H. 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.

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 characteristics of patients with resistant burning mouth syndrome.

The personality characteristics in 32 patients with resistant burning mouth syndrome (BMS) after treatment of diagnosed medical and odontologic diseases were examined and compared with a sex- and age-matched control group. After evaluation of burning mouth symptoms, the personality, the psychologic functioning, and the quality of life were determined by using the Karolinska Scales of Personality (KSP), an additional Personality Scale (PS), a Psychological Functioning Scale (PFS), and a Quality of Life Scale (QLS). The result showed that, compared with a control group, the patients with resistant BMS had a significantly lower score in socialization scale and significantly higher scores in somatic anxiety, muscular tension, and psychasthenia scales. Furthermore, the patients with resistant BMS were significantly more easily fatigued and more sensitive and showed a tendency to be more concerned about their health. With regard to the psychologic functioning, the BMS patients had significantly more problems taking the initiative, more easily became dizzy, and had more sad thoughts. They also showed a tendency to report palpitations and/or indigestions more often. The observed significant differences in personality and psychologic functioning might suggest that the burning sensations are psychosomatic symptoms in these patients. We recommend that patients with resistant BMS should undergo psychologic investigation. If psychologic and/or psychosocial disturbances are diagnosed, adequate treatment should be offered.

Life events and depression

Abstract This is the first of three articles dealing with some basic aspects of the relationship between life events and depression, and is also one part of a larger study in which the possible impact of stressful events has been studied from a multifactorial point of view. Two-hundred and four patients suffering from a depressive disorder, consecutively admitted to the Department of Psychiatry of the Umea University have participated in a study of life events carried out by means of a specially constructed life events inventory that was used as a guideline for a semistructured interview. The results of this part of the study show that there are no pronounced differences in the occurrence, or appraisal of life events between male and female patients. The more vulnerable, older patients have experienced significantly fewer life events, even of the fateful type, prior to the onset of depression. No difference was found between patients who were married or lived together with a partner and patients who were unmarried, separated, divorced or widowed except in the categories of events (e.g. ‘conflict’ events) which might have been the very reason for a separation or a divorce. The results are discussed in relation to other findings in the literature.

Psychologic aspects of patients with oral lichenoid reactions

Psychologic aspects of 49 patients with oral lichenoid reactions (OLR) in contact with amalgam fillings were studied and compared with an age- and sex-matched control group. Psychologic factors such as personality, psychologic functioning, and quality of life were determined by using the Karolinska Scales of Personality (KSP), an additional Personality Scale (PS), a Psychological Functioning Scale (PFS), and a Quality of Life Scale (QLS). With regard to personality the OLR patients had significantly higher scores on the muscular tension and suspicion scales and significantly lower scores on the indirect aggression scale. In addition, the OLR patients were significantly more worried about their health and more helpful. With regard to psychologic functioning the OLR patients had significantly more sad thoughts, became dizzy more easily, found it harder to imagine themselves free from anxiety, and had more difficulty in concentrating. The results indicated that OLR patients had a tendency to be depressive. The need for a systemic investigation including odontologic, medical, and psychologic aspects was expressed.

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.

Pain as a symptom in depressive disorders. II. Relationship to personality traits as assessed by means of KSP.

Abstract The series included 140 hospitalized patients with depressive disorders, who were rated by means of the Comprehensive Psychopathological Rating Scale (CPRS). Furthermore, a personality inventory, KSP, was completed when the patients had improved markedly. Forty‐six per cent of the patients were found to have pain as a symptom. The patients with pain were found to have more somatic anxiety, more muscular tension, more psychasthenia and more inhibition of aggression but no significant differences were found in guilt. Thus pain as a symptom in depressive disorders seems to be linked to muscular tension and the patients seem to have more introjected aggression while no evidence emerges indicating that pain could serve to relieve the feelings of guilt.

The genetics of depression

Sixty unipolar (23 male and 37 female) patients and 67 patients (25 male and 42 female) suffering from a neurotic-reactive depressive disorder, consecutively admitted to the Department of Psychiatry of Umeå University have participated in a family study aimed at identifying morbidity risks for psychiatric illnesses among first degree relatives (n=437). Besides the classification of affective disorders used in Umeå for research purposes the patients have been classified, according to the ICD-9, DSM-III, age at onset (below or above 40 years), and the Winokurs classification of primary affective disorders. However, only the findings regarding the Umeå classification and the Winokurs classification are given in the present article. Of the patients 90% fulfilled Kendells criteria for depression at the time of the investigation whereas the others were in a phase of remission when studied. The diagnosis of secondary cases were made without knowledge of the diagnoses of the probands. Among relatives of unipolar probands only two secondary cases of bipolar affective disorder were found—one among parents, and one among siblings (MR% 1.1 and 0.6 respectively). The overall morbidity risk for affective disorders (MR% 22.8 among parents and 15.5 among siblings) proved to be higher than in previous studies. In the families of neuroticreactive patients the morbidity risk for bipolar affective disorders was also very low (MR% 1.0 among parents and 0.7 among siblings), whereas the overall MR% for affective disorders proved to be surprisingly high (12.1 among parents and 6.7 among siblings). No increased risk for schizophrenia or alcoholism was found among the relatives of either group. When the relatives were divided according to their sex no clear-cut difference in morbidity risk emerged when fathers and brothers were compared with mothers and sisters but alcoholisms occurred more frequently in male relatives. Preliminary findings in second degree relatives suggest that secondary cases of affective disorders might occur among second degree relatives of patients classified as suffering from “sporadic depression” according to Winokurs classification.ZusammenfassungSechzig (23 Männer und 37 Frauen) monopolare Patienten und 67 (25 Männer und 42 Frauen) Patienten mit einer neurotisch-reaktiven Depression, fortlaufend in die Psychiatrische Klinik der Universität Umeå aufgenommen, nahmen an einer Familienstudie mit dem Ziel das Morbiditätsrisiko (MR) für psychiatrische Erkrankungen unter Verwandten 1. Grades (n=437) zu identifizieren, teil. Außer dem in Umeå zu Forschungszwecken angewandten Klassifikationssystems, wurden die Patienten auch gemäß dem ICD-9, DSM-III, Ausbruchsalter (unter bzw. über 40 Jahre alt) und der Winokurschen Klassifikation der primären affektiven Erkrankungen eingeteilt. In diesem Artikel sind jedoch nur die Ergebnisse hinsichtlich der Umeå- und der Winokurschen Klassifikation wiedergegeben.Neunzig Prozent der Patienten erfüllten Kendells Kriteria für Depressionen zur Zeit der Untersuchung, wohingegen der Rest sich in der Besserungsphase befand. Die Diagnosen der Sekundärfälle wurden ohne Kenntnis der Diagnosen der Probanden gestellt. Unter den Verwandten der monopolaren Probanden wurden nur 2 sekundäre Fälle von bipolaren affektiven Erkrankungen gefunden — einer unter Eltern und einer unter Geschwistern (MR% 1,1 bzw. 0,6). Das Gesamtmorbiditätsrisiko für affektive Erkrankungen (MR% 22,8 unter Eltern und 15.5 unter Geschwistern) erwies sich höher als in früheren Untersuchungen. Auch in den Familien der neurotisch-reaktiven Patienten lag das Morbiditätsrisiko für manisch-depressive Erkrankungen sehr niedrig (MR% 1,0 unter Eltern und 0,7 unter Geschwistern), das Gesamtmorbiditätsrisiko für affektive Erkrankungen dagegen stellte sich als überraschend hoch (12,1% unter Eltern bzw. 6,7% unter Geschwistern) heraus. In keiner der beiden Gruppen zeigte sich ein erhöhtes Risiko für Schizophrenia oder Alkoholismus unter den Verwandten. Bei der Aufteilung der Verwandten nach dem Geschlecht ergab sich, außer für Alkoholismus, der häufiger unter männlichen Verwandten auftrat, kein eindeutiger Unterschied bezüglich des Morbiditätsrisikos, nachdem die Väter und Brüder mit den Müttern und Schwestern verglichen worden waren.Vorläufige Ergebnisse unter Verwandten zweiten Grades deuten darauf hin, daß sekundäre Fälle von affektiven Erkrankungen unter Verwandten zweiten Grades von solchen Patienten auftreten, die gemäß der Winokurschen Klassifikation als an einer „sporadischen Depression“ leidend, bezeichnet werden können.

Presentation of a subscale for the rating of depression and some additional items to the Comprehensive Psychopathological Rating Scale

ABSTRACT– From the Comprehensive Psychopathological Rating Scale (CPRS) a subscale for depression has been derived in the course of a study of depression in which 209 patients took part. The subscale presented in this article comprises 28 items from the original pool and two additional items constructed later. The scale has a high degree of internal consistency and is satisfactorily reliable also among previously unskilled raters who have undergone a minimum of training. It is able to significantly differentiate between ill and recovered patients and among patients with syndromes of different severity according to various classification principles. Reported symptoms rated by the subscale correlated significantly with self‐ratings of depression. Since the original CPRS pool also comprises items for the rating of manic manifestations, the scale is particularly suitable for the study of patients suffering from affective disorders, also when a switch from depression to mania could occur in the course of treatment.