Do the Spontaneity and Anger and Aggression subscales of the Ward Atmosphere Scale form homogeneous dimensions? A cross‐sectional study of 54 wards for psychotic patients

OBJECTIVE: The main aim of this study was to examine the psychometric properties of the two subscales of the Ward Atmosphere Scale (WAS), Spontaneity and Anger and Aggression, which measure the level of expressed emotion. We wanted to examine if the items measuring attitude and behavior form different dimensions. METHOD: A total of 550 patients in 54 different psychiatric wards for psychotic patients completed the WAS and the Good Milieu Index. RESULTS: Removing, respectively, four items from the Spontaneity subscale, three items from the Anger and Aggression subscale the psychometric properties improved. The two revised subscales were named Spontaneous Behavior (SB) and Angry, Aggressive Behavior (AAB). A new 'attitude' subscale, comprising three items, was named Staff Attitude to Expressed Feelings (SAEF). CONCLUSION: For patients the attitude and behavior items seem to form separate dimensions. The three subscales examined are probably of central importance for patient satisfaction.     

Can general practice help address youth mental health? A retrospective cross‐sectional study in Dublin's south inner city

Aims: With general practice potentially having an important role in early intervention of mental and substance use disorders among young people, we aim to explore this issue by determining the prevalence of psychological problems and general practice/health service utilization among young people attending general practice. Methods: A retrospective cross‐sectional study of patients attending three general practices in Dublin city. Results: Among a sample of young people (mostly women, 44% general medical services (GMS) eligible), we observed considerable contact with general practice, both lifetime and for the 2 years of the study. The mean consultation rate was 3.9 consultations in 2 years and psychosocial issues (most commonly stress/anxiety and depression) were documented in 35% of cases. Identification of psychosocial issues was associated with GMS eligibility, three or more doctor consultations, and documentation of smoking and drinking status. Conclusions: Psychosocial issues are common among young people attending general practice and more work on their epidemiology and further identification in general practice are advocated.     

Do personality traits predict the occurrence of Alzheimer's disease?

OBJECTIVE: To identify specific premorbid personality traits in patients with Alzheimer's disease (AD). DESIGN: A prospective case-control study. SETTING: A memory clinic of a department of geriatric medicine in a teaching hospital. PATIENTS: Fifty-six consecutive patients with probable AD. Sixty-five controls with Parkinson's disease (PD). MEASURES: Premorbid personality traits were assessed using the relative rating version of the Munich Personality Test (MPT). RESULTS: The AD patients showed higher neuroticism than the controls with PD (p=0.013). In comparison with MPT normative values for psychiatric inpatients, the AD patients scored significantly (p<0.05) lower on neuroticism and higher on frustration tolerance and rigidity. CONCLUSION: Our results support the assumption of specific premorbid characteristics in AD patients, ie increased neuroticism and rigidity. More research is needed to confirm the existence of typical premorbid personality traits in AD.     

Is there a relationship between chocolate consumption and symptoms of depression? A cross‐sectional survey of 13,626 US adults

Objective: To examine associations between chocolate consumption and depressive symptoms in a large, representative sample of US adults. Methods: The data were from 13,626 adults (≥20 years) participating in the National Health and Nutrition Examination Survey between 2007–08 and 2013–14. Daily chocolate consumption was derived from two 24‐hr dietary recalls. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ‐9), with scores ≥10 indicating the presence of clinically relevant symptoms. We used multivariable logistic regression to test associations of chocolate consumption (no chocolate, non‐dark chocolate, dark chocolate) and amount of chocolate consumption (grams/day, in quartiles) with clinically relevant depressive symptoms. Adults with diabetes were excluded and models controlled for relevant sociodemographic, lifestyle, health‐related, and dietary covariates. Results: Overall, 11.1% of the population reported any chocolate consumption, with 1.4% reporting dark chocolate consumption. Although non‐dark chocolate consumption was not significantly associated with clinically relevant depressive symptoms, significantly lower odds of clinically relevant depressive symptoms (OR = 0.30, 95%CI 0.21–0.72) were observed among those who reported consuming dark chocolate. Analyses stratified by the amount of chocolate consumption showed participants reporting chocolate consumption in the highest quartile (104–454 g/day) had 57% lower odds of depressive symptoms than those who reported no chocolate consumption (OR = 0.43, 95%CI 0.19–0.96) after adjusting for dark chocolate consumption. Conclusions: These results provide some evidence that consumption of chocolate, particularly dark chocolate, may be associated with reduced odds of clinically relevant depressive symptoms. Further research capturing long‐term chocolate consumption and using a longitudinal design are required to confirm these findings and clarify the direction of causation.     

Are personality traits of juvenile myoclonic epilepsy related to frontal lobe dysfunctions? A proton MRS study

Purpose:   Personality traits characterized by emotional instability and immaturity, unsteadiness, lack of discipline, hedonism, frequent and rapid mood changes, and indifference toward one's disease have been associated with patients who have juvenile myoclonic epilepsy (JME). Literature data demonstrate worse seizure control and more psychosocial dysfunctions among patients with JME who have those traits. In this controlled study we performed a correlation analysis of psychiatric scores with magnetic resonance spectroscopy (MRS) values across JME patients, aiming to verify the existence of a possible relation between frontal lobe dysfunction and the prevalence of personality disorders (PDs) in JME.
Methods:   Sixteen JME patients with cluster B PDs, 41 JME patients without any psychiatric disorder, and 30 healthy controls were submitted to a psychiatric evaluation and to a quantitative multivoxel MRS of thalamus; insula; cingulate gyrus; striatum; and frontal, parietal, and occipital lobes. Groups were homogeneous according to age, gender, and manual dominance. Psychiatric evaluation was performed through the Scheduled Clinical Interview for DSM-IV, Axis I and II (SCID I and II, respectively).
Results:   A significant reduction of N -acetyl-aspartate over creatinine (NAA/Cr) ratio was observed mainly in the left frontal lobe in the JME and PD group. In addition, a significant increase in the glutamate–glutamine over creatinine GLX/Cr ratio was also observed in this referred region in the same group.
Discussion:   These data support the hypothesis that PDs in JME could represent neuronal dysfunction and possibly a more severe form of this epileptic syndrome.     

The distribution of psychopathy among a household population: categorical or dimensional?

Objective  

The study aimed to examine the distribution of psychopathic traits in a representative household population to identify whether a transition point is reached on a continuum of psychopathy to indicate a ‘disease’ or categorical entity.     

Is there a relationship between elderly suicide rates and smoking? A cross‐national study

BACKGROUND: An independent relationship between smoking cigarettes and completed suicides has been reported in several cohort and case-control studies of younger subjects, but this relationship has rarely been examined in the elderly. METHODS: The relationship between the prevalence of smoking in males and females and suicide rates in males and females in the age-bands 65-74 years and 75 + years was examined using national-level aggregate data from the World Health Organisation and the United Nations Development Programme websites. In addition to univariate analysis, multivariate analysis were conducted to ascertain an independent relationship between the prevalence of smoking and elderly suicide rates. RESULTS: The main findings were: (i) on univariate analysis, the prevalence of smoking in males was positively correlated with suicide rates in males aged 65-74 years and males aged 75 + years, but this relationship was absent in females and (ii) on multivariate analysis there was no independent relationship between the prevalence of smoking in males and suicide rates in males in both the elderly age-bands. CONCLUSIONS: There is a case for examination of the relationship between smoking and elderly suicides in individual-level cohort or case-control studies because of the potential methodological difficulties in cross-national studies using national- level aggregate data, paucity of cohort or case-control studies at an individual-level in the elderly, and the observation of an independent relationship between smoking and completed suicides in individual-level cohort and case-control studies in younger age groups.     

Is MAO‐B activity in platelets associated with the occurrence of suicidality and behavioural personality traits in depressed patients?

Objective: Low platelet monoaminoxidase B (MAO‐B) activity has been associated with various forms of impulsive behaviour and suicidality. The present study investigated the relationship between MAO‐B activity in platelets and aspects of suicidality in depressed patients and controls. Method: In 87 patients with affective spectrum disorders (58% suffering from a major depressive episode – MDE) the potential association between platelet MAO‐B activity and suicidality was examined. Fifty‐nine of the patients had committed suicide attempt recently (SA –‘suicide attempters’), 28 patients were acutely depressed without having shown suicidal thoughts or suicidal behaviour in the past (NA –‘non‐suicide attempters’). Results: The SA and NA were comparable as to their diagnoses and general demographic and psychopathological parameters. MAO‐B activity did not differ between SA and NA. No systematic correlations existed between MAO‐B activity and any dimensions of suicidal behaviour or psychopathology. As a single finding only a weak positive association of higher MAO‐B activity in SA with a fatal intention of the SA was observed. Conclusion: Our findings do not support a consistent association of platelet MAO‐B activity and suicidal behaviour in general, but specific facts of suicidality might be associated.     

Can diffusion tensor imaging and tractography represent cross‐sectional area of lumbar multifidus in patients with LUMBAR spine disease?

Introduction: Cross‐sectional area (CSA) is a useful measurement to evaluate the lumbar multifidus, but it cannot reflect the morphological characteristics of the entire muscle. Recently, diffusion tensor imaging (DTI) and tractography (DTT) have been used to assess 3‐dimensional muscle structures both qualitatively and quantitatively. In this study we investigate the correlation between CSA and multifidus volume and the clinical utility of DTI and DTT. Methods: Twenty‐eight lumbar multifidi from 14 subjects with lumbar spine disease were analyzed. We conducted correlation analysis between CSA from conventional magnetic resonance images and DTI‐derived parameters, including muscle volume, fractional anisotropy (FA), and mean diffusivity (MD); we performed morphological assessment using DTT. Results: Multifidus volume had a strong positive correlation with CSA (r = 0.760, P < 0.001). Neither FA nor MD correlated with CSA. Multifidi spanning fewer vertebral segments were smaller in volume. Discussion: DTT can be a valuable tool to visualize and quantify the lumbar multifidus in lumbar spine disease. Muscle Nerve 57 : 200–205, 2018