Silia Vitoratou

Mixed handedness is associated with the Disorganization dimension of schizotypy in a young male population

Within the ASPIS (Athens Study of Psychosis Proneness and Incidence of Schizophrenia) we sought out to examine in accordance with previous reports if a deviation from dextrality is associated with an augmented endorsement of self rated schizotypal personality traits in a large population of 1129 young male army recruits. Schizotypal traits were assessed using the Schizotypal Personality Questionnaire and hand preference membership was determined by applying stringent criteria derived from the Annett Handedness Questionnaire and the Porac-Coren questionnaire of lateral preferences. By adopting three different definitions of hand preference membership, we confirmed an association between mixed handedness and increased schizotypal personality traits, and in particular with Disorganization schizotypy that encompasses aspects of self perceived difficulties in verbal communication. Non-verbal cognitive ability, as indexed by measurement of non-verbal IQ, sustained attention and working memory was not associated with hand preference. We argue that a deviation from normal cerebral lateralization, as indexed by mixed handedness, is associated with mild sub clinical language dysfunction, rather than non-verbal cognitive ability, and this might be relevant to the expression of psychosis phenotype.

Factorial composition of the Aggression Questionnaire: A multi-sample study in Greek adults

The primary aim of the current article was the evaluation of the factorial composition of the Aggression Questionnaire (AQ(29)) in the Greek population. The translated questionnaire was administered to the following three heterogeneous adult samples: a general population sample from Athens, a sample of young male conscripts and a sample of individuals facing problems related to substance use. Factor analysis highlighted a structure similar to the one proposed by Buss and Perry [Buss, A.F., Perry, M., 1992. The Aggression Questionnaire. Journal of Personality and Social Psychology 63, 452-459]. However, the refined 12-item version of Bryant and Smith [Bryant, F.B., Smith, B.D., 2001. Refining the architecture of aggression: a measurement model for the Buss-Perry Aggression Questionnaire. Journal of Research in Personality 35, 138-167] provided a better fit to our data. Therefore, the refined model was implemented in further analysis. Multiple group confirmatory factor analysis was applied in order to assess the variability of the 12-item AQ across gender and samples. The percentage of factor loading invariance between males and females and across the three samples defined above was high (higher than 75%). The reliability (internal consistency) of the scale was satisfactory in all cases. Content validity of the 12-item AQ was confirmed by comparison with the Symptom Check-List 90 Revised.

Brain derived neurotropic factor (BDNF) is associated with childhood abuse but not cognitive domains in first episode psychosis

BACKGROUND The Brain-derived Neurotrophic Factor (BDNF) modulates cognitive processes and is associated with increased risk of schizophrenia. Childhood trauma (CT) is frequent in patients with psychosis and severely affects course and outcome. AIMS We investigated the hypothesis that BDNF is associated with both CT and cognitive deficits in a sample of first-episode psychosis (FEP) cases and unaffected controls. METHOD Participants with FEP and healthy controls were recruited between August 2008 and July 2011 from South London, UK. Childhood traumatic events were detected using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q). Neuropsychological data were also collected. BDNF plasma levels were measured from fasting blood samples. RESULTS Data were available on 87 FEP patients and 152 controls. Our results showed a significant effect of separation (F=5.5; df=1,115; p=.02), physical (F=4.7; df=1, 118; p=.03) and sexual abuse (F=5.4; df=1,117; p=.02) on BDNF levels with lower levels among those who experienced the traumatic event compared to those who did not. Physical abuse predicted lower plasma levels of BDNF (β=-.30; p=.03) whereas sexual and/or physical abuse showed a trend (β=-.26; p=.06) in FEP patients but not in unaffected controls. No association between BDNF plasma levels and cognitive functions was found among patients with FEP and controls. CONCLUSION Our findings suggest the possible involvement of BDNF in the onset of first-episode psychosis in individuals exposed to early trauma and propose BDNF as a potential clinical biomarker to detect the detrimental effects of CT on human brain plasticity.

Neuroticism, social network, stressful life events: association with mood disorders, depressive symptoms and suicidal ideation in a community sample of women.

According to the stress-diathesis hypothesis, depression and suicidal behavior may be precipitated by psychosocial stressors in vulnerable individuals. However, risk factors for mental health are often gender-specific. In the present study, we evaluated common risk factors for female depression in association with depressive symptoms and suicidal ideation in a community sample of women. The sample was composed by 415 women evaluated for mood disorders (MDs), depressive symptoms and suicidal ideation by structured interviews and the Beck depression inventory II (BDI II). All women also filled in the Eysenck personality questionnaire to evaluate neuroticism and were interviewed for social contact frequency and stressful life events (SLEs). In the whole sample, 19% of the women satisfied criteria for MD and suicidal ideation was reported by 12% of the women. Though stressful life events, especially personal and interpersonal problems, and poor social network were associated with all the outcome variables (mood disorder, depressive symptomatology and suicidal ideation), neuroticism survived to all multivariate analyses. Social network, together with neuroticism, also showed strong association with depressive severity, independently from current depressive state. Though we were unable to compare women and men, data obtained from the present study suggest that in women neurotic traits are strongly related to depression and suicidal ideation, and potentially mediate reporting of stressful life events and impaired social network. Independently from a current diagnosis of depression, impaired social network increases depressive symptoms in the women.

DEVELOPMENT AND VALIDATION OF ‘SURE’: A PATIENT REPORTED OUTCOME MEASURE (PROM) FOR RECOVERY FROM DRUG AND ALCOHOL DEPENDENCE

Highlights • ‘SURE’ is a new patient reported outcome measure of recovery from drug and alcohol dependence.• ‘SURE’ has been developed with significant input from people in recovery.• ‘SURE’ has good face and content validity, acceptability and usability for people in recovery.• SURE’ comprises 21 items (5 factors) and is psychometrically valid, quick and easy-to-complete.• ‘SURE’ can be used by individuals in private or in a therapeutic context

Potential role of membrane-bound COMT gene polymorphisms in female depression vulnerability.

BACKGROUND Several polymorphic variants within the catechol-O-methyltransferase (COMT) gene locus have been associated with a number of diverse psychiatric phenotypes including affective disorders. COMT enzyme participates in metabolic pathways involving brain catecholamines, as well as steroid hormones such as estrogens. Given the suggested mood enhancing role of estrogens and the higher prevalence of depression in women, we set out to investigate the potential impact of functional COMT genetic variants on depression and anxiety symptoms in a homogeneous female community sample. METHODS We genotyped three common polymorphisms within the COMT gene in a rural female population isolate (n=391) interviewed for the presence of lifetime major depression episodes and generalized anxiety disorder. Furthermore, well validated self-rated questionnaires were administered evaluating state depressive symptoms and neuroticism personality trait. Single-marker and haplotype association analyses were performed. RESULTS Two highly correlated markers located in the membrane-bound (MB) COMT promoter region (rs2020917, rs737865) were significantly associated with both self-rated and clinician-rated depressive symptomatology. We did not detect any robust association with generalized anxiety disorder or neuroticism. Exploratory haplotype analysis examining the two promoter markers in combination with the extensively studied val 158met polymorphism (rs4680) did not provide any further support for the contribution of this variant in depressive mood. LIMITATIONS The relative small sample size should be considered a limitation of this study. CONCLUSIONS Our results provide promising evidence that MB-COMT specific genetic variation may represent an as yet unrecognized genetic factor that influences predisposition to depression amongst females.

Psychometric Properties and Factor Structure of the Greek Version of the Cardiac Anxiety Questionnaire (CAQ)

The present study assesses the psychometric properties and factor structure of the Greek version of the Cardiac Anxiety Questionnaire (CAQ). The questionnaire was administered to 598 healthy individuals from 15 different regions of Greece with a measure of socioeconomic characteristics and the Symptom Checklist-90–Revised (SCL-90–R). The sample was split into two random halves, and exploratory factor analysis indicated a three-factor solution. This solution was tested using a confirmatory factor analysis on the second half of the sample. In terms of latent dimensions, the Greek version retains the three-factor structure as proposed by the initial authors. However, adequate fit was achieved only after omitting eight items. The shorter (10-item) version was submitted to further analysis. The shorter version provided satisfactory internal reliability and evidence indicating the validity of the scale with respect to SCL-90–R subscales. The stability of the questionnaire was verified by a high test-retest reliability over a 3-mo. period (r = .86). Sex and age differences were assessed. The 10-item version appears to be a practical, brief tool for clinical use.

Bipolar disorder and self-stigma: A comparison with schizophrenia

AIM Even though numerous studies have focused on the effects of self-stigma on patients with schizophrenia, little is known about self-stigma of patients with bipolar disorder (BD). In this study, a self-administered scale of self-stigmatising attitudes of patients with BD and schizophrenia was used to explore these attitudes, examine the potential differences between the two groups and study the factors that influence stigma within groups. METHODS Self-stigma of 120 patients with schizophrenia and BD was assessed with the Self-stigma Questionnaire (SSQ) and the Stigma Inventory for Mental Illness (SIMI). Presence of clinical symptoms, overall functioning and level of self-esteem were also evaluated. RESULTS Self-stigma is present in both groups but differs in its intensity. Patients with BD experience self-stigma in a lesser degree without affecting their social life or overall functioning. Patients with schizophrenia adopt more intense self-stigmatising attitudes leading to social exclusion and lower level of overall functioning. LIMITATIONS The results are limited by the small sample size, whereas the inclusion of other questionnaires would broaden our insight to self-stigma. CONCLUSIONS Self-stigma has a direct effect on overall functioning of patients with BD and schizophrenia tampering the clinical outcome of therapeutic interventions. Therefore, it should be incorporated in every treatment plan and be addressed as a clinical symptom of the mental illness.

Aspects of perceived stigma: The Stigma Inventory for Mental Illness, its development, latent structure and psychometric properties

OBJECTIVE The aim of this study was to develop a new brief and easy to administer self-stigma scale for mental illness as well as to assess the correlations between self-stigma and psychopathology of chronic schizophrenic patients. METHODS The Stigma Inventory for Mental Illness (SIMI) was administered to 100 outpatients diagnosed with schizophrenia. Psychopathology and overall functioning were assessed with the Positive and Negative Symptom Scale (PANSS) and Global Assessment Scale (GAS), respectively. RESULTS The final scale consists of 12 items. Factor analysis concluded to two dimensions: perceptions of social stigma and self-efficacy. Both factors were found to be reliable (high internal consistency and stability coefficients). Significant correlations were present with psychopathology, functioning and selected items from the Community Attitudes toward the Mentally Ill (CAMI) inventory. CONCLUSION The SIMI scale is a reliable and valid psychometric tool that can be used to assess patients self-stigma and self-efficacy. The findings suggest also that psychopathology has an immediate effect on endorsing self-stigmatizing attitudes.

Measuring the needs of mental health patients in Greece: Reliability and validity of the Greek version of the Camberwell Assessment of Need

Background: Evaluation of mental health services based on patients’ needs assessments has never taken place in Greece, although it is a crucial factor for the efficient use of their limited resources. Aim: To examine the inter-rater and test–retest reliability and the concurrent/convergent validity of the Greek research version of the Camberwell Assessment of Need–Research (CAN-R). Method: A total of 53 schizophrenic patient–staff pairs were interviewed twice to test the inter-rater and test–retest reliability of the Greek version of the CAN-R. The World Health Organization Quality of Life–Brief Form (WHOQOL-BREF) and World Health Organization Disability Assessment Schedule–2.0 (WHODAS-2.0) were administered to the patients to examine concurrent validity. Results: The inter-rater and test–retest reliability of patient and staff interviews for the 22 individual items and the eight summary scores of the instrument’s four sections were good to excellent. Significant correlations emerged between CAN scores and the WHOQOL-BREF and WHODAS-2.0 domains for both patient and staff ratings, indicating good concurrent validity. Conclusion: Our results suggest that the Greek version of the CAN-R is a reliable instrument for assessing mental health patients’ needs. Moreover, it is the first CAN-R validity study with satisfactory results using WHOQOL-BREF and WHODAS-2.0 as criterion variables.