RESUMO
Although it is known that depressive symptoms have significant impact on quality of life (QOL) in epilepsy and that atypical symptoms are common in interictal depression, less is known about the clinical significance of the atypical form of interictal depression as opposed to major depressive disorder (MDD). We compared quality of life among 30 patients with epilepsy (1) with major depressive disorder (group D), (2) with interictal dysphoric disorder (group ID), and (3) without MDD or IDD (group ND). The mean t scores on the 31-item Quality of Life in Epilepsy questionnaire were lower in groups D (20.3, 95% CI 9.02-31.7, n=3) and ID (38.7, 95% CI 34.2-43.2, n=19) compared with group ND (59.1, 95% CI 52.2-66.1, n=8). These results underscore the clinical significance of IDD that not only accounts for a large portion of mood symptoms in the population with epilepsy, but also is not adequately captured by the DSM-IV criteria for MDD.
Assuntos
Transtorno Depressivo Maior/epidemiologia , Epilepsia/epidemiologia , Transtornos do Humor/epidemiologia , Qualidade de Vida/psicologia , Adulto , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Índice de Gravidade de Doença , Inquéritos e QuestionáriosRESUMO
We evaluated a new measure, the Cancer and Deity Questionnaire (CDQ), which assesses perceived relations with God after a cancer diagnosis. Based on object relations theory, the 12-item CDQ assesses benevolent and abandoning God representations. Sixty-one older participants with recent cancer diagnoses completed the questionnaire at baseline, and 52 of these participants completed the same questionnaire at follow-up. Internal consistency was excellent for the Benevolence scale (alpha = .97) and good for the Abandonment scale (alpha = .80). Moderate correlations with the Spiritual Well-Being Scale support divergent validity. Correlations between CDQ scales and the Styles of Religious Coping scales support convergent validity. The CDQ is brief, easily scored, practical for psycho-oncology research, and adaptable for use with other illnesses.
Assuntos
Neoplasias/psicologia , Religião e Medicina , Espiritualidade , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Psicológicos , Religião , Reprodutibilidade dos TestesAssuntos
Transtorno Conversivo , Transtornos Dissociativos/diagnóstico , Convulsões/complicações , Adulto , Transtorno Conversivo/classificação , Transtorno Conversivo/complicações , Transtorno Conversivo/diagnóstico , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Eletroencefalografia , Teoria Freudiana , Humanos , Histeria/psicologia , Classificação Internacional de Doenças , Masculino , Convulsões/diagnóstico , Transtornos de Estresse Pós-Traumáticos/complicaçõesRESUMO
BACKGROUND: In 1989 the National Institute of Mental Health began a collaborative effort to identify genes for bipolar disorder. The first 97 pedigrees showed evidence of linkage to chromosomes 1, 6, 7, 10, 16, and 22 (Nurnberger et al 1997). An additional 56 bipolar families have been genotyped, and the combined sample of 153 pedigrees studied. METHODS: Three hierarchical affection status models were analyzed with 513 simple sequence repeat markers; 298 were common across all pedigrees. The primary analysis was a nonparametric genome-wide scan. We performed conditional analyses based on epistasis or heterogeneity for five regions. RESULTS: One region, on 16p13, was significant at the genome-wide p <.05 level. Four additional chromosomal regions (20p12, 11p15, 6q24, and 10p12) showed nominally significant linkage findings (p =.01). Conditional analysis assuming epistasis identified a significant increase in linkage at four regions. Families linked to 6q24 showed a significant increase in nonparametric logarithms of the odds (NPL) scores at 5q11 and 7q21. Epistasis also was observed between 20p12 and 13q21, and 16p13 and 9q21. CONCLUSIONS: The findings are presented in rank order of nominal significance. Several of these regions have been previously implicated in independent studies of either bipolar disorder or schizophrenia. The strongest finding is at 16p13 at D16S748 with an NPL of 3.3, there is evidence of epistasis between this locus and 9q21. Application of conditional analyses is potentially useful in larger sample collections to identify susceptibility genes of modest influence that may not be identified in a genome-wide scan aimed to identify single gene effects.
Assuntos
Transtorno Bipolar/genética , Genoma Humano , Cromossomos Humanos , Saúde da Família , Feminino , Ligação Genética , Genótipo , Humanos , Masculino , National Institute of Mental Health (U.S.) , Linhagem , Estados UnidosRESUMO
We conducted genomewide linkage analyses on 1,152 individuals from 250 families segregating for bipolar disorder and related affective illnesses. These pedigrees were ascertained at 10 sites in the United States, through a proband with bipolar I affective disorder and a sibling with bipolar I or schizoaffective disorder, bipolar type. Uniform methods of ascertainment and assessment were used at all sites. A 9-cM screen was performed by use of 391 markers, with an average heterozygosity of 0.76. Multipoint, nonparametric linkage analyses were conducted in affected relative pairs. Additionally, simulation analyses were performed to determine genomewide significance levels for this study. Three hierarchical models of affection were analyzed. Significant evidence for linkage (genomewide P<.05) was found on chromosome 17q, with a peak maximum LOD score of 3.63, at the marker D17S928, and on chromosome 6q, with a peak maximum LOD score of 3.61, near the marker D6S1021. These loci met both standard and simulation-based criteria for genomewide significance. Suggestive evidence of linkage was observed in three other regions (genomewide P<.10), on chromosomes 2p, 3q, and 8q. This study, which is based on the largest linkage sample for bipolar disorder analyzed to date, indicates that several genes contribute to bipolar disorder.