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PubMedDate not supplied

Evaluation of the reported association of obsessive-compulsive symptoms or disorder with Tourette's disorder.

This review evaluates the evidence reporting an association of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) with Tourette's syndrome or disorder (TS). Published reports in the literature describing a relationship between OCS-OCD and TS provided the data for the review. The methodological adequacy of the studies are discussed and rated on five criteria: adequacy of the experimental sample, presence and adequacy of the control sample, whether tics are defined as OCS-OCD, whether blind procedures are used to diagnose OCS-OCD in subjects and controls, and evidence for the reliability and validity of OCS-OCD measures. Although there are considerable clinical indications suggesting an association of OCS-OCD with TS and chronic motor tic disorder (CMT), and a possible overlap between OSC-OCD and TS, our evaluation of the evidence does not provide adequate support for an association between these disorders. To meaningfully evaluate the possible relationship between OCS-OCD and TS requires development of specific criteria for classification of OCS-OCD-TS symptoms, use of adequate experimental and control samples, blind evaluation, reliable and valid measures of OCS-OCD-TS, and appropriate statistical analysis. If such studies are performed, it is possible that the strong relationship reported between OCS-OCD and TS is more likely to be artifact than fact, and recent bandwagon effect rather than the latest breakthrough.

Diagnosis, Differential↗
PubMed1993

Nonspecific motor disorder of the esophagus: a real disorder or a manometric curiosity?

BACKGROUND: Nonspecific esophageal motility disorder (NEMD) has become a catchall term to describe abnormal esophageal manometric findings that do not meet strict criteria for established esophageal motility disorders. The aim of this study was to determine whether NEMD is a real esophageal motility disorder characterized by impairment of its motor function or simply a manometric disturbance with no clinical consequences. METHODS: Esophageal transit of liquid and semisolids was studied using radioscintigraphic techniques in 10 symptomatic patients with manometrically diagnosed NEMD, 26 healthy control subjects, and 40 disease control subjects. The disease controls included 24 patients with achalasia, 9 with scleroderma, and 7 with diffuse esophageal spasm. RESULTS: Patients with NEMD had no impairment of liquid emptying compared with healthy controls. Liquid emptying was markedly delayed in patients with achalasia and scleroderma. However, semisolid emptying was markedly delayed in patients with NEMD compared with healthy controls (P < 0.001), and the extent of its delayed emptying was similar to that seen in patients with achalasia, scleroderma, and diffuse esophageal spasm. CONCLUSIONS: NEMD is not a manometric curiosity but a disorder characterized by selective impairment of semisolid emptying.

Adult↗
PubMed1996

Plasma neuropeptide Y in anxiety disorders: findings in panic disorder and social phobia.

The demonstration in preclinical studies that centrally administered neuropeptide Y (NPY) has anxiolytic effects had led to speculation that NPY may play a role in human anxiety disorders. We therefore decided to study plasma NPY levels in 22 patients with DSM-III-R anxiety disorders (11 with panic disorder and 11 with social phobia, generalized type) and 12 never psychiatrically ill comparison subjects. Under resting conditions, plasma NPY levels did not differ among the three diagnostic groups. Following hand immersion in ice water, plasma NE levels--but not NPY levels--increased immediately, but there were no significant differential diagnostic effects. These results are convergent with prior reports of normal sympathetic nerve activity in patients with anxiety disorders.

Adult↗
PubMed2005

[Attention deficit and hyperactivity disorder or multiplex developmental disorders in child? Let us be sure...].

Personality disorders in child can be easily confused -- initially at least -- with Attention Deficit and Hyperactivity Disorder (ADHD). Because of the therapeutic and prognostic stake related to the early psychiatric care of Child Developmental Personality Disorders it is important to sensitize pédiatric and general practitioner with the clinical screening of these disorders. Indeed any premature prescription of psychostimulant treatment in these children can have regrettable consequences on their psychic functioning already precarious.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

The AUDIT-C: screening for alcohol use disorders and risk drinking in the presence of other psychiatric disorders.

This article examines the performance of the AUDIT-C, as embedded in a large national survey, as a screener for alcohol use disorders (AUDs) and risk drinking among individuals with past-year psychopathology. The analysis is based on data collected in personal interviews from a representative population sample of US adults. The study population consisted of past-year drinkers with any past-year mood disorder (n = 2818), any past-year anxiety disorder (n = 3173), or any personality disorder (n = 4389). Screening performance was evaluated by means of sensitivity, specificity, and areas under receiver operating characteristic curves (AUCs). The AUCs for the AUDIT-C were from 0.888 to 0.893 for alcohol dependence, from 0.864 to 0.876 for any AUD, and from 0.941 to 0.951 for any AUD or risk drinking-all on a par with those observed in the general population. Among men, cut points of either > or =5 or > or =6 points (the former favoring sensitivity and the latter favoring specificity) were optimal for detecting dependence, and cut points of > or =5 points were optimal for any AUD and for any AUD or risk drinking. Among women, a cut point of > or =4 points was optimal for the outcomes of both alcohol dependence and any AUD, whereas a cut point of > or =3 points was preferable for detecting any AUD or risk drinking.

Adolescent↗
PubMed2006

Impulse control disorders in eating disorders: clinical and therapeutic implications.

OBJECTIVE: Few studies have explored impulse control disorders (ICDs) in women with bulimia nervosa (BN). We explored the prevalence of lifetime ICDs in women with BN, compared the severity of eating disorder symptoms in women with BN with and without ICD, and compared their personality profiles to females with one form of ICD, namely, pathologic gambling. METHOD: A total sample of 269 female patients consecutively admitted to our unit participated in the current study (173 BN without comorbid ICD [BN - ICD]; 54 BN with comorbid ICD [BN + ICD]; and 42 pathologic gamblers [PG]). All participants were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. EVALUATION: Assessment measures included the Symptom Checklist-90 revised and the Temperament and Character Inventory-revised, as well as a number of other clinical and psychopathologic indices. RESULTS: In BN, the observed lifetime prevalence of ICD was 23.8%. Lifetime compulsive buying (17.6%) and intermittent explosive disorder (13.2%) were the most frequently reported ICD. Bulimia nervosa subtype was not significantly associated with lifetime ICD (P = .051) or with ICD subtype (P = .253). After using multinomial regression models, we observed that BN + ICD and PG showed the highest scores on novelty seeking (P < .0001). But BN + ICD women had the lowest scores on self-directedness (P < .03) and higher scores on general psychopathology (P < .01) and drug abuse (P < .01). CONCLUSIONS: Individuals with BN + lifetime ICD presented more extreme personality profiles, especially on novelty seeking and impulsivity, and general psychopathology than individuals with BN without ICD. On some personality traits, those BN + ICD more closely resembled individuals with PG than those with BN without ICD.

Adult↗
PubMed2006

Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later?

OBJECTIVE: To determine if adolescents who report dieting and different weight-control behaviors are at increased or decreased risk for gains in body mass index, overweight status, binge eating, extreme weight-control behaviors, and eating disorders 5 years later. DESIGN: Population-based 5-year longitudinal study. PARTICIPANTS: Adolescents (N=2,516) from diverse ethnic and socioeconomic backgrounds who completed Project EAT (Eating Among Teens) surveys in 1999 (Time 1) and 2004 (Time 2). MAIN OUTCOME MEASURES: Weight status, binge eating, extreme weight control, and self-reported eating disorder. STATISTICAL ANALYSIS: Multiple linear and logistic regressions. RESULTS: Adolescents using unhealthful weight-control behaviors at Time 1 increased their body mass index by about 1 unit more than adolescents not using any weight-control behaviors and were at approximately three times greater risk for being overweight at Time 2 (odds ratio [OR]=2.7 for girls; OR=3.2 for boys). Adolescents using unhealthful weight-control behaviors were also at increased risk for binge eating with loss of control (OR=6.4 for girls; OR=5.9 for boys) and for extreme weight-control behaviors such as self-induced vomiting and use of diet pills, laxatives, and diuretics (OR=2.5 for girls; OR=4.8 for boys) 5 years later, compared with adolescents not using any weight-control behaviors. CONCLUSIONS: Dieting and unhealthful weight-control behaviors predict outcomes related to obesity and eating disorders 5 years later. A shift away from dieting and drastic weight-control measures toward the long-term implementation of healthful eating and physical activity behaviors is needed to prevent obesity and eating disorders in adolescents.

Adolescent↗
PubMed2001

REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson's disease: is there a need for polysomnography?

We reviewed the polysomnograms (PSGs) of 292 consecutive patients with sleep disorders (Parkinson's disease (PD), n=19, other sleep disorders, n=273) to investigate the sensitivity and specificity of the clinical diagnosis of rapid eye movement behavior disorder (RBD) compared with polysomnographic diagnosis. Patients with dementia, multiple system atrophy, or any other neurodegenerative disease were excluded. RBD was diagnosed clinically if the minimal criteria, according to the guidelines given in the International Sleep Disorders Classification, were fulfilled. The following PSG criteria were required for diagnosis of RBD: REM sleep without muscle atonia seen in PSG associated with motor behavior visible in the PSG-synchronized videotape. Nine of nineteen PD patients (47%) had RBD. RBD occurred in only four patients without PD (1.8%). The sensitivity of specialized interviews for identifying RBD clinically was good in non-PD patients (sensitivity: 100%, specificity: 99.6%). However, the sensitivity was poor (33%) with a specificity of 90%, in patients with PD. We conclude that the diagnosis of RBD in patients with PD requires PSG, whereas interviews are sufficient for diagnosing RBD in non-PD patients.

Aged↗
PubMed2000

[Hysteria epidemics, epidemic conversion disorder or epidemic somatotrophic disorders?: a new case of a fact for the 21st century].

OBJECTIVES: To describe a new outbreak of "mass hysteria" or "epidemic conversion disorder" occurring in Barcelona in 1997. Based on this outbreak's features differentiating it from other similar outbreaks described in the literature or treated by the same team, to propose a change in the theoretical framework for these group somatomorphic phenomena. DESIGN: A study describing clinical epidemiological research and the interventions performed. SETTING: Urban health centre. Epidemiological research and data analysis performed by the Municipal Health Institute (MHI) of Barcelona. INTERVENTIONS AND MEASUREMENTS: The following were performed: a) Diagnostic screening of population. b) The usual epidemiological surveys of the MHI. c) Semi-structured interviews with the quarter's care professionals. d) Two group sessions with the quarter's health professionals. MHI experts analysed statistically the data provided by measurements b) and c). RESULTS: 276 people (42% of the population of the quarter) were studied. The attack rate was 10%. Data analysis noted that communication of the fantasy of the outbreak of scabies facilitated self-diagnosis and even diagnosis by health professionals. CONCLUSIONS: Given the frequency and the social and health implications of this kind of somatomorphic disorder, both in the developed countries and those "on the road to development", clinical researchers and epidemiologists should not wait to pose the possibility of hysteria until after the "organic" aetiology of an epidemic outbreak has been completely discounted. The second series of conclusions points towards the incorrectness of defining all these outbreaks as mass hysterical disorders. In reality, we should be thinking, more openly and in a more scientifically modern way, of epidemic somatomorphic disorders of various kinds. The outbreak described in the current study could be referred to as the hypochondriform variety of outbreak, whereas those described elsewhere by the same team could be understood as the conversion variety.

Adolescent↗
PubMed2002

Role of family history and 5-HTTLPR polymorphism in female seasonal affective disorder patients with and without premenstrual dysphoric disorder.

Seasonal affective disorder (SAD) and premenstrual dysphoric disorder (PMDD) share many clinical features, and have been associated with brain serotonin dysfunction. Females with SAD frequently fulfil the diagnostic criteria for PMDD. A polymorphism in the serotonin transporter promoter gene (5-HTTLPR) has been associated with SAD. We investigated the role of family history and 5-HTTLPR in female SAD patients with and without PMDD. Forty-four SAD females with, and 43 SAD females without PMDD, were genotyped for 5-HTTLPR. Family history of affective disorders in first degree relatives was assessed. An association between the presence of PMDD and family history (P=0.0029) and 5-HTTLPR long/short allele-heterozygosity (P=0.033) was found in females with SAD. PMDD and SAD may share genetic vulnerability factors, one candidate gene being 5-HTTLPR. The elevated rate of affective disorders in relatives of patients with SAD and PMDD suggests higher genetic vulnerability in this subgroup when compared to patients with SAD alone.

Adult↗
PubMed2006

Diagnostic and measurement issues in the assessment of pediatric bipolar disorder: implications for understanding mood disorder across the life cycle.

The goal of this paper is to review assessment research of bipolar disorder in children and adolescents. The review addresses numerous themes: the benefits and costs of involving clinical judgment in the diagnostic process, particularly with regard to diagnosis and mood severity ratings; the validity of parent, teacher, and youth self-report of manic symptoms; how much cross-situational consistency is typically shown in mood and behavior; the extent to which a parent's mental health status influences their report of child behavior; how different measures compare in terms of detecting bipolar disorder, the challenges in comparing the performance of measures across research groups, and the leading candidates for research or clinical use; evidence-based strategies for interpreting measures as diagnostic aids; how test performance changes when a test is used in a new setting and what implications this has for research samples as well as clinical practice; the role of family history of mood disorder within an assessment framework; and the implications of assessment research for the understanding of phenomenology of bipolar disorder from a developmental framework.

Adolescent↗
PubMed2000

Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder.

This article describes the development and validation of a brief self-report scale for diagnosing anorexia nervosa, bulimia nervosa, and binge-eating disorder. Study 1 used a panel of eating-disorder experts and provided evidence for the content validity of this scale. Study 2 used data from female participants with and without eating disorders (N = 367) and suggested that the diagnoses from this scale possessed temporal reliability (mean kappa = .80) and criterion validity (with interview diagnoses; mean kappa = .83). In support of convergent validity, individuals with eating disorders identified by this scale showed elevations on validated measures of eating disturbances. The overall symptom composite also showed test-retest reliability (r = .87), internal consistency (mean alpha = .89), and convergent validity with extant eating-pathology scales. Results implied that this scale was reliable and valid in this investigation and that it may be useful for clinical and research applications.

Adolescent↗
PubMed2002

Effects of paternal drinking, conduct disorder and childhood home environment on the development of alcohol use disorders in a Thai population.

AIMS: To identify influences on the development of alcohol use disorders in a Thai population, particularly parental drinking and childhood environment. DESIGN: Case-control study. SETTING: A university hospital, a regional hospital and a community hospital in southern Thailand. PARTICIPANTS: Ninety-one alcohol-dependents and 77 hazardous/harmful drinkers were recruited as cases and 144 non- or infrequent drinkers as controls. MEASUREMENTS: Data on parental drinking, family demographic characteristics, family activities, parental disciplinary practice, early religious life and conduct disorder were obtained using a structured interview questionnaire. The main outcome measure was the subject's classification as alcohol-dependent, hazardous/harmful drinker or non-/infrequent drinker. FINDINGS: A significant relationship was found between having a drinking father and the occurrence of hazardous/harmful drinking or alcohol dependence in the subjects. Childhood factors (conduct disorder and having been a temple boy, relative probability ratios, RPRs and 95% CI: 6.39, 2.81-14.55 and 2.21, 1.19-4.08, respectively) also significantly predicted alcohol dependence, while perceived poverty and ethnic alienation was reported less frequently by hazardous/harmful drinkers and alcohol-dependents (RPRs and 95% CIs=0.34, 0.19-0.62 and 0.59, 0.38-0.93, respectively) than the controls. The relative probability ratio for the effect of the father's infrequent drinking on the son's alcohol dependence was 2.92 (95% CI=1.42-6.02) and for the father's heavy or dependent drinking 2.84 (95% CI=1.31-6.15). CONCLUSIONS: Being exposed to a light-drinking father increases the risk of a son's alcohol use disorders exhibited either as hazardous-harmful or dependent drinking. However, exposure to a heavy- or dependent-drinking father is associated more uniquely with an increased risk of his son being alcohol-dependent. The extent to which this is seen in other cultures is worthy of exploration.

Adolescent↗
PubMed2000

A case report of comorbid eating disorder and factitious disorder.

A review of the literature on comorbid eating disorder and factitious disorder reveals that they are very rare. In this report the authors present the case of a 26-year-old Japanese female, who, in the midst of treatment for eating disorder, was found to be fabricating her physical symptoms, by injecting unclean water into her intravenous bottle. As a result she was diagnosed with factitious disorder.

Adult↗
PubMedDate not supplied

The paraphilia-related disorders: an empirical investigation of nonparaphilic hypersexuality disorders in outpatient males.

The frequency distribution of nonparaphilic hypersexual behaviors was investigated in an outpatient sample of 206 consecutively evaluated males seeking help for sexual impulsivity disorders (SIDs), either paraphilia-related disorders (PRD; n = 63) or paraphilias (PA; n = 143). Paraphilia-related disorders associated with help-seeking behaviors included compulsive masturbation (sample prevalence, 69%), protracted heterosexual or homosexual promiscuity (51%), pornography dependence (50%), telephone-sex dependence (24%), and severe sexual desire incompatibility (12%). Eighty-six percent of the PA sample reported at least one lifetime PRD. The subgroup of males with both PAs and lifetime PRDs (n = 123) self-reported the greatest number of lifetime SIDs, the highest incidence of physical and sexual abuse, the fewest years of completed education, and the highest likelihood of current unemployment or disability. As well, the subgroup of males with PAs but no lifetime PRDs (n = 20) self-reported the fewest lifetime SIDs; this subgroup was not statistically different from the PRD group on these aforementioned variables. These data suggest that social disadvantage, as assessed in this sample, is associated with the cumulative incidence of SIDs but not necessarily with the diathesis to develop paraphilic disorders.

Adult↗
PubMed1999

The influence of traumatic brain injury on acute stress disorder and post-traumatic stress disorder following motor vehicle accidents.

This study compared the acute stress disorder and post-traumatic stress disorder (PTSD) symptom profiles in motor vehicle accident survivors who sustained a mild traumatic brain injury (MTBI) or no TBI. Consecutive adult patients who sustained a MTBI (n = 79) and no TBI (n = 92) were assessed for acute stress disorder within 1 month of their trauma and reassessed for PTSD (MTBI: n = 63; non-TBI; n = 72) 6-months post-trauma. Comparable rates of acute stress disorder and PTSD were reported in MTBI and non-TBI patients. Intrusive memories and fear and helplessness in response to the trauma were reported less frequently by MTBI than non-TBI patients at the acute phase. Six-months post-trauma fewer MTBI patients than non-TBI reported fear and helplessness in response to the trauma. These findings suggest that, whereas impaired consciousness at the time of a trauma may reduce the frequency of traumatic memories in the initial month post-trauma, MTBI does not result in a different profile of longer-term PTSD.

Accidents, Traffic↗
PubMed1998

At risk for language disorders? Correlates and course of language disorders in preschool children born at risk.

The language abilities of 324 children of an at-risk population were investigated at age 2 and 4.5 y. Modified research criteria of the ICD-10 for specific developmental disorders of speech and language were applied. Frequencies between 4% and 7%, depending on age and type of disorder, were diagnosed among children whose performance on the language measure was only 1 instead of ICD-10's 2 SD below group mean, but the discrepancy measure of 1 SD between non-verbal language score and language measure was retained. Psychosocial aspects of a child's environment proved to be better predictors of later language disorders than obstetric complications. Stability of specific language disorders was on the whole fairly low, but children who perform below age level on language measures remained at risk. Gender differences are almost compensated by the age 4.5 y.

Child, Preschool↗
PubMed2004

Elderly patients with major depressive disorder and delusional disorder are at increased risk of subsequent dementia.

All the patients (n=150) admitted to psychogeriatric clinic during a 1-year period were followed up until their death or for 10 years. Fifteen of these were lost during the 10-year follow-up. Thus, follow-up data were available for 135 patients. Twenty-four of these fulfilled at baseline the DSM-III-R diagnostic criteria of major depressive disorder and 18 of delusional disorder after careful medical examination and neuropsychological tests to eliminate organic causes. In the follow-up, the diagnoses were gathered from the death certificates of those patients who died during the 10-year period and all of the patients alive at the end of the study were interviewed to assess their mental state. Six out of the 24 (25%) patients with major depressive and five out of 18 (28%) patients with delusional disorder developed clear organic dementia before death or within 10 years (mean follow-up time 6.7 years). This is approximately double the expected incidence in the general population of that age. The gender, age at index admission, the baseline Mini Mental State Examination scores or findings in computer tomography did not contribute to the risk of dementia. Psychogeriatric patients admitted due to major mental disorder may have an increased risk of organic dementia in the near future.

Aged↗