Irritable bowel syndrome, its cognition, anxiety sensitivity, and anticipatory anxiety in panic disorder patients.

AIM: The present study examined the effect of irritable bowel syndrome (IBS), cognitive appraisal of IBS, and anxiety sensitivity on anticipatory anxiety (AA) and agoraphobia (AG) in patients with panic disorder (PD). METHODS: We examined 244 PD patients who completed a set of questionnaires that included the Rome II Modular Questionnaire to assess the presence of IBS, the Anxiety Sensitivity Index (ASI), the Cognitive Appraisal Rating Scale (CARS; assessing the cognitive appraisal of abdominal symptoms in four dimensions: commitment, appraisal of effect, appraisal of threat, and controllability), and items about the severity of AA and AG. The Mini International Neuropsychiatric Interview was used to diagnose AG and PD. RESULTS: After excluding individuals with possible organic gastrointestinal diseases by using 'red flag items,' valid data were obtained from 174 participants, including 110 PD patients without IBS (PD/IBS[-]) and 64 with IBS (PD/IBS[+]). The PD/IBS[+] group had higher AA and higher comorbidity with AG than the PD/IBS[-] group. In the PD/IBS[+] group, the controllability score of CARS was significantly correlated with AA and ASI. Multiple regression analysis showed a significant effect of ASI but not of controllability on AA in PD/IBS[+] subjects. CONCLUSION: This study suggested that the presence of IBS may be related to agoraphobia and anticipatory anxiety in PD patients. Cognitive appraisal could be partly related to anticipatory anxiety in PD patients with IBS with anxiety sensitivity mediating this correlation.

Prevalence of bipolar disorder in panic disorder patients in the Japanese population.

BACKGROUND: We examined the rate of bipolar I (BPD-I) and bipolar II disorders (BPD-II) in panic disorder (PD) patients, and compared clinical and psychological variables between PD patients with and without bipolar disorders (BPD). METHODS: Participants were 649 Japanese patients with PD (215 men and 434 women, 38.49 ± 10.40 years) at outpatient clinics for anxiety disorders. Constructive interviews using the Mini-International Neuropsychiatric Interview (MINI) were conducted to confirm the diagnosis of PD, agoraphobia, and BPD, as well as the presence and severity of suicide risk in each subject. Clinical records were also reviewed to confirm the diagnosis of PD and BPD. Participants then completed several questionnaires, including the State Trait Anxiety Inventory-Trait scale, the Anxiety Sensitivity Index, and the Revised Neuroticism-Extraversion- Openness Personality Inventory (NEO-PI-R). RESULTS: We found that 22.34% of the PD patients had BPD (BPD-I: 5.24%, BPD-II: 17.10%). PD patients with BPD-I showed higher prevalence and severity of suicide risk, trait anxiety, anxiety sensitivity, and neuroticism, and lower agreeableness (subscales of the NEO-PI-R) than those with BPD-II and those without BPD. LIMITATION: First, we could not investigate the order of the onset of PD and BPD. Second, BPD patients without PD were not studied as another control group for PD patients with BPD. CONCLUSION: PD patients had high prevalence of BPD. Both PD patients with BPD-I and those with BPD-II had high severity of suicide risk, trait anxiety, anxiety sensitivity, neuroticism, and agreeableness, though these characteristics were more prominent in patients with BPD-I.

Association of RGS2 variants with panic disorder in a Japanese population.

Panic disorder (PD) is a severe and chronic psychiatric disorder with significant genetic components underlying its etiology. The gene regulator of G protein signaling 2 (RGS2) has been reported to be associated with anxiety disorders. To confirm the association of RGS2 with PD, we investigated three single nucleotide polymorphisms (SNPs) of RGS2 (rs10801152, rs4606, and rs1819741) in 677 Japanese PD cases and 460 controls. The SNP rs10801152 was suggestive of an association with PD (allele P = 0.045 adjusted using sex and age as confounding factors). The three-SNP haplotype was significantly associated with PD (global permutation P = 4 × 10(-4)). The haplotypes T-G-C and T-C-T showed significant association and protective effect on PD (T-G-C, permutation P = 0.038, OR = 0.80, 95%CI = 0.68-0.95; T-C-T, permutation P = 0.004, OR = 0.38, 95%CI = 0.21-0.70). These results provide support for an association of RGS2 with PD in a Japanese population.

Six-year stability of affective temperaments as measured by TEMPS-A.

BACKGROUND: A number of psychopathological and neurobiological studies on affective temperament have been conducted based on the assumption that temperament is a stable trait. However, few studies have actually assessed the long-term stability of affective temperament. The objective of this study is to evaluate the 6-year stability of affective temperaments as measured by the Temperament Evaluation of Memphis, Pisa, Paris and San Diego--Autoquestionnaire version (TEMPS-A) in a non-clinical adult population. SAMPLING AND METHODS: Study participants consisted of 178 Japanese white-collar workers (103 males and 75 females; mean age = 38.5 years, SD = 7.8) who completed the Japanese version of TEMPS-A twice over a 6-year interval, and who did not have either past or current DSM-IV affective, anxiety or psychotic disorders, as diagnosed with the Mini-International Neuropsychiatric Interview. The long-term stability of affective temperaments as measured by TEMPS-A was assessed by analyzing Pearson correlation coefficients for temperament scores over a 6-year period. RESULTS: Temperament scores were moderately to highly correlated over the 6-year period (depressive temperament, r = 0.59; cyclothymic temperament, r = 0.68; hyperthymic temperament, r = 0.82; irritable temperament, r = 0.66; anxious temperament, r = 0.74; p < 0.01 for all values). Pearson coefficients were in the range of 0.61-0.83 for males and 0.51-0.79 for females, while they were 0.56-0.85 for younger and 0.63-0.77 for older participants. All correlations were significant at p < 0.01, irrespective of temperament type, gender and age. CONCLUSIONS: Affective temperaments as measured by TEMPS-A exhibited good long-term stability and were robust, irrespective of temperament type, gender and age. Affective temperaments as measured by TEMPS-A may be considered to be stable traits, providing a sound basis for psychopathological and neurobiological studies. Limitations of this study include the fact that our sample was not drawn from the general community, it was entirely composed of Japanese participants and the size was not large.

Replication of a genome-wide association study of panic disorder in a Japanese population.

Panic disorder (PD) is an anxiety disorder characterized by recurrent and unexpected panic attacks, subsequent worry and phobic avoidance. Although a number of association and linkage studies have been conducted, no gene has been identified as a susceptibility locus. We previously conducted a genome-wide association analysis of PD in 200 Japanese patients and the same number of controls, using a 500 K single nucleotide polymorphisms (SNPs) chip. In this study, we report a replication analysis of PD using the DigTag2 assay. The second stage sample consisted of 558 Japanese patients and 566 controls. Thirty-two markers were tested in a replication sample. As a result, no significant association was found after correction for multiple testing. However, the difference was observed at the nominal allele P-value <0.05 for two SNPs (rs6733840 and rs132617). We also conducted haplotype analyses of SNPs in the APOL3 and CLU genes. Our results failed to show any significant association with PD in these genes. Further studies on these variants with a larger sample size may be worth testing to confirm the results.

No association between the brain-derived neurotrophic factor gene and panic disorder in Japanese population.

Panic disorder (PD) is a severe and chronic psychiatric disorder, with significant genetic components in the etiology. Brain-derived neurotrophic factor (BDNF) gene, which has regulatory effects on neurotransmitter systems such as serotonin and dopamine, is a candidate for susceptibility locus of PD. This study investigated three single-nucleotide polymorphisms (SNPs) of BDNF (rs6265 (Val66Met), rs11030104 and rs7103411) in Japanese patients with PD and controls. No significant association was observed between the three SNPs and PD. No association of the Val66Met was consistent with two small studies in Japanese and Chinese populations. We therefore conclude that the BDNF polymorphism may not play a major role in PD in the East Asian populations.

Association study between the cholecystokinin A receptor gene and schizophrenia in the Japanese population.

Cholecystokinin A receptor (CCK-AR) has been implicated in the pathophysiology of schizophrenia through its mediation of dopamine-release in the central nervous system. Several studies have observed the association between the CCK-AR gene and schizophrenia. Especially, the association has been repeatedly observed between the 779T/C polymorphism and auditory hallucinations or positive symptoms of schizophrenia. In this study, we investigated the association between the 779T/C polymorphism of the CCK-AR gene and schizophrenia in 290 Japanese patients with schizophrenia and 290 controls. As a result, no significant difference was observed in genotypic distributions or allelic frequencies between the patients and controls, although there was a trend for the association between the C allele of the polymorphism and hallucination (P=0.024) or hallucinatory-paranoid state (P=0.049). In conclusion, the present results may not provide evidence for the association between the CCK-AR gene and schizophrenia in the Japanese population.

No evidence for an association between the BDNF Val66Met polymorphism and schizophrenia or personality traits.

Brain-derived neurotrophic factor (BDNF) is a member of the nerve growth factor family, which plays a critical role in neurodevelopment. Based on the neurodevelopmental hypothesis, the BDNF gene has been a candidate locus for schizophrenia. In Caucasians, recent studies identified an association with the Val66Met polymorphism, which has been suggested to affect episodic memory and hippocampal function in humans. However, in other populations, the association has not been replicated. In the present study, we investigated the association between the Val66Met polymorphism of the gene and schizophrenia in 401 Japanese patients with schizophrenia and 569 controls. As a result, we did not observe a significant difference in genotypic distribution or allele frequencies between the patients and controls (chi2=0.56, df=2, p=0.76 and chi2=0.39, df=1, p=0.53, respectively). We also investigated the association between the polymorphism and personality traits in the controls; however, no significant association was observed. Thus, the present study did not provide evidence for an association between the BDNF gene and schizophrenia or personality traits in the Japanese population.