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Cognitive and affective functions in patients with affective disorders treated with lithium. An assessment by questionnaire.

A questionnaire of 19 items was devised to assess subtle changes in affective and cognitive function in patient with effective disorders under long-term lithium therapy. Of 147 patients, 138 (93.9%) answered the questionnaire. The function of the hypothalamic-pituitary-thyroid axis was also analysed by biochemical investigations, and the interrelations between the function of this axis and affective and cognitive functions were studied. The patients under lithium maintenance therapy showed no clearcut changes in effective and cognitive functions. Some statistically significant correlations were found between rising thyrotropin levels and improved affective function. Patients who admitted periods of depression under lithium therapy showed highly significantly greater variance both in free thyroxine index and in thyrotropin levels than patients denying such periods. We may conclude that successful prophylactic lithium therapy against depression is linked to a stabilizing effect on the hypothalamic-pituitary-thyroid axis.

Age Factors↗

A large family with hereditary spastic paraparesis due to a frame shift mutation of the spastin (SPG4) gene: association with multiple sclerosis in two affected siblings and epilepsy in other affected family members.

Hereditary spastic paraparesis (HSP) is a clinically and genetically heterogeneous neurodegenerative disorder characterised by progressive lower limb spasticity and weakness. Some forms have been associated with white matter lesions and complex phenotypes. This study was prompted by the diagnosis of multiple sclerosis (MS) in two sisters from a large pedigree with hereditary spastic paraparesis. Twelve affected members of the extended family were examined (MRI and EEG were carried out and evoked potentials measured in five), and historical information was obtained from six affected deceased persons. The inherited disease phenotype was confirmed as autosomal dominant hereditary spastic paraparesis associated with epilepsy in four affected persons. None of the extended family had evidence of MS. Genetic analysis of the family has shown linkage to chromosome 2p and sequencing of the spastin gene has identified a 1406delT frameshift mutation in exon 10. This kindred demonstrates the clinical heterogeneity of HSP associated with spastin mutations. The possible relevance of the concurrence of HSP and MS in the sib pair is discussed.

Adenosine Triphosphatases↗

Lithium and haloperidol treatments differently affect the mononuclear leukocyte Galphas protein levels in bipolar affective disorder.

Despite numerous suggestions of the involvement of GTP-binding proteins in the mechanisms of action of psychoactive drugs in bipolar affective disorder, few studies have been conducted during the drug treatment of patients. The aim of the present study was to investigate the effects of a mood stabilizer and an antipsychotic drug on Galphas proteins. Patients with bipolar affective disorder under lithium treatment with or without haloperidol were assessed with respect to their mononuclear leukocyte (MNL) Galphas subunit protein. Galphas-45 protein subunit levels were analyzed by the Western immunoblot method. The subjects consisted of a group of 20 patients, all diagnosed as euthymic bipolars, and a comparison group of 15 drug-free healthy subjects. Results showed that Galphas levels were significantly decreased in the bipolar patients (BP) compared to drug-free healthy subjects (Mann-Whitney U test, p < 0.002). The drug effect was evaluated by a factorial analysis of variance and showed significant differences between groups (Kruskal-Wallis H test, p < 0.02). Lithium-treated patients displayed the most decreased Galphas levels (normalized mean values 53.2 +/- 31 vs. 122 +/- 45% for BP and controls, respectively, p < 0.001), while no change was observed in Galphas levels of haloperidol-treated patients compared to controls (mean values: 124.9 +/- 37%; NS). The data indicate that lithium and haloperidol affect the mechanism of Galphas protein signal transduction differently, consistent with previous animal studies.

Adult↗

Diagnosing affective disorder in adolescents: the use of the Schedule for Affective Disorders and Schizophrenia.

The Schedule for Affective Disorders and Schizophrenia was administered to 42 consecutively hospitalized psychiatrically disturbed adolescents. The SADS proved to be a good measure of current affective disorder and also identified a large number of adolescents with a positive past history of affective disorder. These patients had not been so identified by traditional assessment means. The use of a semi-structured interview is to be encouraged in the assessment period of psychiatrically disturbed adolescents and in further research at attempts to define the parameters of depressive disorders occurring in adolescents.

Adolescent↗

Psychosis in bipolar and unipolar affective illness with special reference to schizo-affective disorder.

Bipolar and unipolar patients respectively were separated into psychotic and non-psychotic sub-types. The bipolar psychotic patients were more likely to have certain severe symptoms, such as hallucinations and motor abnormalities, than were the unipolar patients, but the family histories of the four sub-groups were identical. The psychotic sub-groups had a different course of illness, in that they were less likely to have had a history of multiple episodes on admission and were more likely to show chronicity for a period of time on discharge. The data are interpreted as being opposed to the concept of a continuum of vulnerability in the affective disorders, and as not favouring either psychotic unipolar or psychotic bipolar illnesses or schizo-affective disorder being considered autonomous. One possible interpretation of the findings is that a trait or propensity to psychosis is transmitted totally independently of the major affective illness, and that this propensity is silent or not observed when the patient is in remission.

Adult↗

W-sash affects positive and negative elements controlling c-kit expression: ectopic c-kit expression at sites of kit-ligand expression affects melanogenesis.

The receptor tyrosine kinase c-kit and its cognate ligand KL are encoded at the white spotting (W) and steel (Sl) loci of the mouse, respectively. Mutations at both the W and the Sl locus cause deficiencies in gametogenesis, melanogenesis and hematopoiesis (erythrocytes and mast cells). The W-sash mutation differs from most W mutations in that it affects primarily mast cells and melanogenesis but not other cellular targets of W and Sl mutations. Thus, Wsh/Wsh mice are fertile and not anemic, but they lack mast cells in their skin and intestine and are devoid of coat pigment. Heterozygotes are black with a broad white sash/belt in the lumbar region. In order to determine the basis for the phenotypes of W-sash mice, we investigated c-kit RNA and protein expression patterns in adult Wsh/Wsh mice and during embryonic development. We show that c-kit expression is absent in bone-marrow-derived Wsh/Wsh mast cells, the fetal and the adult lung, and the digestive tract at embryonic day 13 1/2 (E13 1/2), tissues that normally express c-kit. Unexpectedly, in E10 1/2 and 11 1/2d Wsh/Wsh embryos, we found c-kit expression in the dermatome of the somites, the mesenchyme around the otic vesicle and the floorplate of the neural tube, structures known to express the c-kit ligand in wild-type embryos. The ectopic c-kit expression in Wsh homozygous embryos does not affect c-kit ligand expression. The presumed Wsh/Wsh melanoblasts appeared to be normal and, at E10 1/2, similar numbers were found in normal and homozygous mutant embryos. At E13 1/2 +/+ embryos had a graded distribution of melanoblasts from cranial to caudal with a minimum in the lumbar region. Whereas E13 1/2 homozygous Wsh/Wsh embryos essentially lacked c-kit-positive cells in the skin, E13 1/2 heterozygous Wsh/+ embryos had reduced numbers of melanoblasts compared to +/+ with few or none in the lumbar region (future sash). It is proposed that ectopic c-kit expression in the somitic dermatome affects early melanogenesis in a dominant fashion. Molecular analysis of Wsh chromosomal DNA revealed a deletion or rearrangement in the vicinity of the c-kit gene. These results provide an explanation for the Wsh phenotype and have implications for the control of c-kit expression.

Animals↗

Measles antibodies, anti-proteinase and plasminogen distribution in serum and plasma from patients affected with multiple sclerosis and patients affected with non-neurological diseases.

Total protein content, alpha 1-antitrypsin, alpha 2-macroglobulin and plasminogen levels and measles antibody titers were determined in serum and plasma from patients affected with multiple sclerosis and patients affected with non-neurological diseases. The results were compared with those from a control group of healthy donors. Both multiple sclerosis patients and patients affected with non-neurological diseases differed from controls for the following parameters: total protein, plasminogen and measles antibody activity. However, when studied longitudinally the different parameters were not altered to the same degree in multiple sclerosis and non-neurological diseases, a fact which is translated in the difference of significance levels. Individual plasminogen values were very often higher in non-neurological diseases than in multiple sclerosis, whereas for increased measles antibody titers it was the reverse. Also, there were no notable changes in alpha 1-antitrypsin and alpha 2-macroglobulin values in multiple sclerosis, whereas in some non-neurological disease patients particularly high alpha 1-antitrypsin and alpha 2-macroglobulin values were observed. In the multiple sclerosis patients, no correlations existed between the duration of the disease and disturbed biochemical parameters, or between the disturbed parameters themselves.

Adult↗

Response-to-stimulus interval does not affect implicit motor sequence learning, but does affect performance.

Nissen and Bullemer (1987) reported that implicit motor sequence learning was disrupted by the addition of a secondary task. They suggested that this effect was due to attentional load that the secondary task adds. Recently it has been suggested that the attentional load is not critical, but rather that the secondary task affects timing, either by lengthening or by making inconsistent the response-to-stimulus interval (RSI)--that is, the delay between when a subject makes a response and when the next stimulus appears. In six experiments we manipulated the RSI and found no support for these two hypotheses. An inconsistent RSI did not adversely affect implicit motor sequence learning. A long RSI did not affect learning, although under some conditions subjects did not express learning if the RSI was long. These results are interpreted as reflecting the effects of attention.

Female↗

Sickle cell disease: problem solving/coping methods among affected children and their non-affected siblings.

A small group of children with sickle cell disease and their non-affected siblings served as participants in a descriptive research project designed to describe how these children problem-solve and cope with social and academic stress at school. Data collection involved pictorial stimuli to evoke story telling. The study's results indicate that both problem-solving and coping methods were identical between affected and non-affected children in the sample: both groups utilized direct action in dealing with stressful situations. The study's generalizability is limited on account of small sample size.

Adaptation, Psychological↗

Positive association of dopamine D2 receptor polymorphism with bipolar affective disorder in a European Multicenter Association Study of affective disorders.

Convincing evidence for a genetic component in the etiology of affective disorders (AD), including bipolar affective disorder (BPAD) and unipolar affective disorder (UPAD), is supported by traditional and molecular genetic studies. Most arguments lead to the complex inheritance hypothesis, suggesting that the mode of inheritance is probably not Mendelian but most likely oligogenic (or polygenic) and that the contribution of genes could be moderate or weak. The purpose of the present European multicenter study (13 centers) was to test the potential role in BPAD and UPAD of two candidate dopaminergic markers, DRD2 and DRD3, using a case-control association design. The following samples were analyzed for DRD2: 358 BPAD/358 control (C) and 133 UPAD/ 133 C subjects, and for DRD3: 325 BPAD/ 325 C and 136 UPAD/136 C subjects. Patients and controls were individually matched for sex, age ( plus minus five years) and geographical origin. Evidence for significant association between BPAD and DRD2 emerged, with an over-representation of genotype 5-5 (P=0.004) and allele 5 (P=0.002) in BPAD cases compared to controls. No association was found for DRD2 in UPAD, and for DRD3 neither in BPAD or UPAD. Our results suggest that the DRD2 microsatellite may be in linkage disequilibrium with a nearby genetic variant involved in the susceptibility to BPAD. Our large European sample allowed for replicating of some previous reported positive findings obtained in other study populations.

Alleles↗

Reproductive factors affecting the course of affective illness in women.

Women are at higher risk than men to develop depressive episodes during the reproductive years. Furthermore, women are vulnerable to depressions associated with oral contraceptives, abortion, the premenstrual period, the puerperium, and menopause. The phenomenology and the biologic mechanisms involved in these illnesses perhaps should be viewed in the context of other manifestations of the link between depression and female reproductive functions. For example, women are especially vulnerable to a rapid cycling form of affective illness and to hypothyroidism, an associated factor for this form of affective disorder. The postpartum period is also associated with impaired thyroid function, and there are reports of the induction of rapid cycles of mood following the termination of pregnancy. Thus, alterations in thyroid hormones may be a feature of both postpartum and rapid cycling forms of affective disorder in women. A previous history of a postpartum depression places a woman at a high risk for the development of a subsequent puerperal episode. Also, difficulties during pregnancy may predispose a woman to the development of other reproductive-related depressions. The role reproductive hormones play in this possible sensitization phenomenon needs to be examined in order to understand the relationship of depression to the female reproductive cycle.

Bipolar Disorder↗

Premature deaths in schizophrenia and affective disorders. An analysis of survival curves and variables affecting the shortened survival.

We have found shortened survival in 200 schizophrenics, 100 manics, and 225 depressives by comparing them with the Iowa general population. The numbers of years of shortened survival were estimated from the survival curves of each diagnostic group by sex. Variables affecting shortened survival were diagnostic group, sex, age at admission, and pay status at admission. Excess causes of death were suicides, accidents, and infective and circulatory system diseases. The absolute mortality for deaths due to neoplasm in our sample was not significantly different than that in the Iowa general population. However, the proportional mortality from the same data showed a deficiency in deaths due to neoplasm in schizophrenia and affective disorders. Well-designed epidemiologic studies are needed to see if there is a real deficiency in deaths due to cancer in the major psychoses.

Adolescent↗

Brain potentials in affective picture processing: covariation with autonomic arousal and affective report.

Emotionally arousing picture stimuli evoked scalp-recorded event-related potentials. A late, slow positive voltage change was observed, which was significantly larger for affective than neutral stimuli. This positive shift began 200-300 ms after picture onset, reached its maximum amplitude approximately 1 s after picture onset, and was sustained for most of a 6-s picture presentation period. The positive increase was not related to local probability of content type, but was accentuated for pictures that prompted increased autonomic responses and reports of greater affective arousal (e.g. erotic or violent content). These results suggest that the late positive wave indicates a selective processing of emotional stimuli, reflecting the activation of motivational systems in the brain.

Adolescent↗

Intuition, affect, and personality: unconscious coherence judgments and self-regulation of negative affect.

According to personality systems interaction theory, a negative mood was expected to reduce access to extended semantic networks and to reduce performance on intuitive judgments of coherence for participants who have an impaired ability to down-regulate negative affect (i.e., state-oriented participants). Consistent with expectations, state-oriented participants reporting higher levels of perseverating negative mood had a reduced discrimination between coherent and incoherent standard word triples (Study 1) and individually derived word triples describing persons (Study 2). Participants who are able to down-regulate negative affect (i.e., action-oriented participants) did not show this tendency. In addition, Study 2 revealed a dissociation between state orientation and Neuroticism that is discussed in terms of a functional difference between the two constructs.

Adult↗

Affect and the computer game player: the effect of gender, personality, and game reinforcement structure on affective responses to computer game-play.

Previous research on computer games has tended to concentrate on their more negative effects (e.g., addiction, increased aggression). This study departs from the traditional clinical and social learning explanations for these behavioral phenomena and examines the effect of personality, in-game reinforcement characteristics, gender, and skill on the emotional state of the game-player. Results demonstrated that in-game reinforcement characteristics and skill significantly effect a number of affective measures (most notably excitement and frustration). The implications of the impact of game-play on affect are discussed with reference to the concepts of "addiction" and "aggression."

Adolescent↗

Use of the Research Diagnostic Criteria and the Schedule for Affective Disorders and Schizophrenia to study affective disorders.

In a pilot study of 150 manic or depressive patients, the authors used the Research Diagnostic Criteria (RDC) and the Schedule for Affective Disorders and schizophrenia (SADS) to perform preliminary analysis of symptom pictures of the index episode of different diagnostic groups, joint diagnostic classification of the different subtypes of major depressive disorder, and differential outcome by diagnostic groups. The results suggest that schizophrenic symptoms in affective disorders do have diagnostic and prognostic significance, that the term "psychotic depression" should be limited to impaired reality testing without reference to degree of incapacitation, that situational-nonsituational and endogenous-nonendogenous classifications are separate depressive subtypes, and that it may not be true that patients with endogenous major depressive disorder have a better prognosis than patients with nonendogenous depression.

Adjustment Disorders↗

Premenstrual affective syndrome and affective disorder.

Sixty-four per cent of 874 freshmen and sophomore women sent questionnaires about premenstrual and menstrual symptoms returned them. They differed from those not returning the questionnaires only in year of school. As predicted, women reporting premenstrual affective symptoms were more likely than those who did not report them to seek psychiatric care at the Student Health Service and to be diagnosed as affective disorder at the service.

Affective Symptoms↗

[The proportion affect in affective priming: replication and evaluation of a theoretical explanation].

In the paradigm of the evaluative decision task, K. C. Klauer, C. Rossnagel and J. Musch (1997) have been able to show that in affective priming, contrary to semantic priming, a list context effect occurs already at a short SOA, whereas it does not occur at long SOAs. As a possible explanation of this surprising context effect at a short SOA, a matching mechanism was proposed. The theoretically important consistency proportion effect at an SOA of 0 ms could be replicated in an experiment with 40 participants. The results of a subsequent recognition test, however, suggest that the consistency proportion effect is not mediated by the supposed relatedness-checking mechanism. The Stroop paradigm may provide a better theoretical framework for the explanation of affective priming than the previously assumed analogy to semantic priming.

Adult↗