[Conduct symptoms and emotional decision making in non-clinical adolescents]. / Viselkedészavar tünetek és érzelmi döntéshozatal kapcsolata serdülokben.

BACKGROUND: In adults with antisocial personality disorder, literature data indicate alterations in emotional decision making and in the working of the prefrontal cortex. Similar alterations were described in adolescents with psychopathic traits, however, a dimensional link was not established between behavioral variables and variables associated with decision making. The aim of the present study was to describe the relationship between externalizing symptoms and emotional decision making in non-clinical adolescents. METHODS: Originally 57, 7th-10th grade students between 13-16 years participated in the study after informed consent, but the data of 4 adolescents were not used because of incomplete data-set (N=53; 24 girls and 29 boys; age=14.7 ± 1.0 years, mean ± SD). The parent version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess behavioral problems. The Iowa Gambling Task (IGT) performance and Raven IQ measures were also assessed. RESULTS: The number of summarized risky choices was positively correlated with Conduct Problems Scale of SDQ (r=0.31, p<0.05). While the number of risky choices was not correlated with conduct problems in the first 20 selections (r=0.11, p=n.s.), a marked positive correlation was present in the above measures in the last 20 selections (r=0.28, p<0.05). The number of risky choices did not depend on Raven IQ, age, and other behavioral scales of SDQ. CONCLUSIONS: Even subthreshold conduct symptoms are associated with altered emotional decision making in adolescents, what might be important in the development of antisocial behavior.

Gender interactions in the recognition of emotions and conduct symptoms in adolescents.

BACKGROUND: According to literature data, impairment in the recognition of emotions might be related to antisocial developmental pathway. In the present study, the relationship between gender-specific interaction of emotion recognition and conduct symptoms were studied in non-clinical adolescents. METHODS: After informed consent, 29 boys and 24 girls (13-16 years, 14 ± 0.1 years) participated in the study. The parent version of the Strengths and Difficulties Questionnaire was used to assess behavioral problems. The recognition of basic emotions was analyzed according to both the gender of the participants and the gender of the stimulus faces via the "Facial Expressions of Emotion- Stimuli and Tests". RESULTS: Girls were significantly better than boys in the recognition of disgust, irrespective from the gender of the stimulus faces, albeit both genders were significantly better in the recognition of disgust in the case of male stimulus faces compared to female stimulus faces. Both boys and girls were significantly better in the recognition of sadness in the case of female stimulus faces compared to male stimulus faces. There was no gender effect (neither participant nor stimulus faces) in the recognition of other emotions. Conduct scores in boys were inversely correlated with the recognition of fear in male stimulus faces (R=-0.439, p<0.05) and with overall emotion recognition in male stimulus faces (R=-0.558, p<0.01). In girls, conduct scores were shown a tendency for positive correlation with disgust recognition in female stimulus faces (R=0.376, p<0.07). CONCLUSIONS: A gender-specific interaction between the recognition of emotions and antisocial developmentalpathway is suggested.

The relationship between conduct symptoms and the recognition of emotions in non-clinical adolescents.

BACKGROUND: In adult individuals with antisocial personality disorder, impairment in the recognition of fear seems established. In adolescents with conduct disorder (antecedent of antisocial personality disorder), only sporadic data were assessed, but literature data indicate alterations in the recognition of emotions. The aim of the present study was to assess the relationship between emotion recognition and conduct symptoms in non-clinical adolescents. METHODS: 53 adolescents participated in the study (13-16 years, boys, n=29, age 14.7±0.2 years; girls, n=24, age=14.7±0.2 years) after informed consent. The parent version of the Strengths and Difficulties Questionnaire was used to assess behavioral problems. The recognition of six basic emotions was established by the "Facial expressions of emotion-stimuli and tests", while Raven IQ measures were also performed. RESULTS: Compared to boys, girls showed significantly better performance in the recognition of disgust (p<0.035), while no significant difference occurred in the recognition of other emotions. In boys, Conduct Problems score was inversely correlated with the recognition of fear (Spearman R=-0.40, p<0.031) and overall emotion recognition (Spearman R=-0.44, p<0.015), while similar correlation was not present in girls. CONCLUSIONS: The relationship between the recognition of emotions and conduct problems might indicate an important mechanism in the development of antisocial behavior.

[The relationship between reactive/proactive aggression, callous/unemotional traits and behavioural problems in Hungarian adolescents]. / A reaktiv/proaktiv agresszió, a rideg/érzéketlen vonások és a viselkedési problémák kapcsolata magyar serdüloknél.

INTRODUCTION: The relationship between the type of physical aggressive behavior, callous/unemotional traits and behavioral problems was extensively studied in the literature, but no similar data exist in Hungarian adolescents. AIM: In the present study, the type of aggressive behavior was assessed in adolescents on a normative sample to study its relationship with callous/unemotional traits and behavioral problems. SAMPLE: 223 students were participated in the study after informed consent (girls, n=106, age: 14.2±1.5 years; boys, n=117, age: 13.9±1.6 years) from primary and secondary schools in Miskolc and adjacent areas. METHODS: The Reactive/Proactive Aggression Questionnaire was used to assess the level of aggressive behavior, the Inventory of Callous Unemotional Traits was used to measure callous/unemotional traits, while behavioral problems were established by the means of the Strengths and Difficulties Questionnaire. RESULTS: In the present non-clinical sample, the level of reactive aggression was higher than the level of proactive aggressive behavior. In boys, proactive and total aggression measures were significantly higher compared to girls. In both genders, reactive aggression was specifically associated with emotional and peer-related problems. Proactive aggression was correlated positively with callous traits in both genders, while self-reported prosocial behavior had an inverse correlation with proactive aggressive behavior in boys. Self reported conduct- and hyperactivity problems were positively correlated with both types of aggressive behavior in both genders. The strongest positive correlation was observed between self-reported conduct symptoms and both types of aggressive behavior. CONCLUSIONS: Callous/unemotional traits were related with proactive forms of aggression, similar to literature data. Reactive aggressive behavior was related to peer-related and emotional problems, thus our data outlined the importance of the distinction between the two main types of aggression.

[Investigation of callous/unemotional traits and interpersonal characteristics among Hungarian adolescents--preliminary research results]. / Rideg/érzékelten vonások és interperszonális jellemzok vizsgálata magyar serdüloknél--elso vizsgálati eredmények.

UNLABELLED: In the understanding of aggressive behaviour an important role is contributed to callous/unemotional (C/U) traits (lack of guilty and empathy, grandiose self, manipulation). C/U traits are parts of psychopathy construct. There were a growing amount of researches in last decades connected to the appearance of C/U traits among children. Cognitive, behavioral and emotional features were identified among children with C/U traits which may contribute to the appearance of aggressive behavior. AIM: Aim of this paper is to examine connection between C/U traits and interpersonal characteristics in normative population. This paper is a part of a publication serial taken by the Institution of Psychology at the University of Debrecen and Vadaskert Child Psychiatry Hospital and Outpatient Clinic about callous/unemotional traits. METHODS AND SAMPLE: We studied 223 elementary and secondary school students using the Inventory of Callous Unemotional Traits and the Strenghts and Difficulties Questionnare. RESULTS: In case of moderate appearance of callous/unemotional traits behavior problems, relationship problems and hyperactivity are more typical furthermore presence of prosocial behavior is less typical. CONCLUSION: Results from normal population confirm assumption that C/U traits contribute to the appearance of juvenile aggression and antisocial behavior.

Restless Legs Syndrome in patients after renal transplantation.

BACKGROUND: There is an almost complete lack of information on the epidemiology of sleep disorders in kidney-transplanted patients. In this report the authors assess the prevalence and clinical correlates of restless legs syndrome (RLS) in kidney-transplanted (Tx) patients. They also analyze the impact of declining renal function on this condition in the Tx population. Finally, the prevalence of RLS was compared between waitlisted dialysis patients (WL), and the Tx group. METHODS: In a cross-sectional study enrolling 992 patients (816 Tx and 176 WL), the presence of RLS was assessed using the Restless Legs Syndrome Questionnaire. Clinical and sociodemographic data were collected from the patients' medical records. RESULTS: In transplanted patients, the prevalence of RLS was 4.8%. RLS was associated strongly with declining renal function. In groups formed on the basis of estimated glomerular filtration rate (eGFR), the prevalence of RLS was 1.8%, 5.1%, 6.5%, and 23.5% in patients with eGFR greater than 60 mL/min/1.73 m 2 ; eGFR 30 to 59 mL/min/1.73 m 2 ; eGFR 15 to 29 mL/min/1.73 m 2 ; and eGFR less than 15 mL/min/1.73 m 2 , respectively (P < 0.001). There was also a significant association between RLS and lower serum hemoglobin, higher number of self-reported comorbid conditions, and higher prevalence of iron deficiency. RLS was significantly less frequent in patients taking steroids than in patients not taking this medication (4% versus 9%, P < 0.05). In multivariate analysis, not taking steroids, eGFR, self-reported comorbidity, and iron deficiency were significant and independent predictors of RLS. Dialysis treatment was associated with increased odds for RLS (odds ratio 2.2; 95% confidence interval 1.11 to 4.35; P < 0.05) even after adjusting for serum hemoglobin and comorbidity. CONCLUSION: The prevalence of RLS is significantly lower in Tx patients than in patients on maintenance dialysis. Declining renal function is associated with increasing prevalence of the condition.

Emotion recognition pattern in adolescent boys with attention-deficit/hyperactivity disorder.

BACKGROUND: Social and emotional deficits were recently considered as inherent features of individuals with attention-deficit hyperactivity disorder (ADHD), but only sporadic literature data exist on emotion recognition in adolescents with ADHD. The aim of the present study was to establish emotion recognition profile in adolescent boys with ADHD in comparison with control adolescents. METHODS: Forty-four adolescent boys (13-16 years) participated in the study after informed consent; 22 boys had a clinical diagnosis of ADHD, while data were also assessed from 22 adolescent control boys matched for age and Raven IQ. Parent- and self-reported behavioral characteristics were assessed by the means of the Strengths and Difficulties Questionnaire. The recognition of six basic emotions was evaluated by the "Facial Expressions of Emotion-Stimuli and Tests." RESULTS: Compared to controls, adolescents with ADHD were more sensitive in the recognition of disgust and, worse in the recognition of fear and showed a tendency for impaired recognition of sadness. Hyperactivity measures showed an inverse correlation with fear recognition. CONCLUSION: Our data suggest that adolescent boys with ADHD have alterations in the recognition of specific emotions.

A community outbreak of Legionnaires' disease from an industrial cooling tower: assessment of clinical features and diagnostic procedures.

An outbreak of Legionnaires' disease (LD) occurred in Lidköping, Sweden, in August 2004. A cooling tower was identified as the probable source of infection. During the outbreak period an unexpected 3-6-fold increase in pneumonia patients was noted at the local hospital. During 7 weeks LD was diagnosed in 15 patients by urinary antigen and/or sputum culture. Additionally, 15 LD patients were diagnosed later by serology. Patients with LD were generally younger, more healthy, and more often smokers compared to other pneumonia patients. On admittance they had more severe symptoms with high fever and raised CRP levels, and more often hyponatraemia, gastrointestinal and CNS symptoms. A causative agent besides Legionella was found in 2 patients only. A significant titre rise for Mycoplasma and/or Chlamydophila pneumoniae was found in 13 of 29 tested patients with confirmed LD. We conclude that the clinical diagnosis of LD is difficult and that available diagnostic methods detect only a minority of patients in the acute phase. Therefore in severe pneumonia, empirically targeted therapy should be instituted on clinical grounds irrespective of the results of diagnostic tests. The observation of increased antibody levels for M. and C. pneumoniae suggests an unspecific immune reaction and merits further study.

Anemia in kidney transplanted patients.

BACKGROUND: Although a known cardiovascular risk factor, anemia in the renal transplant recipients has only recently been receiving an increasing attention. METHODS: In a cross-sectional study, data was obtained from 959 patients followed at a single outpatient transplant clinic. Based on the guideline of the American Society of Transplantation, anemia was defined as hemoglobin (Hb) < or =130 g/L in males and < or =120 g/L in females. RESULTS: About one-third (34%) of the patients were anemic. The prevalence of anemia was comparable in males and females. Serum Hb concentration was significantly correlated with the estimated glomerular filtration rate (eGFR) (abbreviated modification of diet in renal disease formula) (r = 0.266, p < 0.001), serum transferrin (r = 0.268, p < 0.001) and serum albumin (r = 0.196, p < 0.001). None of the immunosuppressive medications or the use of angiotensin converting enzyme inhibitors was associated with a higher likelihood of anemia. In multivariate analysis the eGFR, serum albumin and serum transferrin, potential markers of nutritional status and/or chronic inflammation, and also iron deficiency were independently and significantly associated with anemia. Erythropoietin was administered only to 63 (19%) anemic patients. CONCLUSIONS: Post-transplant anemia is a prevalent and under-treated condition. Based on our results we suggest that, besides other factors, protein/energy malnutrition and/or chronic inflammation may be independently associated with anemia. Further studies are needed to determine whether the presence of anemia and its treatment will have an impact on long-term outcomes of this population.