C. Perris

Development of a new inventory for assessing memories of parental rearing behaviour

A new inventory (EMBU) to assess the own memories of parental rearing behaviour was constructed. EMBU is comprised of 81 questions grouped in 15 subscales and two additional questions referring to consistency and strictness of parental rearing behaviour to be answered in a four‐step scale for the father and for the mother separately. The subscales cover such rearing practices as for example overinvolvement, affection, overprotectiveness, guilt engendering, rejection.

Pain as a symptom in depressive disorders: I. Relationship to diagnostic subgroup and depressive symptomatology.

Abstract The incidence of pain as a symptom in depressive disorders has been studied in a series of 161 depressed patients admitted to the Department of Psychiatry, Umeå University. 57% of the patients reported pain as a symptom. Female patients reported pain significantly more often than male patients and the patients with pain were found to be significantly older than those without. Despite the fact that patients with neurotic reactive depressions were significantly younger than the patients in the other diagnostic subgroups, they reported pain significantly more often than patients with other depressive disorders. Patients with pain were found to have significantly more muscular tension and more autonomic disturbances while no significant differences were found in items measuring sadness or inhibition‐retardation.

Biochemistry of the Augmenting-Reducing Response in Visual Evoked Potentials

The augmenting-reducing response in visual evoked potentials (VEP) has between shown to be a useful tool in psychiatric research. A series of studies has been devoted to the search for the biochemical basis of this phenomenon. An augmenter response in VEP is shown to be clearly related to low levels of endorphins, 5-HIAA and homovanillic acid in CSF and to low serum-dopamine-beta-hydroxylase activity, while no significant relationship was found with 4-hydroxy-3-methoxyphenylethylene glycol or tryptophan in CSF or MAO in thrombocytes. The results indicate that an augmenter response in VEP is related to low activity in the serotoninergic, dopaminergic and endophinergic pathways in CNS.

Cognitive therapy with schizophrenic patients

Cognitive therapy has emerged as a feasible and valuable complement to the treatment of patients suffering from a schizophrenic disorder. It can be carried out at various levels and with different goals in mind and its use is not in conflict with concomitant and strictly individualized medication. In the article some of the approaches most commonly used are pointed out and some of the results of various approaches are highlighted.

Enzymes related to biogenic amine metabololism and personality charateristics in depressed patients

Levels of the activity of enzyme systems involved in the synthesis and metabolism of biogenic amines have been linked in several reports in the literature with various psychopathological conditions and with variations in personality characteristics. In particular, significant negative correlations have been reported between levels of MAO‐activity and sensation seeking. In the present study levels of MA0 and DBH‐activity were investigated in a series of 30 depressed patients, admitted consecutively, who completed a new personality inventory, the KSP, assumed to measure relatively stable personality traits. Our findings appeared to be consistent with those of earlier authors in that the most pronounced significant (negative) correlation occurred between MAO‐activity levels and the monotony avoidance subscale of the KSP. This particular subscale is aimed precisely at measuring thrill‐seeking and bears a close relation to the Sensation Seeking Scale used by other authors. In addition a weak positive correlation was found between the same subscale and levels of DBH‐activity. Finally a weak negative correlation emerged between levels of MAO and the Guilt subscale of the KSP.

PERSONALITY PATTERNS IN PATIENTS WITH AFFECTIVE DISORDERS

In a previous report (Perris 1966) i t was shown that bipolar (manicdepressive) and unipolar depressive psychotics have different personality traits. The series comprised 108 patients (50 bipolar and 58 unipolar) who were studied with an abridged version of the Nyman-Marke Temperament Scale (NMTS: Nyman & Marke 1958) during a symptomfree interval. Bipolar patients showed higher scores in the ”substability” (syntony) variable, the unipolar ones, on the other hand, in the ”subvalidity” (psychasthenia) variable; the difference was independent of sex and age. Global personality evaluation by Angst (1966) gave results in line with the above-mentioned study and agrees, by and large, with results presented by Leonhard et al. (1962, 1963). In a recent careful investigation von Zerssen et al. (1968) came to the conclusion that unipolar patients frequently show psychasthenic and anancastic traits. Metcalfe (1968) suggested a tendency to repetitive worrying as well as a rigid attitude in recovered depressive patients; this also agrees with the opinion of Kielholz (1959) as regards patients classified as suffering from ”involutional melancholy”. There are a few studies concerned with the Maudsley Personality Inventory (MPI: Eysenck 1959) and depressive disorders (Astroim & Olander 1960, Wretmark et al. 1961, 1970, Coppen & Metcalfe 1965, Metcalfe 1968, Thelma et al. 1969, Kerr et al. 1970). Most of these studies have been concerned more with the influence of a depressive disorder on MPI scores than with possible differences between different groups of depressed patients. Changes in MPI scores were reported by all investigators in patients who improved or recovered. E-scores increased and N-scores decreased from the phase of illness to that of recovery both in patients diagnosed as ”endogenous” and ”reactive”. Astrom & Olander (1960) found on discharge higher E-scores in ”endogenous” than in ”reactive” patients, but no difference in N-scores. Kerr et al. (1970) among

NON-PSYCHOTIC DEPRESSIVE DISORDERS: A TEN YEAR FOLLOW-UP

While much work has been done in achieving a more extensive knowledge about the course and the prognosis of psychotic depressive syndromes, these aspects are still insufficiently explored where nonpsychotic depressive disorders are concerned. In a follow-up study of men admitted to a psychiatric ward five or ten years earlier, Forssman QJansson (1960) found that 92 per cent of the patients with reactive depression were symptom-free or at least capable of work at the time of re-ex am inat ion.

X. Mortality, Suicide and Life‐cycles

This report covers part of an investigation (Perris: 1966) concerned with a possible differential diagnosis between bipolar (manic-depressive) and unipolar recurrent depressive psychoses according to the classification of Leonhard (1959) and deals with a study of mortality rate and the incidence of suicide. Some details will also be given concerning the lifecycles of patients who died during the period of investigation. Investigations into mortality in depressive psychotics have appeared in the litterature: Pollock (1931), Malzberg (1934), Essen-Moller [1935), Schultz (1 949), Stenstedt (1 952, 1959), Kinkelin (1 954), Astrup e t al. (1959). The mortality in the series combining both bipolar and unipolar depressive patients has been found to be higher than in the normal population. Pollock Cop. cit.) found that 65 per cent of his large series of ))manicdepressive)) patients died before the age of 50. Stenstedt (1952) reports that the remaining mean expectation of life in manic-depressive patients is about 15 per cent lower than in the normal population. Astrup e t al. (op. cit.) found that the mortality in a group of treated manic-depressive patients was higher in males. This finding is confirmed by Lewis (1964) who states that the crude death rate in men is nine times and in women six times the corresponding rate for persons aged 16 or more in the general population. As was pointed out elsewhere: Perris & d’Elia (1964) it is probable that under the diagnosis of involutional melancholia have also been collected, among others, depressive psychoses which were to be considered as ))unipolar)) in the sense of Leonhard (op. cit.). In his series of ))involutional melancholia)), Stenstedt (1959) found that the remaining mean expectation of life was 42 per cent in the males and 26 per cent in the females lower than in the general population. Stenstedt, however, makes some reservations on these results.

AVERAGED EVOKED RESPONSES (AER) IN PATIENTS WITH AFFECTIVE DISORDERS

In recent years researchers’ interest in the functional differences between the two hemipheres of the brain has increased with the greater availability of research methods. This stream of research has permitted known clinical signs to be experimentally verified as well as reproduced and has .opened the way €or a closer knowledge of the functional differences between the dominant (DH) and the nondominant hemisphere (NDH). Even though attention has been mainly directed to the more or less complex neurological and neurophysiological functions, psychological and psychopathological aspects are increasingly beginning to be considered.

Cross-national generalizability of patterns of parental rearing behaviour: Invariance of EMBU dimensional representations of healthy subjects from Australia, Denmark, Hungary, Italy and The Netherlands

Abstract A psychometric study was carried out on Australian, Danish, Hungarian, Italian and Dutch non-patient samples examining cross-national invariance characteristics of dimensions of perceived parental rearing behaviour and attitudes as measured by the EMBU. Of the four primary factors identified previously with Dutch Ss, namely Rejection, Emotional Warmth, Overprotection and Favouring Subject, the first three were retrieved in a similar form in the Australian, Danish and Italian healthy Ss. Less satisfactory findings emerged in the Hungarian sample. Further analyses examining metric equivalence of the scales and the strength of the factors for each group indicated that it would be warranted to carry out future pattern and level comparisons between groups from the respective countries (except Hungary) on the three factors evidencing cross-national constancy. Higher order factor analyses of the corresponding scales produced identical two-factor compositions (Care and Protection) in the Australian, Danish and Italian groups when compared to the factorial composition of EMBU scales of their Dutch counterparts, which further supported this conclusion. It was proposed to either rephrase or omit and replace the unsuitable Hungarian EMBU items by alternative items to be tried out in the next round of data gathering and their psychometric evaluation.