The improvement in neurocognitive functioning in anorexia nervosa adolescents throughout the integrative model of psychotherapy including cognitive remediation therapy.

BACKGROUND: Patients with anorexia nervosa (AN) experience difficulties in neurocognitive functioning in the acute phase of illness which might be related to clinical presentation, but also in the apparently remitted state after weight recovery. Among the most commonly reported persistent deficits is cognitive inflexibility, which can be interpreted as a vulnerability trait or a "neuropsychological scar" reflecting the detrimental effect of prolonged semi-starvation in patients with a long duration of illness. Studies of adolescent samples with a relatively short clinical course may enable avoiding the effect of prolonged illness and help to determine whether neuropsychological deficits are trait or state dependent. The aim of this study is to assess cognitive functioning in adolescents with AN before and after the inpatient treatment programme, including cognitive remediation therapy (CRT). METHODS: Forty-seven adolescent female inpatients with AN diagnosed according to DSM-5 and fifty healthy female adolescents matched for the education level and age were recruited. The patients underwent a multimodal treatment including a ten-week CRT. The standardized and cross-validated neuropsychological (Trail Making Test - TMT A and B, Color-Word Stroop Task - CWST, Ruff Figural Fluency Test - RFFT) and clinical measurements (Beck Depression Inventory - BDI, Eating Attitude Test - EAT-26, Yale-Brown Obsessive Compulsive Scale - Y-BOCS) were used to assess both clinical (in the acute phase and after partial weight recovery) and control subjects. RESULTS: Initially, AN patients performed significantly worse compared to the controls, but afterwards, inpatient treatment improvement was noted on all examined measures. In a few subtests (TMT, CWST) performance of AN patients after the programme was still significantly poorer than in HC. CONCLUSIONS: Cognitive inflexibility in adolescent AN patients, as measured with TMT, CWST, and RFFT tends to improve after therapy. Nevertheless, a few neuropsychological subtests which did not show complete normalization may warrant attention in subsequent studies. Further research including control intervention is needed to conclude whether CRT intervention affects the outcome.

A genome-wide association study of anorexia nervosa.

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.

Quality of life and depression in schizophrenic patients.

PURPOSE: The aim of the study was to assess depressive symptoms, and to establish their influence on the subjective and objective quality of life (QOL) in schizophrenia patients. MATERIAL AND METHODS: Seventy four subjects: 46 male and 28 female, aged 24.7 +/- 6.7 years, were enrolled for the study. World Health Organization of Life Instrument-Bref (WHO-QOL-BREF), Social Functioning Scale (SFS) and Calgary Depression Scale for Schizophrenia (CDSS) were used. RESULTS: Severity of depressive symptoms showed moderate correlation with objective and strong correlation with subjective measures of QOL. CONCLUSIONS: Detection and appropriate treatment of depressive symptoms in schizophrenic patients may affect their functioning and perception of own health.

Objective and subjective quality of life in schizophrenic patients after a first hospitalization.

PURPOSE: There is no single, universally accepted definition of quality of life (QOL). Both subjective and objective information is necessary to assess QOL. The aim of the study was to evaluate in cross-sectional and prospective manner objective and subjective quality of life in schizophrenic patients 1 month after hospitalization and in one year follow-up. MATERIAL AND METHODS: A study sample consisted of 86 schizophrenic subjects: 52 male and 34 female; age 25.5; +/-5.8 (range 17-47) and control group of matched 52 male and 34 female subjects were enrolled. Subjective QOL scale (WHOQOL-BREF), Social Functioning Scale (SFS) and structured questionnaire were used. Patients were evaluated 1 month (T1) and 13 months (T2) after a discharge from the hospital. RESULTS: In both T1 and T2 we found similar levels of SFS score and subjective measurement of QOL in patients, which were significantly lower than in healthy controls. CONCLUSIONS: This study showed that both objective and subjective quality of life are significantly decreased directly after hospitalization, and they are relatively stable in 1-year follow-up.

Temperament and character inventory and pharmacotherapeutic outcome in bulimia nervosa.

OBJECTIVE: To assess the relationship between the personality dimensions measured by the temperament and character inventory (TCI) and pharmacotherapeutic outcome in bulimia nervosa (BN). METHODS: Thirty female BN patients aged 19.5+/-2.9 years were enrolled to receive 12 weeks' treatment with fluoxetine or buspirone and assessed using the Polish version of the TCI. The personality dimensions of the patients with good and poor treatment responses were compared. RESULTS: The subjects with a good outcome had a higher self-directedness and lower harm avoidance score; this difference was more pronounced in the fluoxetine-treated subjects. At multiple regression analysis, only self-directedness predicted a good outcome. DISCUSSION: The results indicate that self-directedness is associated with a good pharmacotherapeutic outcome in BN. This seems to confirm the results of previous studies of the pharmacotherapy of depression and cognitive-behavioural therapy (CBT) in BN.

[Polish version of Temperament and Character Inventory (TCI): the analysis of reliability]. / Polska wersja Inwentarza Temperamentu i Charakteru (TCI): analiza rzetelnosci.

The reliability of every main scale of the Polish version of Temperament and Character Inventory (TCI) was proven on the group of 144 students.

Polymorphisms in the dopamine, serotonin, and norepinephrine transporter genes and their relationship to temperamental dimensions measured by the Temperament and Character Inventory in healthy volunteers.

There is evidence for an association between polymorphisms of monoamine transporter genes and temperamental personality traits. Recent findings have shown that interaction of allelic variants of the different genes may contribute to the personality factors. We studied the association between temperamental personality dimensions measured with the Temperament and Character Inventory (TCI) and polymorphisms of the dopamine (DAT), norepinephrine (NET) and serotonin (5-HTT) transporter genes in 127 healthy Polish volunteers. There were no significant differences between means of TCI temperamental dimensions (novelty seeking, reward dependence, persistence and harm avoidance) and the transporter genes compared by ANOVA. There were some significant associations between genotypes and TCI subdimensions. Individuals carrying the A9/A9 DAT genotype have lower RD4 scores (dependence vs. independence) than A10/A10 individuals (3.0 +/- 1.4 vs. 3.5 +/- 1.3); p = 0.01. Examining 5-HTT gene promoter polymorphism, heterozygous individuals (l/s) and individuals with 44-bp deletion (s/s) scored significantly lower in the HA1 subdimension (anticipatory worry and pessimism vs. uninhibited optimism; 4.3 +/- 2.3 vs. 5.5 +/- 2.6) in comparison with individuals without deletion (l/l); p = 0.021. The NET transporter gene polymorphism showed no significant association with any of the temperamental TCI subdimensions.

[Genetic factors in the etiology of anorexia nervosa]. / Czynniki genetyczne w etiologii jadlowstretu psychicznego.

Anorexia nervosa (AN) is a disease of complex ethiopatogenesis. Population genetics studies suggest a significant role of genetic factors in the morbidity risk. Family and twin studies allow for the estimation of the heritability--the influence of genetic factors on the specific phenotype--of the anorexia nervosa in 50-80%. Due to the low prevalence of the disease, the adoption studies have not been performed. The rapid development of the molecular biology methods gives possibility for the searching of the specific genes increasing the risk of anorexia nervosa. Linkage studies are based on scanning the whole genome for loci associated with susceptibility to a certain disease. In the preliminary studies, no linkage was found between anorexia nervosa and the markers on the chromosomes 1-5, 13 and X. In the association studies, relationship between vulnerability to AN and polymorphism in 5-HT2a receptor and uncoupling proteins gene were reported. These results need further confirmation.

[Detection of anti-Borna disease virus antibodies in patients hospitalized in psychiatric hospitals located in the mid-Western region of Poland]. / Przeciwciala prezeciwko wirusowi choroby Borna u pacjentów hospitalizowanych w szpitalach psychiatrycznych na terenach województw lubuskiego i wielkopolskiego.

Borna Disease Virus (BDV) is single stranded RNA virus, which may infect a wide range of animal species. Manifestations of the experimental BDV infection show some resemblance to psychopathological symptoms of mental disorders in humans. Several reports suggest the higher prevalence of anti-BDV antibodies in psychiatric patients than in healthy controls. However, the seroprevalence of anti-BDV antibodies varied due to the different serological methods used in the previous studies. Electrochemiluminescence Immunoassay (ECLIA) is a recently developed, highly specific method of detecting antibodies directed toward two BDV proteins: p24 and p40. We used the ECLIA method for the assessment of seropositivity in 946 psychiatric patients hospitalized in the psychiatric hospitals in the western part of Poland. All patients were clinically diagnosed with ICD-10 criteria. Anti-p40 antibodies have not been found in the studied sample. We found anti p-24 antibodies in 23 cases, which give the seroprevalence rate of 2.4%. This result is consistent with the outcome of Japanese population assessment, done with the same methodology. The seropositive cases did not show diagnostic specificity. We did not find statistically significant gender differences in rate of seropositivity. The seroprevalence of anti-BDV antibodies was not significantly different in patients of urban and rural residence, and in patients of different age groups. This is the first demonstration of anti-BDV antibodies in the Polish population of patients hospitalized in psychiatric hospitals.

[Transmission of Borna disease virus as etiopathogenetic factor in schizophrenia and affective disorders]. / Zakazenia wirusem choroby Borna jako czynnik etiopatogenetyczny w schizofrenii oraz w chorobach afektywnych.

Borna Disease Virus (BDV) is a negative single-stranded ribonucleic acid (RNA) virus, showing strong neurotropism. BDV may infect many different warm-blooded animal species, causing neurological and behavioral disorders. Seroepidemiological studies suggest the existence of human infections with BDV and their higher prevalence in psychiatric patients. Using different serological assays, anti-BDV antibodies were found in about 10%-20% of patients with schizophrenia, and in 1%-2% of the control group of healthy subjects. There are also reports on BDV antigens and BDV RNA in peripheral blood mononuclear cells of human subjects, and in the brain tissue examined during the autopsy in patients with psychiatric disorders. Higher prevalence of BDV infection markers was also found in the group of patients with affective illness. A hypothesis was put forward on the activation of BDV-infection in patients with affective illness during acute episode. There are also reports on higher BDV-seropositivity in various psychiatric disorders compared with healthy control subjects. It also would be purposeful to study a possibility of BDV infections in patients with psychiatric disturbances, having their onset in childhood or adolescence.