Lars von Knorring

Swedish universities Scales of Personality (SSP): construction, internal consistency and normative data

Objective: A thorough revision of the Karolinska Scales of Personality (KSP) was made by reducing the number of items and improving the psychometric quality as concerns face validity, internal consistency and response differentiation. The revised version was labelled The Swedish universities Scales of Personality (SSP) and now include 91 items divided into 13 scales.

Citalopram in patients with fibromyalgia - a randomized, double-blind, placebo-controlled study.

The effect of the selective serotonin reuptake inhibitor citalopram was studied in a randomized, double‐blind, placebo‐controlled, 4‐month trial in patients with the fibromyalgia syndrome (FMS) who all fulfilled the American College of Rheumatology criteria. The citalopram doses varied between 20–40 mg daily. Forty female patients, 21 patients in the citalopram and 19 in the placebo group, participated. Assessment of pain, depressive symptoms and physical functioning were made using Visual Analogue Scales (VAS), the Montgomery Åsberg Depression Rating Scale (MADRS) and the Fibrositis Impact Questionnaire (FIQ).

Efficacy and safety of risperidone in the long-term treatment of patients with schizophrenia

The long-term efficacy and safety of risperidone were evaluated in patients with chronic schizophrenia in an open-label study. Thirty-two patients received risperidone for 1 year and 19 of the 32 received risperidone for 2 years. The mean dose of risperidone was 9.4 mg/d in the 1-year follow-up. At the end of 1 and 2 years, improvements were found in total scores on the Positive and Negative Syndrome Scale (PANSS), on four PANSS factors (positive, negative, excited, and cognitive), and the Clinical Global Impression scale. Severity of extrapyramidal symptoms (based on scores on the Extrapyramidal Symptom Rating Scale) was also reduced. Clinical improvement (defined as a 20% or more reduction in total PANSS scores) was shown by 54% of the patients at end point. Social functioning (as assessed by using the modified Strauss/Carpenter scale) was significantly improved after 2 years. Number of days spent in hospitals was significantly reduced during the 2 years of treatment, and the number of days in treatment (group) homes significantly increased. It is concluded that treatment with risperidone for 1 and 2 years is associated with significant reductions in symptoms of schizophrenia, improved social functioning, and reduction in days spent in the hospital.

Axis V--Global Assessment of Functioning Scale. Evaluation of a self-report version.

The present study examines a self‐report version of the Global Assessment of Functioning Scale according to Axis V (GAF self‐report). The sample (n= 73) was a psychiatric outpatient population from a catchment area clinic. Patients with psychotic and organic mental disorders were not included. The diagnostic distribution on Axis I was similar to the findings from previous studies. Axis II disorders were identified among 47%, of whom a majority also had a concomitant Axis I disorder. The mean GAF expert score was 66.5 (range: 48–86). High complexity and severity of disorders and a high number of fulfilled Axis II criteria were significantly associated with low GAF scores. Independent expert ratings on GAF were correlated with the GAF self‐report overall at r= 0.62, varying from 0.45 to 0.91 between different diagnostic groups. In general, the patients scored themselves lower (mean: ‐ 4.4 units) than expert ratings. Patients with depressive symptoms from an adjustment disorder or mood disorder were most prone to underestimation. Women also tended to score themselves lower than experts did. Conclusively, the GAF self‐report turned out to be a valid and reliable unidimensional instrument measuring psychological, social and occupational functioning. The GAF is easy to handle, and with a self‐report version as a complement, Axis V could be more frequently used in future clinical practice and research.

Personality traits and platelet MAO activity in alcohol and drug abusing teenage boys

ABSTRACT— The aim of this study has been to investigate whether teenage boys with mixed drug abuse differ from those with pure alcohol abuse as concerns personality traits and platelet monoamine axidase activity. The series included 1129 consecutive 18‐year‐old males called to the Enlistment Center in the northern part of Sweden. A special inventory was constructed based on Zuckerman Sensation Seeking Scale (SSS), Eysencks Personality Inventory (EPI), the Karolinska Scales of Personality (KSP) and questions about alcohol and drug consumption. The subjects with mixed drug abuse (n= 96) had high scores in the two subscales of SSS and KSP related to ability to stand boredom, high scores in both subscales of EPI and KSP related to impulsivity, high scores in Thrill and Adventure Seeking (TAS) and Experience Seeking (ES) of SSS as well as low platelet monoamine oxidase activity. The males with pure alcohol abuse (n= 33) also showed signs of monotony avoidance and impulsivity, but this type of abuse was not clearly related to low platelet monoamine oxidase activity and not to the aspects of curiosity included in the SSS such as TAS and ES. These findings are consistent with the picture earlier found as concerns “Type II” alcoholism which has an early onset, is genetically transmitted, is associated with mixed drug abuse and social complications.

Effect of an educational program for general practitioners on Gotland on the pattern of prescription of psychotropic drugs

During the years 1983–1984, an educational program was given to all general practitioners on the island of Gotland. This report evaluates changes in prescription habits from 1982 to 1985. To correct for general trends that occurred simultaneously, the prescription habits were compared to the habits in the rest of Sweden. Both on Gotland and in Sweden as a whole, the use of antidepressants increased from 1982–1985, but significantly more on Gotland. In 1982, the use of antidepressants was low on Gotland, 54% of that in the rest of Sweden. After the educational programs, Gotland reached 77% of the use in the rest of Sweden. In 1982, the use of lithium was 123% of that in the rest of Sweden. After the educational programs, the use of lithium was unchanged, and a small increase of 5.6% was seen in the rest of Sweden. After the educational programs, the prescription of sedatives on Gotland decreased (– 8.2%), and an increase of 4.5% was seen in the rest of Sweden. The use of major tranquilizers also decreased significantly (– 23%) on Gotland. Even in the rest of Sweden, a significant but much smaller decrease was seen: – 13%. On Gotland the frequency of hypnotics remained stable from 1982–1985, and a significant increase was seen in the rest of Sweden.

Pain perception and endorphine levels in cerebrospinal fluid

&NA; In 45 consecutive patients with chronic pain syndromes endorphins, fraction I of the cerebrospinal fluid and pain measures by means of electric stimulation via saline electrodes were investigated. In patients with high levels of fraction I (above median) pain threshold, PT and tolerance level, TL, in condition C (continuous stimulation increase) were found to be significantly higher than in patients with low levels of fraction I (below median). The results indicate that the endorphins are one of the physiological factors that contribute to the pain threshold and the tolerance level.

Personality traits and platelet monoamine oxidase in tobacco smokers

A study was made of the smoking habits of an unselected series of 1129 18-year-old men from the general population. Their smoking habits were related to personality traits, intellectual level and platelet monoamine oxidase (MAO). Regular smokers were found to be extraverts, sensation seekers who were easily bored and with a strong tendency to avoid monotony. They also had a lower than average intellectual level, and were more prone to the abuse of alcohol, glue, cannabis, amphetamine and morphine. Furthermore, they had a low platelet MAO. The results are discussed in relation to the pharmacological reasons for smoking and favour the hypothesis that tobacco smoking is related to arousal-seeking behaviour. Ex-smokers had personality traits, intellectual levels and platelet MAO of the same magnitude as non-smokers: this may be the reason why they were able to give up smoking.

Personality disorders and relationship to personality dimensions measured by the Temperament and Character Inventory in patients with obsessive-compulsive disorder.

The occurrence of personality disorders was investigated in 36 patients with obsessive‐compulsive disorder by means of the SCID Screen questionnaire. In addition, the personality dimensions were explored by means of the Temperament and Character Inventory (TCI). In total, 75% of the patients fulfilled the criteria for a personality disorder according to the SCID Screen questionnaire, mostly (55%) within cluster C. Several significant correlations were found between the separate personality disorders (PD) and subscales of the TCI, the most pronounced being between avoidant and obsessive‐compulsive PD and novelty‐seeking and self‐directedness. Strong correlations were also found between self‐directedness and paranoid and borderline PD. In multiple regressions where the presence of PD in clusters A, B and C, respectively, were used as dependent variables and where the separate subscales of the TCI were used as independent variables, the multiple R reached 0.68, 0.76 and 0.80 in clusters A, B and C, respectively. Thus 46–64% of the variance in the personality disorder clusters could be explained by the TCI subscales.

The DSM-IV and ICD-10 personality questionnaire (DIP-Q): Construction and preliminary validation

This paper describes the construction and preliminary validation of a new selport inventory for personality disorders — DSM-IV and ICD-10 Personality Disorder Questionnaire (DIP-Q). In a consensus process the criteria sets of DSM-IV and ICD-10 were scrutinized. Twenty-seven criteria were judged completely identical in both systems. In addition, 20 criteria were close to identical. The total number of different criteria could thus be reduced from 161 to 114. Since 24 criteria could not be covered by a single statement, the final version of the DIP-Q includes 135 statements reflecting the criteria and additionally 5 statements reflecting the general criteria. The questionnaire is generally completed within 20 min. In the preliminary validation among 33 psychiatric patients Cronbachs alpha coefficients within each personality disorder were acceptable for most personality disorders and somewhat higher for the DSM-IV personality disorders than for those in the ICD-10. The criteria set of Dissocial disorder in...