Do age and education contribute to performance on the clock drawing test? Normative data for the Greek population.

Our purpose in undertaking the present study was to develop norms for the Greek population for the Clock Drawing Test (CDT), using a systematic scoring procedure, and to explore the influence of demographic factors on the performance of healthy individuals. We administered the CDT to 223 healthy adults and scored it according to the method of Freedman et al. (1994). In 136 of the participants, we also measured global cognitive status with the Mini-Mental State Examination. We found that both age and level of education contributed to CDT performance. Interestingly, CDT performance was relatively consistent across the ages between 14-59 years, showing a marked decline after 60 and another decline after 70. Therefore, we concluded that CDT performance is relatively resistant to the effects of age for those below 60 years old. We present preliminary normative data for the Greek population stratified by age and level of education. Further research should include more extensive sampling of elderly participants (>60 years old) with varying levels of education, in order to establish more reliable norms for the elderly.

Quality of life of children and adolescents with diabetes of Northern Greek origin.

AIM: To culturally adapt the diabetes- specific quality of life (QOL) instrument PedsQL 3.0 Diabetes Module (DM) and the generic QOL instrument PedsQL 4.0 Generic Core Scales (GCS) to the population of Greek diabetic children. Also, to evaluate QOL in youths with type 1 diabetes, compare it with that of healthy youths, and identify relationships between QOL and metabolic control and intensity of treatment. PATIENTS AND METHODS: Eighty nine (89) children and adolescents with type I diabetes and 89 without diabetes, all with their parents (2-18 years of age, diabetes duration>6 months) completed the Greek GCS. Those with diabetes also completed the Greek DM. RESULTS: Cronbach alpha coefficient of child and parent report of both instruments, in general approached 0.70, indicating their internal consistency reliability. Both instruments demonstrated positive intercorrelations with their total scores and subscales of DM demonstrated positive intercorrelations with total score of the generic instrument, supporting the validity of both instruments for the evaluation of QOL of Greek diabetic children. No statistically important differences were found among patient and parent report of diabetes and control group in both instruments. Exception was "Social functioning" in which children with diabetes reported better QOL. Growing age, female gender, large BMI, poor metabolic control and intensity of treatment did not influence QOL of children with diabetes. CONCLUSIONS: Greek PedsQL GCS and DM have sufficient acceptability, reliability and validity so as to be used for the purposes of a comparative study. Youth with diabetes reported similar QOL with non-diabetic youth of the same age and socioeconomic status.

Treatment of Huntington's disease with galantamine.

We present the case of a patient with Huntington's disease and psychosis, whose motor and psychiatric symptoms improved after administration of galantamine, an acetylcholinesterase inhibitor.

Urinary retention caused after fluoxetine-risperidone combination.

A case of urinary retention emerging after fluoxetine (20 mg/day) addition to low risperidone doses (2 mg/day) is presented. Severe extrapyramidal side-effects (EPS) also occurred after fluoxetine-risperidone combination. Several possibilities, based on the pharmacodynamic and pharmacokinetic properties of risperidone and fluoxetine, which merit consideration in an attempt to explain our patient's side-effects, are discussed. Extrapyramidal side-effects can be due to an increase of the plasma concentration of risperidone and/or the intrinsic propensity of fluoxetine to produce EPS. Urinary retention may be the consequence of a central serotoninergic mechanism in, or without, combination central D2 blockade.

Schizophrenic-like symptoms in a patient with thrombo-angiitis obliterans (Winiwarter-Buerger's disease).

In this article a case of schizophrenic-like symptoms in a patient with thrombo-angiitis obliterans (TAO) is presented. His CT and MRI findings indicated a diffuse ischemia in the white matter, suggestive of TAO, not of focal lesions. The patient, except for age, did not have other risk factors for other cerebrovascular diseases. Psychotic symptoms may be the result of cerebral TAO, via deep and periventricular white matter lesions.

Dependence on zolpidem in high dose.

There are some indications that zolpidem is open to potential abuse. We present four cases of former drug or alcohol abusers with personality disorders, who all developed dependence on zolpidem in high dose.

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.

Literacy and hemispheric specialization for language: dichotic listening in young functionally illiterate men.

The functional cerebral organization of young men who were defined as illiterate was studied by testing their dichotic listening for language stimuli. These functionally illiterate men showed greater right ear advantage for language stimuli than 50 educated subjects, a pattern already observed with completely illiterate persons of both sexes. This finding is consistent with the view that mastering written codes for language might be one of the most relevant parameters in hemispheric specialization when language is studied.

Hemispheric specialization for language in the congenitally blind: the influence of the Braille system.

The functional cerebral organization of two groups of congenitally blind persons of different age and schooling was studied by testing their dichotic listening to pairs of digits. The younger congenitally blind group showed a comparable level of performance to their control counterparts; however, older subjects shifted their initial right ear advantage to an increased left ear performance as they progressed in the mastery of the Braille system. As this system is founded on spatial strategies, we can conclude that this shift is related to the activation of some right hemispheric linguistic mechanisms.