related decline, which ones are preserved and at what point the deficit is so severe to represent an index of mild cognitive impairment (MCI) or a symptom of potential degenerative progression as in the early-stage Alzheimer's disease (AD). In particular, AD (from early onset) is characterised by impairments in constructive abilities, visuospatial intelligence, spatial short-term memory deficits, and disorders of spatial orientation (topographical disorientation). MCI indicates a condition, generally affecting older individuals, characterized by cognitive deficits including memory and/or non memory impairments and at high risk of progression to dementia. Three MCI subgroups have been distinguished and a very high risk of developing AD is associated to the amnestic MCI subtypes. Further, recent studies have suggested that the allocentric component of spatial memory might be taken as predictor of AD from MCI. Given the frequency of visuospatial deficits in early-stage AD, evaluation of visuospatial processes is a promising approach to find predictive markers of AD. Here we report a review of the literature exploring specific visuospatial components in normal aging, MCI, and AD. In this way we could shed some light on the role of these components in the progression from MCI to AD and pave the way for future studies.

  17. Language and Communication Skills in Preschool Children with Autism Spectrum Disorders: Contribution of Cognition, Severity of Autism Symptoms, and Adaptive Functioning to the Variability

    ERIC Educational Resources Information Center

    Kjellmer, Liselotte; Hedvall, Asa; Fernell, Elisabeth; Gillberg, Christopher; Norrelgen, Fritjof

    2012-01-01

    This study examined the contribution of cognitive function, severity of autism, and adaptive functioning to the variability in language and communication skills in 129 preschool children (aged 24-63 months) with autism spectrum disorder (ASD). Participants were selected from a representative research cohort of 208 preschool children on the basis…

  18. Identification of Genetic Loci Affecting the Severity of Symptoms of Hirschsprung Disease in Rats Carrying Ednrbsl Mutations by Quantitative Trait Locus Analysis

    PubMed Central

    Torigoe, Daisuke; Lei, Chuzhao; Lan, Xianyong; Chen, Hong; Sasaki, Nobuya; Wang, Jinxi; Agui, Takashi

    2015-01-01

    Hirschsprung’s disease (HSCR) is a congenital disease in neonates characterized by the absence of the enteric ganglia in a variable length of the distal colon. This disease results from multiple genetic interactions that modulate the ability of enteric neural crest cells to populate developing gut. We previously reported that three rat strains with different backgrounds (susceptible AGH-Ednrbsl/sl, resistant F344-Ednrbsl/sl, and LEH-Ednrbsl/sl) but the same null mutation of Ednrb show varying severity degrees of aganglionosis. This finding suggests that strain-specific genetic factors affect the severity of HSCR. Consistent with this finding, a quantitative trait locus (QTL) for the severity of HSCR on chromosome (Chr) 2 was identified using an F2 intercross between AGH and F344 strains. In the present study, we performed QTL analysis using an F2 intercross between the susceptible AGH and resistant LEH strains to identify the modifier/resistant loci for HSCR in Ednrb-deficient rats. A significant locus affecting the severity of HSCR was also detected within the Chr 2 region. These findings strongly suggest that a modifier gene of aganglionosis exists on Chr 2. In addition, two potentially causative SNPs (or mutations) were detected upstream of a known HSCR susceptibility gene, Gdnf. These SNPs were possibly responsible for the varied length of gut affected by aganglionosis. PMID:25790447

  19. Adaptive Behaviors in High-Functioning Taiwanese Children with Autism Spectrum Disorders: An Investigation of the Mediating Roles of Symptom Severity and Cognitive Ability

    ERIC Educational Resources Information Center

    Chang, Chen-Lin; Lung, For-Wey; Yen, Cheng-Fang; Yang, Pinchen

    2013-01-01

    We investigated the relationship among cognitive level, autistic severity and adaptive function in a Taiwanese sample of 94 high-functioning children with autism spectrum disorders (ASD) (mean full scale intelligent quotients FSIQ = 84.8). Parents and teachers both completed the Adaptive Behavior Assessment System-II and the Social Responsiveness…

  20. Short-Term Isoflavone Intervention in the Treatment of Severe Vasomotor Symptoms after Surgical Menopause: A Case Report and Literature Review

    PubMed Central

    Teekachunhatean, Supanimit; Mattawanon, Natnita; Khunamornpong, Surapan

    2015-01-01

    Isoflavones are soy phytoestrogens that potentially exert various favorable effects in postmenopausal women, for example, alleviating vasomotor episodes, attenuating bone loss, and stimulating vaginal epithelial maturation. There has, however, been lack of consensus regarding those therapeutic effects. Most clinical studies of isoflavones have been conducted with women who had undergone natural menopause, but not those who had undergone surgical menopause. This study reports on a 51-year-old woman who presented with severe vasomotor episodes after undergoing a hysterectomy and a bilateral oophorectomy due to hypermenorrhea secondary to myoma uteri. She refused hormone therapy due to fear of adverse drug reactions so was treated with oral soy isoflavones (two capsules twice daily, equivalent to at least 100 mg daily dose) for 8 weeks. The number and severity of hot flushes and her menopause-specific quality of life dramatically improved from baseline values. The serum bone resorption marker (beta C-telopeptide) decreased markedly, while vaginal epithelial maturation improved slightly, suggesting the potential of isoflavones in attenuating bone loss and stimulating vaginal maturation. The intervention did not adversely affect the hormonal profile (FSH, LH, and estradiol) and liver or renal functions. Thus, isoflavones could be an option for women experiencing severe vasomotor episodes after surgical menopause. PMID:26605099

  1. DIS in AdS

    SciTech Connect

    Albacete, Javier L.; Kovchegov, Yuri V.; Taliotis, Anastasios

    2009-03-23

    We calculate the total cross section for the scattering of a quark-anti-quark dipole on a large nucleus at high energy for a strongly coupled N = 4 super Yang-Mills theory using AdS/CFT correspondence. We model the nucleus by a metric of a shock wave in AdS{sub 5}. We then calculate the expectation value of the Wilson loop (the dipole) by finding the extrema of the Nambu-Goto action for an open string attached to the quark and antiquark lines of the loop in the background of an AdS{sub 5} shock wave. We find two physically meaningful extremal string configurations. For both solutions we obtain the forward scattering amplitude N for the quark dipole-nucleus scattering. We study the onset of unitarity with increasing center-of-mass energy and transverse size of the dipole: we observe that for both solutions the saturation scale Q{sub s} is independent of energy/Bjorken-x and depends on the atomic number of the nucleus as Q{sub s}{approx}A{sup 1/3}. Finally we observe that while one of the solutions we found corresponds to the pomeron intercept of {alpha}{sub P} = 2 found earlier in the literature, when extended to higher energy or larger dipole sizes it violates the black disk limit. The other solution we found respects the black disk limit and yields the pomeron intercept of {alpha}{sub P} = 1.5. We thus conjecture that the right pomeron intercept in gauge theories at strong coupling may be {alpha}{sub P} = 1.5.

  2. Is the Health of the Nation Outcome Scales appropriate for the assessment of symptom severity in patients with substance-related disorders?

    PubMed

    Andreas, Sylke; Harries-Hedder, Karin; Schwenk, Wolfgang; Hausberg, Maria; Koch, Uwe; Schulz, Holger

    2010-07-01

    The Health of the Nation Outcome Scales (HoNOS) is an internationally established clinician-rated instrument. The aim of the study was to assess the psychometric properties in inpatients with substance-related disorders. The HoNOS was applied in a multicenter, consecutive sample of 417 inpatients. Interrater reliability coefficients, confirmatory factor analysis, and regression tree analyses were calculated to assess the reliability and validity of the HoNOS. The factor validity of the HoNOS and its total score could not be confirmed. After training, all items of the HoNOS revealed sufficient values of interrater reliabilities. As the results of the regression tree analyses showed, the single items of the HoNOS were one of the most important predictor of service utilization. The HoNOS can be recommended for obtaining detailed ratings of the problems of inpatients with substance-related disorders as a clinical application in routine mental health care at present. Further studies should include comparisons of HoNOS and Addiction Severity Index.

  3. HIV Symptoms

    MedlinePlus

    ... Submit Home > HIV/AIDS > What is HIV/AIDS? HIV/AIDS This information in Spanish ( en español ) HIV symptoms Photo courtesy of AIDS.gov More information ... and brain Return to top More information on HIV symptoms Explore other publications and websites Basic Information ...

  4. Early bronchodilator action of glycopyrronium versus tiotropium in moderate-to-severe COPD patients: a cross-over blinded randomized study (Symptoms and Pulmonary function in the moRnING)

    PubMed Central

    Marin, Jose M; Beeh, Kai M; Clemens, Andreas; Castellani, Walter; Schaper, Lennart; Saralaya, Dinesh; Gunstone, Anthony; Casamor, Ricard; Kostikas, Konstantinos; Aalamian-Mattheis, Maryam

    2016-01-01

    Background Morning symptoms associated with COPD have a negative impact on patients’ quality of life. Long-acting bronchodilators with rapid onset may relieve patients’ symptoms. In the Symptoms and Pulmonary function in the moRnING study, we prospectively compared the rapid onset bronchodilator profile of glycopyrronium (GLY) and tiotropium (TIO) during the first few hours after dosing in patients with moderate-to-severe COPD. Methods Patients were randomized (1:1) to receive either once-daily GLY (50 μg) or TIO (18 μg) and corresponding placebos in a cross-over design for 28 days. The primary objective was to demonstrate the superiority of GLY versus TIO in area under the curve from 0 to 4 hours (AUC0-4h) forced expiratory volume in 1 second (FEV1) after the first dose. The secondary objective was to compare GLY versus TIO using the patient reported outcomes Morning COPD Symptoms Questionnaire 3 hours post-inhalation. Results One-hundred and twenty-six patients were randomized (male 70.2%; mean age 65.7 years) and 108 patients completed the study. On Day 1, GLY resulted in significantly higher FEV1 AUC0-4h after the first dose versus TIO (treatment difference [Δ], 0.030 L, 95% confidence interval 0.004–0.056, P=0.025). Improvements in morning COPD symptoms from baseline at Days 1 and 28 were similar between GLY and TIO. Post hoc analysis of the FEV1 AUC0-4h by time point on Day 1 showed significant improvements in patients receiving GLY versus TIO at 5 minutes (Δ=0.029 L, P=0.015), 15 minutes (Δ=0.033 L, P=0.026), and 1 hour (Δ=0.044 L, P=0.014). Safety results were comparable between both treatments. Conclusion The SPRING study demonstrates the superiority of GLY versus TIO in terms of superior bronchodilation in the first 4 hours after administration, thus extending the clinical data that support a faster onset of action of GLY versus TIO. PMID:27418815

  5. Severe Sarcoidosis.

    PubMed

    Kouranos, Vasileios; Jacob, Joe; Wells, Athol U

    2015-12-01

    In sarcoidosis, reduction in mortality and the prevention of disability due to major organ involvement are treatment goals. Thus, it is important to recognize severe disease and identify patients at higher risk of progression to severe disease. In this article, fibrotic lung disease and cardiac sarcoidosis are reviewed as the major contributors to sarcoidosis mortality and morbidity. In the absence of a standardized definition of severe pulmonary disease, a multidisciplinary approach to clinical staging is suggested, based on symptoms, pulmonary function tests, and imaging findings at presentation, integrated with the duration of disease and longitudinal disease behavior during early follow-up.

  6. Plague Symptoms

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Plague Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Plague Home Ecology & Transmission Symptoms Diagnosis & Treatment Maps & Statistics ...

  7. Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis.

    PubMed

    McLeod, Hamish J; Gumley, Andrew I; Macbeth, Angus; Schwannauer, Matthias; Lysaker, Paul H

    2014-07-01

    The negative symptoms of schizophrenia are a major source of impairment and distress but both pharmacological and psychological treatment options provide only modest benefit. Developing more effective psychological treatments for negative symptoms will require a more sophisticated understanding of the psychological processes that are implicated in their development and maintenance. We extended previous work by demonstrating that metacognitive functioning is related to negative symptom expression across the first 12 months of first episode psychosis (FEP). Previous studies in this area have either been cross-sectional or have used much older participants with long-standing symptoms. In this study, forty-five FEP participants were assessed three times over 12 months and provided data on PANSS rated symptoms, premorbid adjustment, metacognitive functioning, and DUP. Step-wise linear regression showed that adding metacognition scores to known predictors of negative symptoms (baseline symptom severity, gender, DUP, and premorbid academic and social adjustment) accounted for 62% of the variance in PANSS negative symptom scores at six months and 38% at 12 months. The same predictors also explained 47% of the variance in positive symptoms at both six and 12 months. However, exploration of the simple correlations between PANSS symptom scores and metacognition suggests a stronger univariate relationship between metacognition and negative symptoms. Overall, the results indicate that problems with mental state processing may be important determinants of negative symptom expression from the very early stages of psychosis. These results provide further evidence that metacognitive functioning is a potentially relevant target for psychological interventions. PMID:24725651

  8. Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis.

    PubMed

    McLeod, Hamish J; Gumley, Andrew I; Macbeth, Angus; Schwannauer, Matthias; Lysaker, Paul H

    2014-07-01

    The negative symptoms of schizophrenia are a major source of impairment and distress but both pharmacological and psychological treatment options provide only modest benefit. Developing more effective psychological treatments for negative symptoms will require a more sophisticated understanding of the psychological processes that are implicated in their development and maintenance. We extended previous work by demonstrating that metacognitive functioning is related to negative symptom expression across the first 12 months of first episode psychosis (FEP). Previous studies in this area have either been cross-sectional or have used much older participants with long-standing symptoms. In this study, forty-five FEP participants were assessed three times over 12 months and provided data on PANSS rated symptoms, premorbid adjustment, metacognitive functioning, and DUP. Step-wise linear regression showed that adding metacognition scores to known predictors of negative symptoms (baseline symptom severity, gender, DUP, and premorbid academic and social adjustment) accounted for 62% of the variance in PANSS negative symptom scores at six months and 38% at 12 months. The same predictors also explained 47% of the variance in positive symptoms at both six and 12 months. However, exploration of the simple correlations between PANSS symptom scores and metacognition suggests a stronger univariate relationship between metacognition and negative symptoms. Overall, the results indicate that problems with mental state processing may be important determinants of negative symptom expression from the very early stages of psychosis. These results provide further evidence that metacognitive functioning is a potentially relevant target for psychological interventions.

  9. Forward genetic approaches for elucidation of novel regulators of Lyme arthritis severity

    PubMed Central

    Bramwell, Kenneth K.C.; Teuscher, Cory; Weis, Janis J.

    2014-01-01

    Patients experiencing natural infection with Borrelia burgdorferi display a spectrum of associated symptoms and severity, strongly implicating the impact of genetically determined host factors in the pathogenesis of Lyme disease. Herein, we provide a summary of the host genetic factors that have been demonstrated to influence the severity and chronicity of Lyme arthritis symptoms, and a review of the resources available, current progress, and added value of a forward genetic approach for identification of novel genetic regulators. PMID:24926442

  10. Recent developments of protein kinase inhibitors as potential AD therapeutics.

    PubMed

    Tell, Volkmar; Hilgeroth, Andreas

    2013-01-01

    Present Alzheimer's disease (AD) therapies suffer from inefficient effects on AD symptoms like memory or cognition, especially in later states of the disease. Used acteylcholine esterase inhibitors or the NMDA receptor antagonist memantine address one target structure which is involved in a complex, multifactorial disease progression. So the benefit for patients is presently poor. A more close insight in the AD progression identified more suggested target structures for drug development. Strategies of AD drug development concentrate on novel target structures combined with the established ones dedicated for combined therapy regimes, preferably by the use of one drug which may address two target structures. Protein kinases have been identified as promising target structures because they are involved in AD progression pathways like pathophysiological tau protein phosphorylations and amyloid β toxicity. The review article will shortly view early inhibitors of single protein kinases like glycogen synthase kinase (gsk3) β and cyclin dependent kinase 5. Novel inhibitors will be discussed which address novel AD relevant protein kinases like dual-specificity tyrosine phosphorylation regulated kinase 1A (DYRK1A). Moreover, multitargeting inhibitors will be presented which target several protein kinases and those which are suspected in influencing other AD relevant processes. Such a multitargeting is the most promising strategy to effectively hamper the multifactorial disease progression and thus gives perspective hopes for a future better patient benefit. PMID:24312003

  11. Recent developments of protein kinase inhibitors as potential AD therapeutics

    PubMed Central

    Tell, Volkmar; Hilgeroth, Andreas

    2013-01-01

    Present Alzheimer’s disease (AD) therapies suffer from inefficient effects on AD symptoms like memory or cognition, especially in later states of the disease. Used acteylcholine esterase inhibitors or the NMDA receptor antagonist memantine address one target structure which is involved in a complex, multifactorial disease progression. So the benefit for patients is presently poor. A more close insight in the AD progression identified more suggested target structures for drug development. Strategies of AD drug development concentrate on novel target structures combined with the established ones dedicated for combined therapy regimes, preferably by the use of one drug which may address two target structures. Protein kinases have been identified as promising target structures because they are involved in AD progression pathways like pathophysiological tau protein phosphorylations and amyloid β toxicity. The review article will shortly view early inhibitors of single protein kinases like glycogen synthase kinase (gsk3) β and cyclin dependent kinase 5. Novel inhibitors will be discussed which address novel AD relevant protein kinases like dual-specificity tyrosine phosphorylation regulated kinase 1A (DYRK1A). Moreover, multitargeting inhibitors will be presented which target several protein kinases and those which are suspected in influencing other AD relevant processes. Such a multitargeting is the most promising strategy to effectively hamper the multifactorial disease progression and thus gives perspective hopes for a future better patient benefit. PMID:24312003

  12. Norovirus Symptoms

    MedlinePlus

    ... Infection, National Institutes of Health NoroCORE Food Virology Symptoms Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Español: SÃntomas Prevent Dehydration Drink plenty of liquids to replace fluids that ...

  13. Rotavirus Symptoms

    MedlinePlus

    ... Rotavirus Vaccine Program American Academy of Pediatrics Symptoms Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ... PATH's Rotavirus Vaccine Program American Academy of Pediatrics Language: English Español (Spanish) File Formats Help: How do I ...

  14. Fibromyalgia Symptoms and Cirrhosis

    PubMed Central

    Bielefeldt, Klaus; Wasan, Ajay D.; Szigethy, Eva; Lotrich, Francis; DiMartini, Andrea F.

    2015-01-01

    Background An association between fibromyalgia and hepatitis C virus (HCV) has been previously described. However, the relationship between nonalcoholic steatohepatitis (NASH) and fibromyalgia symptoms has not been assessed, though they share several risk factors. Aim We aimed to assess the factors associated with fibromyalgia symptoms across etiologies of liver disease. Methods Patients with cirrhosis due to HCV, NASH, or alcohol were recruited from an outpatient hepatology clinic and administered the Hospital Anxiety and Depression Score, Pittsburgh Sleep Quality Index, and the modified 2010 American College of Rheumatology Diagnostic Criteria for Fibromyalgia. Serum inflammatory markers were measured with standard luminex assays. Results Of 193 participants, 53 (27 %) met criteria for fibromyalgia. Fibromyalgia symptoms were significantly associated with etiology of liver disease (HCV: 35 %, NASH: 30 %, alcohol-related liver disease: 12 %, p < 0.01). Using logistic regression, mood symptoms (OR 1.14, 95 % CI 1.06, 1.22), sleep disturbance (OR 1.32, 95 % CI 1.16, 1.52), and etiology of liver disease (NASH vs. HCV not different, alcohol vs. HCV OR 0.19, 95 % CI 0.05, 0.63) were associated with fibromyalgia symptoms. If abdominal pain was included in the model, etiology became nonsignificant, indicating that it may be central sensitization due to abdominal pain in patients with chronic liver disease that explains fibromyalgia symptoms rather than the etiology of liver disease or inflammation. Conclusions Fibromyalgia symptoms were significantly associated with HCV and NASH cirrhosis and with psychiatric symptoms. Future work should focus on the underlying pathophysiology and management of widespread pain in patients with cirrhosis. PMID:25433921

  15. Polarised black holes in AdS

    NASA Astrophysics Data System (ADS)

    Costa, Miguel S.; Greenspan, Lauren; Oliveira, Miguel; Penedones, João; Santos, Jorge E.

    2016-06-01

    We consider solutions in Einstein-Maxwell theory with a negative cosmological constant that asymptote to global AdS 4 with conformal boundary {S}2× {{{R}}}t. At the sphere at infinity we turn on a space-dependent electrostatic potential, which does not destroy the asymptotic AdS behaviour. For simplicity we focus on the case of a dipolar electrostatic potential. We find two new geometries: (i) an AdS soliton that includes the full backreaction of the electric field on the AdS geometry; (ii) a polarised neutral black hole that is deformed by the electric field, accumulating opposite charges in each hemisphere. For both geometries we study boundary data such as the charge density and the stress tensor. For the black hole we also study the horizon charge density and area, and further verify a Smarr formula. Then we consider this system at finite temperature and compute the Gibbs free energy for both AdS soliton and black hole phases. The corresponding phase diagram generalizes the Hawking-Page phase transition. The AdS soliton dominates the low temperature phase and the black hole the high temperature phase, with a critical temperature that decreases as the external electric field increases. Finally, we consider the simple case of a free charged scalar field on {S}2× {{{R}}}t with conformal coupling. For a field in the SU(N ) adjoint representation we compare the phase diagram with the above gravitational system.

  16. Symptoms: Lymphedema.

    PubMed

    Paskett, Electra D

    2015-01-01

    Lymphedema is one of the main late effects from breast cancer treatment affecting 3-60% of breast cancer survivors. Primarily occurring in the hand, arm, and/or affected breast, symptoms of lymphedema include swelling, pain, redness, restriction of arm/hand movement, tightness and feelings of fullness. These symptoms not only may limit physical functioning but also negatively affect quality of life, body image, social functioning, and financial status of breast cancer survivors with lymphedema. Unfortunately, there are no standardized methods for prevention, diagnosis, and treatment of breast cancer-related lymphedema. Despite its prevalence and lack of clinical guidelines, lymphedema is one of the most poorly understood, relatively underestimated, and least researched complications of cancer treatment. This chapter reviews the current problem of breast cancer-related lymphedema by investigating prevention and risk reduction strategies, diagnosis, and treatment. In addition, this chapter identifies future research opportunities focusing on prevention and risk reduction strategies, quality of life and physical function, surveillance, patient education, cost, diagnosis, and treatment. Challenges and recommendations for future research in these areas, particularly among underserved populations, are discussed. PMID:26059932

  17. Symptoms of gallstone disease.

    PubMed

    Diehl, A K

    1992-11-01

    The most certain symptomatic manifestation of gallstones is episodic upper abdominal pain. Characteristically, this pain is severe and located in the epigastrium and/or the right upper quadrant. The onset is relatively abrupt and often awakens the patient from sleep. The pain is steady in intensity, may radiate to the upper back, be associated with nausea and lasts for hours to up to a day. Dyspeptic symptoms of indigestion, belching, bloating, abdominal discomfort, heartburn and specific food intolerance are common in persons with gallstones, but are probably unrelated to the stones themselves and frequently persist after surgery. Many, if not most, persons with gallstones have no history of pain attacks. Persons discovered to have gallstones in the absence of typical symptoms appear to have an annual incidence of biliary pain of 2-5% during the initial years of follow-up, with perhaps a declining rate thereafter. Gallstone-related complications occur at a rate of less than 1% annually. Those whose stones are symptomatic at discovery have a more severe course, with approximately 6-10% suffering recurrent symptoms each year and 2% biliary complications. The far higher rates of symptom development reported in a few studies raise the possibility that these incidence estimates may be too low. The best predictors of future biliary pain are a history of pain at the time of diagnosis, female gender and possibly obesity. The risk of acute cholecystitis appears to be greater in those with large solitary stones, that of biliary pancreatitis in those with multiple small stones, and that of gallbladder cancer in those with large stones of any number. Drugs that inhibit the synthesis of prostaglandins may now be the treatment of choice in patients with gallstones who are suffering acute pain attacks. Persistent dyspeptic symptoms occur frequently following cholecystectomy. A prolonged history of such symptoms prior to surgery and evidence of significant psychological distress

  18. Indoor environmental exposures and symptoms.

    PubMed

    Hodgson, Michael

    2002-08-01

    The label "sick building syndrome" is often used to imply the absence of a physiologic basis for symptoms in the built environment. Although building-related illness is widely recognized but considered rare, several well-studied mechanisms may be responsible for many symptoms in buildings. These mechanisms do not explain why some individuals perceive disability. Until researchers distinguish physiologic mechanisms from other aspects of disease and study them systematically, poorly defined symptoms will remain poorly understood. The disability associated with such symptoms and syndromes, not the physiology, is the primary interest and generates controversy.

  19. Signs and Symptoms of Untreated Lyme Disease

    MedlinePlus

    ... occurs . Early Signs and Symptoms (3 to 30 days after tick bite) Fever, chills, headache, fatigue, muscle ... examples of EM rashes Later Signs and Symptoms (days to months after tick bite) Severe headaches and ...

  20. Psychotic symptoms in a population-based sample of 85-year-old individuals with dementia.

    PubMed

    Ostling, Svante; Gustafson, Deborah; Blennow, Kaj; Börjesson-Hanson, Anne; Waern, Margda

    2011-03-01

    Psychotic symptoms are common in elderly persons with dementia. These symptoms affect a person's ability to function in daily life and put strain on the caregiver. Most studies focus on psychotic symptoms in clinical samples with Alzheimer disease (AD). Thus, their prevalence and relation with dementia subtype and severity in very old populations is unclear. We assessed a representative sample of 85-year-old individuals living in Gothenburg, Sweden (n = 494) using neuropsychiatric examinations, key informant interviews, and medical record reviews; 147 had dementia. Dementia and its severity were diagnosed in accordance with Diagnostic and Statistical Manual of Mental Disorders (Third Edition, Revision [DSM-III-R]) criteria. Alzheimer disease according to the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria was diagnosed in 64 persons and vascular dementia (VaD) according to Erkinjuntti criteria was observed in 69. Fourteen had dementia due to other causes. Psychotic symptoms were classified according to DSM-III-R. The prevalence of psychotic symptoms in this very old population was 36% among AD cases compared to 54% in VaD cases (P = .04). Proportions with psychotic symptoms increased with increasing dementia severity in individuals with AD. No such association could be shown in those with VaD. This finding of a high proportion of psychotic symptoms also in individuals with mild severity of VaD should alert health professionals to evaluate dementia in very old patients who present with hallucinations or delusions.

  1. Interventions for Neuropsychiatric Symptoms in Neurocognitive Impairment Due to Alzheimer's Disease: A Review of the Literature.

    PubMed

    McClam, Tamela D; Marano, Christopher M; Rosenberg, Paul B; Lyketsos, Constantine G

    2015-01-01

    Neurocognitive impairment due to Alzheimer's disease (previously termed Alzheimer's dementia) (AD) is the most common form of cognitive impairment worldwide. Given the anticipated increase in the population aged 65 and over, the prevalence of persons with AD is expected to increase exponentially during the next 30 years. Noncognitive neuropsychiatric symptoms (NPS) commonly occur in AD and are associated with adverse outcomes for patients and their caregivers. This review summarizes randomized, controlled trials (RCTs) published between 2004 and 2014 with a primary outcome measure of change in symptom severity for NPS in AD. Of the 388 articles initially identified through a literature search, 33 trials met inclusion criteria. Fifteen of these studies had agitation/aggression as a targeted symptom. Twenty-eight evaluated pharmacologic treatments, including psychotropics, cognitive enhancers, stimulants, and nutraceuticals. Nonpharmacologic interventions included bright light, music, exercise, and cognitive-stimulation therapies. Among the pharmacologic interventions, modest efficacy was reported with aripiprazole, citalopram, trazodone, methylphenidate, and scheduled analgesics. Significant reduction in symptom severity was reported with nearly all the nonpharmacologic interventions. Variations in methodology such as inclusion criteria, study setting, and outcome measures limit the generalizability of these results. Barriers to the implementation of nonpharmacologic interventions in clinical settings include resource and training limitations. Electroconvulsive therapy and dronabinol are promising as emerging treatment strategies. Randomized clinical trials are needed in order to validate the utility of electroconvulsive therapy and dronabinol, including where and with whom these interventions will prove most valuable. PMID:26332220

  2. A three-nucleotide mutation altering the Maize streak virus Rep pRBR-interaction motif reduces symptom severity in maize and partially reverts at high frequency without restoring pRBR-Rep binding.

    PubMed

    Shepherd, Dionne N; Martin, Darren P; McGivern, David R; Boulton, Margaret I; Thomson, Jennifer A; Rybicki, Edward P

    2005-03-01

    Geminivirus infectivity is thought to depend on interactions between the virus replication-associated proteins Rep or RepA and host retinoblastoma-related proteins (pRBR), which control cell-cycle progression. It was determined that the substitution of two amino acids in the Maize streak virus (MSV) RepA pRBR-interaction motif (LLCNE to LLCLK) abolished detectable RepA-pRBR interaction in yeast without abolishing infectivity in maize. Although the mutant virus was infectious in maize, it induced less severe symptoms than the wild-type virus. Sequence analysis of progeny viral DNA isolated from infected maize enabled detection of a high-frequency single-nucleotide reversion of C(601)A in the 3 nt mutated sequence of the Rep gene. Although it did not restore RepA-pRBR interaction in yeast, sequence-specific PCR showed that, in five out of eight plants, the C(601)A reversion appeared by day 10 post-inoculation. In all plants, the C(601)A revertant eventually completely replaced the original mutant population, indicating a high selection pressure for the single-nucleotide reversion. Apart from potentially revealing an alternative or possibly additional function for the stretch of DNA that encodes the apparently non-essential pRBR-interaction motif of MSV Rep, the consistent emergence and eventual dominance of the C(601)A revertant population might provide a useful tool for investigating aspects of MSV biology, such as replication, mutation and evolution rates, and complex population phenomena, such as competition between quasispecies and population turnover. PMID:15722543

  3. Hippocampal volume correlates with attenuated negative psychotic symptoms irrespective of antidepressant medication

    PubMed Central

    Bernasconi, Raffaele; Smieskova, Renata; Schmidt, André; Harrisberger, Fabienne; Raschle, Nora Maria; Lenz, Claudia; Walter, Anna; Simon, Andor; Riecher-Rössler, Anita; Radue, Ernst-Wilhelm; Lang, Undine E.; Fusar-Poli, Paolo; Borgwardt, Stefan J.

    2015-01-01

    Background Individuals with at-risk mental state for psychosis (ARMS) often suffer from depressive and anxiety symptoms, which are clinically similar to the negative symptomatology described for psychosis. Thus, many ARMS individuals are already being treated with antidepressant medication. Objectives To investigate clinical and structural differences between psychosis high-risk individuals with or without antidepressants. Methods We compared ARMS individuals currently receiving antidepressants (ARMS-AD; n = 18), ARMS individuals not receiving antidepressants (ARMS-nonAD; n = 31) and healthy subjects (HC; n = 24), in terms of brain structure abnormalities, using voxel-based morphometry. We also performed region of interest analysis for the hippocampus, anterior cingulate cortex, amygdala and precuneus. Results The ARMS-AD had higher ‘depression’ and lower ‘motor hyperactivity’ scores than the ARMS-nonAD. Compared to HC, there was significantly less GMV in the middle frontal gyrus in the whole ARMS cohort and in the superior frontal gyrus in the ARMS-AD subgroup. Compared to ARMS-nonAD, the ARMS-AD group showed more gray matter volume (GMV) in the left superior parietal lobe, but less GMV in the left hippocampus and the right precuneus. We found a significant negative correlation between attenuated negative symptoms and hippocampal volume in the whole ARMS cohort. Conclusion Reduced GMV in the hippocampus and precuneus is associated with short-term antidepressant medication and more severe depressive symptoms. Hippocampal volume is further negatively correlated with attenuated negative psychotic symptoms. Longitudinal studies are needed to distinguish whether hippocampal volume deficits in the ARMS are related to attenuated negative psychotic symptoms or to antidepressant action. PMID:26110110

  4. AdS duals of matrix strings

    NASA Astrophysics Data System (ADS)

    Morales, Jose F.; Samtleben, Henning

    2003-06-01

    We review recent work on the holographic duals of type II and heterotic matrix string theories described by warped AdS3 supergravities. In particular, we compute the spectra of Kaluza-Klein primaries for type I, II supergravities on warped AdS3 × S7 and match them with the primary operators in the dual two-dimensional gauge theories. The presence of non-trivial warp factors and dilaton profiles requires a modification of the familiar dictionary between masses and 'scaling' dimensions of fields and operators. We present these modifications for the general case of domain wall/QFT correspondences between supergravities on warped AdSd+1 × Sq geometries and super Yang-Mills theories with 16 supercharges.

  5. One-year longitudinal evaluation of neuropsychiatric symptoms in Alzheimer's disease. The REAL.FR Study.

    PubMed

    Benoit, M; Robert, P H; Staccini, P; Brocker, P; Guerin, O; Lechowski, L; Vellas, B

    2005-01-01

    Behavioral and Psychological Symptoms are major and frequent manifestations of Alzheimer's Disease (AD). The aim of the present study was to evaluate neuropsychiatric symptoms in the PHRC REAL.FR cohort (for Réseau sur la maladie d'Alzheimer Français) after one year of evolution. Four hundred and eighty two patients with mild and moderate AD were assessed. A majority of them had significant symptoms at inclusion (85.3 % of subjects with mild AD, 89.7% of patients with a moderate AD). Patients with mild AD had a significant increase of the Neuropsychiatric Inventory (NPI) frequency x severity scores for apathy and aberrant motor behavior. Patients with moderate AD had a significant increase of NPI disinhibition, aberrant motor behavior and sleep disorders scores. The variation of NPI total score at one year correlated positively with change in Zarit's caregiver burden score, independently of global cognitive evolution. After one year, a group of 54 patients were institutionalized in nursing home or long term care unit. When compared to non institutionalized patients, the institutionalized group was characterized at base line by a lower MMSE score, a higher Zarit caregiver burden score, and a higher NPI agitation and disinhibition scores.

  6. Evolution of depressive symptoms in Alzheimer disease: one-year follow-up.

    PubMed

    Garre-Olmo, J; López-Pousa, S; Vilalta-Franch, J; Turon-Estrada, A; Hernàndez-Ferràndiz, M; Lozano-Gallego, M; Fajardo-Tibau, C; Puig-Vidal, O; Morante-Muñoz, V; Cruz-Reina, M M

    2003-01-01

    The current longitudinal study analyzes the natural course of depressive symptoms in patients with Alzheimer disease (AD). The goals were to identify the clinical and sociodemographic variables related to depressive symptoms, to assess the effect of depressive symptoms on the course of cognitive and functional impairment and on associated neuropsychiatric disorders, and to identify which factors are associated with remission, persistence, and emergence of depressive symptoms at 12 months. A sample of 150 patients with mild or moderate severity was assessed at baseline and at 12 months using the neuropsychologic battery Cambridge Cognitive Examination. The Neuropsychiatric Inventory and Rapid Disability Rating Scale were administered to the caregiver. Prevalence, persistence, and emergence of depressive symptoms at baseline were 51%, 55%, and 20%, respectively. Remission of depressive symptoms at 12 months leads to a decreased frequency of other noncognitive disorders and to a slight improvement in the assessment of global function. The presence of depressive symptoms does not affect the course of cognitive impairment at 12 months, and a psychiatric history of the patient and the number of depressive symptoms at baseline are risk factors for the emergence and persistence of depressive symptoms at 12 months.

  7. Mindfulness Is Associated with Fewer PTSD Symptoms, Depressive Symptoms, Physical Symptoms, and Alcohol Problems in Urban Firefighters

    ERIC Educational Resources Information Center

    Smith, Bruce W.; Ortiz, J. Alexis; Steffen, Laurie E.; Tooley, Erin M.; Wiggins, Kathryn T.; Yeater, Elizabeth A.; Montoya, John D.; Bernard, Michael L.

    2011-01-01

    Objective: This study investigated the association between mindfulness, other resilience resources, and several measures of health in 124 urban firefighters. Method: Participants completed health measures of posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, physical symptoms, and alcohol problems and measures of resilience…

  8. Interoception and Positive Symptoms in Schizophrenia.

    PubMed

    Ardizzi, Martina; Ambrosecchia, Marianna; Buratta, Livia; Ferri, Francesca; Peciccia, Maurizio; Donnari, Simone; Mazzeschi, Claudia; Gallese, Vittorio

    2016-01-01

    The present study focuses on the multifaceted concept of self-disturbance in schizophrenia, adding knowledge about a not yet investigated aspect, which is the interoceptive accuracy. Starting from the assumption that interoceptive accuracy requires an intact sense of self, which otherwise was proved to be altered in schizophrenia, the aim of the present study was to explore interoceptive accuracy in a group of schizophrenia patients, compared to healthy controls. Furthermore, the possible association between interoceptive accuracy and patients' positive and negative symptomatology was assessed. To pursue these goals, a group of 23 schizophrenia patients and a group of 23 healthy controls performed a heartbeat perception task. Patients' symptomatology was assessed by means of the Positive and Negative Syndrome Scale (PANSS). Results demonstrated significantly lower interoceptive accuracy in schizophrenia patients compared to healthy controls. This difference was not accounted for participants' age, BMI, anxiety levels, and heart rate. Furthermore, patients' illness severity, attention and pharmacological treatment did not influence their interoceptive accuracy levels. Interestingly, a strong positive relation between interoceptive accuracy and positive symptoms severity, especially Grandiosity, was found. The present results demonstrate for the first time that interoceptive accuracy is altered in schizophrenia. Furthermore, they prove a specific association between interoceptive accuracy and positive symptomatology, suggesting that the symptom Grandiosity might be protective against an altered basic sense of self in patients characterized by higher sensibility to their inner bodily sensations. PMID:27512369

  9. Interoception and Positive Symptoms in Schizophrenia

    PubMed Central

    Ardizzi, Martina; Ambrosecchia, Marianna; Buratta, Livia; Ferri, Francesca; Peciccia, Maurizio; Donnari, Simone; Mazzeschi, Claudia; Gallese, Vittorio

    2016-01-01

    The present study focuses on the multifaceted concept of self-disturbance in schizophrenia, adding knowledge about a not yet investigated aspect, which is the interoceptive accuracy. Starting from the assumption that interoceptive accuracy requires an intact sense of self, which otherwise was proved to be altered in schizophrenia, the aim of the present study was to explore interoceptive accuracy in a group of schizophrenia patients, compared to healthy controls. Furthermore, the possible association between interoceptive accuracy and patients’ positive and negative symptomatology was assessed. To pursue these goals, a group of 23 schizophrenia patients and a group of 23 healthy controls performed a heartbeat perception task. Patients’ symptomatology was assessed by means of the Positive and Negative Syndrome Scale (PANSS). Results demonstrated significantly lower interoceptive accuracy in schizophrenia patients compared to healthy controls. This difference was not accounted for participants’ age, BMI, anxiety levels, and heart rate. Furthermore, patients’ illness severity, attention and pharmacological treatment did not influence their interoceptive accuracy levels. Interestingly, a strong positive relation between interoceptive accuracy and positive symptoms severity, especially Grandiosity, was found. The present results demonstrate for the first time that interoceptive accuracy is altered in schizophrenia. Furthermore, they prove a specific association between interoceptive accuracy and positive symptomatology, suggesting that the symptom Grandiosity might be protective against an altered basic sense of self in patients characterized by higher sensibility to their inner bodily sensations. PMID:27512369

  10. Decreased gray matter volume is associated with the subtypes of psychotic symptoms in patients with antipsychotic-naïve mild or moderate Alzheimer's disease: A voxel-based morphometry study.

    PubMed

    Lee, Young-Min; Chung, Young-In; Park, Je-Min; Lee, Byung-Dae; Moon, Eunsoo; Jeong, Hee-Jeong; Kim, Ji-Hoon; Kim, Hak-Jin; Mun, Chi-Woong; Kim, Tae-Hyung; Kim, Young-Hoon; Kim, Eun-Joo

    2016-03-30

    The purpose of this study was to investigate the association between brain regional gray matter volume and two subtypes of psychotic symptoms, namely paranoid and misidentification subtypes, in antipsychotic-naïve mild or moderate Alzheimer's disease (AD) patients. Forty AD patients with psychotic symptoms and 25 AD patients without psychotic symptoms were assessed for cognitive and functional impairment. Presence and subtype of psychotic symptoms were assessed by using the delusion and hallucination subscale of the Korean Neuropsychiatric Inventory (K-NPI). Structural MRI images were acquired on a 3 T scanner, and were analyzed using voxel-based morphometry (VBM) for automated analysis. The misidentification subtype is associated with more severe gray matter atrophy, and paranoid subtype is associated with less severe gray matter atrophy compared to non-psychosis group. These results suggest that the misidentification, the paranoid subtype and the non-psychosis group have a distinct neural correlation. PMID:27000306

  11. Agricultural Education: Value Adding.

    ERIC Educational Resources Information Center

    Riesenberg, Lou E.; And Others

    1989-01-01

    This issue develops the theme of "Agricultural Education--Value Adding." The concept value adding has been a staple in the world of agricultural business for describing adding value to a commodity that would profit the producer and the local community. Agricultural education should add value to individuals and society to justify agricultural…

  12. Neuropsychiatric Symptom Clusters in Stroke and Transient Ischemic Attack by Cognitive Status and Stroke Subtype: Frequency and Relationships with Vascular Lesions, Brain Atrophy and Amyloid

    PubMed Central

    Wong, Adrian; Lau, Alexander Y. L.; Yang, Jie; Wang, Zhaolu; Liu, Wenyan; Lam, Bonnie Y. K.; Au, Lisa; Shi, Lin; Wang, Defeng; Chu, Winnie C. W.; Xiong, Yun-yun; Lo, Eugene S. K.; Law, Lorraine S. N.; Leung, Thomas W. H.; Lam, Linda C. W.; Chan, Anne Y. Y.; Soo, Yannie O. Y.; Leung, Eric Y. L.; Wong, Lawrence K. S.; Mok, Vincent C. T.

    2016-01-01

    Background The objectives of this study are 1) to examine the frequencies of neuropsychiatric symptom clusters in patients with stroke or transient ischemic attack (TIA) by cognitive level and stroke subtype; and 2) to evaluate effect of demographic, clinical, and neuroimaging measures of chronic brain changes and amyloid upon neuropsychiatric symptom clusters. Methods Hospital-based, cross-sectional study. 518 patients were administered the Neuropsychiatric Inventory (NPI) 3–6 months post index admission. NPI symptoms were classified into four symptom clusters (Behavioral Problems, Psychosis, Mood Disturbance & Euphoria) derived from a confirmatory factor analysis of the 12 NPI items. Multivariable logistic regression was used to determine independent associations between demographic, clinical and neuroimaging measures of chronic brain changes (white matter changes, old infarcts, whole brain atrophy, medial temporal lobe atrophy [MTLA] and frontal lobe atrophy [FLA]) with the presence of NPI symptoms and all symptom clusters except euphoria. 11C-Pittsburg Compound B Positron Emission Tomography (11C-PiB PET) was performed in 24 patients to measure amyloid retention for Alzheimer’s Disease (AD) pathology. Results 50.6% of the whole sample, including 28.7% cognitively normal and 66.7% of patients with mild cognitive symptoms, had ≥1 NPI symptoms. Frequencies of symptom clusters were largely similar between stroke subtypes. Compared to patients with cardioembolic stroke and intracranial haemorrhage, those with TIA had less frequent mood disturbance. Stroke severity at admission and MTLA were the most robust correlates of symptoms. FLA was associated with behavioral problems cluster only. Frequency of symptom clusters did not differ between patients with and without significant amyloid retention. Conclusion Frequency of neuropsychiatric symptoms increased with level of cognitive impairment but was largely similar between stroke subtypes. Stroke severity and MTLA

  13. Potential drug-drug interactions in Alzheimer patients with behavioral symptoms.

    PubMed

    Pasqualetti, Giuseppe; Tognini, Sara; Calsolaro, Valeria; Polini, Antonio; Monzani, Fabio

    2015-01-01

    The use of multi drug regimens among the elderly population has increased tremendously over the last decade although the benefits of medications are always accompanied by potential harm, even when prescribed at recommended doses. The elderly populations are particularly at an increased risk of adverse drug reactions considering comorbidity, poly-therapy, physiological changes affecting the pharmacokinetics and pharmacodynamics of many drugs and, in some cases, poor compliance due to cognitive impairment and/or depression. In this setting, drug-drug interaction may represent a serious and even life-threatening clinical condition. Moreover, the inability to distinguish drug-induced symptoms from a definitive medical diagnosis often results in addition of yet another drug to treat the symptoms, which in turn increases drug-drug interactions. Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, are the most widely prescribed agents for Alzheimer's disease (AD) patients. Behavioral and psychological symptoms of dementia, including psychotic symptoms and behavioral disorders, represent noncognitive disturbances frequently observed in AD patients. Antipsychotic drugs are at high risk of adverse events, even at modest doses, and may interfere with the progression of cognitive impairment and interact with several drugs including anti-arrhythmics and acetylcholinesterase inhibitors. Other medications often used in AD patients are represented by anxiolytic, like benzodiazepine, or antidepressant agents. These agents also might interfere with other concomitant drugs through both pharmacokinetic and pharmacodynamic mechanisms. In this review we focus on the most frequent drug-drug interactions, potentially harmful, in AD patients with behavioral symptoms considering both physiological and pathological changes in AD patients, and potential pharmacodynamic/pharmacokinetic drug interaction mechanisms.

  14. Potential drug–drug interactions in Alzheimer patients with behavioral symptoms

    PubMed Central

    Pasqualetti, Giuseppe; Tognini, Sara; Calsolaro, Valeria; Polini, Antonio; Monzani, Fabio

    2015-01-01

    The use of multi drug regimens among the elderly population has increased tremendously over the last decade although the benefits of medications are always accompanied by potential harm, even when prescribed at recommended doses. The elderly populations are particularly at an increased risk of adverse drug reactions considering comorbidity, poly-therapy, physiological changes affecting the pharmacokinetics and pharmacodynamics of many drugs and, in some cases, poor compliance due to cognitive impairment and/or depression. In this setting, drug–drug interaction may represent a serious and even life-threatening clinical condition. Moreover, the inability to distinguish drug-induced symptoms from a definitive medical diagnosis often results in addition of yet another drug to treat the symptoms, which in turn increases drug–drug interactions. Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, are the most widely prescribed agents for Alzheimer’s disease (AD) patients. Behavioral and psychological symptoms of dementia, including psychotic symptoms and behavioral disorders, represent noncognitive disturbances frequently observed in AD patients. Antipsychotic drugs are at high risk of adverse events, even at modest doses, and may interfere with the progression of cognitive impairment and interact with several drugs including anti-arrhythmics and acetylcholinesterase inhibitors. Other medications often used in AD patients are represented by anxiolytic, like benzodiazepine, or antidepressant agents. These agents also might interfere with other concomitant drugs through both pharmacokinetic and pharmacodynamic mechanisms. In this review we focus on the most frequent drug–drug interactions, potentially harmful, in AD patients with behavioral symptoms considering both physiological and pathological changes in AD patients, and potential pharmacodynamic/pharmacokinetic drug interaction mechanisms. PMID:26392756

  15. Potential drug-drug interactions in Alzheimer patients with behavioral symptoms.

    PubMed

    Pasqualetti, Giuseppe; Tognini, Sara; Calsolaro, Valeria; Polini, Antonio; Monzani, Fabio

    2015-01-01

    The use of multi drug regimens among the elderly population has increased tremendously over the last decade although the benefits of medications are always accompanied by potential harm, even when prescribed at recommended doses. The elderly populations are particularly at an increased risk of adverse drug reactions considering comorbidity, poly-therapy, physiological changes affecting the pharmacokinetics and pharmacodynamics of many drugs and, in some cases, poor compliance due to cognitive impairment and/or depression. In this setting, drug-drug interaction may represent a serious and even life-threatening clinical condition. Moreover, the inability to distinguish drug-induced symptoms from a definitive medical diagnosis often results in addition of yet another drug to treat the symptoms, which in turn increases drug-drug interactions. Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, are the most widely prescribed agents for Alzheimer's disease (AD) patients. Behavioral and psychological symptoms of dementia, including psychotic symptoms and behavioral disorders, represent noncognitive disturbances frequently observed in AD patients. Antipsychotic drugs are at high risk of adverse events, even at modest doses, and may interfere with the progression of cognitive impairment and interact with several drugs including anti-arrhythmics and acetylcholinesterase inhibitors. Other medications often used in AD patients are represented by anxiolytic, like benzodiazepine, or antidepressant agents. These agents also might interfere with other concomitant drugs through both pharmacokinetic and pharmacodynamic mechanisms. In this review we focus on the most frequent drug-drug interactions, potentially harmful, in AD patients with behavioral symptoms considering both physiological and pathological changes in AD patients, and potential pharmacodynamic/pharmacokinetic drug interaction mechanisms. PMID:26392756

  16. Adding flavor to AdS4/CFT3

    NASA Astrophysics Data System (ADS)

    Ammon, Martin; Erdmenger, Johanna; Meyer, René; O'Bannon, Andy; Wrase, Timm

    2009-11-01

    Aharony, Bergman, Jafferis, and Maldacena have proposed that the low-energy description of multiple M2-branes at a Bbb C4/Bbb Zk singularity is a (2+1)-dimensional Script N = 6 supersymmetric U(Nc) × U(Nc) Chern-Simons matter theory, the ABJM theory. In the large-Nc limit, its holographic dual is supergravity in AdS4 × S7/Bbb Zk. We study various ways to add fields that transform in the fundamental representation of the gauge groups, i.e. flavor fields, to the ABJM theory. We work in a probe limit and perform analyses in both the supergravity and field theory descriptions. In the supergravity description we find a large class of supersymmetric embeddings of probe flavor branes. In the field theory description, we present a general method to determine the couplings of the flavor fields to the fields of the ABJM theory. We then study four examples in detail: codimension-zero Script N = 3 supersymmetric flavor, described in supergravity by Kaluza-Klein monopoles or D6-branes; codimension-one Script N = (0,6) supersymmetric chiral flavor, described by D8-branes; codimension-one Script N = (3,3) supersymmetric non-chiral flavor, described by M5/D4-branes; codimension-two Script N = 4 supersymmetric flavor, described by M2/D2-branes. Finally we discuss special physical equivalences between brane embeddings in M-theory, and their interpretation in the field theory description.

  17. Twistor methods for AdS5

    NASA Astrophysics Data System (ADS)

    Adamo, Tim; Skinner, David; Williams, Jack

    2016-08-01

    We consider the application of twistor theory to five-dimensional anti-de Sitter space. The twistor space of AdS5 is the same as the ambitwistor space of the four-dimensional conformal boundary; the geometry of this correspondence is reviewed for both the bulk and boundary. A Penrose transform allows us to describe free bulk fields, with or without mass, in terms of data on twistor space. Explicit representatives for the bulk-to-boundary propagators of scalars and spinors are constructed, along with twistor action functionals for the free theories. Evaluating these twistor actions on bulk-to-boundary propagators is shown to produce the correct two-point functions.

  18. AdS3: the NHEK generation

    NASA Astrophysics Data System (ADS)

    Bena, Iosif; Heurtier, Lucien; Puhm, Andrea

    2016-05-01

    It was argued in [1] that the five-dimensional near-horizon extremal Kerr (NHEK) geometry can be embedded in String Theory as the infrared region of an infinite family of non-supersymmetric geometries that have D1, D5, momentum and KK monopole charges. We show that there exists a method to embed these geometries into asymptotically- {AdS}_3× {S}^3/{{Z}}_N solutions, and hence to obtain infinite families of flows whose infrared is NHEK. This indicates that the CFT dual to the NHEK geometry is the IR fixed point of a Renormalization Group flow from a known local UV CFT and opens the door to its explicit construction.

  19. Supergravity background of the λ-deformed AdS3 × S3 supercoset

    NASA Astrophysics Data System (ADS)

    Chervonyi, Yuri; Lunin, Oleg

    2016-09-01

    We construct the solution of type IIB supergravity describing the integrable λ-deformation of the AdS3 ×S3 supercoset. While the geometry corresponding to the deformation of the bosonic coset has been found in the past, our background is more natural for studying superstrings, and several interesting features distinguish our solution from its bosonic counterpart. We also report progress towards constructing the λ-deformation of the AdS5 ×S5 supercoset.

  20. Shadows, currents, and AdS fields

    SciTech Connect

    Metsaev, R. R.

    2008-11-15

    Conformal totally symmetric arbitrary spin currents and shadow fields in flat space-time of dimension greater than or equal to four are studied. A gauge invariant formulation for such currents and shadow fields is developed. Gauge symmetries are realized by involving the Stueckelberg fields. A realization of global conformal boost symmetries is obtained. Gauge invariant differential constraints for currents and shadow fields are obtained. AdS/CFT correspondence for currents and shadow fields and the respective normalizable and non-normalizable solutions of massless totally symmetric arbitrary spin AdS fields are studied. The bulk fields are considered in a modified de Donder gauge that leads to decoupled equations of motion. We demonstrate that leftover on shell gauge symmetries of bulk fields correspond to gauge symmetries of boundary currents and shadow fields, while the modified de Donder gauge conditions for bulk fields correspond to differential constraints for boundary conformal currents and shadow fields. Breaking conformal symmetries, we find interrelations between the gauge invariant formulation of the currents and shadow fields, and the gauge invariant formulation of massive fields.

  1. Gastrointestinal Symptoms in Morbid Obesity

    PubMed Central

    Huseini, Mustafa; Wood, G. Craig; Seiler, Jamie; Argyropoulos, George; Irving, Brian A.; Gerhard, Glenn S.; Benotti, Peter; Still, Christopher; Rolston, David D. K.

    2014-01-01

    Background: Several reports have shown an increased prevalence of gastrointestinal (GI) symptoms in obese subjects in community-based studies. To better understand the role of the GI tract in obesity, and because there are limited clinic-based studies, we documented the prevalence of upper and lower GI symptoms in morbidly obese individuals in a clinic setting. Objective: The aim of our study was to compare the prevalence of GI symptoms in morbidly obese individuals in a weight management clinic with non-obese individuals with similar comorbidities as morbidly obese individuals in an Internal Medicine clinic. Methods: Class II and III obese patients BMI >35 kg/m2 (N = 114) and 182 non-obese patients (BMI <25 kg/m2) completed the GI symptoms survey between August 2011 and April 2012 were included in this study. The survey included 24 items pertaining to upper and lower GI symptoms. The participants rated the frequency of symptoms as absent (never, rarely) or present (occasionally, frequently). The symptoms were clustered into five categories: oral symptoms, dysphagia, gastroesophageal reflux, abdominal pain, and bowel habits. Responses to each symptom cluster were compared between obese group and normal weight groups using logistic regression. Results: Of the 24 items, 18 had a higher frequency in the obese group (p < 0.005 for each). After adjusting for age and gender, the obese patients were more likely to have upper GI symptoms: any oral symptom (OR = 2.3, p = 0.0013), dysphagia (OR 2.9, p = 0.0006), and any gastroesophageal reflux (OR 3.8, p < 0.0001). Similarly, the obese patients were more likely to have lower GI symptoms: any abdominal pain (OR = 1.7, p = 0.042) and altered bowel habits (OR = 2.8, p < 0.0001). Conclusion: These observations suggest a statistically significant increase in frequency of both upper and lower GI symptoms in morbidly obese patients when compared to non-obese subjects. PMID:25593922

  2. Symptom Patterns Among Gulf War Registry Veterans

    PubMed Central

    Hallman, William K.; Kipen, Howard M.; Diefenbach, Michael; Boyd, Kendal; Kang, Han; Leventhal, Howard; Wartenberg, Daniel

    2003-01-01

    Objectives. We identify symptom patterns among veterans who believe they suffer from Gulf War–related illnesses and characterize groups of individuals with similar patterns. Methods. A mail survey was completed by 1161 veterans drawn from the Gulf War Health Registry. Results. An exploratory factor analysis revealed 4 symptom factors. A K-means cluster analysis revealed 2 groups: (1) veterans reporting good health and few moderate/severe symptoms, and (2) veterans reporting fair/poor health and endorsing an average of 37 symptoms, 75% as moderate/severe. Those in Cluster 2 were more likely to report having 1 or more of 24 medical conditions. Conclusions. These findings are consistent with previous investigations of symptom patterns in Gulf War veterans. This multisymptom illness may be more fully characterized by the extent, breadth, and severity of symptoms reported. PMID:12660208

  3. Negative Generalization and Symptoms of Anxiety Disorders

    PubMed Central

    Fulford, Daniel; Rosen, Rebecca K.; Johnson, Sheri L.; Carver, Charles S.

    2013-01-01

    The tendency to generalize from a single failure to one's entire self-worth is an important correlate and predictor of depression. Despite conceptual overlap between cognitive biases in anxiety and depression, little research has examined whether negative generalization relates to anxiety symptoms. We examined associations of negative generalization with symptoms of several anxiety disorders, above and beyond its association with lifetime symptoms of depression, among 248 undergraduates. After controlling for lifetime symptoms of major depression, negative generalization was significantly correlated with symptoms of each anxiety disorder tested, most notably generalized anxiety and social phobia. PMID:24340170

  4. An evaluation of the effect of an alpha hydroxy acid-blend skin cream in the cosmetic improvement of symptoms of moderate to severe xerosis, epidermolytic hyperkeratosis, and ichthyosis.

    PubMed

    Kempers, S; Katz, H I; Wildnauer, R; Green, B

    1998-06-01

    A number of genetic, intrinsic, and extrinsic factors can cause conditions of problem dry skin, marked by unusual dryness, rough texture, and extreme flaking and scaling, that are generally not controlled by conventional moisturizers. A study was undertaken to evaluate the safety and efficacy of two novel alpha hydroxy acid (AHA)-containing creams in reducing the appearance and symptoms of problem dry skin on subjects with a range of dry skin conditions, including xerosis, epidermolytic hyperkeratosis, and ichthyosis. Twenty subjects completed a course of treatment with either regular or extra strength AHA-blend cream on a test site, compared with a currently marketed, non-AHA moisturizing lotion on a control site. Subjects were treated for 4 weeks, with clinical evaluations performed at weeks 0, 2, and 4. The test for mulations reduced symptoms and improved cosmetic appearance following 2 weeks of use, with continued improvement following 4 weeks of use. Improvements were significant compared to baseline and compared to sites treated with the control lotion. Some patients experienced mild to moderate local adverse effects; all subjects were able to continue using the test product for the duration of the study.

  5. Evaluation of potential severe accidents during low power and shutdown operations at Surry, Unit 1: Analysis of core damage frequency from internal events during mid-loop operations, Appendices A--D. Volume 2, Part 2

    SciTech Connect

    Chu, T.L.; Musicki, Z.; Kohut, P.

    1994-06-01

    During 1989, the Nuclear Regulatory Commission (NRC) initiated an extensive program to carefully examine the Potential risks during low Power and shutdown operations. The program includes two parallel projects being performed by Brookhaven National Laboratory (BNL) and Sandia National Laboratories (SNL). Two plants, Surry (pressurized water reactor) and Grand Gulf (boiling water reactor), were selected as the Plants to be studied. The objectives of the program are to assess the risks of severe accidents initiated during plant operational states other than full power operation and to compare the estimated core damage frequencies, important accident sequences and other qualitative and quantitative results with those accidents initiated during full power operation as assessed in NUREG-1150. The objective of this report is to document the approach utilized in the Surry plant and discuss the results obtained. A parallel report for the Grand Gulf plant is prepared by SNL. This study shows that the core-damage frequency during mid-loop operation at the Surry plant is comparable to that of power operation. We recognize that there is very large uncertainty in the human error probabilities in this study. This study identified that only a few procedures are available for mitigating accidents that may occur during shutdown. Procedures written specifically for shutdown accidents would be useful. This document, Volume 2, Pt. 2 provides appendices A through D of this report.

  6. Premenstrual symptoms and smoking-related expectancies.

    PubMed

    Pang, Raina D; Bello, Mariel S; Stone, Matthew D; Kirkpatrick, Matthew G; Huh, Jimi; Monterosso, John; Haselton, Martie G; Fales, Melissa R; Leventhal, Adam M

    2016-06-01

    Given that prior research implicates smoking abstinence in increased premenstrual symptoms, tobacco withdrawal, and smoking behaviors, it is possible that women with more severe premenstrual symptoms have stronger expectancies about the effects of smoking and abstaining from smoking on mood and withdrawal. However, such relations have not been previously explored. This study examined relations between premenstrual symptoms experienced in the last month and expectancies that abstaining from smoking results in withdrawal (i.e., smoking abstinence withdrawal expectancies), that smoking is pleasurable (i.e., positive reinforcement smoking expectancies), and smoking relieves negative mood (i.e., negative reinforcement smoking expectancies). In a cross-sectional design, 97 non-treatment seeking women daily smokers completed self-report measures of smoking reinforcement expectancies, smoking abstinence withdrawal expectancies, premenstrual symptoms, mood symptoms, and nicotine dependence. Affect premenstrual symptoms were associated with increased negative reinforcement smoking expectancies, but not over and above covariates. Affect and pain premenstrual symptoms were associated with increased positive reinforcement smoking expectancies, but only affect premenstrual symptoms remained significant in adjusted models. Affect, pain, and water retention premenstrual symptoms were associated with increased smoking abstinence withdrawal expectancies, but only affect premenstrual symptoms remained significant in adjusted models. Findings from this study suggest that addressing concerns about withdrawal and alternatives to smoking may be particularly important in women who experience more severe premenstrual symptoms, especially affect-related changes. PMID:26869196

  7. Premenstrual symptoms and smoking-related expectancies.

    PubMed

    Pang, Raina D; Bello, Mariel S; Stone, Matthew D; Kirkpatrick, Matthew G; Huh, Jimi; Monterosso, John; Haselton, Martie G; Fales, Melissa R; Leventhal, Adam M

    2016-06-01

    Given that prior research implicates smoking abstinence in increased premenstrual symptoms, tobacco withdrawal, and smoking behaviors, it is possible that women with more severe premenstrual symptoms have stronger expectancies about the effects of smoking and abstaining from smoking on mood and withdrawal. However, such relations have not been previously explored. This study examined relations between premenstrual symptoms experienced in the last month and expectancies that abstaining from smoking results in withdrawal (i.e., smoking abstinence withdrawal expectancies), that smoking is pleasurable (i.e., positive reinforcement smoking expectancies), and smoking relieves negative mood (i.e., negative reinforcement smoking expectancies). In a cross-sectional design, 97 non-treatment seeking women daily smokers completed self-report measures of smoking reinforcement expectancies, smoking abstinence withdrawal expectancies, premenstrual symptoms, mood symptoms, and nicotine dependence. Affect premenstrual symptoms were associated with increased negative reinforcement smoking expectancies, but not over and above covariates. Affect and pain premenstrual symptoms were associated with increased positive reinforcement smoking expectancies, but only affect premenstrual symptoms remained significant in adjusted models. Affect, pain, and water retention premenstrual symptoms were associated with increased smoking abstinence withdrawal expectancies, but only affect premenstrual symptoms remained significant in adjusted models. Findings from this study suggest that addressing concerns about withdrawal and alternatives to smoking may be particularly important in women who experience more severe premenstrual symptoms, especially affect-related changes.

  8. The precipitation of symptoms by common foods in children with atopic dermatitis.

    PubMed

    Steinman, H A; Potter, P C

    1994-01-01

    Atopic dermatitis (AD) is a chronic and disabling condition that has a major impact on financial and social resources of the individual and the community. Its incidence is increasing dramatically, and no cure is available. Pharmacological treatment is only partially effective. The evidence that diet plays a role in children with atopic dermatitis is now irrefutable. Prophylactic measures can prevent or limit the development of AD, and partially restricted diets can modify the disease's course or severity. This study reports the reactions to various foods as perceived by parents of 112 children affected by AD. It demonstrates that many foods exacerbate AD and that reactions are caused by two distinct groups of food. The commonest triggers of cutaneous symptoms are tomatoes, oranges, sweets, pineapple, chocolate, and softdrinks preserved with sulfur dioxide. These foods result in symptoms in 30% to 49% of the children. The traditional IgE reaction type foods, namely egg, fish, milk, and peanut, resulted in reactions in 14% to 25% of the children, and with many non-cutaneous symptoms. The study further shows that allergen avoidance measures are not practiced in our community, and that sound advice is not often proffered. Practical advice on prophylactic dietary preventative measures and dietary management of children with atopic dermatitis is presented.

  9. The precipitation of symptoms by common foods in children with atopic dermatitis.

    PubMed

    Steinman, H A; Potter, P C

    1994-01-01

    Atopic dermatitis (AD) is a chronic and disabling condition that has a major impact on financial and social resources of the individual and the community. Its incidence is increasing dramatically, and no cure is available. Pharmacological treatment is only partially effective. The evidence that diet plays a role in children with atopic dermatitis is now irrefutable. Prophylactic measures can prevent or limit the development of AD, and partially restricted diets can modify the disease's course or severity. This study reports the reactions to various foods as perceived by parents of 112 children affected by AD. It demonstrates that many foods exacerbate AD and that reactions are caused by two distinct groups of food. The commonest triggers of cutaneous symptoms are tomatoes, oranges, sweets, pineapple, chocolate, and softdrinks preserved with sulfur dioxide. These foods result in symptoms in 30% to 49% of the children. The traditional IgE reaction type foods, namely egg, fish, milk, and peanut, resulted in reactions in 14% to 25% of the children, and with many non-cutaneous symptoms. The study further shows that allergen avoidance measures are not practiced in our community, and that sound advice is not often proffered. Practical advice on prophylactic dietary preventative measures and dietary management of children with atopic dermatitis is presented. PMID:7806078

  10. A Comparison of Problem Behavior Profiles in Turkish Children with AD/HD and Non-AD/HD Children

    ERIC Educational Resources Information Center

    Ozdemir, Selda

    2010-01-01

    Introduction: There is an increasing number of studies describing the symptoms of ADHD among school-age children in western cultures. Yet, studies on children with ADHD living in non-western cultures are limited. Thus, the purpose of this study was to compare problem behavior profiles of Turkish children with AD/HD and non-AD/HD children. Method:…

  11. PER3 Polymorphism and Insomnia Severity in Alcohol Dependence

    PubMed Central

    Brower, Kirk J.; Wojnar, Marcin; Sliwerska, Elzbieta; Armitage, Roseanne; Burmeister, Margit

    2012-01-01

    Study Objectives: Insomnia is common, persistent, and associated with relapse in alcohol-dependent (AD) patients. Although the underlying mechanisms are mostly unstudied, AD patients have impaired circadian rhythms and sleep drive, which may be genetically influenced. A polymorphism in the PER3 gene (PER34/4, PER34/5, PER35/5) has previously been associated with circadian preference and sleep homeostasis, and the PER34/4genotype has been characterized by evening preference and decreased sleep drive. The purpose of this study was to examine the influence of this polymorphism on insomnia severity in AD patients. We hypothesized that the PER3 polymorphism would be an independent predictor of insomnia severity with greatest severity observed in those with the PER34/4genotype. Design: Cross-sectional association of patient characteristics, genotype, and insomnia severity. Significant (P < 0.05) bivariate correlates were further analyzed by hierarchical, forced entry multiple linear regression. Setting: Alcohol treatment programs in Warsaw, Poland. Patients: Diagnosed with alcohol dependence (n = 285), according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Measurements and Results: Drinking frequency, mental and physical health status, childhood abuse, and PER3 genotype were independent predictors of insomnia severity, as measured by a 7-item subscale of the Sleep Disorders Questionnaire, explaining 28.9% of the variance. Addition of the genotype in the final step significantly increased the amount of variance explained by 1.1% (P = 0.027). Those with the PER34/4genotype had the greatest severity of insomnia symptoms. Conclusions: PER3 genotype contributed unique variance in predicting insomnia severity in AD patients. These results are consistent with genetically influenced impairment in sleep regulation mechanisms in AD patients with insomnia. Citation: Brower KJ; Wojnar M; Sliwerska E; Armitage R; Burmeister M. PER3 polymorphism and

  12. Pharmacological treatments of behavioral and psychological symptoms of dementia in Alzheimer's disease: role of acetylcholinesterase inhibitors and memantine.

    PubMed

    Desmidt, Thomas; Hommet, Caroline; Camus, Vincent

    2016-09-01

    Behavioral and psychological symptoms of dementia (BPSD) are frequent in Alzheimer's disease (AD). They are associated with disability and suffering for both the patients and their caregivers. Even if BPSD are now well diagnosed and characterized by standardized tools, their treatment remains often challenging in clinical setting because of the frequent and severe side effects of the psychotropic drugs when used in this indication. Evidence-based data confirm that antipsychotics and antidepressants are efficient for the treatment of BPSD but have a poor tolerance profile and their use is problematic. Use of cholinesterase inhibitors and memantine, whom French authorities have questioned the relevance in 2008, also have a significant efficacy on non-cognitive symptoms of AD. Therefore, and although their tolerance profile is considered unsatisfying, they keep an indication in patients with AD and BPSD. PMID:27651011

  13. Behavioural symptoms in patients with Alzheimer's disease and their association with cognitive impairment

    PubMed Central

    2010-01-01

    Background Behavioural and psychological symptoms of dementia (BPSD) are non-cognitive symptoms commonly associated to Alzheimer's disease (AD). The characterization of the clinical profile of AD patients might help to better understand disease evolution and to improve diagnosis and treatment. Thus, the aim of the present study is to describe the clinical profile of AD patients, and to correlate the presence of BPSD with the severity of the disease. Methods A cross-sectional, observational and multicenter study was conducted at 115 centres in Spain. Patients suffering from AD with higher and lower BPSD scores (ADAS-Noncog score 26-50 and ≤25, respectively) were included. Demographic and clinical data were collected, and dementia severity was assessed by the Mini Mental State Examination (MMSE) [mild 27-21, moderate 20-11, severe ≤10]. The use of ADAS-Noncog in clinical practice was also explored. Results A total of 1014 patients (463 with higher and 551 with lower BPSD scores) were included (mean age 77 ± 7 years, 65% women). Almost all patients (90%) had BPSD at inclusion, 17% of which reported psychotic outbreaks. The most prevalent symptoms were lack of concentration (56%), tremors (56%), depression (44%), lack of cooperation (36%), and delusions (32%). Patients with higher BPSD scores showed a significantly higher prevalence of psychotic symptoms (delusions, hallucinations, and delirium) and tremors, while emotional symptoms (tearfulness and apathy) predominated in patients with lower BPSD scores. MMSE and ADAS-Noncog scores were negatively associated (p = 0.0284), suggesting a correlation between cognitive impairment and BPSD. Lack of concentration and appetite change significantly correlated with MMSE (p = 0.0472 and p = 0.0346, respectively). Rivastigmine and donepezil were the first choice therapies in mild to moderate dementia. ADAS-Noncog was generally considered better or similar to other scales (82%), and 68% of the investigators were willing to

  14. ADS pilot program Plan

    NASA Technical Reports Server (NTRS)

    Clauson, J.; Heuser, J.

    1981-01-01

    The Applications Data Service (ADS) is a system based on an electronic data communications network which will permit scientists to share the data stored in data bases at universities and at government and private installations. It is designed to allow users to readily locate and access high quality, timely data from multiple sources. The ADS Pilot program objectives and the current plans for accomplishing those objectives are described.

  15. The assessment of vegetative and functional symptoms in fibromyalgia patients: the tropisetron experience.

    PubMed

    Kohnen, R; Färber, L; Späth, M

    2004-01-01

    Vegetative and functional symptoms are, besides pain and tenderness of tender points, considered as additional information for the diagnosis of fibromyalgia (FM). In clinical trials, vegetative and functional symptoms have been included for selection of patients (e.g. sleep disturbances) and as secondary outcome parameters. Despite the relevance of these symptoms, no validated method is currently available but symptom lists are ad hoc developed by investigators. In this manuscript, data from a published double blind, randomised study are reanalysed which compared oral therapy over 10 days with 5 mg, 10 mg, and 15 mg to placebo in FM patients. This study applied a list of 17 vegetative and functional symptoms, which had to be scored by the patients by use of a 4-point severity scale (0 = none to 3 = severe). Factor analysis of the baseline data from 195 patients suggested to separate 6 sub-scales: Cardiovascular, gastrointestinal, psychiatric (sleep disturbance), nervous, autonomic system, and general disorders. Sleep disturbances, general symptoms (morning stiffness, fatigue) and autonomic symptoms (cold extremities, hyperhidrosis) were most severe in intensity. Analysis of sensitivity for treatment effects made use of differences between placebo and 5 mg tropisetron in changes between baseline and final assessment of the tropisetron trial. While, on the item level, differences in favour of tropisetron could only be demonstrated for sleep disorders, on the sub-scale level, also favourable effects of tropisetron could be shown for cardiovascular and nervous system complaints and, as a tendency, for general symptoms. On the other side, the sub-scale score of gastrointestinal symptoms worsened under tropisetron whilst it improved under placebo which effect was due to side effects of the active treatment. It is concluded that symptom clusters like sub-scales of a list of vegetative and functional symptoms will be more suitable for diagnostic purposes and evaluation of

  16. Symptoms of Aspergillosis

    MedlinePlus

    ... gov . Fungal Diseases Types of Fungal Diseases Aspergillosis Definition Symptoms People at Risk & Prevention Sources Diagnosis & Testing Treatment Healthcare Professionals Statistics More Resources Blastomycosis Definition Symptoms Risk & Prevention Sources Diagnosis & Testing Treatment & Outcomes ...

  17. Symptoms of Ovarian Cancer

    MedlinePlus

    ... Informed Cancer Home What Are the Symptoms of Ovarian Cancer? Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Gynecologic cancer symptoms diaries Ovarian cancer may cause one or more of these signs ...

  18. Signs and Symptoms

    MedlinePlus

    ... print email share facebook twitter google plus linkedin Signs and Symptoms Partly because there are different types ... This section presents a general picture of CMT signs and symptoms. Contractures and bone deformities Many people ...

  19. Dermatomyositis: Signs and Symptoms

    MedlinePlus

    ... print email share facebook twitter google plus linkedin Signs and Symptoms What happens to someone with dermatomyositis? ... be damaged as a result. About Dermatomyositis (DM) Signs and Symptoms Diagnosis Causes/Inheritance Medical Management Research ...

  20. Bell's Palsy Symptoms

    MedlinePlus

    ... Stories Español Eye Health / Eye Health A-Z Bell's Palsy Sections What Is Bell's Palsy? Bell's Palsy Symptoms ... Bell's Palsy? Bell's Palsy Diagnosis Bell's Palsy Treatment Bell's Palsy Symptoms Reviewed by: Philip R Rizzuto, MD FACS ...

  1. The Emergence of Depressive Symptoms during Adolescence.

    ERIC Educational Resources Information Center

    Brooks-Gunn, Jeanne, Ed.; Petersen, Anne C., Ed.

    1991-01-01

    Twelve papers on the emergence and maintenance of severe clinical depression and depressive symptoms during adolescence are presented. Topics include parental influences, epidemiological data, depressive and negative affect, hormonal effects, preadolescent symptoms, sex differences, longitudinal studies with rhesus monkeys, suicidal ideation,…

  2. Delayed bedtimes and obsessive-compulsive symptoms.

    PubMed

    Coles, Meredith E; Schubert, Jessica R; Sharkey, Katherine M

    2012-10-01

    There is increasing recognition of an important interplay between psychiatric disorders and sleep. Clinical observations and several empirical studies have shown that later bedtimes are associated with obsessive-compulsive disorder (OCD). This study examined the relation of delayed bedtimes (DBs) and symptoms of OCD. Two hundred and sixty-six undergraduates completed a battery of questionnaires assessing sleep patterns, mood, and obsessive-compulsive (OC) symptoms. Results showed that participants with DBs reported increased rates of OC symptoms, as compared with non-DB participants. Further, this relation remained significant when controlling for negative affect. Additional work examining the interplay between sleep and OC symptoms is warranted. PMID:22946735

  3. What is severe asthma?

    PubMed

    Blakey, J D; Wardlaw, A J

    2012-05-01

    Asthma is common, and some individuals are severely affected by it. Learned institutions have sought to provide a definition of 'severe asthma' to facilitate research and clinical care. This is a challenging undertaking given the difficulty in defining asthma and the lack of supportive evidence for a distinct severe asthma phenotype. In this review, we discuss the rationale for a definition of severe asthma and the relative merits of the sequential attempts that have been made to produce such a definition. The difficulty in disentangling control and severity is highlighted, as is the heterogeneity of phenotype in severe asthma, and potential for misclassification. We conclude that the search for a singular definition of severe asthma is problematic, though likely to continue. We suggest the alternative strategy of using classifiers with a specific aim related to symptoms, pathophysiology or service provision.

  4. Demographic correlates of attenuated positive psychotic symptoms

    PubMed Central

    Waford, Rachel N.; MacDonald, Allison; Goines, Katrina; Novacek, Derek M.; Trotman, Hanan D.; Walker, Elaine F.; Addington, Jean; Bearden, Carrie E.; Cadenhead, Kristin S.; Cannon, Tyrone D.; Cornblatt, Barbara A.; Heinssen, Robert; Mathalon, Daniel H.; Tsuang, Ming T.; Perkins, Diana O.; Seidman, Larry J.; Woods, Scott W.; McGlashan, Thomas H.

    2015-01-01

    It is now well established that the utilization of standardized clinical criteria can enhance prediction of psychosis. These criteria are primarily concerned with the presence and severity of attenuated positive symptoms. Because these symptom criteria are used to derive algorithms for designating clinical high risk (CHR) status and for maximizing prediction of psychosis risk, it is important to know whether the symptom ratings vary as a function of demographic factors that have previously been linked with symptoms in diagnosed psychotic patients. Using a sample of 356 CHR individuals from the NAPLS-II multi-site study, we examined the relation of three sex, age, and educational level, with the severity of attenuated positive symptom scores from the Scale of Prodromal Symptoms (SOPS). Demographic factors accounted for little of the variance in symptom ratings (5–6%). Older CHR individuals manifested more severe suspiciousness, and female CHR participants reported more unusual perceptual experiences than male participants. Contrary to prediction, higher educational level was associated with more severe ratings of unusual thought content, but less severe perceptual abnormalities. Overall, sex, age and education were modestly related to unusual thought content and perceptual abnormalities, only, suggesting minimal implication for designating CHR status and predicting psychosis-risk. PMID:25999040

  5. What Value "Value Added"?

    ERIC Educational Resources Information Center

    Richards, Andrew

    2015-01-01

    Two quantitative measures of school performance are currently used, the average points score (APS) at Key Stage 2 and value-added (VA), which measures the rate of academic improvement between Key Stage 1 and 2. These figures are used by parents and the Office for Standards in Education to make judgements and comparisons. However, simple…

  6. Introducing ADS Labs

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Henneken, E.; Grant, C. S.; Kurtz, M. J.; Di Milia, G.; Luker, J.; Thompson, D. M.; Bohlen, E.; Murray, S. S.

    2011-05-01

    ADS Labs is a platform that ADS is introducing in order to test and receive feedback from the community on new technologies and prototype services. Currently, ADS Labs features a new interface for abstract searches, faceted filtering of results, visualization of co-authorship networks, article-level recommendations, and a full-text search service. The streamlined abstract search interface provides a simple, one-box search with options for ranking results based on a paper relevancy, freshness, number of citations, and downloads. In addition, it provides advanced rankings based on collaborative filtering techniques. The faceted filtering interface allows users to narrow search results based on a particular property or set of properties ("facets"), allowing users to manage large lists and explore the relationship between them. For any set or sub-set of records, the co-authorship network can be visualized in an interactive way, offering a view of the distribution of contributors and their inter-relationships. This provides an immediate way to detect groups and collaborations involved in a particular research field. For a majority of papers in Astronomy, our new interface will provide a list of related articles of potential interest. The recommendations are based on a number of factors, including text similarity, citations, and co-readership information. The new full-text search interface allows users to find all instances of particular words or phrases in the body of the articles in our full-text archive. This includes all of the scanned literature in ADS as well as a select portion of the current astronomical literature, including ApJ, ApJS, AJ, MNRAS, PASP, A&A, and soon additional content from Springer journals. Fulltext search results include a list of the matching papers as well as a list of "snippets" of text highlighting the context in which the search terms were found. ADS Labs is available at http://adslabs.org

  7. First episodes of behavioral symptoms in Alzheimer's disease patients at age 90 and over, and early-onset Alzheimer's disease: comparison with senile dementia of Alzheimer's type.

    PubMed

    Hori, Koji; Oda, Tatsuro; Asaoka, Toshiyasu; Yoshida, Masahiro; Watanabe, Shoichi; Oyamada, Reiko; Tominaga, Itaru; Inada, Toshiya

    2005-12-01

    We evaluated dementia symptoms to clarify the character of dementia with Alzheimer's disease (AD) observed in the oldest old patients and that of dementia with early-onset AD. Subjects were consecutive AD inpatients admitted for the first time at age of 90 years and over because of behavioral symptoms (demented nonagenarian group: D90G; n=18) and those with 24 consecutive inpatients with AD with early-onset (EOG). The Gottfries, Brane and Steen's scale and the Dementia Behavior Disturbance scale were used to evaluate the symptoms and troublesome behaviors. The scores of these scales in D90G and in EOG were compared with those of 26 sex distribution-, severity of dementia-, and disease duration-matched inpatients with AD with late-onset (LOG). Compared with LOG, wakefulness was more impaired and waking up at night was more frequent in D90G, while memory, orientation and inappropriate behaviors were more severe in EOG. These results suggest that the clinical features of dementia in EOG were quantitatively different from those of LOG. In contrast, the clinical feature of dementia of D90G were sleep-wake pattern disturbance and were qualitatively different from those of LOG. PMID:16401251

  8. Medications for Ataxia Symptoms

    MedlinePlus

    ... Ropinirole (Requip) Rigidity : Pramipexole (Mirapex), Ropinirole (Requip) Sleep Disorders/Parasomnias (vivid dreams, nightmares, acting out dreams, sleepwalking) : Clonazepam. Sleep apnea symptoms must be evaluated with ...

  9. Two Virasoro symmetries in stringy warped AdS3

    NASA Astrophysics Data System (ADS)

    Compère, Geoffrey; Guica, Monica; Rodriguez, Maria J.

    2014-12-01

    We study three-dimensional consistent truncations of type IIB supergravity which admit warped AdS3 solutions. These theories contain subsectors that have no bulk dynamics. We show that the symplectic form for these theories, when restricted to the non-dynamical subsectors, equals the symplectic form for pure Einstein gravity in AdS3. Consequently, for each consistent choice of boundary conditions in AdS3, we can define a consistent phase space in warped AdS3 with identical conserved charges. This way, we easily obtain a Virasoro × Virasoro asymptotic symmetry algebra in warped AdS3; two different types of Virasoro × Kač-Moody symmetries are also consistent alternatives.

  10. Neuropsychiatric Symptoms in Posterior Cortical Atrophy and Alzheimer Disease

    PubMed Central

    Crutch, Sebastian J.; Franco-Macías, Emilio; Gil-Néciga, Eulogio

    2016-01-01

    Background: Posterior cortical atrophy (PCA) is a rare neurodegenerative syndrome characterized by early progressive visual dysfunction in the context of relative preservation of memory and a pattern of atrophy mainly involving the posterior cortex. The aim of the present study is to characterize the neuropsychiatric profile of PCA. Methods: The Neuropsychiatric Inventory was used to assess 12 neuropsychiatric symptoms (NPS) in 28 patients with PCA and 34 patients with typical Alzheimer disease (AD) matched by age, disease duration, and illness severity. Results: The most commonly reported NPS in both groups were depression, anxiety, apathy, and irritability. However, aside from a trend toward lower rates of apathy in patients with PCA, there were no differences in the percentage of NPS presented in each group. All those patients presenting visual hallucinations in the PCA group also met diagnostic criteria for dementia with Lewy bodies (DLB). Auditory hallucinations were only present in patients meeting diagnosis criteria for DLB. Conclusion: Prevalence of the 12 NPS examined was similar between patients with PCA and AD. Hallucinations in PCA may be helpful in the differential diagnosis between PCA-AD and PCA-DLB. PMID:26404166

  11. Exercise: An Alternative Approach to the Treatment of AD/HD.

    ERIC Educational Resources Information Center

    Putnam, Steve; Copans, Stuart A.

    1998-01-01

    Suggests that the increase of Attention Deficit/Hyperactivity Disorder (AD/HD) cases in America and Canada may be due in part to decreased levels of children's physical activity. Research has shown that exercise helps to lessen the symptoms of AD/HD. Claims that the use of regular exercise programs in school and at home is beneficial for AD/HD…

  12. Elementary School Students with AD/HD: Predictors of Academic Achievement

    ERIC Educational Resources Information Center

    DuPaul, G.J.; Volpe, R. J.; Jitendra, A. K.; Lutz, J. G.; Lorah, K. S.; Gruber, R.

    2004-01-01

    Academic underachievement frequently is associated with attention-deficit/hyperactivity disorder (AD/HD); however, the role of variables beyond AD/HD symptoms and cognitive mediators is unknown. Further, whether prediction models vary (a) relative to non-AD/HD students, (b) between math and reading, and (c) based on how achievement is defined has…

  13. Severe Weather

    ERIC Educational Resources Information Center

    Forde, Evan B.

    2004-01-01

    Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This article deals with a poster entitled, "Severe Weather," that has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in…

  14. Severe Weather

    ERIC Educational Resources Information Center

    Forde, Evan B.

    2004-01-01

    Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This month's insert, Severe Weather, has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in this poster are hurricanes,…

  15. Leading Change, Adding Value.

    PubMed

    Evans, Nick

    2016-09-12

    Essential facts Leading Change, Adding Value is NHS England's new nursing and midwifery framework. It is designed to build on Compassion in Practice (CiP), which was published 3 years ago and set out the 6Cs: compassion, care, commitment, courage, competence and communication. CiP established the values at the heart of nursing and midwifery, while the new framework sets out how staff can help transform the health and care sectors to meet the aims of the NHS England's Five Year Forward View. PMID:27615573

  16. PAK Inactivation Impairs Social Recognition in 3xTg-AD Mice without Increasing Brain Deposition of Tau and Aβ

    PubMed Central

    Arsenault, Dany; Dal-Pan, Alexandre; Tremblay, Cyntia; Bennett, David A.; Guitton, Matthieu J.; De Koninck, Yves; Tonegawa, Susumu

    2013-01-01

    Defects in p21-activated kinase (PAK) are suspected to play a role in cognitive symptoms of Alzheimer's disease (AD). Dysfunction in PAK leads to cofilin activation, drebrin displacement from its actin-binding site, actin depolymerization/severing, and, ultimately, defects in spine dynamics and cognitive impairment in mice. To determine the role of PAK in AD, we first quantified PAK by immunoblotting in homogenates from the parietal neocortex of subjects with a clinical diagnosis of no cognitive impairment (n = 12), mild cognitive impairment (n = 12), or AD (n = 12). A loss of total PAK, detected in the cortex of AD patients (−39% versus controls), was correlated with cognitive impairment (r2 = 0.148, p = 0.027) and deposition of total and phosphorylated tau (r2 = 0.235 and r2 = 0.206, respectively), but not with Aβ42 (r2 = 0.056). Accordingly, we found a decrease of total PAK in the cortex of 12- and 20-month-old 3xTg-AD mice, an animal model of AD-like Aβ and tau neuropathologies. To determine whether PAK dysfunction aggravates AD phenotype, 3xTg-AD mice were crossed with dominant-negative PAK mice. PAK inactivation led to obliteration of social recognition in old 3xTg-AD mice, which was associated with a decrease in cortical drebrin (−25%), but without enhancement of Aβ/tau pathology or any clear electrophysiological signature. Overall, our data suggest that PAK decrease is a consequence of AD neuropathology and that therapeutic activation of PAK may exert symptomatic benefits on high brain function. PMID:23804095

  17. Simple Identification of Complex ADHD Subtypes Using Current Symptom Counts

    ERIC Educational Resources Information Center

    Volk, Heather E.; Todorov, Alexandre A.; Hay, David A.; Todd, Richard D.

    2009-01-01

    The results of the assessment of the accuracy of simple rules based on symptom count for assigning youths to attention deficit hyperactivity disorder subtypes show that having six or more total symptoms and fewer than three hyperactive-impulsive symptoms is an accurate predictor for the latent class sever inattentive subtype.

  18. Nonlinear realization of local symmetries of AdS space

    SciTech Connect

    Clark, T.E.; Love, S.T.; Nitta, Muneto; Veldhuis, T. ter

    2005-10-15

    Coset methods are used to construct the action describing the dynamics associated with the spontaneous breaking of the local symmetries of AdS{sub d+1} space due to the embedding of an AdS{sub d} brane. The resulting action is an SO(2,d) invariant AdS form of the Einstein-Hilbert action, which in addition to the AdS{sub d} gravitational vielbein, also includes a massive vector field localized on the brane. Its long wavelength dynamics is the same as a massive Abelian vector field coupled to gravity in AdS{sub d} space.

  19. [Clinical significance of psychotic-like symptoms in youth].

    PubMed

    Lindgren, Maija; Therman, Sebastian; Granö, Niklas

    2016-01-01

    Symptoms of the psychotic type are relatively common in young persons, but seldom result in the development of an actual psychotic disorder. Psychotic-like symptoms in the young are, however, associated with more severe psychiatric symptoms and a less favorable prognosis, whereby their identification is important in psychiatric treatment. A symptom-oriented approach is important in the treatment: instead of the possible risk of psychosis, focus will be on the actual situation, taking the total symptom picture and the person's life situation into consideration. Cognitive psychotherapy is the recommended first-line treatment for psychotic-like symptoms. PMID:27132292

  20. Trust Based Routing in Ad Hoc Network

    NASA Astrophysics Data System (ADS)

    Talati, Mikita V.; Valiveti, Sharada; Kotecha, K.

    Ad Hoc network often termed as an infrastructure-less, self- organized or spontaneous network.The execution and survival of an ad-hoc network is solely dependent upon the cooperative and trusting nature of its nodes. However, this naive dependency on intermediate nodes makes the ad-hoc network vulnerable to passive and active attacks by malicious nodes and cause inflict severe damage. A number of protocols have been developed to secure ad-hoc networks using cryptographic schemes, but all rely on the presence of trust authority. Due to mobility of nodes and limitation of resources in wireless network one interesting research area in MANET is routing. This paper offers various trust models and trust based routing protocols to improve the trustworthiness of the neighborhood.Thus it helps in selecting the most secure and trustworthy route from the available ones for the data transfer.

  1. Anxiety Symptoms across the Lifespan in People Diagnosed with Autistic Disorder

    ERIC Educational Resources Information Center

    Davis, Thompson E., III; Hess, Julie A.; Moree, Brittany N.; Fodstad, Jill C.; Dempsey, Tim; Jenkins, Whitney S.; Matson, Johnny L.

    2011-01-01

    Symptoms of psychiatric disorders have been found to co-occur at high rates in those diagnosed with Autistic Disorder (AD). However, to date, no study has yet examined the developmental trajectory of comorbid psychiatric symptoms across the lifespan within the AD population. Therefore, the purpose of this study was to conduct a cross-sectional…

  2. Examining the Relationship between Executive Functions and Restricted, Repetitive Symptoms of Autistic Disorder

    ERIC Educational Resources Information Center

    Lopez, Brian R.; Lincoln, Alan J.; Ozonoff, Sally; Lai, Zona

    2005-01-01

    The executive function theory was utilized to examine the relationship between cognitive process and the restricted, repetitive symptoms of Autistic Disorder (AD). Seventeen adults with AD were compared to 17 nonautistic controls on a new executive function battery (Delis-Kaplin Executive Function Scales). Restricted, repetitive symptoms were…

  3. Indoor air pollution aggravates symptoms of atopic dermatitis in children.

    PubMed

    Kim, Eun-Hye; Kim, Soyeon; Lee, Jung Hyun; Kim, Jihyun; Han, Youngshin; Kim, Young-Min; Kim, Gyo-Boong; Jung, Kweon; Cheong, Hae-Kwan; Ahn, Kangmo

    2015-01-01

    Most of researches on the impact of indoor air pollutants on atopic dermatitis (AD) have been based upon animal models, in vitro experiments and case-control studies. However, human data to elucidate the role of indoor air pollution on worsening symptoms of pre-existing AD from a longitudinal study are scarce. The objective of this prospective study was to evaluate the effect of indoor air pollution on AD symptoms in children. We surveyed 30 children with AD in a day-care centre, which moved to a new building during the study. These children stayed there for 8 hours a day Monday through Friday, and their daily symptom scores were recorded. Indoor and outdoor air pollutant levels were continuously measured 24 hours a day for 12 months (Period 1 to 4). Data were analyzed using a generalized linear mixed model. Compared to the period before moving (Period 1), concentrations of indoor air pollutants mostly increased after moving (Period 2) and decreased by natural ventilation and bake-out (Periods 3 and 4). The rate of positive AD symptom increased from 32.8% (Period 1) up to 43.8% (Period 2) and 50.5% (Period 3), then decreased to 35.4% in Period 4 (P < 0.0001). When the delayed effects of indoor air pollutants on AD symptoms 2 days later were evaluated, AD symptoms significantly increased by 12.7% (95% CI: -0.01 to 27.1) as toluene levels increased by 1 ppb (P = 0.05). In conclusion, indoor air pollutants increase the risk of AD aggravation in children and toluene in the indoor environment might act as an aggravating factor.

  4. Severe symptoms following a massive intentional L-thyroxine ingestion.

    PubMed

    Hack, J B; Leviss, J A; Nelson, L S; Hoffman, R S

    1999-10-01

    L-Thyroxine (T4) is commonly prescribed medication for hypothyroidism in humans and animals. Overdose has generally resulted in limited symptomatology managed with sedatives and beta-adrenergic receptor antagonists. We describe the largest acute T4 ingestion ever reported, which resulted in a profound thyrotoxicosis, resistant to treatment. A 34-y-old man ingested 900 (0.8 mg) tablets of veterinary T4 (720 mg) and was given 60 g of activated charcoal. He became lethargic on post-ingestion days 2 and 3; had vomiting, diaphoresis and insomnia on day 4; on day 5 he "looked like he had too much coffee", began "using a lot of words" and became agitated, assaultive and stopped speaking intelligibly; and on day 6 returned to the hospital combative and confused. He was diaphoretic, mydriatic, hyperreflexic, tremulous, with clear lungs and active bowel sounds, and received activated charcoal, haloperidol, diazepam, and phenobarbital, and was tracheally intubated. During hospitalization he was rehydrated, treated with propranolol and diazepam, but remained continuously tachycardic. On day 12 he became afebrile and his tachycardia resolved. Free T4 levels ranged from > 13 mcg/dL on day 6 to 1.2 mcg/dL on day 12. By discharge (day 15) he had lost 20 kilograms of body weight, but was clinically euthyroid 2 w later. This case suggests that large intentional T4 ingestions should be managed differently than current T4 overdose protocol.

  5. Symptom Severity and Challenging Behavior in Children with ASD

    ERIC Educational Resources Information Center

    Jang, Jina; Dixon, Dennis R.; Tarbox, Jonathan; Granpeesheh, Doreen

    2011-01-01

    The prevalence of challenging behaviors in the autism spectrum disorders (ASD) population is often assumed to be high but relatively little research has actually been published on it. Furthermore, challenging behaviors are likely to impede progress in evidence-based treatment programs, such as early intensive behavioral intervention (EIBI). Little…

  6. Single Nucleotide Polymorphisms Predict Symptom Severity of Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Jiao, Yun; Chen, Rong; Ke, Xiaoyan; Cheng, Lu; Chu, Kangkang; Lu, Zuhong; Herskovits, Edward H.

    2012-01-01

    Autism is widely believed to be a heterogeneous disorder; diagnosis is currently based solely on clinical criteria, although genetic, as well as environmental, influences are thought to be prominent factors in the etiology of most forms of autism. Our goal is to determine whether a predictive model based on single-nucleotide polymorphisms (SNPs)…

  7. PTSD symptom courseduring the first year of college

    PubMed Central

    Read, Jennifer P.; Bachrach, Rachel L.; Wright, Aidan G.C.; Colder, Craig R.

    2015-01-01

    In this study we examined patterns of transition in posttraumatic stress symptoms over the first year of college. We also examined two factors that might predict these transitions, trauma exposure and alcohol involvement. Matriculating students (N=944; 65% female) completed assessments of PTSD, trauma exposure, and alcohol use and consequences multiple times in their freshman year. Three symptom classes (No Symptoms, Moderate Symptoms, and Severe Symptoms) were identified. Examination of transitions from one status to another was conducted with latent transition analysis (LTA). These models revealed considerable variability in the course of PTSD symptoms. The most common pattern was resolution, yet a significant portion of students showed other patterns. Symptom worsening was more commonly observed in the second semester. Trauma exposure had a deleterious effect on PTSD symptom change trajectories, as did alcohol involvement, though less consistently so. Interventions that focus on the timing and correlates of symptom progression may benefit college students with posttraumatic distress. PMID:26828977

  8. Cigarette Ads and Youth.

    ERIC Educational Resources Information Center

    Carol, Julia

    1988-01-01

    Points out ways the tobacco industry markets products to youth, including paid advertisements, sponsorship of sporting events, music concerts, and magazines. Relates several focal points for smoking prevention, which include deglamorization of cigarette advertisements and making smoking socially undesirable. (LS)

  9. Gum Disease Symptoms

    MedlinePlus

    ... Classified Ads Member Directory Find a Periodontist Update Form Professional Education Networking Opportunities AAP Resource Programs Organization Information AAP Committees and Task Forces AAP Volunteer ...

  10. Dressing phases of AdS3/CFT2

    NASA Astrophysics Data System (ADS)

    Borsato, Riccardo; Ohlsson Sax, Olof; Sfondrini, Alessandro; Stefański, Bogdan, Jr.; Torrielli, Alessandro

    2013-09-01

    We determine the all-loop dressing phases of the AdS3/CFT2 integrable system related to type IIB string theory on AdS3×S3×T4 by solving the recently found crossing relations and studying their singularity structure. The two resulting phases present a novel structure with respect to the ones appearing in AdS5/CFT4 and AdS4/CFT3. In the strongly coupled regime, their leading order reduces to the universal Arutyunov-Frolov-Staudacher phase as expected. We also compute their subleading order and compare it with recent one-loop perturbative results and comment on their weak-coupling expansion.

  11. Bubbling geometries for AdS2× S2

    NASA Astrophysics Data System (ADS)

    Lunin, Oleg

    2015-10-01

    We construct BPS geometries describing normalizable excitations of AdS2×S2. All regular horizon-free solutions are parameterized by two harmonic functions in R 3 with sources along closed curves. This local structure is reminiscent of the "bubbling solutions" for the other AdS p ×S q cases, however, due to peculiar asymptotic properties of AdS2, one copy of R 3 does not cover the entire space, and we discuss the procedure for analytic continuation, which leads to a nontrivial topological structure of the new geometries. We also study supersymmetric brane probes on the new geometries, which represent the AdS2×S2 counterparts of the giant gravitons.

  12. Development of a symptom assessment instrument for chronic hemodialysis patients: the Dialysis Symptom Index.

    PubMed

    Weisbord, Steven D; Fried, Linda F; Arnold, Robert M; Rotondi, Armando J; Fine, Michael J; Levenson, David J; Switzer, Galen E

    2004-03-01

    Little is known about the prevalence, severity, or impact of symptoms in hemodialysis patients because of the lack of a validated symptom assessment instrument. We systematically developed an index to assess physical and emotional symptom burden in this patient population. We employed four steps in the generation of this index: a review of dialysis quality-of-life instruments, three focus groups, experts' content validity assessment, and test-retest reliability measurement. Seventy-five symptoms were identified. Of these, 46 appeared in > or = 4 of the instruments/focus groups and were considered for inclusion. Twelve were grouped into other symptom constructs and experts judged four of the remaining items not to be pertinent, leaving 30 items in the new index. Overall kappa statistic was 0.48+/-0.22. These steps allowed the systematic development of a 30-item symptom assessment index for hemodialysis patients. Additional reliability and validity testing is needed prior to its widespread use.

  13. Studies on the ADS/CFT correspondence

    NASA Astrophysics Data System (ADS)

    Muck, Wolfgang

    1999-11-01

    This thesis summarizes original research on the topic of the ``AdS/CFT correspondence.'' This correspondence, which was first conjectured by Maldacena [ Adv. Theor. Math. Phys. 2, 231 (1998)] and subsequently formulated by Gubser, Klebanov and Polyakov [Phys. Lett. B 428, 105 (1998) and by Witten [Adv. Theor. Math. Phys. 2, 253 (1998)], relates field theories on (d + 1)-dimensional anti-de Sitter (AdS) spaces and conformal field theories (CFTs) in d dimensions with each other. Its main prediction is that the correlation functions of certain quantum CFTs are determined by the dynamics of classical field theories on AdS spaces. Starting from a correspondence formula provided by the authors above, several CFT correlation functions are calculated and agreement with the forms dictated by conformal invariance is found. The necessary renormalization is carried out in the ``ɛ- prescription.'' Details of renormalization and the breaking of conformal symmetries in special cases are investigated by means of the example of the scalar field. The ``asymptotic prescription'' is used to prove a suggestion by Klebanov and Witten [hep- th/9905104] about the treatment of irregular boundary conditions valid to all orders of perturbation theory. The treatment of AdS gravity, which enables the calculation of correlation functions of CFT energy momentum tensors, is carried out in the time slicing formalism. The calculated two-point functions and Weyl anomalies agree with results known from pure CFT considerations. The Wess Zumino model on AdS4 is discussed as an example containing supersymmetry. It is shown that the model yields the correlation functions of conformal fields belonging to a d = 3, N = 1 superconformal multiplet.

  14. [Value-Added--Adding Economic Value in the Food Industry].

    ERIC Educational Resources Information Center

    Welch, Mary A., Ed.

    1989-01-01

    This booklet focuses on the economic concept of "value added" to goods and services. A student activity worksheet illustrates how the steps involved in processing food are examples of the concept of value added. The booklet further links food processing to the idea of value added to the Gross National Product (GNP). Discussion questions, a student…

  15. Development and initial validation of a traditional Chinese medicine symptom-specific outcome measure: a Zheng-related atopic dermatitis symptom questionnaire (ZRADSQ)

    PubMed Central

    2013-01-01

    Background Zheng represents pattern differentiation in Traditional Chinese Medicine (TCM), as the basic unit and a key concept in TCM therapeutic theory, is based on the physiology and pathology of TCM. None of the outcome measurements of atopic dermatitis (AD) are Zheng-specific. The effectiveness of TCM is likely to be underestimated without a Zheng-related symptom-specific instrument. The aim of this study was to develop an instrument for measuring the Zheng-related symptom-specific status of patients with AD. Methods We followed standard methodology to develop the instrument, including item generation and selection, item reduction and presentation, and pretesting, and recruited 188 patients with AD involved in a six-center randomized-controlled trial (ChiCTR-TRC-08000156) to validate the questionnaire. We conducted construct validity, reliability, and responsiveness analysis. The standardized effect size (SES) and standardized response mean (SRM) were used to calculate the responsiveness of additional items and the total score for the rating items. Results ZRADSQ has 15 items, with 12 rating items and 3 additional items. The 12 rating items fall within three domains: AD symptoms (n = 6 items); Heat (n = 4 items) and Mood (n = 2 items). Confirmatory factor analysis provided good support for a three-factor model (d.f. = 51, x2=97.11, RMSEA = 0.07, CFI = 0.96), and the Pearson’s correlation coefficient between ZRADSQ and Severity Scoring of Atopic Dermatitis (SCORAD) was 0.40 (P < 0.001). The reliability was also good, with a Cronbach’s alpha value for ZRADSQ of 0.84, a split-half coefficient of 0.75, and a test-retest reliability coefficient of 0.98. The standardized effect size and standardized response mean were close to or larger than 1, which indicated moderate to good responsiveness. Conclusions The ZRADSQ demonstrates promising reliability, validity, and responsiveness. It can be used to determine whether Zheng-specific or

  16. Listeriosis: Definition and Symptoms

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Listeria (Listeriosis) Note: Javascript is disabled or is not ... message, please visit this page: About CDC.gov . Listeria (Listeriosis) Definition & Symptoms Outbreaks Listeriosis Linked to Frozen ...

  17. Medically Unexplained Symptoms

    MedlinePlus

    WRIISC War Related Illness and Injury Study Center Office of Public Health Department of Veterans Affairs MEDICALLY UNEXPLAINED SYMPTOMS ... showed that CFS was more common in Gulf War Veterans than non- Gulf War Veterans ( Kang et ...

  18. Symptoms of Tickborne Illness

    MedlinePlus

    ... disease , southern tick-associated rash illness (STARI) , Rocky Mountain spotted fever (RMSF) , ehrlichiosis , and tularemia can result ... or neurologic symptoms. The rash seen with Rocky Mountain spotted fever (RMSF) varies greatly from person to ...

  19. Symptoms and Warning Signs

    MedlinePlus

    ... excessive exercise, self-induced vomiting, misuse of laxatives, diuretics, or enemas Other symptoms that may develop over ... with self-induced vomiting, misuse of laxatives and diuretics, fasting, and excessive exercise binging and purging in ...

  20. Cold symptoms (image)

    MedlinePlus

    Colds are caused by a virus and can occur year-round. The common cold generally involves a runny nose, nasal congestion, and ... symptoms include sore throat, cough, and headache. A cold usually lasts about 7 days, with perhaps a ...

  1. Adding Users to the Website Design Process

    ERIC Educational Resources Information Center

    Tomeo, Megan L.

    2012-01-01

    Alden Library began redesigning its website over a year ago. Throughout the redesign process the students, faculty, and staff that make up the user base were added to the conversation by utilizing several usability test methods. This article focuses on the usability testing conducted at Alden Library and delves into future usability testing, which…

  2. Sever's Disease

    MedlinePlus

    ... Are Reading Upsetting News Reports? What to Say Vaccines: Which Ones & When? Smart School Lunches Emmy-Nominated Video "Cerebral Palsy: Shannon's Story" 5 Things to Know About Zika & Pregnancy Sever's Disease KidsHealth > ...

  3. Hairy black holes in AdS5 × S 5

    NASA Astrophysics Data System (ADS)

    Markeviciute, Julija; Santos, Jorge E.

    2016-06-01

    We use numerical methods to exhaustively study a novel family of hairy black hole solutions in AdS5. These solutions can be uplifted to solutions of type IIB supergravity with AdS5 × S 5 asymptotics and are thus expected to play an important role in our understanding of AdS/CFT. We find an intricate phase diagram, with the aforementioned family of hairy black hole solutions branching from the Reissner-Nordström black hole at the onset of the superradiance instability. We analyse black holes with spherical and planar horizon topology and explain how they connect in the phase diagram. Finally, we detail their global and local thermodynamic stability across several ensembles.

  4. Adding Confidence to Knowledge

    ERIC Educational Resources Information Center

    Goodson, Ludwika Aniela; Slater, Don; Zubovic, Yvonne

    2015-01-01

    A "knowledge survey" and a formative evaluation process led to major changes in an instructor's course and teaching methods over a 5-year period. Design of the survey incorporated several innovations, including: a) using "confidence survey" rather than "knowledge survey" as the title; b) completing an…

  5. Action growth for AdS black holes

    NASA Astrophysics Data System (ADS)

    Cai, Rong-Gen; Ruan, Shan-Ming; Wang, Shao-Jiang; Yang, Run-Qiu; Peng, Rong-Hui

    2016-09-01

    Recently a Complexity-Action (CA) duality conjecture has been proposed, which relates the quantum complexity of a holographic boundary state to the action of a Wheeler-DeWitt (WDW) patch in the anti-de Sitter (AdS) bulk. In this paper we further investigate the duality conjecture for stationary AdS black holes and derive some exact results for the growth rate of action within the Wheeler-DeWitt (WDW) patch at late time approximation, which is supposed to be dual to the growth rate of quantum complexity of holographic state. Based on the results from the general D-dimensional Reissner-Nordström (RN)-AdS black hole, rotating/charged Bañados-Teitelboim-Zanelli (BTZ) black hole, Kerr-AdS black hole and charged Gauss-Bonnet-AdS black hole, we present a universal formula for the action growth expressed in terms of some thermodynamical quantities associated with the outer and inner horizons of the AdS black holes. And we leave the conjecture unchanged that the stationary AdS black hole in Einstein gravity is the fastest computer in nature.

  6. Heart Failure Functional Class Associated with Depression Severity But Not Anxiety Severity

    PubMed Central

    Celik, Etem; Cay, Serkan; Sensoy, Baris; Murat, Sani; Oksuz, Fatih; Cankurt, Tayyar; Ali Mendi, Mehmet

    2016-01-01

    Background Depression and anxiety are common in heart failure (HF) patients and associated with adverse clinical outcomes. However, there are little or no published data that focuses on the relationship between these commonly observed situations and HF classes. The aim of this study was to evaluate the relationship between these psychiatric co-morbidities and HF symptom classes. As a second objective of our study, the associations between patient characteristics and depression severity were also assessed. Methods Our study enrolled a total of 420 HF study participants. The severity of depressive and anxiety symptoms was evaluated by Beck’s depression and anxiety. The measured total scores were used to grade depression severity and anxiety as minimal/mild and moderate/severe. Results According to NYHA Functional Classification, 228 patients (51%) had class I symptoms, 101 (23%) had class II symptoms, 31 (7%) had class III symptoms, and class IV symptoms were noted in the remaining 60 patients (19%). The mean Beck’s depression and anxiety scores were 12.4 ± 11.1 and 13.4 ± 9.0, respectively. While no association between HF symptom classes and anxiety severity was observed, a significant positive relation between HF symptom class and depression score was found. Conclusions The results of our study suggested that HF symptom class was positively associated with severity of depression. On the other hand, there was no association between HF symptom class and anxiety score in a wide population of heart failure patients. PMID:27122931

  7. Peripheral Neuropathy: Symptoms and Signs

    MedlinePlus

    ... Research News Make a Difference Symptoms of Peripheral Neuropathy Print This Page Peripheral Neuropathy symptoms usually start ... slowly over many years. The symptoms of peripheral neuropathy often include: A sensation of wearing an invisible “ ...

  8. Levothyroxine Poisoning - Symptoms and Clinical Outcome.

    PubMed

    Nygaard, Birgitte; Saedder, Eva A; Dalhoff, Kim; Wikkelsoe, Mette; Jürgens, Gesche

    2015-10-01

    Levothyroxine (LT), T4, poisoning is rarely associated with a severe outcome. However, cases with significant complications have been reported. The aim of this study was to identify factors associated with symptoms of poisoning including late-onset symptoms. All enquiries to the Danish Poison Information Centre (DPIC) concerning LT poisoning between March 2007 and September 2012 were reviewed and the following parameters were recorded: age, dose, time from ingestion, multiple drug intake and symptoms. To evaluate the frequency of late-onset symptoms, a subgroup of patients without initial symptoms were contacted. A total of 181 patients were registered (112 children). Ingested LT dose ranged from 10 to 9000 mcg (median 275 mcg). A total of 29 of 181 (16%) patients were symptomatic at the time of enquiry, and there was no difference in ingested LT dose between asymptomatic and symptomatic patients, neither in children nor in adults (age 16-92 years) (p < 0.68 and p < 0.47, respectively). In total, 153 of 181 (85%) patients did not have symptoms of poisoning at the time of enquiry; however, in 9 of 21 (43%) patients, we were able to contact, late-onset symptoms existed. In none of the cases, hospital contact was needed and there were no reports of long-term sequelae. Acute LT poisoning often follows a benign course. The occurrence of symptoms appears not to be dose dependent. Late-onset symptoms seem to be common. However, all symptoms resolved spontaneously without need of medical care.

  9. Trial design innovations: Clinical trials for treatment of neuropsychiatric symptoms in Alzheimer's Disease

    PubMed Central

    Zhong, K

    2015-01-01

    Neuropsychiatric symptoms are common in Alzheimer's disease (AD) and other neurodegenerative disorders. Recent progress has been made with clinical trials, advancing new therapies for psychosis in Parkinson's disease (PD), agitation in AD, and apathy in AD. Definitions have emerged for agitation and apathy in patients with cognitive impairment, facilitating recruitment of clinical trial populations. Progress in clinical trial design and the agents being assessed promise to advance therapies for disabling symptoms and improve quality of life for patients and caregivers. PMID:26206713

  10. Superstring theory in AdS(3) and plane waves

    NASA Astrophysics Data System (ADS)

    Son, John Sang Won

    This thesis is devoted to the study of string theory in AdS 3 and its applications to recent developments in string theory. The difficulties associated with formulating a consistent string theory in AdS3 and its underlying SL(2, R) WZW model are explained. We describe how these difficulties can be overcome by assuming that the SL(2, R) WZW model contains spectral flow symmetry. The existence of spectral flow symmetry in the fully quantum treatment is proved by a calculation of the one-loop string partition function. We consider Euclidean AdS 3 with the time direction periodically identified, and compute the torus partition function in this background. The string spectrum can be reproduced by viewing the one-loop calculation as the free energy of a gas of strings, thus providing a rigorous proof of the results based on spectral flow arguments. Next, we turn to spacetimes that are quotients of AdS 3, which include the BTZ black hole and conical spaces. Strings propagating in the conical space are described by taking an orbifold of strings in AdS3. We show that the twisted states of these orbifolds can be obtained by fractional spectral flow. We show that the shift in the ground state energy usually associated with orbifold twists is absent in this case, and offer a unified framework in which to view spectral flow. Lastly, we consider the RNS superstrings in AdS 3 x S3 x M , where M may be K3 or T 4, based on supersymmetric extensions of SL(2, R) and SU(2) WZW models. We construct the physical states and calculate the spectrum. A subsector of this theory describes strings propagating in the six dimensional plane wave obtained by the Penrose limit of AdS3 x S3 x M . We reproduce the plane wave spectrum by taking J and the radius to infinity. We show that the plane wave spectrum actually coincides with the large J spectrum at fixed radius, i.e. in AdS3 x S3. Relation to some recent topics of interest such as the Frolov-Tseytlin string and strings with critical tension

  11. Evaluation of cognitive restructuring for post-traumatic stress disorder in people with severe mental illness

    PubMed Central

    Mueser, Kim T.; Gottlieb, Jennifer D.; Xie, Haiyi; Lu, Weili; Yanos, Philip T.; Rosenberg, Stanley D.; Silverstein, Steven M.; Duva, Stephanie Marcello; Minsky, Shula; Wolfe, Rosemarie S.; McHugo, Gregory J.

    2015-01-01

    Background A cognitive–behavioural therapy (CBT) programme designed for post-traumatic stress disorder (PTSD) in people with severe mental illness, including breathing retraining, education and cognitive restructuring, was shown to be more effective than usual services. Aims To evaluate the incremental benefit of adding cognitive restructuring to the breathing retraining and education components of the CBT programme (trial registration: clinicaltrials.gov identifier: NCT00494650). Method In all, 201 people with severe mental illness and PTSD were randomised to 12- to 16-session CBT or a 3-session brief treatment programme (breathing retraining and education). The primary outcome was PTSD symptom severity. Secondary outcomes were PTSD diagnosis, other symptoms, functioning and quality of life. Results There was greater improvement in PTSD symptoms and functioning in the CBT group than in the brief treatment group, with both groups improving on other outcomes and effects maintained 1-year post-treatment. Conclusions Cognitive restructuring has a significant impact beyond breathing retraining and education in the CBT programme, reducing PTSD symptoms and improving functioning in people with severe mental illness. PMID:25858178

  12. Brain areas involved in the acupuncture treatment of AD model rats: a PET study

    PubMed Central

    2014-01-01

    Background Acupuncture may effectively treat certain symptoms of Alzheimer’s disease (AD). Although several studies have used functional brain imaging to investigate the mechanisms of acupuncture treatment on AD, these mechanisms are still poorly understood. We therefore further explored the mechanism by which needling at ST36 may have a therapeutic effect in a rat AD model. Methods A total of 80 healthy Wistar rats were divided into healthy control (n = 15) and pre-model (n = 65) groups. After inducing AD-like disease, a total of 45 AD model rats were randomly divided into three groups: the model group (n = 15), the sham-point group (n = 15), and the ST36 group (n = 15). The above three groups underwent PET scanning. PET images were processed with SPM2. Results The brain areas that were activated in the sham-point group relative to the model group were primarily centred on the bilateral limbic system, the right frontal lobe, and the striatum, whereas the activated areas in the ST36 group were primarily centred on the bilateral limbic system (pyriform cortex), the bilateral temporal lobe (olfactory cortex), the right amygdala and the right hippocampus. Compared with the sham-point group, the ST36 group showed greater activation in the bilateral amygdalae and the left temporal lobe. Conclusion We concluded that needling at a sham point or ST36 can increase blood perfusion and glycol metabolism in certain brain areas, and thus may have a positive influence on the cognition of AD patients. PMID:24886495

  13. Anxiety symptoms in amnestic mild cognitive impairment are associated with medial temporal atrophy and predict conversion to Alzheimer's disease

    PubMed Central

    Mah, Linda; Binns, Malcolm A.; Steffens, David C.

    2014-01-01

    Background The purpose of the current study was to test the hypothesis that anxiety in amnestic mild cognitive impairment (aMCI) increases rates of conversion to Alzheimer's disease (AD), and to identify potential neural mechanisms underlying such an association. Methods 376 participants with aMCI from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were studied over a median period of 36 months. A Cox proportional-hazards model was used to assess the association between anxiety severity ratings on the Neuropsychiatric Inventory Questionnaire and AD risk. Other variables in the model were depression, memory loss, and MRI-derived AD-related regions-of-interest (ROI), including hippocampal (HC), amygdalar (AMYG), entorhinal cortical (EC) volumes and EC thickness, In addition, a linear regression model was used to determine the effect of anxiety in aMCI on rates of atrophy within ROIs. Results Anxiety severity increased rate of aMCI conversion to AD, after controlling for depression and cognitive decline. The association between anxiety and AD remained significant even with inclusion of ROI baseline values or atrophy rates as explanatory variables. Further, anxiety status predicted greater rates of decrease in EC volume. An association between anxiety and EC-thickness missed significance. Conclusions Anxiety symptoms in aMCI predict conversion to AD, over and beyond the effects of depression, memory loss, or atrophy within AD neuroimaging biomarkers. These findings, together with the greater EC atrophy rate predicted by anxiety, are compatible with the hypothesis that anxiety is not a prodromal non-cognitive feature of AD, but may accelerate decline towards AD through direct or indirect effects on EC. PMID:25500120

  14. Entanglement entropy for free scalar fields in AdS

    NASA Astrophysics Data System (ADS)

    Sugishita, Sotaro

    2016-09-01

    We compute entanglement entropy for free massive scalar fields in anti-de Sitter (AdS) space. The entangling surface is a minimal surface whose boundary is a sphere at the boundary of AdS. The entropy can be evaluated from the thermal free energy of the fields on a topological black hole by using the replica method. In odd-dimensional AdS, exact expressions of the Rényi entropy S n are obtained for arbitrary n. We also evaluate 1-loop corrections coming from the scalar fields to holographic entanglement entropy. Applying the results, we compute the leading difference of entanglement entropy between two holographic CFTs related by a renormalization group flow triggered by a double trace deformation. The difference is proportional to the shift of a central charge under the flow.

  15. Asymptotically AdS spacetimes with a timelike Kasner singularity

    NASA Astrophysics Data System (ADS)

    Ren, Jie

    2016-07-01

    Exact solutions to Einstein's equations for holographic models are presented and studied. The IR geometry has a timelike cousin of the Kasner singularity, which is the less generic case of the BKL (Belinski-Khalatnikov-Lifshitz) singularity, and the UV is asymptotically AdS. This solution describes a holographic RG flow between them. The solution's appearance is an interpolation between the planar AdS black hole and the AdS soliton. The causality constraint is always satisfied. The entanglement entropy and Wilson loops are discussed. The boundary condition for the current-current correlation function and the Laplacian in the IR is examined. There is no infalling wave in the IR, but instead, there is a normalizable solution in the IR. In a special case, a hyperscaling-violating geometry is obtained after a dimensional reduction.

  16. New massive gravity and AdS(4) counterterms.

    PubMed

    Jatkar, Dileep P; Sinha, Aninda

    2011-04-29

    We show that the recently proposed Dirac-Born-Infeld extension of new massive gravity emerges naturally as a counterterm in four-dimensional anti-de Sitter space (AdS(4)). The resulting on-shell Euclidean action is independent of the cutoff at zero temperature. We also find that the same choice of counterterm gives the usual area law for the AdS(4) Schwarzschild black hole entropy in a cutoff-independent manner. The parameter values of the resulting counterterm action correspond to a c=0 theory in the context of the duality between AdS(3) gravity and two-dimensional conformal field theory. We rewrite this theory in terms of the gauge field that is used to recast 3D gravity as a Chern-Simons theory. PMID:21635026

  17. Detailed ultraviolet asymptotics for AdS scalar field perturbations

    NASA Astrophysics Data System (ADS)

    Evnin, Oleg; Jai-akson, Puttarak

    2016-04-01

    We present a range of methods suitable for accurate evaluation of the leading asymptotics for integrals of products of Jacobi polynomials in limits when the degrees of some or all polynomials inside the integral become large. The structures in question have recently emerged in the context of effective descriptions of small amplitude perturbations in anti-de Sitter (AdS) spacetime. The limit of high degree polynomials corresponds in this situation to effective interactions involving extreme short-wavelength modes, whose dynamics is crucial for the turbulent instabilities that determine the ultimate fate of small AdS perturbations. We explicitly apply the relevant asymptotic techniques to the case of a self-interacting probe scalar field in AdS and extract a detailed form of the leading large degree behavior, including closed form analytic expressions for the numerical coefficients appearing in the asymptotics.

  18. Context processing and negative symptoms in schizophrenia.

    PubMed

    Thoma, Patrizia; Zoppelt, Diana; Wiebel, Burkhard; Daum, Irene

    2007-05-01

    The objective of the study was to test the assumption that patients with a high level of negative symptoms show disproportionate impairments of inhibition and multitasking, both representing an underlying context processing mechanism. A total of 26 schizophrenia patients scoring high or low on negative symptoms (Positive and Negative Syndrome Scale) and a group of 13 healthy controls were assessed on measures of response inhibition (AX- Continuous Performance Task, Stroop Test) and multitasking (Dual Task, Trail Making Test). Only the high negative symptoms group showed significantly higher inhibition costs and multitasking costs than healthy controls. In the AX-Continuous Performance Test, inhibition costs exceeded context costs in patients with more severe negative symptoms, while in controls a tendency towards the reverse pattern emerged. There were no statistically significant effects involving the patient group with lower negative symptom scores. The pattern of results suggests that primarily patients with more severe negative symptoms have difficulties benefiting from contextual information. The deficit may manifest itself via increased multitasking costs and increased inhibition costs but also via reduced context costs.

  19. [Pain and unexpressed symptoms: the other dementia].

    PubMed

    Marín Carmona, José Manuel

    2009-11-01

    Patients with advanced dementia are biologically, socially and personally highly vulnerable. The care of these patients is a challenge in terms of both the quantity of care required and qualitative aspects (the need for specific and adapted approaches). The advanced phases of dementia are characterized by severe speech impairment, loss of mobility, and feeding and nutritional alterations (in patients with severe cognitive and functional impairment). Problems of recognition and verbal expression of sensations hampers the diagnostic and therapeutic approach. This article briefly reviews the clinical characteristics of the symptoms and syndromes prevalent in these patients (pain, neuropsychiatric symptoms, delirium, epilepsy) and emphasizes the general principles for prevention and therapeutic approaches.

  20. Management of Menopausal Symptoms

    PubMed Central

    Kaunitz, Andrew M.; Manson, JoAnn E.

    2015-01-01

    Most menopausal women experience vasomotor symptoms, with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms, with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women’s Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with HT tended to be small, especially in younger women. Neither regimen affected all-cause mortality rates. Given the lower rates of adverse events on HT among women close to menopause onset and at lower baseline risk of cardiovascular disease, risk stratification and personalized risk assessment appears to represent a sound strategy for optimizing the benefit: risk profile and safety of hormone therapy. Systemic HT should not be arbitrarily stopped at age 65; instead treatment duration should be individualized based on patients’ risk profiles and personal preferences. Genitourinary syndrome of menopause represents a common condition that adversely impacts the quality of life of many menopausal women. Without treatment, symptoms worsen over time. Low-dose vaginal estrogen represents highly effective treatment for this condition. Because custom-compounded hormones have not been tested for efficacy or safety, U.S. Food and Drug Administration (FDA)-approved HT is preferred. A low dose formulation of paroxetine mesylate currently represents the only nonhormonal medication FDA-approved to treat vasomotor symptoms. Gynecologists and other clinicians who remain abreast of data addressing the benefit: risk profile of hormonal and nonhormonal treatments can help menopausal women make sound choices regarding management of menopausal symptoms. PMID:26348174

  1. Holography and AdS4 self-gravitating dyons

    NASA Astrophysics Data System (ADS)

    Lugo, A. R.; Moreno, E. F.; Schaposnik, F. A.

    2010-11-01

    We present a self-gravitating dyon solution of the Einstein-Yang-Mills-Higgs equations of motion in asymptotically AdS space. The back reaction of gauge and Higgs fields on the space-time geometry leads to the metric of an asymptotically AdS black hole. Using the gauge/gravity correspondence we analyze relevant properties of the finite temperature quantum field theory defined on the boundary. In particular we identify an order operator, characterize a phase transition of the dual theory on the border and also compute the expectation value of the finite temperature Wilson loop.

  2. AdS box graphs, unitarity and operator product expansions

    NASA Astrophysics Data System (ADS)

    Hoffmann, L.; Mesref, L.; Rühl, W.

    2000-11-01

    We develop a method of singularity analysis for conformal graphs which, in particular, is applicable to the holographic image of AdS supergravity theory. It can be used to determine the critical exponents for any such graph in a given channel. These exponents determine the towers of conformal blocks that are exchanged in this channel. We analyze the scalar AdS box graph and show that it has the same critical exponents as the corresponding CFT box graph. Thus pairs of external fields couple to the same exchanged conformal blocks in both theories. This is looked upon as a general structural argument supporting the Maldacena hypothesis.

  3. Phases of global AdS black holes

    NASA Astrophysics Data System (ADS)

    Basu, Pallab; Krishnan, Chethan; Subramanian, P. N. Bala

    2016-06-01

    We study the phases of gravity coupled to a charged scalar and gauge field in an asymptotically Anti-de Sitter spacetime ( AdS 4) in the grand canonical ensemble. For the conformally coupled scalar, an intricate phase diagram is charted out between the four relevant solutions: global AdS, boson star, Reissner-Nordstrom black hole and the hairy black hole. The nature of the phase diagram undergoes qualitative changes as the charge of the scalar is changed, which we discuss. We also discuss the new features that arise in the extremal limit.

  4. The forecaster's added value

    NASA Astrophysics Data System (ADS)

    Turco, M.; Milelli, M.

    2009-09-01

    skill scores of two competitive forecast. It is important to underline that the conclusions refer to the analysis of the Piemonte operational alert system, so they cannot be directly taken as universally true. But we think that some of the main lessons that can be derived from this study could be useful for the meteorological community. In details, the main conclusions are the following: - despite the overall improvement in global scale and the fact that the resolution of the limited area models has increased considerably over recent years, the QPF produced by the meteorological models involved in this study has not improved enough to allow its direct use, that is, the subjective HQPF continues to offer the best performance; - in the forecast process, the step where humans have the largest added value with respect to mathematical models, is the communication. In fact the human characterisation and communication of the forecast uncertainty to end users cannot be replaced by any computer code; - eventually, although there is no novelty in this study, we would like to show that the correct application of appropriated statistical techniques permits a better definition and quantification of the errors and, mostly important, allows a correct (unbiased) communication between forecasters and decision makers.

  5. The range of symptoms in refugees of war: the New Mexico Refugee Symptom Checklist-121.

    PubMed

    Hollifield, Michael; Warner, Teddy D; Krakow, Barry; Jenkins, Janis; Westermeyer, Joseph

    2009-02-01

    The range of symptoms experienced by refugees of war has not been empirically assessed. The New Mexico Refugee Symptom Checklist-121 (NMRSCL-121) was developed utilizing established guidelines and evaluated for its psychometric properties. Community-dwelling Kurdish and Vietnamese refugees reported 48 (SD = 31) persistent and bothersome somatic and psychological symptoms on the NMRSCL-121. Internal consistency and test-retest reliability for the total scale and for most subscales were acceptable, and construct and concurrent validity for the NMRSCL-121 data was shown. There were modest ethnic group differences on symptom severity and psychometric properties of NMRSCL-121 subscales. The NMRSCL-121 produces reliable and valid assessments of a wide range of symptoms in 2 broad community samples of displaced adult refugees.

  6. Symptom Management of Bulimia.

    ERIC Educational Resources Information Center

    Johnson, Craig; And Others

    1987-01-01

    Describes a treatment approach for the symptom management of bulimia that is a synthesis of various techniques, including cognitive-behavioral therapy, response prevention, relapse training, and psychodynamic therapy. The model has been a useful teaching tool for staff and patients in both group and individual formats. Addresses the challenges of…

  7. Bullying and PTSD Symptoms

    ERIC Educational Resources Information Center

    Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici

    2012-01-01

    PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that…

  8. Teacher Testing: A Symptom.

    ERIC Educational Resources Information Center

    Shaker, Paul

    Current teacher testing is a symptom of what is wrong with American public education, rooted in invalid generalizations of method from one discipline to another. America's top educational policymakers are rarely educators, instead tending to be political leaders. The Interstate New Teacher Assessment and Support Consortium (INTASC) has produced a…

  9. [Severe asthma].

    PubMed

    González, Claudio D

    2016-01-01

    The objectives of this work were to investigate the frequency of severe asthma (SA) according to WHO definition and to compare SA patients' characteristics with those of non-severe asthma (NSA); secondly, to investigate the level of control reached throughout a period of regular treatment. Between 1-1-2005 and 12-31-2014, 471 medical records from patients with bronchial asthma assisted in Buenos Aires City were analyzed. SA frequency was 40.1% (189/471), being significantly higher among patients from the public health system (47.7%, 108/226 vs. 33%, 81/245, p = 0.001). SA patients were older than NSA ones (51.3 ± 17.4 vs. 42.6 ± 17.1 years, p = 0.000), presented longer time since onset of the disease (median 30 vs. 20 years, p = 0.000), lower educational levels (secondary level or higher 41.7% vs. 58.1%, p = 0.000), lower frequency of rhinitis (47% vs. 60.6%, p = 0.004), more severe levels of airway obstruction (FEV% 50.2 ± 13.7 vs. 77.7 ± 12.4, p = 0.000), more frequent antecedents of Near Fatal Asthma (11.1% vs. 2.8%, p = 0.000), higher levels of serum IgE (median of 410 vs. 279 UI/l, p = 0.01) and higher demand of systemic steroids requirements and hospitalizations (68.7% vs. 50.7%, p = 0.000 and 37.5% vs. 15.9%, p = 0.000, respectively). A 30.6% of SA patients (58/189) reached a follow-up period of 12 months, 13 (22.5%) of whom reached the controlled asthma level. The frequency of SA found seems to be considerable. Multicenter studies to investigate the levels of control reached by SA patients with access to proper treatment are recommended.

  10. Anchoring the Panic Disorder Severity Scale

    ERIC Educational Resources Information Center

    Keough, Meghan E.; Porter, Eliora; Kredlow, M. Alexandra; Worthington, John J.; Hoge, Elizabeth A.; Pollack, Mark H.; Shear, M. Katherine; Simon, Naomi M.

    2012-01-01

    The Panic Disorder Severity Scale (PDSS) is a clinician-administered measure of panic disorder symptom severity widely used in clinical research. This investigation sought to provide clinically meaningful anchor points for the PDSS both in terms of clinical severity as measured by the Clinical Global Impression-Severity Scale (CGI-S) and to extend…

  11. D-branes on AdS flux compactifications

    NASA Astrophysics Data System (ADS)

    Koerber, Paul; Martucci, Luca

    2008-01-01

    We study D-branes in Script N = 1 flux compactifications to AdS4. We derive their supersymmetry conditions and express them in terms of background generalized calibrations. Basically because AdS has a boundary, the analysis of stability is more subtle and qualitatively different from the usual case of Minkowski compactifications. For instance, stable D-branes filling AdS4 may wrap trivial internal cycles. Our analysis gives a geometric realization of the four-dimensional field theory approach of Freedman and collaborators. Furthermore, the one-to-one correspondence between the supersymmetry conditions of the background and the existence of generalized calibrations for D-branes is clarified and extended to any supersymmetric flux background that admits a time-like Killing vector and for which all fields are time-independent with respect to the associated time. As explicit examples, we discuss supersymmetric D-branes on IIA nearly Kähler AdS4 flux compactifications.

  12. Dyonic AdS black holes from magnetohydrodynamics

    NASA Astrophysics Data System (ADS)

    Caldarelli, Marco M.; Dias, Óscar J. C.; Klemm, Dietmar

    2009-03-01

    We use the AdS/CFT correspondence to argue that large dyonic black holes in anti-de Sitter spacetime are dual to stationary solutions of the equations of relativistic magnetohydrodynamics on the conformal boundary of AdS. The dyonic Kerr-Newman-AdS4 solution corresponds to a charged diamagnetic fluid not subject to any net Lorentz force, due to orthogonal magnetic and electric fields compensating each other. The conserved charges, stress tensor and R-current of the fluid are shown to be in exact agreement with the corresponding quantities of the black hole. Furthermore, we obtain stationary solutions of the Navier-Stokes equations in four dimensions, which yield predictions for (yet to be constructed) charged rotating black strings in AdS5 carrying nonvanishing momentum along the string. Finally, we consider Scherk-Schwarz reduced AdS gravity on a circle. In this theory, large black holes and black strings are dual to lumps of deconfined plasma of the associated CFT. We analyze the effects that a magnetic field introduces in the Rayleigh-Plateau instability of a plasma tube, which is holographically dual to the Gregory-Laflamme instability of a magnetically charged black string.

  13. AdS Branes from Partial Breaking of Superconformal Symmetries

    SciTech Connect

    Ivanov, E.A.

    2005-10-01

    It is shown how the static-gauge world-volume superfield actions of diverse superbranes on the AdS{sub d+1} superbackgrounds can be systematically derived from nonlinear realizations of the appropriate AdS supersymmetries. The latter are treated as superconformal symmetries of flat Minkowski superspaces of the bosonic dimension d. Examples include the N = 1 AdS{sub 4} supermembrane, which is associated with the 1/2 partial breaking of the OSp(1|4) supersymmetry down to the N = 1, d = 3 Poincare supersymmetry, and the T-duality related L3-brane on AdS{sub 5} and scalar 3-brane on AdS{sub 5} x S{sup 1}, which are associated with two different patterns of 1/2 breaking of the SU(2, 2|1) supersymmetry. Another (closely related) topic is the AdS/CFT equivalence transformation. It maps the world-volume actions of the codimension-one AdS{sub d+1} (super)branes onto the actions of the appropriate Minkowski (super)conformal field theories in the dimension d.

  14. Worldsheet dilatation operator for the AdS superstring

    NASA Astrophysics Data System (ADS)

    Ramírez, Israel; Vallilo, Brenno Carlini

    2016-05-01

    In this work we propose a systematic way to compute the logarithmic divergences of composite operators in the pure spinor description of the AdS 5 × S 5 superstring. The computations of these divergences can be summarized in terms of a dilatation operator acting on the local operators. We check our results with some important composite operators of the formalism.

  15. Influence of Asian Desert Dust on Lower Respiratory Tract Symptoms in Patients with Asthma over 4 Years.

    PubMed

    Watanabe, Masanari; Kurai, Jun; Igishi, Tadashi; Yamasaki, Akira; Burioka, Naoto; Takeuchi, Hiromi; Sako, Takanori; Touge, Hirokazu; Nakamoto, Masaki; Hasegawa, Yasuyuki; Chikumi, Hiroki; Matsumoto, Shingo; Yamasaki, Chie; Minato, Sayaka; Ueda, Yutaka; Horasaki, Kazunori; Watanabe, Tetsushi; Shimizu, Eiji

    2012-06-01

    The Asian Dust Storm (ADS) aggravates symptoms and pulmonary dysfunction in adult asthma patients. Our objective was to investigate the association of air pollutants and metals in desert dust with worsening of asthma symptoms during the ADS. A telephone survey was performed to investigate the upper and lower respiratory tract symptoms, ocular symptoms and skin symptoms of asthma patients during the ADS in March between 2007 and 2010. Four surveys were conducted in 46 patients. Two patients noted worsening of lower respiratory tract symptoms in all four surveys, as well as 2 patients in three surveys, 7 patients in two surveys, and 9 patients in one survey. There was no worsening of lower respiratory tract symptoms in 26 patients. In each patient, the influence of the ADS on lower respiratory tract symptoms varied between surveys. In 2010, the level of suspended particulate matter was highest in all four years, but the smallest number of patients noted worsening of lower respiratory tract symptoms. Among pollutants, only the maximum concentration of nitrogen dioxide during the ADS was significantly associated with the worsening of lower respiratory tract symptoms. The influence of the ADS on lower respiratory tract symptoms of adult asthma patients is variable. PMID:24031138

  16. Psychological symptoms, smoking lapse behavior, and the mediating effects of nicotine withdrawal symptoms: A laboratory study.

    PubMed

    Ameringer, Katherine J; Leventhal, Adam M

    2015-03-01

    The influence of psychological symptoms on smoking-lapse behavior is critical to understand. However, this relationship is obscured by comorbidity across multiple forms of psychological symptoms and their overlap with nicotine withdrawal. To address these challenges, we constructed a structural model of latent factors underlying 9 manifest scales of affective and behavioral symptoms and tested relations between latent factors and manifest scale residuals with nicotine withdrawal and smoking lapse in a laboratory analog task. Adult daily smokers (N = 286) completed a baseline session at which several forms of affective and behavioral symptoms were assessed and 2 experimental sessions (i.e., following 16 hr of smoking abstinence and following regular smoking), during which withdrawal symptoms and delay of smoking in exchange for monetary reinforcement, as an analogue for lapse propensity, were measured. A single second-order factor of general psychological maladjustment associated with more severe withdrawal-like symptoms, which in turn associated with shorter delay of smoking. The first-order factors, which tapped qualitatively unique domains of psychological symptoms (low positive affect, negative affect, disinhibition), and the manifest scale residuals provided little predictive power beyond the second-order factor with regard to lapse behavior. Relations among general psychological maladjustment, withdrawal-like symptoms, and lapse were significant in both abstinent and nonabstinent conditions, suggesting that psychological maladjustment, and not nicotine withdrawal per se, accounted for the relation with lapse. These results highlight the potential for smoking-cessation strategies that target general psychological maladjustment processes and have implications for addressing withdrawal-like symptoms among individuals with psychological symptoms.

  17. Depressive symptoms amongst asthmatic children's caregivers.

    PubMed

    Szabó, Alexandra; Mezei, Györgyi; Kovári, Eva; Cserháti, Endre

    2010-06-01

    We wanted to find out, whether the number of depressive symptoms is higher amongst asthmatic children's caregivers, compared to international data, to the Hungarian population average, and to parents of children with chronic renal disease. Are these depressive symptoms connected to the children's psychological status, asthma severity or current asthma symptoms? One-hundred and eight, 7- to 17-yr-old asthmatic children were enrolled, who have been treated at the Semmelweis University, First Department of Pediatrics. Children were suffering from asthma for at least 1 yr, with a median of 8 yr (1-16 yr), they started to develop asthmatic symptoms between the age of 0.5-14 yr (median: 3 yr). We also identified 27 children with chronic renal diseases and their caregivers, who functioned as a control group. Children were asked to complete the Hungarian-validated versions of the Child Depression Inventory, the Spielberger State Anxiety Inventory for Children and the Juniper Pediatric Asthma Quality of Life Questionnaire. Asthma severity and current symptoms were also documented, 56% had no symptoms on the preceding week. Caregivers were asked to complete the Hungarian versions of the Beck Depression Inventory (BDI) short form, the Spielberger Anxiety Inventory and the Juniper Pediatric Asthma Caregivers' Quality of Life Questionnaire. Caregivers of asthmatic children had significantly more depressive symptoms (7.73 +/- 6.69 s.d.) than the age-specific normal population (p < 0.01). Caregivers of renal patients also experience more depressive symptoms (9.61 +/- 7.43 s.d.) than their healthy peers, but difference between the two chronic diseases' group did not prove to be significant. Asthmatic children's caregivers who scored more points on the BDI than the population average suffer from more anxiety symptoms, but their quality of life is not worse than the caregivers' with less depressive points. Depressive symptoms were neither connected to the children's psychological

  18. Entanglement temperature and perturbed AdS3 geometry

    NASA Astrophysics Data System (ADS)

    Levine, G. C.; Caravan, B.

    2016-06-01

    Generalizing the first law of thermodynamics, the increase in entropy density δ S (x ) of a conformal field theory (CFT) is proportional to the increase in energy density, δ E (x ) , of a subsystem divided by a spatially dependent entanglement temperature, TE(x ) , a fixed parameter determined by the geometry of the subsystem, crossing over to thermodynamic temperature at high temperatures. In this paper we derive a generalization of the thermodynamic Clausius relation, showing that deformations of the CFT by marginal operators are associated with spatial temperature variations, δ TE(x ) , and spatial energy correlations play the role of specific heat. Using AdS/CFT duality we develop a relationship between a perturbation in the local entanglement temperature of the CFT and the perturbation of the bulk AdS metric. In two dimensions, we demonstrate a method through which direct diagonalizations of the boundary quantum theory may be used to construct geometric perturbations of AdS3 .

  19. Symptoms of autism among children with congenital deafblindness.

    PubMed

    Dammeyer, Jesper

    2014-05-01

    Associations between congenital deafness or blindness and autism have been found. The main consequences of congenital sensory impairment, being barriers for communication, language and social interaction development, may lead to symptoms of autism. To date only few studies have been reported concerning individuals with congenital deafblindness. This study examines symptoms of autism among 71 children with congenital deafblindness using the Autism Behavior Checklist. The cohort of children with congenital deafblindness was found to have symptoms of autism on a level similar to children with another developmental disorder than autism for example intellectual disability. No association was found between severity of congenital sensory impairment and severity or type of symptoms of autism. PMID:24127166

  20. Cerebrolysin improves symptoms and delays progression in patients with Alzheimer's disease and vascular dementia.

    PubMed

    Allegri, R F; Guekht, A

    2012-04-01

    Dementia is the result of various cerebral disorders, leading to an acquired loss of memory and impaired cognitive ability. The most common forms are Alzheimer's disease (AD) and vascular dementia (VaD). Neurotrophic factors are essential for the survival and differentiation of developing neurons and protecting them against damage under pathologic conditions. Cerebrolysin is a peptide preparation that mimics the pleiotropic effects of neurotrophic factors. Several clinical trials investigating the therapeutic efficacy of Cerebrolysin in AD and VaD have confirmed the proof of concept. The results of these trials have shown statistically significant and clinically relevant treatment effects of Cerebrolysin on cognitive, global and functional domains in mild to moderately severe stages of dementia. Doses of 10 and 30 mL were the most effective, but higher doses of up to 60 mL turned out to be most effective in improving neuropsychiatric symptoms, which become relevant at later stages of the disease. Combining treatment with cholinesterase inhibitors and Cerebrolysin indicated long-term synergistic treatment effects in mild to moderate AD. The efficacy of Cerebrolysin persisted for up to several months after treatment suggesting Cerebrolysin has not merely symptomatic benefits, but a disease-delaying potential. This paper reviews the clinical efficacy of Cerebrolysin in the treatment of dementia. Data were obtained from international, multicenter, randomized clinical trials performed in compliance with Good Clinical Practice and the principles of the Declaration of Helsinki (1964) and subsequent revisions.

  1. The New York Times ad.

    PubMed

    Hunt, M E; Kissling, F

    1993-01-01

    Feminization of patriarchal institutions is necessary in order to eliminate the exclusivity and mutuality of hierarchical, gender, class, and race stratification. The aim of this paper is to explain the history and activities surrounding the New York Times ad on Sunday, October 7, 1984 (the Catholic Statement on Pluralism and Abortion signed by Barbara Ferraro and Patricia Hussey of the Sisters of Note Dame de Namur, Rose Dominic Trapasso of the Maryknoll Sisters, and 67 other signers). The significance of this ad for Roman Catholic feminists and suggestions for new models of relationships between feminists is given. The Statement was written by Daniel Maguire and Frances Kissling and reviewed by 20 Roman Catholic ethicists. A sponsoring committee of early signers sought other support. Catholics for a Free Choice sponsored the funding for circulation of the Statement among professional societies, but not necessarily canonical communities. Publication of the entire statement in the Times was at the height of the presidential campaign. Conservative Bishops Bernard Law of Boston and John O'Connor of Boston publicly denounced Ferraro's position. The first institutional church response came on November 14, 1984, and stated that the Statement was personal opinion and contradictory to clear and constant church teachings about abortion. On November 30, 1984, Cardinal Jean Jerome Hamer of the Congregation for Religious and Secular Institutes responded to most presidents of canonical communities to request a public retraction from signers under threat of dismissal. The issue was obedience to the church. Several members of the canonical community and priests published retractions; negotiations with the Vatican began. Freedom of conscience and empowerment of canonical communities, as agents of their own lives, were given as reasons for the challenge to paternalism. The response was that women were subject to obedience within their communities and had taken public vows and were

  2. Hyperactivity: Symptom Complex or Complex Symptom?

    ERIC Educational Resources Information Center

    Levine, Melvin D.; Oberklaid, Frank

    1980-01-01

    Long-term follow-up studies show that children diagnosed as hyperactive are at risk for severe problems during adolescence and adulthood. However, no common diagnostic criteria exist for hyperactivity, which can refer to many different behaviors, and children diagnosed as hyperactive may also exhibit one or more concomitant difficulties. Journal…

  3. School-associated problem behavior in childhood and adolescence and development of adult schizotypal symptoms: a follow-up of a clinical cohort.

    PubMed

    Fagel, Selene; de Sonneville, Leo; van Engeland, Herman; Swaab, Hanna

    2014-01-01

    How school-associated behavioral problems in childhood and adolescence precede distinctive adult schizotypal symptoms was examined. Gender specific findings were explored. After 11.6 (SD = 3.1) years, 159 patients of the Department of Child and Adolescent Psychiatry of the University Medical Centre Utrecht, the Netherlands were reassessed for adult schizotypal symptoms. Severity of behavioral symptoms in childhood and adolescence using Teacher Report Form (TRF; Verhulst et al. 1997) and adult schizotypal symptoms using Schizotypal Personality Questionnaire-Revised (Raine in Schizophrenia Bulletin 17:555-564, 1991) were examined by Spearman's bivariate correlations. Multiple regression analyses were performed to determine the combined predictive value of significant TRF subscales for schizotypal symptomatology. Moderation was tested by adding the interactions of gender with TRF subscales to the models. Disregarding gender, correlational analyses revealed that TRF Total problems, in specific thought problems, social problems, and attentional problems were associated with disorganized schizotypal symptoms in adult life. TRF thought problems was also associated with future positive schizotypal symptoms. When gender was taken into account, for boys only thought problems was associated with adult positive schizotypal symptoms, whereas for girls externalizing problems, specifically attentional and aggressive problems, were associated with the higher levels of adult disorganized schizotypal symptoms. Moderated regression analyses provided trend significant evidence confirming that in girls externalizing problems were positively associated with general and disorganized schizotypal symptoms. When using teachers as informants, it was found that juvenile behavioral abnormalities were differentially associated with type of adult schizotypal symptoms, with these associations being further modified by gender.

  4. Effective Ad-Hoc Committees.

    ERIC Educational Resources Information Center

    Young, David G.

    1983-01-01

    Ad-hoc committees may be symbolic, informational, or action committees. A literature survey indicates such committees' structural components include a suprasystem and three subsystems involving linkages, production, and implementation. Other variables include size, personal factors, and timing. All the factors carry implications about ad-hoc…

  5. Lorentzian AdS geometries, wormholes, and holography

    SciTech Connect

    Arias, Raul E.; Silva, Guillermo A.; Botta Cantcheff, Marcelo

    2011-03-15

    We investigate the structure of two-point functions for the quantum field theory dual to an asymptotically Lorentzian Anti de Sitter (AdS) wormhole. The bulk geometry is a solution of five-dimensional second-order Einstein-Gauss-Bonnet gravity and causally connects two asymptotically AdS spacetimes. We revisit the Gubser-Klebanov-Polyakov-Witten prescription for computing two-point correlation functions for dual quantum field theories operators O in Lorentzian signature and we propose to express the bulk fields in terms of the independent boundary values {phi}{sub 0}{sup {+-}} at each of the two asymptotic AdS regions; along the way we exhibit how the ambiguity of normalizable modes in the bulk, related to initial and final states, show up in the computations. The independent boundary values are interpreted as sources for dual operators O{sup {+-}} and we argue that, apart from the possibility of entanglement, there exists a coupling between the degrees of freedom living at each boundary. The AdS{sub 1+1} geometry is also discussed in view of its similar boundary structure. Based on the analysis, we propose a very simple geometric criterion to distinguish coupling from entanglement effects among two sets of degrees of freedom associated with each of the disconnected parts of the boundary.

  6. One-loop diagrams in AdS space

    SciTech Connect

    Hung Lingyan; Shang Yanwen

    2011-01-15

    We study the complex scalar loop corrections to the boundary-boundary gauge two-point function in pure AdS space in Poincare coordinates, in the presence of boundary quadratic perturbations to the scalar. These perturbations correspond to double-trace perturbations in the dual CFT and modify the boundary conditions of the bulk scalars in AdS. We find that, in addition to the usual UV divergences, the one-loop calculation suffers from a divergence originating in the limit as the loop vertices approach the AdS horizon. We show that this type of divergence is independent of the boundary coupling; making use of this we extract the finite relative variation of the imaginary part of the loop via Cutkosky rules as the boundary perturbation varies. Applying our methods to compute the effects of a time-dependent impurity to the conductivities using the replica trick in AdS/CFT, we find that generally an IR-relevant disorder reduces the conductivity and that in the extreme low frequency limit the correction due to the impurities overwhelms the planar CFT result even though it is supposedly 1/N{sup 2} suppressed. We also comment on the more physical scenario of a time-independent impurity.

  7. Psychiatric Symptoms in Alpha-Mannosidosis

    ERIC Educational Resources Information Center

    Malm, D.; Pantel, J.; Linaker, O. M.

    2005-01-01

    Alpha-mannosidosis is characterized by mild to moderate intellectual disability (ID), moderate to severe neurosensory hearing loss, frequent infections, psychomotor disturbances and skeletal dysmorphism. For the first time, a panel of nine alpha-mannosidosis patients with psychiatric symptoms is presented. The clinical picture has several…

  8. Emotion Regulation and Depressive Symptoms in Preadolescence

    ERIC Educational Resources Information Center

    Siener, Shannon; Kerns, Kathryn A.

    2012-01-01

    This study examined associations among several measures of emotion regulation, and their links to depressive symptoms, in a sample of children ages 10-12 years old (N = 87). Both temporal features of emotion regulation and regulation processes involved in the evaluation, monitoring, and modification of emotion were assessed through parent and…

  9. West Nile Virus: Symptoms and Treatment

    MedlinePlus

    ... Nile virus infection are available. Over-the-counter pain relievers can be used to reduce fever and relieve some symptoms In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing ...

  10. Comparison of disease-severity measures within severe and very severe COPD patients: results from a nationally representative chart review and patient survey

    PubMed Central

    Solem, Caitlyn T; Sun, Shawn X; Liu, Sizhu; Macahilig, Cynthia; Katyal, Monica; Gao, Xin; Shorr, Andrew F

    2014-01-01

    Objective This study aimed to compare spirometry- and risk + symptom-based classification systems to physician-based severity assessment and find which system is most predictive of patient-reported health status, as measured by the St George’s Respiratory Questionnaire for COPD (chronic obstructive pulmonary disease; SGRQ-C). Materials and methods In this chart review/patient survey, 99 physicians recruited patients with physician-assessed severe or very severe COPD who had recently experienced a moderate or severe exacerbation. A cross-tabulation was undertaken comparing physician report, spirometry (mild/moderate, forced expiratory volume in 1 second [FEV1] ≥50%; severe, 30% ≤ FEV1 <50%; very severe, FEV1 <30% predicted), and risk + symptom-based (A, low risk/fewer symptoms; B, low risk/more symptoms; C, high risk/fewer symptoms; D, high risk/more symptoms) severity systems. Analysis of covariance models were run for SGRQ-C, varying COPD-severity systems. Results Of 244 patients, 58.6% were severe and 34.8% very severe by physician report, 70% had FEV1 ≤50% at their most recent visit, and 86% fell into quadrant D. Spirometry and physician report had 57.4% agreement, with physicians often indicating higher severity. Physician report and risk + symptom agreement was high (81.2% severe/very severe and D). Physician-reported severity, risk + symptoms, exacerbations in the previous year, and symptoms were significant SGRQ-C predictors, while spirometry was not. Conclusion For recently exacerbating severe or very severe COPD patients, risk + symptoms more closely aligned with physician-reported severity and SGRQ-C versus spirometry. PMID:25284999

  11. Kolmogorov-Zakharov spectrum in AdS gravitational collapse.

    PubMed

    de Oliveira, H P; Pando Zayas, Leopoldo A; Rodrigues, E L

    2013-08-01

    We study black hole formation during the gravitational collapse of a massless scalar field in asymptotically D-dimensional anti-de Sitter AdS(D) spacetimes for D = 4, 5. We conclude that spherically symmetric gravitational collapse in asymptotically AdS spaces is turbulent and characterized by a Kolmogorov-Zakharov spectrum. Namely, we find that after an initial period of weakly nonlinear evolution, there is a regime where the power spectrum of the Ricci scalar evolves as ω(-s) with the frequency, ω, and s ≈ 1.7 ± 0.1.

  12. Symptoms of hypoglycemia, thresholds for their occurrence, and hypoglycemia unawareness.

    PubMed

    Cryer, P E

    1999-09-01

    Ultimately traceable to neural glucose deprivation, symptoms of hypoglycemia include neurogenic (autonomic) and neuroglycopenic symptoms. Neurogenic symptoms (tremulousness, palpitations, anxiety, sweating, hunger, paresthesias) are the results of the perception of physiologic changes caused by the autonomic nervous system's response to hypoglycemia. Neuroglycopenic symptoms (confusion, sensation of warmth, weakness or fatigue, severe cognitive failure, seizure, coma) are the results of brain glucose deprivation itself. Glycemic thresholds for symptoms of hypoglycemia shift to lower plasma glucose concentrations following recent episodes of hypoglycemia, leading to the syndrome of hypoglycemia unawareness--loss of the warning symptoms of developing hypoglycemia. Thus, patients with recurrent hypoglycemia (e.g., those with tightly controlled diabetes or with an insulinoma) often tolerate abnormally low plasma glucose concentrations without symptoms. PMID:10500927

  13. Therapeutics for multiple sclerosis symptoms.

    PubMed

    Ben-Zacharia, Aliza Bitton

    2011-01-01

    Symptoms management in multiple sclerosis is an integral part of its care. Accurate assessment and addressing the different symptoms provides increased quality of life among patients with multiple sclerosis. Multiple sclerosis symptoms may be identified as primary, secondary, or tertiary symptoms. Primary symptoms, such as weakness, sensory loss, and ataxia, are directly related to demyelination and axonal loss. Secondary symptoms, such as urinary tract infections as a result of urinary retention, are a result of the primary symptoms. Tertiary symptoms, such as reactive depression or social isolation, are a result of the social and psychological consequences of the disease. Common multiple sclerosis symptoms include fatigue and weakness; decreased balance, spasticity and gait problems; depression and cognitive issues; bladder, bowel, and sexual deficits; visual and sensory loss; and neuropathic pain. Less-common symptoms include dysarthria and dysphagia, vertigo, and tremors. Rare symptoms in multiple sclerosis include seizures, hearing loss, and paralysis. Symptom management includes nonpharmacological methods, such as rehabilitation and psychosocial support, and pharmacological methods, ie, medications and surgical procedures. The keys to symptom management are awareness, knowledge, and coordination of care. Symptoms have to be recognized and management needs to be individualized. Multiple sclerosis therapeutics include nonpharmacological strategies that consist of lifestyle modifications, rehabilitation, social support, counseling, and pharmacological agents or surgical procedures. The goal is vigilant management to improve quality of life and promote realistic expectations and hope.

  14. Hearing symptoms personal stereos

    PubMed Central

    da Luz, Tiara Santos; Borja, Ana Lúcia Vieira de Freitas

    2012-01-01

    Summary Introduction: Practical and portable the personal stereos if had become almost indispensable accessories in the day the day. Studies disclose that the portable players of music can cause auditory damages in the long run for who hear music in high volume for a drawn out time. Objective: to verify the prevalence of auditory symptoms in users of amplified players and to know its habits of use Method: Observational prospective study of transversal cut carried through in three institutions of education of the city of Salvador BA, being two of public net and one of the private net. 400 students had answered to the questionnaire, of both the sex, between 14 and 30 years that had related the habit to use personal stereos. Results: The symptoms most prevalent had been hyperacusis (43.5%), auricular fullness (30.5%) and humming (27.5), being that the humming is the symptom most present in the population youngest. How much to the daily habits: 62.3% frequent use, 57% in raised intensities, 34% in drawn out periods. An inverse relation between exposition time was verified and the band of age (p = 0,000) and direct with the prevalence of the humming. Conclusion: Although to admit to have knowledge on the damages that the exposition the sound of high intensity can cause the hearing, the daily habits of the young evidence the inadequate use of the portable stereos characterized by long periods of exposition, raised intensities, frequent use and preference for the insertion phones. The high prevalence of symptoms after the use suggests a bigger risk for the hearing of these young. PMID:25991931

  15. [Depressive symptoms and sexuality].

    PubMed

    Porto, Robert

    2014-10-01

    The mutually reinforcing dyad of depressive symptoms and erectile dysfunction is scientifically established. The cure of depression improves sexual dysfunction (SD) and the treatment of SD induces improvement of depression. Most of anti-depressants induce negative sexual side effects that lead to non-compliance of these treatments. The knowledge of interrelation between depression, anti-depressants and sexuality is of great importance in clinical practice.

  16. Neurobiology Underlying Fibromyalgia Symptoms

    PubMed Central

    Ceko, Marta; Bushnell, M. Catherine; Gracely, Richard H.

    2012-01-01

    Fibromyalgia is characterized by chronic widespread pain, clinical symptoms that include cognitive and sleep disturbances, and other abnormalities such as increased sensitivity to painful stimuli, increased sensitivity to multiple sensory modalities, and altered pain modulatory mechanisms. Here we relate experimental findings of fibromyalgia symptoms to anatomical and functional brain changes. Neuroimaging studies show augmented sensory processing in pain-related areas, which, together with gray matter decreases and neurochemical abnormalities in areas related to pain modulation, supports the psychophysical evidence of altered pain perception and inhibition. Gray matter decreases in areas related to emotional decision making and working memory suggest that cognitive disturbances could be related to brain alterations. Altered levels of neurotransmitters involved in sleep regulation link disordered sleep to neurochemical abnormalities. Thus, current evidence supports the view that at least some fibromyalgia symptoms are associated with brain dysfunctions or alterations, giving the long-held “it is all in your head” view of the disorder a new meaning. PMID:22135739

  17. Menstruation: symptoms, management and attitudes in university students.

    PubMed

    Cronjé, H S; Kritzinger, I E

    1991-06-01

    The aim of the study was documentation of the attitude towards and management of menstruation in Afrikaans speaking university students. Of 130 questionnaires issued, 102 (78.5%) were analysed. Severe symptoms occurred in 23% of the women. Premenstrually, the major symptoms were irritability, moodiness, breast tenderness, skin changes and increased appetite. During menstruation, dysmenorrhea was the most important symptom. Although only 17.6% of the women consulted a physician during the 2 years preceding the study, 47.1% used medication for symptoms. Seventy-six (74.5%) of the women accepted menstruation as an integral part of a woman's life whereas 19.6% preferred not to menstruate. In this latter group, the majority reported severe symptoms. Fear of consulting a physician for menstrual symptoms was documented.

  18. A Comparison of the Behavioral and Psychological Symptoms of Dementia (BPSD) in Early-Onset and Late-Onset Alzheimer’s Disease - A Study from South East Asia (Kashmir, India)

    PubMed Central

    Mushtaq, Raheel; Pinto, Charles; Hussain, Arshad; Shoib, Sheikh; Shah, Tabindah; Shah, Sahil; Manzoor, Mushbiq; Bhat, Mudassir; Arif, Tasleem

    2016-01-01

    Background A gradual increase in the longevity due to advancement of treatment modalities and a subsequent surge in elderly population in India have led to a growing curiosity in the geriatric age group with Alzheimer’s disease (AD). Behavioral and psychological symptoms of dementia (BPSD) represent epiphenomena of AD. However, no comprehensive study has been carried out in South East Asia (Kashmir, India), to assess the behavioral and psychological symptoms in subtypes of AD. Objectives The purpose of this study was to assess BPSD in early-onset Alzheimer’s disease (EOAD) and late-onset Alzheimer’s disease (LOAD). Material and Methods The study was conducted in the Memory clinic of the postgraduate department of psychiatry, Government Medical College, Kashmir, India from January 2012 to March 2014. The diagnosis of AD patients was done according to NINCDS-ADRDA criteria. A total of 80 patients of AD were screened (40 with age of onset less than 65, and 40 with age of onset greater than 64). Neuropsychiatric inventory (NPI) was the instrument used for evaluating symptoms of BPSD. The data was analyzed using paired t-test. Results The mean age of presentation of EOAD and LOAD was 63.10 years and 84.28 years, respectively, and the difference between the two was found to be statistically significant. The LOAD group had significantly higher symptom severity for delusions, agitation, anxiety, disinhibition, and nighttime behavioral disturbances (NBD) than the EOAD group (p ≤.0001). Conclusion The behavioral and psychological symptoms are significantly severe in late onset subtype compared to the early onset subtype of Alzheimer’s disease in the Kashmiri (Indian) population.  PMID:27433404

  19. Semiclassical Virasoro blocks from AdS3 gravity

    NASA Astrophysics Data System (ADS)

    Hijano, Eliot; Kraus, Per; Perlmutter, Eric; Snively, River

    2015-12-01

    We present a unified framework for the holographic computation of Virasoro conformal blocks at large central charge. In particular, we provide bulk constructions that correctly reproduce all semiclassical Virasoro blocks that are known explicitly from conformal field theory computations. The results revolve around the use of geodesic Witten diagrams, recently introduced in [1], evaluated in locally AdS3 geometries generated by backreaction of heavy operators. We also provide an alternative computation of the heavy-light semiclassical block — in which two external operators become parametrically heavy — as a certain scattering process involving higher spin gauge fields in AdS3; this approach highlights the chiral nature of Virasoro blocks. These techniques may be systematically extended to compute corrections to these blocks and to interpolate amongst the different semiclassical regimes.

  20. AdS6 solutions of type II supergravity

    NASA Astrophysics Data System (ADS)

    Apruzzi, Fabio; Fazzi, Marco; Passias, Achilleas; Rosa, Dario; Tomasiello, Alessandro

    2014-11-01

    Very few AdS6 × M 4 supersymmetric solutions are known: one in massive IIA, and two IIB solutions dual to it. The IIA solution is known to be unique; in this paper, we use the pure spinor approach to give a classification for IIB supergravity. We reduce the problem to two PDEs on a two-dimensional space Σ. M 4 is then a fibration of S 2 over Σ; the metric and fluxes are completely determined in terms of the solution to the PDEs. The results seem likely to accommodate near-horizon limits of ( p, q)-fivebrane webs studied in the literature as a source of CFT5's. We also show that there are no AdS6 solutions in eleven-dimensional supergravity.

  1. ADHD Symptoms and Subtypes: Relationship between Childhood and Adolescent Symptoms

    ERIC Educational Resources Information Center

    Hurtig, Tuula; Ebeling, Hanna; Taanila, Anja; Miettunen, Jouko; Smalley, Susan L.; McGough, James J.; Loo, Sandra K.; Jarvelin, Marjo-Riitta; Moilanen, Irma K.

    2007-01-01

    A study aims to examine attention-deficit/hyperactivity disorder(ADHD) symptoms and subtypes in childhood and adolescence. The results conclude the persistence of ADHD from childhood to adolescence with specific symptoms contributing to persistent ADHD.

  2. Conserved higher-spin charges in AdS4

    NASA Astrophysics Data System (ADS)

    Gelfond, O. A.; Vasiliev, M. A.

    2016-03-01

    Gauge invariant conserved conformal currents built from massless fields of all spins in 4d Minkowski space-time and AdS4 are described in the unfolded dynamics approach. The current cohomology associated with non-zero conserved charges is found. The resulting list of charges is shown to match the space of parameters of the conformal higher-spin symmetry algebra in four dimensions.

  3. On information loss in AdS3/CFT2

    DOE PAGES

    Fitzpatrick, A. Liam; Kaplan, Jared; Li, Daliang; Wang, Junpu

    2016-05-18

    We discuss information loss from black hole physics in AdS3, focusing on two sharp signatures infecting CFT2 correlators at large central charge c: ‘forbidden singularities’ arising from Euclidean-time periodicity due to the effective Hawking temperature, and late-time exponential decay in the Lorentzian region. We study an infinite class of examples where forbidden singularities can be resolved by non-perturbative effects at finite c, and we show that the resolution has certain universal features that also apply in the general case. Analytically continuing to the Lorentzian regime, we find that the non-perturbative effects that resolve forbidden singularities qualitatively change the behavior ofmore » correlators at times t ~SBH, the black hole entropy. This may resolve the exponential decay of correlators at late times in black hole backgrounds. By Borel resumming the 1/c expansion of exact examples, we explicitly identify ‘information-restoring’ effects from heavy states that should correspond to classical solutions in AdS3. Lastly, our results suggest a line of inquiry towards a more precise formulation of the gravitational path integral in AdS3.« less

  4. DISTINCT ETIOLOGICAL INFLUENCES ON OBSESSIVE-COMPULSIVE SYMPTOM DIMENSIONS: A MULTIVARIATE TWIN STUDY

    PubMed Central

    López-Solà, Clara; Fontenelle, Leonardo F.; Verhulst, Brad; Neale, Michael C.; Menchón, José M.; Alonso, Pino; Harrison, Ben J.

    2016-01-01

    Background Obsessive-compulsive disorder (OCD) is characterized by five major dimensions, including contamination/washing, harm/checking, symmetry/ordering, hoarding, and forbidden thoughts. How these dimensions may relate etiologically to the symptoms of other obsessive-compulsive related disorders (OCRDs) and anxiety disorders (ADs) is not well known. The aim of this study was to examine the genetic and environmental overlap between each major obsessive-compulsive dimension with the symptoms of other OCRDs and ADs. Methods Two thousand four hundred ninety-five twins of both sexes, aged between 18 and 45 years, were recruited from the Australian Twin Registry. Measures used scores on four dimensions (obsessing (forbidden thoughts), washing, checking, and ordering) of the Obsessive-Compulsive Inventory-Revised, Dysmorphic Concerns Questionnaire, Hoarding Rating Scale, Anxiety Sensitivity Index, Social Phobia Inventory, and Stress subscale of the Depression, Anxiety, and Stress Scale. Multivariate twin modeling methods using continuous and categorized variables were performed, also controlling for age and gender. Results Our findings suggested that forbidden thoughts and washing demonstrated the strongest genetic overlap with other AD symptoms, while ordering was genetically related to OCRD symptoms. Common genetic influences on checking symptoms were best estimated when modeling OCRDs together with AD symptoms. Common environmental factors of ordering and checking were shared with AD symptoms. Conclusions Important shared genetic and environmental risk factors exist between OCD, OCRDs, and ADs, but which vary alongside the expression of its major dimensions. PMID:26630089

  5. Advancing Symptom Science Through Use of Common Data Elements

    PubMed Central

    Redeker, Nancy S.; Anderson, Ruth; Bakken, Suzanne; Corwin, Elizabeth; Docherty, Sharron; Dorsey, Susan G.; Heitkemper, Margaret; McCloskey, Donna Jo; Moore, Shirley; Pullen, Carol; Rapkin, Bruce; Schiffman, Rachel; Waldrop-Valverde, Drenna; Grady, Patricia

    2015-01-01

    Background Use of common data elements (CDEs), conceptually defined as variables that are operationalized and measured in identical ways across studies, enables comparison of data across studies in ways that would otherwise be impossible. Although healthcare researchers are increasingly using CDEs, there has been little systematic use of CDEs for symptom science. CDEs are especially important in symptom science because people experience common symptoms across a broad range of health and developmental states, and symptom management interventions may have common outcomes across populations. Purposes The purposes of this article are to (a) recommend best practices for the use of CDEs for symptom science within and across centers; (b) evaluate the benefits and challenges associated with the use of CDEs for symptom science; (c) propose CDEs to be used in symptom science to serve as the basis for this emerging science; and (d) suggest implications and recommendations for future research and dissemination of CDEs for symptom science. Design The National Institute of Nursing Research (NINR)-supported P20 and P30 Center directors applied published best practices, expert advice, and the literature to identify CDEs to be used across the centers to measure pain, sleep, fatigue, and affective and cognitive symptoms. Findings We generated a minimum set of CDEs to measure symptoms. Conclusions The CDEs identified through this process will be used across the NINR Centers and will facilitate comparison of symptoms across studies. We expect that additional symptom CDEs will be added and the list will be refined in future work. Clinical Relevance Journal of Nursing Scholarship, 47:5, ©2015 Sigma Theta Tau International. PMID:26250061

  6. Treatment Outcomes of a Crisis Intervention Program for Dementia with Severe Psychiatric Complications: The Kansas Bridge Project

    ERIC Educational Resources Information Center

    Johnson, David Kevin; Niedens, Michelle; Wilson, Jessica R.; Swartzendruber, Lora; Yeager, Amy; Jones, Kelly

    2013-01-01

    Purpose: Although declines in memory and attention are hallmark symptoms of Alzheimer's disease (AD), noncognitive symptoms are prevalent. Over 80% of individuals will experience neuropsychiatric symptoms, which complicates symptom profiles. Research indicates a community-integrated response to dementia crisis can reduce negative consequences…

  7. A continuum of misidentification symptoms.

    PubMed

    Sno, H N

    1994-01-01

    A case study of a schizophrenic patient with differing forms of experiences of inappropriate familiarity is described. Reduplicative paramnesia is redefined as a delusion of familiarity related to a reduplication of time, place or person. The author proposes the concept of a continuum of positive and negative misidentification symptoms. The positive pole of the continuum ranges from the minor form of déjà vu experience to reduplicative paramnesia. The negative pole ranges from depersonalisation to nihilistic delusions. Differentiation is based on the severity of the disturbance of reality testing. The argumentation is based on the fact that both déjà vu experiences and depersonalisation occurring in pathological as well as non-pathological conditions are phenomenologically uniform.

  8. Evaluation of Physical Symptoms in Patients on Peritoneal Dialysis

    PubMed Central

    Figueiredo, Ana Elizabeth; Goodlad, Cate; Clemenger, Michelle; Haddoub, San San; McGrory, Jacqueline; Pryde, Kim; Tonkins, Emma; Hisole, Nora; Brown, Edwina Anne

    2012-01-01

    Introduction. Little is known about physical symptoms in peritoneal dialysis (PD) Patients. This study aims to determine the prevalence of symptoms (general and abdominal) in PD patients. Methods. A cross-sectional study, with subsequent followup, using an author-designed 21 symptoms questionnaire (15 nonabdominal and 6 abdominal). Each symptom was assessed on a scale 0–3 for severity (none–severe) and frequency (never–every day). Results. We studied 41 patients, mean age 60 ± 15 years, 56% male, 19.5% diabetics, and 51.5% on APD. Mean number of symptoms was 9.5 ± 3.9 and total symptoms score was 28.5 ± 12 with abdominal scores of 6.4 ± 4.8. Most frequent symptoms were lack of energy, itching, cramps, poor sleep, and loss of appetite. A second evaluation in 20 patients disclosed no statistical difference between the first and second assessments, or between subgroups. Cramps were the only symptoms which decreased over time (P = 0.120). Lack of energy did not correlate with haemoglobin, neither did itching with phosphate level. Conclusions. Physical symptoms are frequent and troublesome; they relate to advanced kidney disease and not specifically to PD. Symptoms remain stable over time and do not appear to relate to dialysis parameter markers. PMID:23050149

  9. On elliptic string solutions in AdS3 and dS3

    NASA Astrophysics Data System (ADS)

    Bakas, Ioannis; Pastras, Georgios

    2016-07-01

    Classical string actions in AdS3 and dS3 can be connected to the sinh-Gordon and cosh-Gordon equations through Pohlmeyer reduction. We show that the problem of constructing a classical string solution with a given static or translationally invariant Pohlmeyer counterpart is equivalent to solving four pairs of effective Schrödinger problems. Each pair consists of a flat potential and an n = 1 Lamé potential whose eigenvalues are connected, and, additionally, the four solutions satisfy a set of constraints. An approach for solving this system is developed by employing an interesting connection between the specific class of classical string solutions and the band structure of the Lamé potential. This method is used for the construction of several families of classical string solutions, one of which turns out to be the spiky strings in AdS3. New solutions include circular rotating strings in AdS3 with singular time evolution of their radius and angular velocity as well as classical string solutions in dS3.

  10. Emotion regulation predicts symptoms of depression over five years.

    PubMed

    Berking, Matthias; Wirtz, Carolin M; Svaldi, Jennifer; Hofmann, Stefan G

    2014-06-01

    Deficits in emotion regulation have been identified as an important risk and maintaining factor for depression. The aim of this study was to examine the long-term effects of emotion regulation on symptoms of depression. Moreover, we investigated which specific emotion regulation skills were associated with subsequent symptoms of depression. Participants were 116 individuals (78% women, average age 35.2 years) who registered for an online-based assessment of depression and its risk-factors and reported at least some symptoms of depression. Successful application of emotion regulation skills and depressive symptom severity were assessed twice over a 5-year period. We utilized cross-lagged panel analyses to assess whether successful skills application would be negatively associated with subsequent depressive symptom severity. Cross-lagged panel analyses identified successful skills application as a significant predictor for depressive symptom severity even when controlling for the effects of initial symptoms of depression. A comparison of the effect sizes for different emotion regulation skills on subsequent depressive symptoms suggests that most of the skills included have similar predictive value. These findings provide preliminary evidence for the hypotheses that deficits in emotion regulation may contribute to the development of depression and that interventions systematically enhancing adaptive emotion regulation skills may help prevent and treat depressive symptoms.

  11. Symptoms of Valley Fever (Coccidioidomycosis)

    MedlinePlus

    ... gov . Fungal Diseases Types of Fungal Diseases Aspergillosis Definition Symptoms People at Risk & Prevention Sources Diagnosis & Testing Treatment Healthcare Professionals Statistics More Resources Blastomycosis Definition Symptoms Risk & Prevention Sources Diagnosis & Testing Treatment & Outcomes ...

  12. Experimental investigation of the effects of naturalistic dieting on bulimic symptoms: moderating effects of depressive symptoms.

    PubMed

    Presnell, Katherine; Stice, Eric; Tristan, Jennifer

    2008-01-01

    Prospective studies suggest that dieting increases risk for bulimic symptoms, but experimental trials indicate dieting reduces bulimic symptoms. However, these experiments may be unrepresentative of real-world weight loss dieting. In addition, the fact that most dieters do not develop eating disorders suggests moderating factors may be important. Accordingly, we randomly assigned 157 female intermittent dieters to either diet as they usually do for weight loss or eat as they normally do when not dieting for 4 weeks. Naturalistic dieting halted the weight gain shown by controls, but did not result in significant weight loss. Although there was no main effect of the dieting manipulation on bulimic symptoms, moderation analyses indicated that naturalistic dieting decreased bulimic symptoms among participants with initially low depressive symptoms. Results suggest that self-initiated weight loss dieting is not particularly effective, which appears to explain several discrepancies in the literature. Additionally, depressive symptoms may be an important determinant of bulimic symptoms that eclipses the effects of naturalistic dieting on this outcome. PMID:17662503

  13. ADS/CFT and QCD

    SciTech Connect

    Brodsky, Stanley J.; de Teramond, Guy F.; /Costa Rica U. /SLAC

    2007-02-21

    The AdS/CFT correspondence between string theory in AdS space and conformal .eld theories in physical spacetime leads to an analytic, semi-classical model for strongly-coupled QCD which has scale invariance and dimensional counting at short distances and color confinement at large distances. Although QCD is not conformally invariant, one can nevertheless use the mathematical representation of the conformal group in five-dimensional anti-de Sitter space to construct a first approximation to the theory. The AdS/CFT correspondence also provides insights into the inherently non-perturbative aspects of QCD, such as the orbital and radial spectra of hadrons and the form of hadronic wavefunctions. In particular, we show that there is an exact correspondence between the fifth-dimensional coordinate of AdS space z and a specific impact variable {zeta} which measures the separation of the quark and gluonic constituents within the hadron in ordinary space-time. This connection allows one to compute the analytic form of the frame-independent light-front wavefunctions, the fundamental entities which encode hadron properties and allow the computation of decay constants, form factors, and other exclusive scattering amplitudes. New relativistic lightfront equations in ordinary space-time are found which reproduce the results obtained using the 5-dimensional theory. The effective light-front equations possess remarkable algebraic structures and integrability properties. Since they are complete and orthonormal, the AdS/CFT model wavefunctions can also be used as a basis for the diagonalization of the full light-front QCD Hamiltonian, thus systematically improving the AdS/CFT approximation.

  14. An unusual cause of cerebellovestibular symptoms.

    PubMed

    Alzuabi, Muayad A; Saad, Anas M; Al-Husseini, Muneer J; Nada, Maha A

    2016-01-13

    Hashimoto encephalopathy (HE) is a controversial autoimmune disorder, probably underdiagnosed, that causes a wide variety of neurological manifestations. Symptoms differ among patients and may be very severe in some cases. However, it can be treated, with a very good prognosis. In our case, a teenaged girl with a family history of migraine, vitiligo and benign paroxysmal positional vertigo presented with severe ataxia, vomiting and hypotension. She had a history of similar, but milder, symptoms and was misdiagnosed several times. She had subclinical hypothyroidism, and high levels of antithyroid antibodies. There were abnormal MRI and visual evoked potential findings. After excluding other more common causes, we diagnosed her as having 'Hashimoto Encephalopathy', and started treatment with corticosteroids, on which she showed dramatic improvement. After about 2 years of presentation, the patient is able to continue her life independently.