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PubMed2003

Interrater agreement for the schedule for affective disorders and schizophrenia epidemiological version for school-age children (K-SADS-E).

OBJECTIVE: The main objective of this study was to assess the interrater agreement for the Schedule for Affective Disorders and Schizophrenia Epidemiological version for School-Age Children (K-SADS-E). METHODS: Four interviewers being trained with the K-SADS-E scored independently 29 videotaped interviews performed with psychiatric outpatients in the ADHD Outpatient Clinic at Hospital de Clínicas de Porto Alegre. Interrater agreement analysis was performed using the kappa coefficient (k). RESULTS: Kappa coefficients were.93 (p<.001) for affective disorders,.9 (p<.001) for anxiety disorders,.94 (p<.001) for attention-deficit/hyperactivity disorders and disruptive behavior disorders. CONCLUSION: These findings suggest an excellent interrater agreement for the diagnosis of several mental disorders in childhood and adolescence by the Brazilian Portuguese version of the K-SADS-E.

Child↗

PubMedDate not supplied

[Occurrence of congenital malformations in dead fetuses and neonates autopsied between 1991 and 2001 at the Institute of Pathology and Histology in Novi Sad].

INTRODUCTION: Congenital malformations are morphological developmental anomalies visible during clinical examination or autopsy (in case of death, stillborn or abortion). Their incidence in human population is estimated to be between 5-10%, and perinatal mortality rate varies from 20-25%. MATERIAL AND METHODS: The research was conducted at the Department of Pathology and Histology and at the Department of Obstetrics and Gynecology in Novi Sad. We analyzed autopsy reports of newborns (under 28 days old), stillborns and miscarried fetuses in 1991 and 2001. Data on type and incidence of malformations in 1991 and 2001 were compared in order to determine statistically significant differences. RESULTS: Autopsy reports for 1991 revealed malformations in 21 cases, whereas autopsies were performed in 103 fetuses and newborns. The total number of deliveries at the Department of Obstetrics and Gynecology in Novi Sad was 6,160. Autopsy reports for 2001 revealed malformations in 33 cases, and autopsies were performed in 126 fetuses and newborns. The total number of deliveries at the Department of Obstetrics and Gynecology in Novi Sad was 6,101. Comparison regarding incidence of malformations in 1991 and 2001, showed no statistically significant difference. DISCUSSION: Congenital malformations are the most important cause of prenatal and perinatal mortality and morbidity. One reason for that is better treatment of other diseases, but on the other side, there are more toxic materials in human environment. CONCLUSION: It is concluded that the incidence of congenital malformations in mortality of fetuses and newborns is high (20.39% in 1991, and 26.19% in 2001). We can also point to increase of central nervous system malformations in comparison with malformations of other organ systems.

Abnormalities, Multiple↗

PubMed1995

Maternal drug use, personality, child-rearing practices, and toddlers' sadness.

We investigated the influence of maternal drug use/personality attributes and child-rearing on 2-yr-olds' sadness. The sample consisted of 62 girls and 53 boys and their mothers. Analysis showed maternal parenting practices served as a mediator for the effect of the mothers' personalities on the children's feelings of sadness. Moreover, the mothers' personality traits of low interpersonal difficulty, anxiety, and depression were important in enhancing low maternal alcohol or illegal drug use, leading to less sadness in the children.

Child Rearing↗

PubMed2006

Distinguishing bipolar major depression from unipolar major depression with the screening assessment of depression-polarity (SAD-P).

BACKGROUND: Patients with bipolar I or II major depression are often misdiagnosed with unipolar major depression. The goal of this study was to develop and validate a brief instrument to screen for bipolar disorder in patients actively ill with major depression. METHOD: The sample consisted of subjects who enrolled in the National Institute of Mental Health-Collaborative Program on the Psychobiology of Depression-Clinical Studies from 1978 to 1981 during an episode of major depression and included 91 subjects with bipolar I major depression, 52 with bipolar II major depression, and 338 with unipolar major depression diagnosed according to Research Diagnostic Criteria. Most of the subjects were inpatients at the time of enrollment, and subjects were prospectively followed for up to 20 years. In order to create, test, and cross-validate the screening instrument, a split-sample data analytic procedure was performed. This procedure yielded 3 groups of subjects: the bipolar I index sample, the bipolar I cross-validation sample, and the bipolar II cross-validation sample. Each group included subjects with bipolar major depression and subjects with unipolar major depression. Within the bipolar I index sample, subjects with bipolar I major depression at study intake were compared with subjects with unipolar major depression at study intake on a pool of 59 sociodemographic and clinical candidate variables. The 3 variables showing the greatest disparity between bipolar I subjects and unipolar subjects were selected for the screen, the Screening Assessment of Depression-Polarity (SAD-P). The operating characteristics of the SAD-P were then examined within the bipolar I index sample, bipolar I cross-validation sample, and bipolar II cross-validation sample. RESULTS: The items selected for the screening instrument were (1) presence of delusions during the current episode of major depression, (2) number of prior episodes of major depression, and (3) family history of major depression or mania. The screen identified bipolar major depression with a sensitivity of 0.82 in the bipolar I index sample, 0.72 in the bipolar I cross-validation sample, and 0.58 in the bipolar II cross-validation sample. With regard to misclassifying subjects with unipolar major depression, the screen provided a positive predictive value of 0.36 in the bipolar I index sample, 0.29 in the bipolar I cross-validation sample, and 0.27 in the bipolar II cross-validation sample. CONCLUSION: We suggest using the 3-item SAD-P as a preliminary screen for bipolar disorder in patients who present with an active episode of major depression.

Adult↗

PubMed2001

Anger and advancement versus sadness and subjugation: the effect of negative emotion expressions on social status conferral.

Four studies examined status conferral (decisions about who should be granted status). The studies show that people confer more status to targets who express anger than to targets who express sadness. In the 1st study, participants supported President Clinton more when they viewed him expressing anger about the Monica Lewinsky scandal than when they saw him expressing sadness about the scandal. This effect was replicated with an unknown politician in Study 2. The 3rd study showed that status conferral in a company was correlated with peers' ratings of the workers' anger. In the final study, participants assigned a higher status position and a higher salary to a job candidate who described himself as angry as opposed to sad. Furthermore, Studies 2-4 showed that anger expressions created the impression that the expresser was competent and that these perceptions mediated the relationship between emotional expressions and status conferral.

Adult↗

PubMedDate not supplied

[Menopause in women in Novi Sad].

INTRODUCTION: This study deals with the occurrence of menopause in women of Novi Sad during 1996 and 1997 in ambulatory-care services for women of the Health Center Novi Sad. MATERIAL AND METHODS: This retrospective study included 640 women, 42-82 years of age. RESULTS AND DISCUSSION: The mean age at menopause is 49.05 +/- 3.51 years, and median 50.05 +/- 0.17. Menopause in women under the age of 40 has been referred to as premature and it occurred in 16 women (2.49%). In regard to a longer time interval, in 585 women (91.41%) menopause occurred between 45-55 years of age. In our previous study of menarche in Novi Sad, we found that the mean age was 13.07 +/- 1.1 whereas the average reproductive period lasted 35.98 years. CONCLUSION: In order to perform relevant comparison of data in regard to menopause, it is necessary to establish a unified methodology. Foundation of Counseling Centers for menopausal women is desirable in the aim of better understanding their numerous problems during premenopausal and postmenopausal periods.

Adult↗

PubMedDate not supplied

[Changes of sleep quality and mood disorders under the influence of phototherapy in patients with seasonal affective disorders SAD].

UNLABELLED: Major depression, seasonal pattern (seasonal affective disorder SAD) characterize the winter recurrence depressive episodes with remission of symptoms in spring and summer. Patients with winter depression report hypersomnia, fatigue, loss of energy, carbohydrate craving, appetite and weight gain. AIM: The aim of this study was to assess the effect of phototherapy on the quality of sleep parameters and subjective estimation of mood disorders in patients with seasonal affective disorders. METHOD: The investigated group consisted of 17 patients with SAD (15 female, 2 male) aged 18-64 (mean 38+/-12) years. Phototherapy (bright light therapy) was applied for 14 days, everyday morning--30 minutes, between 6.00 to 10.00--exposition to light of about 10,000 lux intensity. Polysomnogram (sleep EEG) was recorded before and after treatment. RESULTS: After phototherapy patients reported a significant mood improvement (57%) measured by the Seasonal Pattern Assessment Questionnaire. Sleep investigation showed: increased sleep efficiency, decreased sleep latency, decreased slow wave sleep latency and increased of sleep spindles in the first hour of sleep. CONCLUSIONS: Research confirms that phototherapy is an effective method of treatment of choice for patients with SAD. The result indicates that phototherapy markedly improved mood and sleep quality.

Adult↗

PubMedDate not supplied

[Interrater reliability of the Spanish version of Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL)].

INTRODUCTION: The K-SADS-PL diagnostic interview is useful for the cross-sectional and longitudinal evaluation of psychopathology in children and adolescents. The objective of this article was to describe the interrater reliability of the Spanish version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime version (K-SADS-PL). METHOD: The interview was translated, back-translated and adapted to Spanish. Forty psychiatric outpatients (aged 6 to 17 years) were evaluated. The interviews were videotaped and scored by three independent raters. All of them included both the child's and parent's interview. Interrater reliability was obtained for affective, anxiety and conduct disorders using the Cohen's kappa coefficient. RESULTS: Kappa coefficients were between the good and excellent range for present and lifetime disorders (major depressive disorder kappa = 0.76, any anxiety disorder kappa = 0.84, attention deficit hyperactivity disorder kappa = 0.91 and conduct disorder, kappa = 1). CONCLUSION: The Spanish version of the K-SADS-PL is a reliable instrument for the assessment of psychopathology in children and adolescents.

Adolescent↗

PubMed1996

[Epidemiologic analysis of emergency conditions in the diabetic population as observed in the work of emergency medical services in the area of Novi Sad].

The authors analyzed a group of 236 diabetic patients in the municipality of Novi Sad who asked for the help of the Emergency medical service of the Health Center "Novi Sad". A special emergency team which manages vitally endangered patients acted on their requests. After anamnestic data were gathered and physical examination done, electrocardiographic monitoring was performed. Glycemia was determined from semiquantitative analysis of the capillary blood, while glycosuria and acetonuria from urine. In regard to these patients the gathered results point to predominant presence of chronic, degenerative complications, especially of the cardiovascular apparatus. However, this was the case due to the fact that these were elderly persons (62.78 +/- 12.21 years of age) suffering from diabetes mellitus for about 8 years, which is sufficient for development of chronic, degenerative complications of diabetes. Although the studied group was metabolically unregulated (glycemia: 18.13 +/- 5.43 mmol/l, glycosuria positive in 4.54%, acetonuria in 2.20% of patients) there were no elements for diagnosis of some acute metabolic complications. The decrease of acute metabolic complications may be connected to better organization of the antidiabetic service in the municipality of Novi Sad. It is especially important to point out the occurrence of serious hypoglycemias caused by oral hypoglycemics (64.28%) which require, according to contemporary approach, a long-term hospital treatment.

Adolescent↗

PubMed1996

Display rules for anger, sadness, and pain: it depends on who is watching.

This study examined factors that may influence children's decisions to control or express their emotions including type of emotion (anger, sadness, physical pain), type of audience (mother, father, peer, alone), age, and sex. Children's reported use of display rules, reasons for their decisions, and reported method of expression were examined. Subjects were 32 boys and 32 girls in each of the first (M = 7.25 years old), third (M = 9.33 years old), and fifth grades (M = 11.75 years old). Regardless of the type of emotion experienced, children reported controlling their expression of emotion significantly more in the presence of peers than when they were with either their mother or father or when they were alone. Younger children reported expressing sadness and anger significantly more often than did older children, and girls were more likely than boys to report expressing sadness and pain. Children's primary reason for controlling their emotional expressions was the expectation of a negative interpersonal interaction following disclosure.

Anger↗

PubMed1997

Psychometric properties of the K-SADS-PL in an Israeli adolescent clinical population.

The main objective of this study was to evaluate the reliability and validity of the Schedule for Affective-Disorders and Schizophrenia for School-Aged Children Lifetime Version (K-SADS-PL) in an Israeli sample. Fifty-seven adolescent admissions to two psychiatric units were evaluated with the Hebrew translation of the K-SADS-PL. Inter-rater and mother-child agreement were evaluated for diagnoses, and 31 affective symptoms. K-SADS diagnoses were also compared with two-month unit evaluation diagnoses as a measure of consensual validity. The reliability of assessing psychosocial functioning was also examined. Reliability and validity of diagnoses were good to excellent. Mother-child agreement fared less well on all measures. The use of semi-structured interviews and DSM-IV criteria in an Israeli adolescent psychiatric setting are discussed.

Adolescent↗

PubMedDate not supplied

[The role and achievements in clinical pathophysiology in the Novi Sad region].

Nowadays, clinical pathophysiology in our conditions is a firmly founded branch of medicine which has had an important role in the improvement of diagnostics, scientific and researching work and all forms and levels of education at the Medical Faculty in Novi Sad. The value and usefulness of clinical pathophysiology has been particularly important in the team work within the Clinical center in Novi Sad in the time it was organized as an unique health care institution. Pathological physiology was ready to take over all its tasks foreseen within this type of organization, and through further constructional and equipment improvements it could soon achieve European standards in its work. Professionally unjustified decision for abandoning the concept of Clinical center in Novi Sad has greatly affected health care service in general. Twenty years of work on the improvement of pathophysiology have been thrown away and its important role in the first-class treatment of the patients has been certainly discredited but not denied. If health care service happens to be reorganized following the model of developed countries there will be a chance for the revitalization of clinical pathophysiology and finalization of its development to fulfill the interests of patients for obtaining the high quality treatment in our conditions.

Health Services↗

PubMed2004

Attenuation of the neural response to sad faces in major depression by antidepressant treatment: a prospective, event-related functional magnetic resonance imaging study.

BACKGROUND: Depression is associated with interpersonal difficulties related to abnormalities in affective facial processing. OBJECTIVES: To map brain systems activated by sad facial affect processing in patients with depression and to identify brain functional correlates of antidepressant treatment and symptomatic response. DESIGN: Two groups underwent scanning twice using functional magnetic resonance imaging (fMRI) during an 8-week period. The event-related fMRI paradigm entailed incidental affect recognition of facial stimuli morphed to express discriminable intensities of sadness. SETTING: Participants were recruited by advertisement from the local population; depressed subjects were treated as outpatients. PATIENTS AND OTHER PARTICIPANTS: We matched 19 medication-free, acutely symptomatic patients satisfying DSM-IV criteria for unipolar major depressive disorder by age, sex, and IQ with 19 healthy volunteers. Intervention After the baseline assessment, patients received fluoxetine hydrochloride, 20 mg/d, for 8 weeks. MAIN OUTCOME MEASURES: Average activation (capacity) and differential response to variable affective intensity (dynamic range) were estimated in each fMRI time series. We used analysis of variance to identify brain regions that demonstrated a main effect of group (depressed vs healthy subjects) and a group x time interaction (attributable to antidepressant treatment). Change in brain activation associated with reduction of depressive symptoms in the patient group was identified by means of regression analysis. Permutation tests were used for inference. RESULTS: Over time, depressed subjects showed reduced capacity for activation in the left amygdala, ventral striatum, and frontoparietal cortex and a negatively correlated increase of dynamic range in the prefrontal cortex. Symptomatic improvement was associated with reduction of dynamic range in the pregenual cingulate cortex, ventral striatum, and cerebellum. CONCLUSIONS: Antidepressant treatment reduces left limbic, subcortical, and neocortical capacity for activation in depressed subjects and increases the dynamic range of the left prefrontal cortex. Changes in anterior cingulate function associated with symptomatic improvement indicate that fMRI may be a useful surrogate marker of antidepressant treatment response.

Affect↗

PubMed2000

Gender differences in regional cerebral activity during sadness.

Functional magnetic resonance imaging and echo-planar-imaging were used to investigate affect related gender differences in regional cerebral activity. The experiment was conducted using a standardized mood induction procedure. Blood-oxygen-level-dependent effect was measured in 13 male and 13 female healthy subjects, during both moods of happiness and sadness, respectively. Parallel to earlier neuroimaging findings, our results show brain activity in the amygdala of males during negative affect. Females failed to demonstrate a similar activation pattern despite matched subjective ratings of negative affect to males. Results point to differential regional cerebral correlates of emotional experience in males and females, which is suggestive of a more focal and subcortical processing of sadness in men.

Adult↗

PubMed1991

Poetic transformations of Yolmo 'sadness'.

One way in which Yolmo Sherpa of Helambu, Nepal, come to terms with loss is to sing of it. The paper seeks to show how one Yolmo 'song of sadness' works to express, evoke and assuage sentiments of funerary grief. Yet to best explore the transformative poetics of the song, we must trace its semantic links to other songs and situations, and so develop a contextual understanding of the experiential contours of Yolmo 'sadness,' the local ethos of emotional avoidance and restraint, and the sociopolitical nature of emotional distress in the Helambu valley. The findings of this analysis lead the author to argue, in contrast with recent ethnographies which treat discourses on emotions as rhetorical strategies rather than as reflections of personal or communal experience, that we need an integrative approach which focuses on the relationship between language and experience, politics and felt emotion.

Cultural Characteristics↗

PubMed1989

Mechanism of action of HI-6 on soman inhibition of acetylcholinesterase in preparations of rat and human skeletal muscle; comparison to SAD-128 and PAM-2.

HI-6 is presently considered the most potent oxime antidote against soman poisoning in mice, rats, dogs and monkeys. However, it is still an open question whether efficiency of HI-6, observed in experimental animals, can be extrapolated to soman intoxicated humans. In this paper efficiency of HI-6 and possible mechanisms of action were compared in rat and human fresh muscle preparations. In rat muscle, about 50% of control AChE activity could be recovered by both therapeutic (5 min after soman) and prophylactic (5 min before soman) application of HI-6. On the other hand, in human muscle therapeutic treatment restored only 5%, while prophylactic application of HI-6 again resulted in about 50% recovery of control AChE activity. As revealed by comparison of the prophylactic effects of HI-6 and the non-oxime bispyridinium compound SAD-128, competitive inhibition of AChE plays a minor role as a protective mechanism. Immediate reactivation of rapidly aging human AChE must therefore be instituted for successful protective treatment by HI-6. Retardation of aging, a direct effect of SAD-128, was roughly estimated to improve reactivation by HI-6 for about 10% of control AChE activity of the human muscle. PAM-2 proved completely inefficient as a therapeutic and as a prophylactic agent on both rat and human muscle preparations.

Acetylcholinesterase↗

PubMed1986

Schedule for Affective Disorders and Schizophrenia--Lifetime Version modified for the study of anxiety disorders (SADS-LA): rationale and conceptual development.

The SADS-LA, a modification of the Lifetime Version of the Schedule for Affective Disorders and Schizophrenia, was designed specifically for studies requiring detailed lifetime information on anxiety disorders, symptoms and traits. This article focuses on current difficulties in assessing and conceptualizing anxiety disorders, as addressed in the SADS-LA. The following topics are discussed: conceptual differentiation of certain anxiety disorders; sub-threshold symptoms and syndromes; the relationship between affective and anxiety syndromes; the residual category, Generalized Anxiety Disorder. We emphasize a lifetime sequential approach to diagnostic assessment for a comprehensive understanding of the interrelationships between mental disorders.

Agoraphobia↗

PubMed1989

Perceptual asymmetry for happy-sad chimeric faces: effects of mood.

Happy-sad chimeric face drawings were viewed in free vision by normal subjects. A significant and reliable perceiver bias toward the left hemiface when judging facial expression was found in right-handers whereas no consistent bias was found in non-right handers. This bias tended to be more pronounced in females. Subjects' current mood influenced their choice of facial affect but not their perceptual bias. In a further experiment, subjects were tested during induced elation and once more during induced depression. Again, though these moods increased the number of happy and sad choices respectively, the magnitude of the left hemifacial bias remained unchanged. The results are best explained by stable properties of the right hemisphere rather than arousal mechanisms. The implications of these findings are discussed in the light of the proposed hemispheric asymmetries in emotional perception and the possible lateralized effects of depressed mood on cognition.

Adult↗