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PubMed2003

Clozapine-induced weight gain predicts improvement in psychopathology.

BACKGROUND: Some, but not all, previous studies have indicated that weight gain is associated with greater improvement in psychopathology during clozapine treatment. Possible reasons for the inconsistent results include failure to adjust for initial body weight and level of psychopathology, differences in trial duration, outcome measures, reliability of assessment, concomitant medications and clozapine dosage. The purpose of this study was to test the hypothesis that clozapine-induced weight gain is related to antipsychotic efficacy at 6 weeks and 6 months after adjusting for initial body weight and severity of illness. METHODS: Weight and psychopathology were determined in 74 patients with schizophrenia or schizoaffective disorder at baseline and after 6 weeks and 6 months of open treatment with clozapine monotherapy. The primary measures of psychopathology were the Brief Psychiatric Rating Scale (BPRS) Total and Positive symptoms subscales, Schedule for Assessment of Negative Symptoms (SANS), Schedule for Assessment of Positive Symptoms (SAPS) and Global Assessment of Function Scale (GAFS). RESULTS: Significant improvement in the key measures of psychopathology was noted at 6 weeks and 6 months. Mean weight gains at 6 weeks and 6 months were 3.7+/-5.7 S.D. and 7.3+/-7.9 S.D. kg, respectively, with the increase between 6 weeks and 6 months being significant. Age, but not gender, initial body weight, clozapine dosage or plasma levels predicted weight gain at both time points. At 6 weeks and 6 months, after adjustment for age, initial weight and level of psychopathology, the percentage change in weight significantly predicted the improvement in the BPRS Total and Positive symptoms subscale, the SANS Global score, as well as other measures of psychopathology. CONCLUSIONS: Increase in weight with clozapine predicted improvement in psychopathology. This suggests that effects of clozapine on neurotransmitters which influence weight gain, e.g. 5-HT(2C) and 5-HT(1a) antagonism, in association with individual variations in these receptors and others molecules, e.g. peptides and transporters, due to polymorphisms or post-translational editing of mRNAs, may also contribute to the improvement in psychopathology.

Adult↗
PubMed2001

An investigation of psychopathology in nonreferred suicidal and nonsuicidal adolescents.

This investigation examined self-reported psychopathology in a school-based sample of 456 suicidal and nonsuicidal adolescents. The sample consisted of four groups: three at-risk for suicidal behavior based on current suicidal ideation as assessed by the Suicidal Ideation Questionnaire (SIQ; Reynolds, 1988), past suicide attempts, or both; and one nonsuicidal comparison group. Psychopathology was examined using ten scales from the Adolescent Psychopathology Scale (APS; Reynolds, 1998a) including: Major Depression, Conduct Disorder, Substance Abuse, Schizophrenia, Adjustment Disorder, Anorexia Nervosa, Borderline Personality Disorder, Obsessive-Compulsive Personality Disorder, Schizotypal Personality Disorder, and Avoidant Personality Disorder. Analyses were conducted separately for males and females using a MANOVA design that examined psychopathology severity among the four groups. Adolescents who engaged in past or current suicidal behavior had higher psychopathology severity scores compared to their nonsuicidal peers. Males with current suicidal thoughts who had attempted suicide had the highest levels of psychopathology severity compared to males in the other three groups. Females with a past suicide attempt or current suicidal ideation had higher psychopathology severity scores compared to nonsuicidal females. Results show greater psychopathology in school-based adolescents who have engaged in past and/or current suicidal behavior. The need for clinicians and mental health professionals working with at-risk youth to focus on concurrent psychopathology along with suicidal behavior is discussed.

Adolescent↗
PubMed1999

In the long run...longitudinal studies of psychopathology in children. Committee on Child Psychology. Group for the Advancement of Psychiatry. Report no.143.

Longitudinal studies are difficult to do well. Too short a study and the results may be meaningless. Too long a study and the subjects cannot be found, money runs out, and research methods become seriously out of date. Despite these problems, there have been some longitudinal studies done that have greatly advanced our understanding of the nature and the treatment of psychopathology in childhood. Without these studies, much less would be known about the clinical course of important disorders, the effects of treatments, and the various risk and protective factors. None of these studies has been perfect. Some longitudinal studies did not focus on quite the right questions, some produced contradictory results, and others produced results that were hard to interpret. What have we learned from the longitudinal studies reviewed in this Group for the Advancement of Psychiatry (GAP) report? Many of the things that we have learned have been surprising--even counterintuitive. Pre- and perinatal insults need not necessarily lead to serious consequences in later life. Premature infants, if raised in nondeprived settings, are not likely to be mentally retarded or learning disabled. Today, of course, premature infants who would not have been kept alive 15 years ago are surviving. Will this advancement led to an untoward outcome? We do not know. New longitudinal studies need to be done. Certain serious illnesses emerging later in childhood may be associated with a greater risk of psychopathology. This risk is true at least for those with asthma. Psychological factors, such as psychological stress, also may lead to exacerbation of asthmatic attacks. Whether other illnesses are associated with a greater risk of psychopathology simply has not been studied adequately. Infant temperamental characteristics can be classified and measured; however, they appear to predict little in terms of later personality development or psychopathology. Although temperamental characteristics measured in infancy correlate poorly with temperamental characteristics measured at age 4 or 5 years, they appear to be much more stable and correlate well with temperament at ages 8 and 12 years. Some of these temperamental characteristics, particularly aggressivity and negativity at age 5 years, are serious risk factors for behavioral psychopathology at age 8 or 12 years and, possibly, at later ages as well. Aggressive, negative 5-year-olds do not necessarily grow out of their problems. Their problems are important and should be dealt with when children are age 5 years. What does appear important is early language development. Delays in language development or developmental language disorders are risk factors for later psychopathology. Fifty percent of school-age children with language problems requiring speech and language therapy also have diagnosable psychopathology. Hyperactivity and short attention span are characteristics that tend to persist in later childhood--even adulthood. Alone, each of these characteristics may not be a risk factor for later psychopathology, but, when accompanied by oppositional behavior and conduct disorder, the outcome is detrimental to the child. Many studies have shown that children with these comorbid problems are at risk later for becoming delinquent and antisocial. Conduct disorder in childhood, which is much more common in males, is a risk factor for later delinquency, even if it is not associated with hyperactivity. Again, early intervention is important. The effects of comorbidity in this instance can be serious. Comorbidity in general, especially as children grow older, leads to adverse social, academic, and psychopathological outcomes. Depression does occur in children, in all of its adult manifestations. Mania, in contrast, is rarely seen in children younger than age 12 years. Depression in school-age children can be severe or mild. In contrast to adolescents with depression, depressed children are most likely to have somatic compla

Adolescent↗
PubMedDate not supplied

Psychopathology: an edgeless razor?

The declining value of schneiderian first-rank symptoms (FRS) in differentiating between the two major functional psychoses has raised questions as to the utility of psychopathological concepts. In current diagnostic systems such as DSMs, psychopathological criteria and chiefly schneiderian symptoms have been used for nosographical purposes. It must be clear that this nosographically oriented use of psychopathology is only one aspect of the psychopathological enterprise. Indeed, while clinical psychopathology is essentially aimed at the identification of symptoms that are significant in view of nosographical distinctions, the specificendeavor of general psychopathology might be conceived as the organization of internal experiences around a core of meaningfulness, regardless of nosographical attributions. We seek to legitimate the value of psychopathological investigation and concepts as independent from any nosographical concern, and propose the concept of "psychopathological organizers" as synthesizing schemes of comprehension aimed at connecting different pathological experiences into unitary cores of meaningfulness.

Diagnosis, Differential↗
PubMed2001

Integrating psychopathological dimensions in functional psychoses: a hierarchical approach.

Previous factor analysis studies of psychotic symptomatology have demonstrated three psychopathological dimensions: positive, negative and disorganization. However, few studies have analyzed non-schizophrenic samples and most use a syndrome-level of analysis or only schizophrenic symptom scales. This study examined how many dimensions underlie psychosis, and whether within psychosis there is a hierarchical organization of dimensions.A total of 660 inpatients with an acute psychotic episode were studied. Psychopathology was measured through a wide psychopathological assessment using the Manual for the Assessment and Documentation of Psychopathology (AMDP-system). Principal component factor analysis was carried out on 64 psychopathological symptoms scoring 1 or higher in at least 10% of the sample. A 15-factor solution was obtained which failed to depict a psychosis model on clinical and methodological grounds. Further predetermined factor analyses ranging from 1 to 15 factors were carried out to examine alternative factor solutions. A 10-dimensional model was the best model on clinical, statistical and conceptual grounds. Moreover, the examination of the 1 to 10 dimensional models allowed us to infer a hierarchical model of psychopathological dimensions, which can be represented in the frame of a tree-structure. The model permitted transitions between psychiatric categories and psychopathological dimensions, and it was able to integrate previous factor solutions with different numbers of resulting dimensions.The findings have implications for the design of future studies and for the hierarchical conceptualization of psychopathological dimensions.

Adult↗
PubMed2000

Psychopathology of alcoholics during withdrawal and early abstinence.

Epidemiologic surveys show a high lifetime co-morbidity with psychiatric disorders (e.g., depression and anxiety) in alcoholics. However, alcoholics frequently complained about psychopathologic symptoms, particularly during alcohol withdrawal. There is some evidence that symptomatology decreases spontaneously with prolonged abstinence. Thus, the question arises whether high levels of psychopathology could be accounted for by withdrawal effects. This study was aimed at examining the impact of the alcohol withdrawal severity (assessed by the AWS scale) on psychopathologic symptoms. The psychopathologic profile of 110 alcoholics as measured by the Symptom Checklist-90 revised (SCL-90-R) was compared to that of 253 patients with adjustment, anxiety or depressive disorders (according to ICD-10 criteria). No relationship between the severity of alcohol withdrawal and psychopathology could be found which might hint at two different neurobiological processes underlying these phenomena. The comparison with patients suffering from depression or anxiety disorders revealed that the global symptom severity of alcoholics undergoing withdrawal was similar, but recovery was achieved more rapidly than in the other groups. On the other hand, the self-rated psychopathologic symptom profile of alcoholics was rather similar to that of patients with adjustment disorders. While about one-quarter of the alcoholics reported severe psychopathology on admission, only about 10% showed symptomatology at discharge about three weeks later, predominantly depression or anxiety. These results underline the notion that much of the psychopathology described by alcoholics decreases within 2-3 weeks after withdrawal without specific treatment.

Acute Disease↗
PubMed2003

Psychopathological features in Alzheimer's disease: course and relationship with cognitive status.

OBJECTIVES: To examine the course, clinical correlates, and relationship between cognitive status and psychopathological features in patients with probable Alzheimer's disease (AD) followed over a 5-year period. DESIGN: Cohort study with follow-up of 5 years. SETTING: Patients were recruited at three sites: 91 patients at Columbia Medical Center, 84 at Johns Hopkins School of Medicine, and 61 at Massachusetts General Hospital. PARTICIPANTS: Patients diagnosed with probable AD (n = 236) enrolled in a longitudinal study (Predictors study). MEASUREMENTS: Wandering/agitation, physical aggression, hallucinations, and delusions were evaluated at 6-month intervals using the Columbia Scale for Psychopathology in Alzheimer's Disease. Descriptive analyses were used to provide estimates of prevalence and course of psychopathological features. General estimating equations determined the odds of having any of the four psychopathological behaviors as a function of cognitive status. Markov analyses provided 6-month transition probabilities for psychopathological behaviors given patients' cognitive status and the presence or absence of such behaviors in the previous evaluation. RESULTS: For wandering/agitation, prevalence (39-57%) and persistence increased as a function of time and decrement in cognitive status. Physical aggression was less prevalent (6-22%) and increased as a function of cognitive decline but tended to persist only in the more severely impaired patients. Delusions (34-49%) reached a peak at the second year and then declined. The odds of delusions were maximal with intermediate decline but remained persistent regardless of cognitive status. Hallucinations, despite some fluctuations, were relatively stable during the follow-up period (8-17%) and moderately persistent. CONCLUSION: Psychopathological features, particularly wandering/agitation and delusions, in AD were common throughout the disease course. The natural history and persistence of the four psychopathological features varied. These findings provide important information to clinicians and caregivers regarding the course, predictability, and possible treatment of psychopathological behaviors in patients with probable AD.

Aged↗
PubMed2002

Age at onset, childhood psychopathology, and 2-year outcome in psychotic bipolar disorder.

OBJECTIVE: The relationships of age at onset and childhood psychopathology to 2-year clinical and functional outcomes in first-admission patients with bipolar I disorder were examined. METHOD: Patients with bipolar I disorder (N=123) presenting with psychotic symptoms were followed over a 2-year period. Age at onset was stratified into <19 and >or=19 years. Childhood psychopathology was categorized as behavior problems, other psychopathology, and none. Functional and clinical outcomes were rated with standard measures. RESULTS: Childhood psychopathology and age at onset were independently related to poorer functional and clinical outcome. In the multivariate models that included psychopathology, age at onset, sex, and education, early age at onset was related to incomplete remission, and childhood psychopathology was related to functional outcome. CONCLUSIONS: Childhood psychopathology and age at onset contribute independently to outcomes of bipolar disorder. Childhood psychopathology is a much stronger predictor of functioning than age at onset.

Adolescent↗
PubMed1984

Predicting psychopathology in six-year-olds from early social relations.

113 children were seen at 1 and 6 years of age in order to examine the relationship between the quality of the early attachment relationship and later psychopathology. On the basis of scores from the Achenbach and Edelbrock Child Behavior Profile, an outcome measure of psychopathology at 6 years, the results indicated different outcomes for male and female children. For males, attachment classification at 1 year was significantly related to later psychopathology; insecurely attached males showed more psychopathology than securely attached males. No relationship between attachment and later psychopathology was observed for females. Even for males, the attachment classification only partly predicted later behavioral problems. Several other factors, including life-stress events and family demographic variables, appeared to influence the development of psychopathology. The findings suggest that although the child's attachment relationship plays an important role in the development of psychopathology, the child is neither made invulnerable by an early secure attachment nor doomed to psychopathology by an insecure attachment.

Child↗
PubMed1996

Prevalence and correlates of psychopathology in pregnant adolescents.

PURPOSE: To investigate the prevalence and correlates of psychopathology, as measured by the Youth Self-Report Scale, in pregnant adolescents so that interventions during pregnancy may be tailored to treat the psychopathology and thereby improve maternal and child outcomes. METHODS: Scores on seven psychologic syndromes (withdrawn, delinquent, aggressive behaviors; anxiety/depression; and social, thought, and attention problems) were compared for groups of pregnant adolescents (n = 185), never pregnant teenagers (n = 126), and previously published normative samples of clinically referred (n = 518) and nonreferred (n = 518) female adolescents using chi-square, Student's t-tests, analysis of covariance, or multiple logistic regression. Correlates of psychopathology were identified for the pregnant sample using odds ratios and 95% confidence limits. RESULTS: Pregnant adolescents exhibited less serious or lower rates of psychopathology than groups against which they were compared. Correlates of psychopathology included substance use during pregnancy, prior assault, maternal childbirth before age 18 years, ethnicity, > or = 3 sexual partners, and absence of a relationship with the baby's father. CONCLUSIONS: Although the prevalence of psychopathology was lower among pregnant patients, those who exhibit psychopathology are likely to engage in risky health behaviors that contribute to poor perinatal outcome.

Adolescent↗
PubMed1995

[The dialectic of the obsessionality and the dissociativity: toward a psychopathology of binge-eating].

Binge-eating is one of the most paradoxical phenomena in the symptomatology of anorexia nervosa and bulimia nervosa. The patients seem to be struggling to control their eating behaviors as strictly as possible, and at the same time, they repeat chaotic patterns of binge-eating. The author investigated the descriptive psychopathology of binge-eating in this paper. The author recognized the impulsive nature of binge-eating at first, and compared it with the clinical features of so-called impulse control disorders, such as kleptomania, trichotillomania, and so on. According to the literature review, most impulse control disorders tended to show high coincidence with eating disorders. The mode of the coincidence and the alternation of the symptoms suggested the common psychopathologies between eating disorders and impulse control disorders. The author then inquired into their common psychopathologies, and revealed characteristic features which could be formulated as dissociative. The study of the concept of dissociation proved that this formulation was not only valid, but also useful in understanding eating disorders clinically and theoretically. Binge-eating could be regarded as a manifestation of dissociative pathology. The author inquired further into the psychopathologies of eating disorders and impulse control disorders, and revealed obsessional features in these disorders. Though some investigators regarded the symptoms of eating disorders as compulsive behaviors and considered that eating disorders were variants of obsessive-compulsive disorder, the author pointed out some descriptive differences between them. Nevertheless, the obsessionality formed an important basis of the psychopathology of binge-eating. Finally, the author discussed the relationship between the obsessionality and the dissociativity in eating disorders. These two features were reciprocal factors in mental activity, and were forming dialectical dynamism in general psychological functioning. In anorexia nervosa and bulimia nervosa, the opposition between two factors was morbidly rigid and their sublation could not occur. Though the obsessional and the dissociative features of binge-eating were opposite phenomena, it was important to comprehend them as an incorporated psychopathology. The conceptualization of the dialectic of the obsessionality and the dissociativity could also be useful in understanding other psychopathological phenomena such as addiction and splitting.

Adult↗
PubMedDate not supplied

Psychopathological aspects of the Ethiopian immigration to Israel.

Of the 352 adult Ethiopian Jews who live in the city of Netanya and who immigrated to Israel during the last few years, 87 were examined for evaluation of psychopathology symptoms and also to verify which factors of their immigration and which absorption conditions were related to their psychopathology. The Physician's Outpatient Psychopathology Scale (211-POPS), as well as three other self-rating scales--The Satisfaction Scale, The Events en route to Israel Scale, and The Frequency of Visits to Family Physician Clinics Scale--were completed with the assistance of well-trained Ethiopian interviewers in the homes of the Ethiopian immigrants. The results prove that a high incidence of psychopathology still existed even after 5 years of residence in Israel. The main topics of dissatisfaction (more than 60% of the sample), in order of severity, were their level of fluency in Hebrew, their financial situation, the attitude of the religious institutions towards the Ethiopian community, and the degree of observance of religious customs in Israel. It was found that a high level of psychopathology was related to a high level of suffering on the journey to Israel. It was also found that psychopathology usually declined with the length of residence in Israel. A high incidence of psychopathology was found to be related to an increase in age and to a low level of education.

Adolescent↗
PubMed2006

School bullying and youth violence: causes or consequences of psychopathologic behavior?

CONTEXT: The causal relation between school bullying and psychopathologic behavior has been the focus of substantial debate. Previous studies have failed to garner causal evidence in either direction, largely because of methodologic constraints such as cross-sectional study designs, shared method variance, and analytic shortfalls. OBJECTIVE: To determine the direction of the causal relation between psychopathologic behavior and school bullying. DESIGN: Prospective cohort study. SETTING: Two Korean middle schools. PARTICIPANTS: A total of 1655 seventh- and eighth-grade students were studied between 2000 and 2001. MAIN OUTCOME MEASURES: School bullying was assessed by peer nomination, and 7 subscales of the Korean Youth Self Report were used to identify symptoms of psychopathologic behaviors. School bullying was categorized into 4 groups: victims, perpetrators, victim-perpetrators, and neither. A T-score on the Korean Youth Self Report greater than 65 was regarded as a clinically significant indicator. RESULTS: Social problems increased the risk of becoming a victim or a victim-perpetrator (odds ratio [OR], 2.3 and 2.7, respectively), and these associations disappeared when baseline bullying status was adjusted. Ten months later, individuals who were victims at baseline showed increased risk of social problems (OR, 3.9), those who were perpetrators had increased aggression (OR, 1.8), and victim-perpetrators had increased aggression and externalizing problems (OR, 4.9 and 4.6, respectively). Analyses that examined exposure history provided additional evidence for the causal effect of bullying experience on the later development of psychopathologic behaviors because most forms of psychopathologic behavior that led to new-onset bullying at follow-up were also present at follow-up, making it impossible to distinguish the temporal sequence of these variables and their causal relationship. However, most forms of new-onset psychopathologic behaviors at follow-up were associated with antecedent bullying experience. CONCLUSIONS: Our study results support the conclusion that psychopathologic behavior, including social problems, aggression, and externalizing behavioral problems, is a consequence rather than a cause of bullying experiences. This causal relation is supported by the strength and specificity of the association and the temporal antecedence of bullying. Because school bullying is a known correlate of youth violence, such a finding adds greater urgency to the search for programs to prevent or diminish bullying among schoolchildren.

Adolescent↗
PubMed2006

Psychopathology in young people with intellectual disability.

CONTEXT: Comorbid severe mental health problems complicating intellectual disability are a common and costly public health problem. Although these problems are known to begin in early childhood, little is known of how they evolve over time or whether they continue into adulthood. OBJECTIVE: To study the course of psychopathology in a representative population of children and adolescents with intellectual disability. DESIGN, SETTING, AND PARTICIPANTS: The participants of the Australian Child to Adult Development Study, an epidemiological cohort of 578 children and adolescents recruited in 1991 from health, education, and family agencies that provided services to children with intellectual disability aged 5 to 19.5 years in 6 rural and urban census regions in Australia, were followed up for 14 years with 4 time waves of data collection. Data were obtained from 507 participants, with 84% of wave 1 (1991-1992) participants being followed up at wave 4 (2002-2003). MAIN OUTCOME MEASURES: The Developmental Behaviour Checklist (DBC), a validated measure of psychopathology in young people with intellectual disability, completed by parents or other caregivers. Changes over time in the Total Behaviour Problem Score and 5 subscale scores of the DBC scores were modeled using growth curve analysis. RESULTS: High initial levels of behavioral and emotional disturbance decreased only slowly over time, remaining high into young adulthood, declining by 1.05 per year on the DBC Total Behaviour Problem Score. Overall severity of psychopathology was similar across mild to severe ranges of intellectual disability (with mean Total Behaviour Problem Scores of approximately 44). Psychopathology decreased more in boys than girls over time (boys starting with scores 2.61 points higher at baseline and ending with scores 2.57 points lower at wave 4), and more so in participants with mild intellectual disability compared with those with severe or profound intellectual disability who diverged from having scores 0.53 points lower at study commencement increasing to a difference of 6.98 points below severely affected children by wave 4. This trend was observed in each of the subscales, except the social-relating disturbance subscale, which increased over time. Prevalence of participants meeting criteria for major psychopathology or definite psychiatric disorder decreased from 41% at wave 1 to 31% at wave 4. Few of the participants (10%) with psychopathology received mental health interventions during the study period. CONCLUSION: These results provide evidence that the problem of psychopathology comorbid with intellectual disability is both substantial and persistent and suggest the need for effective mental health interventions.

Adolescent↗
PubMed2005

Alcohol abuse in Russian delinquent adolescents. Associations with comorbid psychopathology, personality and parenting.

INTRODUCTION: Adolescent delinquency and alcohol abuse have become a growing concern in Russia. Psychopathology, a dysfunctional family and specific personality factors have all been linked to addictive and antisocial behavior. Since delinquent youth represent a specific risk group, where alcohol misuse tends to be more pronounced than in the general population, the objectives of this study were: 1) to compare differences in personality and parenting factors, and in psychopathology in juvenile delinquents with and without alcohol abuse; and 2) to evaluate the associations between alcohol abuse, personality and parenting factors, after controlling for comorbid psychopathology. METHODS: Psychopathology, including alcohol abuse, was assessed by means of a psychiatric interview in 229 Russian incarcerated male juvenile delinquents. In addition, alcohol use, personality, and parenting factors were assessed by self-reports. RESULTS: Alcohol-abusing delinquents (n=138) scored significantly higher on novelty seeking and maternal emotional warmth and reported higher levels of psychopathology, as compared to nonalcohol-abusing delinquents (n=91). Logistic regression analysis demonstrated that personality and parenting factors were significantly related to alcohol abuse, even after controlling for comorbid psychopathology. CONCLUSION: Alcohol-abusing delinquents are at risk for a wide spectrum of psychiatric disorders. Alcohol abuse is associated with personality and parenting factors independently of comorbid psychopathology. Early interventions with high-risk youths may help to reduce their psychiatric problems and alcohol abuse.

Adolescent↗
PubMed2006

Psychopathological profile in children with chronic tic disorder and co-existing ADHD: additive effects.

The nature of the co-occurrence of chronic tic disorders (CTD) and attention deficit hyperactivity disorder (ADHD) is unclear. Especially in the field of psychopathology, the relationship of CTD and ADHD remains to be clarified. Thus, the aim of the present chart review study was to specify the contribution of CTD and/or ADHD to the psychopathological profile of the comorbid group (CTD+ADHD). The psychopathological profiles of four large groups (CTD-only (n=112), CTD+ADHD (n=82), ADHD-only (n=129), controls (n=144)) were measured by the eight subscales of the Child Behavior Checklist (CBCL) and analyzed by a 2x2 factorial design followed by contrasts. There were main effects of ADHD diagnosis on all but one subscale of the CBCL (Somatic Complaints). For CTD diagnosis, main effects were found for Attention Problems, Anxious/Depressed, Thought Problems, Social Problems and Somatic Complaints. The only interaction effect was seen for Somatic Complaints. While CTD and ADHD were both related to internalizing psychopathology of children in the CTD+ADHD group, ADHD had the largest effect on externalizing psychopathology in the comorbid group. At the level of psychopathology, an additive model for the co-occurrence of CTD and ADHD is strongly supported. In the comorbid group (CTD+ADHD), the ADHD diagnosis shows the strongest relation to externalizing psychopathology.

Aggression↗
PubMed1992

Psychopathology and pain in medical in-patients predict resource use during hospitalization but not rehospitalization.

The authors investigated the relationship between psychopathology and resource use in general medical in-patients during hospitalization and rehospitalization. Between 1 July 1987, and 30 April 1989, 1020 in-patients were prospectively screened for depression, anxiety, cognitive dysfunction, and pain. Overall, the screen identified 47% of patients as having high psychopathology or pain, including 25.7% depressed, 21.8% anxious, 17.6% with cognitive dysfunction, and 5.2% with high pain. There were no measured differences in demographics or disease severity between high and low psychopathology groups. High psychopathology patients had longer stays and higher costs during the index hospitalization but there were no differences during subsequent hospitalizations. Length of stay declined overall during the study period, but there were no changes over time in the association between high psychopathology or pain with increased resource use. The measured symptoms of psychopathology and pain we measured are associated with increased short-term utilization of health care resources, but the increase does not extend to subsequent hospitalizations. Outcome studies aiming to reduce psychopathology in medical in-patients should pay particular attention to short term costs.

Anxiety Disorders↗
PubMed2005

Platelet MAO-B, personality, and psychopathology.

The article investigates the relationships between platelet monoamine oxidase-B (MAO-B) activity, personality, and psychopathology (Diagnostic and Statistical Manual of Mental Disorders [4th ed.; American Psychiatric Association, 1994] diagnoses. These relationships were assessed in 178 incarcerated male juvenile delinquents. Even after controlling for smoking, the authors found that both Internalizing and Externalizing Psychopathology were negatively related to MAO-B activity. In the final reduced model, novelty seeking fully mediated the relationships between MAO-B and Externalizing Psychopathology but not between MAO-B and Internalizing Psychopathology. It was hypothesized that low platelet MAO-B activity does not directly predispose individuals to psychopathology but is related to specific personality traits, which in turn represent a vulnerability factor for psychopathology. Future studies should help clarify the nature of the relationships between personality, biological markers, and psychopathology.

Adolescent↗