Relationships between anhedonia, alexithymia, impulsivity, suicidal ideation, recent suicide attempt, C-reactive protein and serum lipid levels among 122 inpatients with mood or anxious disorders.

Several studies have explored the relationship between C-reactive protein (CRP), serum lipid levels, risk of suicide and alexithymia or impulsivity in mood or anxiety disorders. However, to date, no study has evaluated the effects of anhedonia on these parameters. The aim of the study was to evaluate the relationship between anhedonia, alexithymia, impulsivity, suicidal ideation, recent suicide attempt, C-reactive protein (CRP) and lipid levels in patients with mood or anxiety disorders. One hundred and twenty-two inpatients with mood or anxiety disorders were recruited. Alexithymia and impulsivity were rated by the 20-item Toronto Alexithymia Scale (TAS-20) and the Barratt impulsivity scale (BIS-10), respectively. Anhedonia and depression were rated by the Temporal Experience Pleasure Scale (TEPS) and the Beck Depression inventory (BDI-II). The TEPS contained two subscales rating anticipatory and consummatory anhedonia. From the BDI-II an anhedonia subscale was extracted rating anhedonia-state. Trait consummatory anhedonia and state anhedonia were associated with low levels of total cholesterol or HDL and low levels of triglycerides respectively. Trait anticipatory anhedonia and state anhedonia were associated with suicidal ideations. The difficulty of identifying feelings component of alexithymia was associated with low levels of total cholesterol and LDL. A high level of suicidal ideation was associated with low levels of HDL. Higher levels of CRP were found in inpatients having recently attempted suicide compared with inpatients who had not attempted suicide. In mood and anxiety disorders, anhedonia and the "difficulty of identifying feelings" component of alexithymia (which has previously been found to be associated with suicide risk) could explain the relationship between serum lipid levels and higher suicide risk.

Criterion validity of the cognitive slippage and schizotypal ambivalence scales.

This study explored the criterion-validity of the Cognitive Slippage Scale (CSS) and the Schizotypal Ambivalence Scale (SAS). 27 first-degree relatives of individuals with schizophrenia (9 males, 18 females; M age=45.3 yr., SD=13) were compared with 30 first-degree relatives of non-psychotic patients (15 males, 15 females; M age = 44.6 yr., SD = 11.6) on the French versions of the CSS and SAS. The former group, who is at high risk for schizophrenia, had significantly higher scores than the latter group on both scales.

Subjective experiences in first-degree relatives of schizophrenic subjects.

First-degree relatives of patients with schizophrenia may score higher on the Frankfurt Complaint Questionnaire (FCQ) than controls. The present study was designed to provide evidence of validity for the French version of the 24-item subscale of the Frankfurt Complaint Questionnaire (FCQ-24). In 27 first-degree relatives of patients with schizophrenia (high-risk group) and 30 controls, the high-risk group scored significantly higher on the FCQ, as expected.

Test-retest reliability of the Frankfurt Complaint Questionnaire.

Long-term reliability of the Frankfurt Complaint Questionnaire (FCQ) was investigated in two follow-up studies of participants with psychosis using a test-retest method. In the first study (N = 56), the duration of the follow-up ranged from 6 months to 2 years; Spearman rho was .62 for the abridged (18 items) Spanish version of the questionnaire. In Study 2 (N = 21), in participants with stable schizophrenia, the follow-up ranged from 8 to 11 years; test-retest Spearman rho was .83 for the French version of the questionnaire. Subjective experiences could constitute, in psychosis-prone people, traits or markers of psychotic vulnerability.

Relationships between subjective or objective symptoms and mortality in schizophrenia: a prospective study on 310 schizophrenic patients with a median follow-up of 8.4 years.

The aim of the study was to explore the relationships between subjective or objective symptoms and mortality in schizophrenia. 310 subjects meeting the ICD-10 criteria for schizophrenia were included in the study between 1998 and 2000. At the initial assessment the following variables were respectively assessed to evaluate subjective and objective symptoms: the Frankfurt Complaints Questionnaire (FCQ) and the Positive and Negative Syndrome Scale (PANSS). In May 2008, information about the subjects were collected in order to know if they are alive or not and if they are deceased to know the date and the causes of their death. Survival analysis was conducted using the Kaplan-Meier product-limit estimator and standardized mortality ratio (SMR) was calculated. A multivariate Cox regression was done to detect predictive factors associated with mortality. Absolute mortality rates were 10.01%, 4.46% and 5.42% for overall mortality, unnatural causes and natural causes, respectively. SMR for overall mortality was 4.73. Cox regression analyses showed that elevated scores of FCQ was significant predictor of deaths from unnatural causes. High levels of subjective symptoms, as rated by the FCQ were independent predictor of mortality by unnatural causes in schizophrenic subjects. There were several limitations: The causes of death were not determined by autopsy and secondly, the duration of the study could be insufficient to detect significant associations between clinical variables and mortality.

Mortality in Kraepelinian schizophrenic patients: a prospective study with a median follow-up of 8.4 years.

Kraepelinian schizophrenia is a subtype of schizophrenia defined by its very poor outcome. Several studies have demonstrated the validity of this distinction, but the expected excess mortality has not been investigated. The aim of the present study was to test the hypothesis that Kraepelinian schizophrenic subjects have a higher mortality rate, notably due to natural causes, than non-Kraepelinian schizophrenic subjects. The results of a prospective study with a median follow-up of 8.4 years are reported. Three hundred ten schizophrenic subjects meeting the International Classification of Diseases, 10th Revision, criteria for schizophrenia were classified on admission as Kraepelinian schizophrenia (n = 31) and non-Kraepelinian schizophrenia (n = 279); 31 deaths (16 from unnatural causes, 13 from natural causes, and 2 from undetermined causes) were observed during follow-up. Univariate and multivariate Cox regression analyses were performed using schizophrenia subtype (Kraepelinian vs non-Kraepelinian), age, and duration of illness as predictors. Schizophrenia subtype was a significant predictor of mortality in univariate analysis only for death from natural causes, and a trend was observed after adjusting for age and duration of illness. A log-rank test was used to compare mortality rates between Kraepelinian and non-Kraepelinian schizophrenic subjects and showed a significantly higher mortality rate from natural causes in Kraepelinian schizophrenia (16.7%) than in non-Kraepelinian schizophrenia (4.1%).

Fourteen-year prospective follow-up study of positive and negative symptoms in chronic schizophrenic patients dying from suicide compared to other causes of death.

BACKGROUND: Several trials have suggested that negative symptoms are inversely correlated with suicidal risk in schizophrenic patients. This fourteen-year follow-up study compared the positive and negative symptoms of schizophrenic patients who died from suicide to those of subjects dying from other causes. SAMPLING AND METHODS: From 1991 to 1995, 150 patients meeting the research diagnostic criteria for chronic schizophrenia were assessed. On inclusion, they completed the Physical Anhedonia Scale as well as the Beck Depression Inventory, and the positive and negative symptoms were rated by the Positive and Negative Syndrome Scale. RESULTS: During the 14-year follow-up, 8 patients committed suicide, while 17 died from other causes. The suicide victims had a shorter duration of illness and a higher level of education compared to those who died from other causes. The proportion of 'negative' subjects, according to the composite index of the Positive and Negative Syndrome Scale, was lower among the suicide victims than among the participants who died from other causes. All these differences were significant. The rate of deficit syndrome (0%) among the suicides was lower than that (23.5%) of the other subjects. The scores on the Physical Anhedonia Scale and of the social withdrawal item of the Beck Depression Inventory were higher in the suicides than in the subjects who died from other causes. CONCLUSIONS: These findings suggest that negative symptoms and notably deficit-negative symptoms could be associated with a low risk of suicide. In this study, the link between anhedonia and high risk of suicide in schizophrenic patients indicates that this symptom could be more closely related to depression than to negative symptoms.

Relationships between schizotypy and subjective experiences in a sample of 399 university students.

The high-risk approach based on the definition of schizotypy by Meehl (The American Psychologist 1962;17:827-38) and the basic symptom approach proposed by Huber (Fortschritte für Neurologie und Psychiatrie 1957;25:491-520) share many points in common. In particular, several studies have shown that high scores on psychosis proneness or subjective experiences (SE) scales were associated with the onset of psychotic disorders in nonpsychiatric or nonpsychotic subjects. However, the relationships between the 2 concepts have never been studied experimentally. The present study was therefore designed to investigate the relationships between the scores of the SE scale and several psychosis proneness scales evaluating the negative and positive components of schizotypy in a sample of 399 university students. Data were analyzed using multiple regression and principal components analyses. The results show that SE, as assessed by the Frankfurt Complaint Questionnaire, were significantly associated with the positive component of schizotypy but not with the negative component. Subjective experiences could constitute vulnerability traits for psychosis and the Frankfurt Complaint Questionnaire could be use instead of the positive psychosis proneness scales.

Dimensional structure of the Frankfurt Complaint Questionnaire in a sample of French students.

BACKGROUND: The Frankfurt Complaint Questionnaire (FCQ) is a questionnaire designed to evaluate the subjective symptoms of schizophrenics. In schizophrenic samples, several validation studies of the FCQ using principal components analyses (PCA) have shown a one-factor solution. AIM: The aim of the present study was firstly to examine the factor structure and the psychometric properties of the FCQ in a sample of 399 students and secondly to explore the reliability of the FCQ-24, a 24-item subscale extracted from the FCQ. METHOD: PCA was done using several guidelines to select the number of factors. RESULTS: PCA yielded one factor, and the values of the Cronbach alpha were 0.95 and 0.87 for FCQ and FCQ-24, respectively. CONCLUSIONS: These results firstly suggested an unidimensionality underlying FCQ items in nonpsychiatric samples and secondly confirmed the satisfactory reliability and validity of the FCQ and its subscale. Psychometric properties of the rating scales must be confirmed in other nonpsychiatric samples. CLINICAL RELEVANCE: As subjective symptoms allow to detect subjects prone to schizophrenia, it is important to use well-validated rating scales.

Subjective experiences and the psychopathological dimensions in schizophrenia.

The aim of this article was to explore the relationships between subjective experience (SE) and objective symptoms in schizophrenia. Exploratory principal component analysis was used to determine the latent organization of the variables. A group of 310 chronic patients with schizophrenia who met ICD-10 criteria for F20 schizophrenic disorder were included in the study. SE and objective symptoms were rated using, respectively, the 24-item version of the Frankfurt Complaint Questionnaire (FCQ-24) and the Positive and Negative Syndrome Scale (PANSS). An exploratory principal component analysis was performed on the correlation matrix comprising items from both the FCQ-24 and the PANSS. Using several guidelines to select the number of factors, the exploratory principal component analysis yielded a six-factor solution with no overlap of the significant factor loadings for the items from each scale. These six factors represent, respectively, the subjective, negative, positive, disorganization, hostility and anxious-depressive dimensions of the schizophrenic phenomenology. The findings support the view that SE is a construct that is separate and distinct from the objective symptomatology in schizophrenia.

Clinical characteristics and risk factors for Kraepelinian subtype of schizophrenia: replication of previous findings and relation to summer birth.

The aims of the study were: (1) to replicate findings that patients with Kraepelinian schizophrenia constitute a distinct subgroup and (2) to examine the relationship between season of birth and the Kraepelinian subtype. Thirty-one Kraepelinian patients, defined on the basis of a longitudinal criterion--at least 5 years of continuous and complete dependence on others to maintain the basic necessities of life, including food, clothing and shelter--were compared with 279 non-Kraepelinian schizophrenic patients. All patients met ICD-10 criteria for schizophrenia and were evaluated with the Positive and Negative Syndrome Scale. Kraepelinian schizophrenic patients had more negative symptoms and were more disorganized than non-Kraepelinian patients. Positive and anxious-depressive symptoms did not differ between the two groups. Among Kraepelinian patients, there was an excess number of births in the month of July. These findings are consistent with previous reports that Kraepelinian patients could have a disease with an etiopathophysiology separate from that of other schizophrenic patients.

Dimensional structure of the Frankfurt Complaint Questionnaire.

The Frankfurt Complaint Questionnaire (FCQ) was designed to evaluate the subjective symptoms of schizophrenics. Several validation studies of the FCQ using principal components analyses (PCA) have shown one-, two-, or four-factor solutions. The present study was conducted using FCQ data on 310 schizophrenics who met the ICD-10 criteria for F20 (schizophrenia) disorder. Using several guidelines to select the number of factors, the PCA yielded one factor. This result suggests a unidimensionality underlying FCQ items. A new scale comprising 24 items was derived from those items with higher weights in the first factor.