Stergios Kaprinis

Reliability, validity and psychometric properties of the Greek translation of the zung depression rating scale

IntroductionThe current study aimed to assess the reliability, validity and psychometric properties of the Greek translation of the Zung Depression Rating Scale (ZDRS).MethodsThe study sample included 40 depressed patients 29.65 ± 9.38 years old and 120 normal comparison subjects 27.23 ± 10.62 years old. In 20 of them (12 patients and 8 comparison subjects) the instrument was re-applied 1–2 days later. Translation and Back Translation was made. Clinical Diagnosis was reached by consensus of two examiners with the use of the SCAN v.2.0 and the IPDE. Statistical Analysis included ANOVA, the Pearson Product Moment Correlation Coefficient, Principal Components Analysis and Discriminant Function Analysis and the calculation of Cronbachs alpha (α)ResultsBoth Sensitivity and specificity exceed 90.00 at 44/45, Chronbachs alpha for the total scale was equal to 0.09, suggesting that the scale covers a broad spectrum of symptoms. Factor analysis revealed five factors (anxiety-depression, thought content, gastrenterological symptoms, irritability and social-interpersonal functioning). The test-retest reliability was satisfactory (Pearsons R between 0.92).ConclusionThe ZDRS-Greek translation is both reliable and valid and is suitable for clinical and research use with satisfactory properties. Its properties are similar to those reported in the international literature, although the literature is limited. However one should always have in mind the limitations inherent in the use of self-report scales.

Unipolar late-onset depression: A comprehensive review

BackgroundThe older population increases all over the world and so also does the number of older psychiatric patients, which manifest certain specific and unique characteristics. The aim of this article is to provide a comprehensive review of the international literature on unipolar depression with onset at old age.MethodsThe authors reviewed several pages and books relevent to the subject but did not search the entire literature because of its overwhelming size. They chose to review those considered most significant.ResultsThe prevalence of major depression is estimated to be 2% in the general population over 65 years of age. The clinical picture of geriatric depression differs in many aspects from depression in younger patients. It is not yet clear whether it also varies across cultures and different socio-economic backgrounds. Biological data suggest that it is associated with an increased severity of subcortical vascular disease and greater impairment of cognitive performance. Many authors consider the existence of a somatic disorder to be related to the presence of depression in late life, even constituting a negative prognostic factor for the outcome of depression. Most studies support the opinion that geriatric depression carries a poorer prognosis than depression in younger patients. The therapeutic intervention includes pharmacotherapy, mainly with antidepressants, which is of established value and psychotherapy which is not equally validated.ConclusionA significant number of questions regarding the assessment and treatment of geriatric depression remain unanswered, empirical data are limited, and further research is necessary.

Auditory Processing Disorders in children suspected of Learning Disabilities―A need for screening?

AIM The current study aims to assess: (a) the prevalence of auditory processing in a population of children reporting learning difficulties, (b) the correlation of APD diagnosis with age, the intelligence coefficient (IQ) and with the presence of a specific learning disability such as dyslexia and (c) to evaluate the reliability of each auditory processing test used in this study in identifying APD. METHOD We evaluated one hundred and twenty-seven consecutive children referred to the academic tertiary LD Clinic of the Psychiatric Department by means of a psychoacoustic mainly non-verbal test battery. RESULTS APD was found to be present in 43.3% and co-existing with developmental dyslexia in 25% of cases. The diagnosis of APD correlated with age in that children with APD were younger by 2 years than those without a diagnosis of APD. The diagnosis of APD did not correlate with IQ or with the diagnosis of dyslexia. INTERPRETATION High prevalence of APD in the targeted group of children suspected of Learning Disabilities sets the grounds for a possible benefit in screening for the disorder.

Peripheral thyroid dysfunction in depression

The involvement of the thyroid gland and thyroid hormones is generally believed to be important in the aetiopathogenesis of major depression. Major support comes from studies in which alterations in components of the hypothalamic–pituitary–thyroid (HPT) axis have been documented in patients with primary depression. However, screening thyroid tests are often routine and add little to the diagnostic evaluation. Overt thyroid disease is rare among depressed inpatients. The finding that depression often co-exists with autoimmune subclinical thyroiditis suggests that depression may cause alterations in the immune system, or that in fact it could be an autoimmune disorder itself. The outcome of treatment and the course of depression may be related to thyroid status as well. Augmentation of antidepressant therapy with the co-administration of thyroid hormones (mainly T3) is a well-documented treatment option for refractory depressed patients. Review of the literature suggests that there are no conclusive data on the role of thyroid function in depression. It is clear that depression is not characterised by an overt thyroid dysfunction, but it is also clear that a subgroup of depressed patients may manifest subtle thyroid abnormalities, or an activation of an autoimmune process. There is a strong possibility that the presence of a subtle thyroid dysfunction is a negative prognostic factor for depression and may demand specific therapeutic intervention.

Hemispheric laterality assessment with dichotic digits testing in dyslexia and auditory processing disorder

Abstract One of the widely used tests to evaluate functional asymmetry of cerebral hemispheres is the dichotic listening test with the usually prevailing right ear advantage. The current study aims at assessing hemispheric laterality in an adult sample of individuals with dyslexia, with auditory processing disorder (APD), and adults experiencing comorbidity of the two mentioned disorders against a control group with normal hearing and absence of learning disabilities. Results exhibit a right hemispheric dominance for the control and APD group, a left hemispheric dominance for the group diagnosed with both dyslexia and APD, and absence of dominance for the dyslexia group. Assessment of laterality was repeatable and produced stable results, indicating a true deficit. A component of auditory processing, specifically the auditory performance in competing acoustic signals, seems to be deficient in all three groups, and laterality of hemispheric functions influenced at least for auditory-language stimuli in the two of the three groups, one being adults with dyslexia and the other being adults with comorbidity of dyslexia and APD. Sumario Una de las pruebas más ampliamente utilizadas para evaluar la asimetría funcional de los hemisferios cerebrales es la prueba de escucha dicótica, generalmente con la resultante ventaja del oído derecho. El presente estudio tiene como objetivo evaluar la lateralidad hemisférica en una muestra de adultos con dislexia, con desórdenes del procesamiento auditivo (APD) y adultos con ambos problemas vs un grupo control de normoyentes sin alteraciones del aprendizaje. Los resultados muestran una dominancia del hemisferio derecho para el grupo control y el grupo con APD y una dominancia del hemisferio izquierdo para el grupo diagnosticado con ambas condiciones, y ninguna dominancia del grupo de dislexia. La evaluación de la lateralidad fue repetible y produjo resultados estables, indicando un déficit verdadero. Un componente del procesamiento auditivo, específicamente el desempeño auditivo bajo señales acústicas competitivas, parece ser deficiente en los tres grupos y las funciones de lateralidad hemisférica se vieron influidas al menos por los estímulos auditivos lingüísticos en dos de los tres grupos; el de adultos con dislexia y el de adultos con ambas condiciones, dislexia y APD.

Life events and clinical subtypes of major depression : A cross-sectional study

The present study aimed to investigate the relationship between stressful life events and depression. Ninety major depressive patients, aged 36.57 +/- 12.02 years, and 121 matched controls, aged 27.11 +/- 10.59 years, took part in the study. The life change units (LCU) according to Rahe et al. were used for the quantification of life events. The results suggested that males reported significantly more life events than females. Atypical males differed from all other gender-by-type groups, while no other differences emerged. LCU correlated with melancholic indices but did not correlate with anxiety or functioning. The results suggest that subgroups of depressive patients are characterized by the presence of stressful life events. Male atypical patients reported the highest load of life events. The question that arises is whether this finding is valid or whether these patients (who have higher personality psychopathology and interpersonal rejection sensitivity) tend to over-report life events.

Psychophysiology and psychoacoustics of music: Perception of complex sound in normal subjects and psychiatric patients

Perception of complex sound is a process carried out in everyday life situations and contributes in the way one perceives reality. Attempting to explain sound perception and how it affects human beings is complicated. Physics of simple sound can be described as a function of frequency, amplitude and phase. Psychology of sound, also termed psychoacoustics, has its own distinct elements of pitch, intensity and tibre. An interconnection exists between physics and psychology of hearing.Music being a complex sound contributes to communication and conveys information with semantic and emotional elements. These elements indicate the involvement of the central nervous system through processes of integration and interpretation together with peripheral auditory processing.Effects of sound and music in human psychology and physiology are complicated. Psychological influences of listening to different types of music are based on the different characteristics of basic musical sounds. Attempting to explain music perception can be simpler if music is broken down to its basic auditory signals. Perception of auditory signals is analyzed by the science of psychoacoustics. Differences in complex sound perception have been found between normal subjects and psychiatric patients and between different types of psychopathologies.

Are Dexamethasone Suppression Test Nonsuppression and Thyroid Dysfunction Related to a Family History of Dementia in Patients with Major Depression? an Exploratory Study

Objective: Recent data suggest that the low thyroid function syndrome in depression is nonspecific, They also suggest that depression may constitute a risk factor for the development of dementia, especially in atypical patients who have high rates of hypothalamo–pituitary–adrenal axis disorders. This study aimed to search for correlations among Dexamethasone Suppression Test (DST) cortisol levels, thyroid indices, and family history of dementia in patients with depression. Methods: A sample of 30 patients, aged 21 to 60 years and suffering from major depression according to DSM-IV criteria, took part in the study. Three had a family history of dementia in first-degree relatives. We measured their serum levels of free T3, free T4, thyroid-stimulating hormone, thyroid binding inhibitory immunoglobulines, thyroglobulin antibodies, and thyroid microsomal antibodies (TMAs). We applied the 1-mg DST to all patients. The statistical analysis included 1-way multivariate analysis of covariance using t tests as the post hoc tests. Results: Significantly higher levels of TMAs were found in patients with a family history of dementia, compared with those who did not have this family history. Conclusion: The results of this study suggest that a more pronounced autoimmune process may characterize depression patients with a family history of dementia.

Functional Brain Organization in Bipolar Affective Patients during Manic Phase and after Recovery: A Digit Dichotic Listening Study

To study the functional organization of the cerebral hemispheres in patients with bipolar psychosis using a verbal dichotic listening test for pairs of digits 26 patients were tested twice, during the acute expression of manic phase and after recovery. The patient group during the manic phase did not support the expected right-ear advantage of normal subjects on verbal dichotic tests but showed a statistically significant left-ear advantage, which shifted after recovery toward the typical normal asymmetry. Comparing patients during the manic phase and after recovery showed that the left-ear advantage as well as the shift in right-ear advantage after recovery was due to the reduction of left-ear performance. From the over-all neuropsychological findings for these patients mania may be hypothesized to be characterized by overactivation of the right hemisphere. This phaenomenon seems associated with acuteness of the symptoms of the psychotic disorder.

Arguments against the Cognitive Dysmetria Hypothesis of Schizophrenia

Recently, the ‘cognitive dysmetria’ theory for schizophrenia has been formulated. According to this theory. a primary neurocognitive dysfunction is the core of schizophrenia and underlies symptom formation, The suggested perceptual fragmentation of external stimuli and inability to connect such perceptions with internal schemata is suggested to lead to positive symptoms, while defensive self-restriction and the exhaustion of the mental apparatus lead to negative symptomatology. Objections to this theory include observations (i) that patients with dominant positive symptoms, e.g., delusions, hallucinations, manifest better neurocognitive function and (ii) that typically antipsychotics significantly reduce positive symptoms and thus improve both the clinical picture and the functioning (to the extent it is reduced with positive symptoms) of the patients, yet have little or no effect on negative, e.g., loss of volition, emotional blunting, and neurocognitive symptomatology, e.g., attentional and memory deficit. The literature suggests that neurocognitive symptoms group independently of other symptomatology. It is suggested that there is currently more evidence against than in favor of the ‘cognitive dysmetria’ theory.