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PubMed1994

A test of the immunoreactive theory for the origin of neurodevelopmental disorders in the offspring of women with immune disorder.

Gualtieri and Hicks (1985) proposed that male vulnerability for neurodevelopmental disorders (NDs) was partially due to intrauterine immune attack of the fetus. One group of mothers with heightened immunoreactivity might be women with immune disorder. This was tested within an epidemiological sample of 17,283 mother/child pairs. Maternal immune disorders considered were ulcerative colitis or asthma. NDs in the child included: cerebral palsy, mental retardation, seizures, articulation disorder, reading, or arithmetic disability, verbal or performance aptitude deficits, and attention deficit disorder. Unlike prior studies, we controlled for demographic perinatal variables that might confound interpretation of the data. Results indicated that immune dysfunction in the mother, be it autoimmune (ulcerative colitis) or defensive (asthma) was not associated with an increased incidence of any NDs in the offspring, but mothers with ulcerative colitis did have a disproportionate number of offspring who were non-right handed. Few variables discriminated between the children of ulcerative colitis mothers who became right handed when compared to those who did not. We suggest that a) only certain maternal autoimmune disorders such as systemic lupus erythematosus (but not ulcerative colitis or asthma) elevate the risk of intrauterine immune attack and b) the elevated rate of non-right handed offspring among ulcerative colitis mothers was not an instance of immune attack but instead represents some kind of genetic association.

Achievement↗
PubMed2002

Parental alcohol use disorders and alcohol use and disorders in offspring: a community study.

BACKGROUND: We examined the association between parental alcohol use disorders and patterns of alcohol consumption and DSM-IV alcohol use disorders in their offspring in a community-based sample of young adults. METHODS: Data are based on baseline and 4-year follow-up data of 2427 respondents aged 14-24 at baseline. Alcohol use and disorders in respondents were assessed using the Munich-Composite-international-Diagnostic-Interview with DSM-IV algorithms. Diagnostic information about parents was collected by family history information from the respondents, and by direct interview with one parent (cohort aged 14 to 17 years only). RESULTS: Although the association between maternal and paternal alcohol use disorders and non-problematical drinking in offspring was minimal, there was a strong effect for the transition to hazardous use and for alcohol abuse and dependence; the effect of parental concordance for transition into hazardous use was particularly striking. Maternal history was associated with a higher probability of progression from occasional to regular use, whereas paternal history was associated with progression from regular to hazardous use. Parental alcoholism increased the risk for first onset of hazardous use and alcohol dependence between the ages of 14-17, and for an earlier onset of the alcohol outcomes in offspring. The impact of parental alcohol use disorders was comparable for male and female offspring. CONCLUSIONS: Parental alcoholism predicts escalation of alcohol use, development of alcohol use disorders and onset of alcohol outcomes in offspring.

Adolescent↗
PubMed2006

Protein intrinsic disorder and human papillomaviruses: increased amount of disorder in E6 and E7 oncoproteins from high risk HPVs.

It is recognized now that many functional proteins or their long segments are devoid of stable secondary and/or tertiary structure and exist instead as very dynamic ensembles of conformations. They are known by different names including natively unfolded, intrinsically disordered, intrinsically unstructured, rheomorphic, pliable, and different combinations thereof. Many important functions and activities have been associated with these intrinsically disordered proteins (IDPs), including molecular recognition, signaling, and regulation. It is also believed that disorder of these proteins allows function to be readily modified through phosphorylation, acetylation, ubiquitination, hydroxylation, and proteolysis. Bioinformatics analysis revealed that IDPs comprise a large fraction of different proteomes. Furthermore, it is established that the intrinsic disorder is relatively abundant among cancer-related and other disease-related proteins and IDPs play a number of key roles in oncogenesis. There are more than 100 different types of human papillomaviruses (HPVs), which are the causative agents of benign papillomas/warts, and cofactors in the development of carcinomas of the genital tract, head and neck, and epidermis. With respect to their association with cancer, HPVs are grouped into two classes, known as low (e.g., HPV-6 and HPV-11) and high-risk (e.g., HPV-16 and HPV-18) types. The entire proteome of HPV includes six nonstructural proteins [E1, E2, E4, E5, E6, and E7 (the latter two are known to function as oncoproteins in the high-risk HPVs)] and two structural proteins (L1 and L2). To understand whether intrinsic disorder plays a role in the oncogenic potential of different HPV types, we have performed a detailed bioinformatics analysis of proteomes of high-risk and low-risk HPVs with the major focus on E6 and E7 oncoproteins. The results of this analysis are consistent with the conclusion that high-risk HPVs are characterized by the increased amount of intrinsic disorder in transforming proteins E6 and E7.

Algorithms↗
PubMedDate not supplied

Are our definitions of women's desire, arousal and sexual pain disorders too broad and our definition of orgasmic disorder too narrow?

Since each individual female sexual dysfunction is complex, it is necessary to subtype them in addition to dividing them into life-long or acquired disorder. The complexity of women's sexual arousal necessitates appreciation of a number of different types of arousal disorders that vary not only in etiology but also in management. The coexistence of sexual arousal and sexual desire, which develops during a sexual experience, explains the frequent comorbidity of arousal and desire disorders. Subtyping of hypoactive sexual desire disorder allows analysis of lack of receptivity and of any marked loss of the traditional markers of sexual desire over and beyond a normative lessening with relationship duration. Dyspareunia and vaginismus require further analysis prior to any definitive therapy. The definition of orgasmic disorder needs to include loss of orgasmic intensity and the possibility of coincident arousal disorder.

Affect↗
PubMedDate not supplied

Etiological relationships between eating disorder symptoms and dimensions of personality disorder.

A preliminary exploration of the etiological factors that may contribute to the relationship between eating disorder symptoms and personality disorder traits is reported based on a general-population twin sample of 221 pairs. Symptoms of eating disorder, assessed using the Health Information Questionnaire (HIQ), formed 3 factors: Concern for Overeating, Purging, and Body Mass Index (BMI). Modest genetic influences were observed on Concern for Overeating, possible non-additive genetic effects on Purging, and substantial additive genetic effects for BMI. Substantial nonshared environmental effects occurred with the Concern with Overeating and Purging scales, and common environmental effects were noted for the Concern with Overeating scale. Personality disorder traits were assessed using the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). Phenotypic, genetic, and environmental correlations between the HIQ scales and higher-order personality disorder factors were modest. The strongest relationship was between Concern with Overeating and Emotional Dysregulation. Relationships among DAPP-BQ basic trait scales and eating disorder symptoms were modest and relatively non-specific. The strongest relationships were with the Concern with Overeating scale. Purging also showed a modest relationship with affective lability and self-harm.

Journal Article↗
PubMed1997

Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study.

OBJECTIVE: To determine the properties of the alcohol use disorders identification test in screening primary care attenders for alcohol problems. DESIGN: A validity study among consecutive primary care attenders aged 18-65 years. Every third subject completed the alcohol use disorders identification test (a 10 item self report questionnaire on alcohol intake and related problems) and was interviewed by an investigator with the composite international diagnostic interview alcohol use module (a standardised interview for the independent assessment of alcohol intake and related disorders). SETTING: 10 primary care clinics in Verona, north eastern Italy. PATIENTS: 500 subjects were approached and 482 (96.4%) completed evaluation. RESULTS: When the alcohol use disorders identification test was used to detect subjects with alcohol problems the area under the receiver operating characteristic curve was 0.95. The cut off score of 5 was associated with a sensitivity of 0.84, a specificity of 0.90, and a positive predictive value of 0.60. The screening ability of the total score derived from summing the responses to the five items minimising the probability of misclassification between subjects with and without alcohol problems provided an area under the receiver operating characteristic curve of 0.93. A score of 5 or more on the five items was associated with a sensitivity of 0.79, a specificity of 0.95, and a positive predictive value of 0.73. CONCLUSIONS: The alcohol use disorders identification test performs well in detecting subjects with formal alcohol disorders and those with hazardous alcohol intake. Using five of the 10 items on the questionnaire gives reasonable accuracy, and these are recommended as questions of choice to screen patients for alcohol problems.

Adolescent↗
PubMed2005

Medications for panic disorder and generalized anxiety disorder during pregnancy.

OBJECTIVE: Approximately 30% of women experience some type of anxiety disorder during their lifetime. In addition, some evidence exists that anxiety disorders can affect pregnancy outcomes. This article reviews the literature on the course of generalized anxiety disorder (GAD) and panic disorder during pregnancy and the postpartum period and presents guidelines for management. DATA SOURCES AND STUDY SELECTION: An English language electronic search of relevant studies using PubMed (January 1, 1985-January 2004) was performed using the search terms anxiety and pregnancy, maternal mental illness, panic and pregnancy, psychotropic medications in pregnancy, and treatment options in pregnancy. Review articles and primary pharmacologic treatment articles were selected for discussion. DATA EXTRACTION AND SYNTHESIS: Despite the extensive use of psychotropic drugs such as antidepressants during pregnancy, there is a scarcity of information regarding the effect of such exposure on the developing fetus. Review articles and primary pharmacologic treatment trials were analyzed and incorporated into the review based on adequate methodology, completeness of data, and information on pregnancy outcome. CONCLUSION: It is important that physicians understand the course of these disorders during pregnancy and available treatments so they appropriately counsel women who are or intend to become pregnant. The goal of treatment during pregnancy and lactation is sufficient treatment for syndrome remission. To minimize the potential for neonatal withdrawal and maternal toxicity after delivery, vigilant monitoring of side effects is indicated. Also, if possible, nonpharmacologic treatment, such as cognitive-behavioral therapy, should be first-line treatment in pregnant women with GAD or panic disorder.

Journal Article↗
PubMed1999

[Family environment in eating disorders: a study of the familiar factors influencing the onset and course of eating disorders].

OBJECTIVE: This study investigated the association of family environment and symptomatic characteristics in eating disorders. METHOD: The subjects studied were 180 eating disorder patients who sought treatment at Tokai University Hospital and whose diagnoses were made using the SCID (Structured Clinical Interview for DSM-III-R) modified for DSM-IV. The subjects consisted of 52 Anorexia Nervosa Restricting Type (AN/R), 40 Anorexia Nervosa Binge-Eating/Purging Type (AN/BP), 57 Bulimia Nervosa Purging Type (BN/P), 17 Bulimia Nervosa Nonpurging Type (BN/NP) and 14 Binge-Eating Disorder (BED). All subjects were given the Family Adaptability & Cohesion Evaluation Scales III (FACES-III). Seventy eight female college students were administered the FACES-III, as normal controls. RESULTS: On the cohesion (CO) dimensions of FACES-III, most AN/R perceived their families as significantly enmeshed (high CO), whereas most BN and BED perceived their families as disengaged (low CO). The families of AN/BP rated lower CO than AN/R, and higher CO than BN. On the adaptability dimension of FACES-III, most AN/BP and BED perceived their families as rigid, and most BN/P perceived their families either rigid or chaotic. DISCUSSION: 1) The family environment of eating disorder patients exist, on a continuum of cohesion, from AN/R (enmeshed), through AN/BP (intermediate cohesion) and BN (disengaged), to BED (most disengaged). It's suggested that there might be an association of enmeshed family environment and severity of restrict-eating. In addition, the disengaged family environment might have an association with the onset of binge-eating. 2) It's also suggested that the two extremes on the adaptability dimension, rigid and chaotic, were the characteristic features of the family environment, which might precipitate and maintain binge-eating and purging symptoms. 3) The two hypotheses were proposed with regard to the familiar contribution on the outcome of AN/R. (a) AN/R, whose family environment are enmeshed, would not develop bulimic symptoms in the future. (b) AN/R, whose family environment are disengaged, particularly with rigid or chaotic atmosphere, have high risks of developing bulimia later. 4) The author discussed that dividing AN/BP into the two categories: binge subtype and non-binge subtype, should be recommended in the future diagnostic classification of the eating disorders, on the basis of analyzing both groups' family environments. 5) Comparing the family environment of the Japanese BED and the western BED suggested that the Japanese BED might be more severe in psychopathology. The author discussed the comorbidity of BED and the Borderline Personality Disorder, as well as the social influence on the clinical features of BED.

Adult↗
PubMed1999

Channelopathies: ion channel disorders of muscle as a paradigm for paroxysmal disorders of the nervous system.

Cyclic vomiting syndrome (CVS) is manifested by episodic occurrence of emesis that may be precipitated by stress and fatigue. The attacks begin in childhood and often taper in frequency into young and middle adult life. They frequently occur in clusters with intervening normal periods of days, weeks, months, or years. In these regards, CVS shares similarities with many other episodic disorders of brain, heart, and skeletal muscle. These disorders include the periodic paralyses, episodic movement disorders, cardiac dysrhythmia syndromes, epilepsy, and migraine headache. Because of some of the similarities among these disorders, it has been hypothesized that common pathophysiologic mechanisms may underlie some of these disorders. CVS may also share a similar pathophysiologic basis, and this idea may lead to novel approaches to investigation of this fascinating and difficult disorder.

Adolescent↗
PubMed1979

Long-term outcome of major psychoses. II. Schizoaffective disorder compared with schizophrenia, affective disorders, and a surgical control group.

Eighty-five patients with both schizophrenic and affective features at the time of admission to the University of Iowa Psychiatric Hospital between 1934 and 1944 were selected for a 30- to 40-year outcome study. Comparison groups were 200 schizophrenic and 325 affective disorder patients, selected by the Feighner et at criteria, and 160 psychiatric symptom-free surgical patients. We assessed marital, residential, occupational, and psychiatric status to evaluate the outcome of these patients at the time of field follow-up. We used multivariate analysis of covariance to analyze the data by taking admission marital and occupational status into consideration. Patients with schizoaffective disorders had a significantly better outcome than those with schizophrenia, but a significantly poorer outcome than those with affective disorders and surgical conditions. Schizoaffective disorder fell somewhere in between the schizophrenia and mania group. Before final conclusions could be made about the nature of schizoaffective disorders, more research should be done.

Adult↗
PubMed1982

Computed tomography in schizophreniform disorder and other acute psychiatric disorders.

To assess whether computed tomographic findings are present at the onset of schizophrenia, we evaluated CT scans of 35 patients with first-episode schizophreniform disorder, 17 with chronic schizophrenia, 23 with affective disorders, 27 with other psychiatric disorders, and 26 controls. Both the schizophreniform and the chronic schizophrenic patients had significantly larger cerebral ventricles than did the other psychiatric or control subjects. Ventricular size in the patients with affective disorder was not significantly different than in any of the other groups. Twenty percent of the schizophreniform patients had enlarged ventricles, (ventricular-brain ratio, greater than 10). The only other subjects outside this limit were four chronic schizophrenic patients (24%). Five schizophreniform patients and three with affective disorder had evidence of mild cortical atrophy. The results suggest that, in some schizophrenic patients, ventricular enlargement and less frequently cortical atrophy predate the onset of psychoses and are not a result of psychiatric treatment.

Adolescent↗