The relationship between emotional intelligence and quality of life in schizophrenia and bipolar I disorder.

PURPOSE: Social cognitive skills, both psychosocial functioning and well-being of patients with schizophrenia (SZ) or bipolar disorder (BD), have consistently been shown to be interrelated. While previous research mainly focused on emotion perception, the present study investigates the impact of the other subdomains of emotion processing on a subjective Quality of Life (QoL) estimate and objective QoL indicators. We hypothesized that patients with better performance in the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) report better QoL; and assumed that SZ and BD patients report comparable subjective QoL, whereas BD patients show higher levels of objective QoL. METHODS: Patients diagnosed with either SZ (n = 63) or BD (n = 60), as well as 80 healthy controls, were included into a cross-sectional study. Emotional Intelligence (EI) and QoL were assessed using the MSCEIT and the German version of the Lancashire Quality of Life Profile. RESULTS: The two patient groups were comparable with regard to overall EI, as well as subjective and objective QoL, but indicated significantly lower levels of EI and QoL than healthy controls. Whereas EI was not associated with both patient groups' subjective QoL, a significant correlation of EI with objective QoL was only observed in SZ. However, overall effect sizes were small. CONCLUSION: Our findings point to a difference in the interrelation between EI and QoL in patients suffering from SZ and BD, and suggest that they may have different needs to achieve recovery. It will be critical to develop training programs targeting EI in SZ, and to examine their impact on objective QoL in these patients.

[Reliability and concordance validity of a German version of the Young Mania Rating Scale (YMRS-D)]. / Relabilität und Übereinstimmungsvalidität der deutschen Version der Young Mania Rating Scale (YMRS-D).

OBJECTIVE: The Young Mania Rating Scale (YMRS) is the most widely used assessment tool for severity of manic symptoms in bipolar patients. While the original English version has been translated to various different languages, a validated German translation of YMRS has not yet been available. METHODS: We translated the original English version to German (YMRS-D) and tested its use in clinical practice in 81 manic inpatients at two different psychiatric hospitals in Austria. The interviews were carried out by eight experienced and trained psychiatrists in random pairs of two interviewers. In order to assess concordance validity of YMRS-D, all patients were simultaneously rated using the Clinical Global Impression Rating Scale, Bipolar Version (CGIBP), by one of three experienced senior raters. RESULTS: Inter-Rater Reliability was assessed calculating the Intra-Class Correlation Coefficient and showed high values (between 0.79 and 0.97, all p<.001) in all items of the German Rating Scale. Internal Consistency analysis of the scale yielded a value of .74 (Cronbach's Alpha). Spearmans rank correlation coefficient for the total scores of CGI-BP and YMRS-G was high (0.91, p<.001), suggesting good concordance validity of YMRS-D. Sensitivity to change was assessed in a subgroup of 20 patients by comparing YMRS-D and CGI-BP total scores at inclusion and at an additional interview three weeks later which showed a highly significant correlation (r = -0,953; p<.0005). CONCLUSIONS: The German version of YMRS seems to be a valid, reliable and useful tool for the assessment and quantification of manic symptoms.

Treatment of aggression with topiramate in male borderline patients: a double-blind, placebo-controlled study.

BACKGROUND: Borderline personality disorder (BPD) is a complex mental disease associated with severe serious functional impairment, affective instability, and impulsive aggression. The aim of this study was to compare the efficacy of topiramate versus placebo in the treatment of aggression in men with borderline personality disorder. METHODS: We conducted an 8-week, double-blind, placebo-controlled study of topiramate in 42 male subjects (42 of 44) meeting DSM-IV criteria for BPD. The Structured Clinical Interview (SCID I and II) was carried out. The subjects were randomly assigned to topiramate (n = 22) or placebo (n = 20). RESULTS: Significant changes on four STAXI scales (State Anger, p < .01; Trait Anger, p < .05; Anger Out, p < .01; Anger Control, p < .01) were observed in the subjects treated with topiramate. A nonsignificant difference was found on the Anger In scale (p = .86). Additional significant weight loss was observed (difference in weight loss between the both groups was 5.0 kg, p < .01, 95% confidence interval = [-6.5 to 3.4]). All subjects tolerated topiramate relatively well. CONCLUSIONS: Topiramate appears to be an effective agent in the treatment of anger in men with BPD. Mild weight loss can be expected.

Facial affect recognition in symptomatically remitted patients with schizophrenia and bipolar disorder.

Both schizophrenia and bipolar disorder (BD) have consistently been associated with deficits in facial affect recognition (FAR). These impairments have been related to various aspects of social competence and functioning and are relatively stable over time. However, individuals in remission may outperform patients experiencing an acute phase of the disorders. The present study directly contrasted FAR in symptomatically remitted patients with schizophrenia or BD and healthy volunteers and investigated its relationship with patients' outcomes. Compared to healthy control subjects, schizophrenia patients were impaired in the recognition of angry, disgusted, sad and happy facial expressions, while BD patients showed deficits only in the recognition of disgusted and happy facial expressions. When directly comparing the two patient groups individuals suffering from BD outperformed those with schizophrenia in the recognition of expressions depicting anger. There was no significant association between affect recognition abilities and symptomatic or psychosocial outcomes in schizophrenia patients. Among BD patients, relatively higher depression scores were associated with impairments in both the identification of happy faces and psychosocial functioning. Overall, our findings indicate that during periods of symptomatic remission the recognition of facial affect may be less impaired in patients with BD than in those suffering from schizophrenia. However, in the psychosocial context BD patients seem to be more sensitive to residual symptomatology.

Affective prosody perception in symptomatically remitted patients with schizophrenia and bipolar disorder.

Affect perception has frequently been shown to be impaired in patients suffering from schizophrenia or bipolar disorder (BD), but it remains unclear whether these impairments exist during symptomatic remission and whether the two disorders differ from each other in this regard. Most previous studies have investigated facial affect recognition, but not the ability to decode mental states from emotional tone of voice, i.e. affective prosody perception (APP). Accordingly, the present study directly compared APP in symptomatically remitted patients with schizophrenia or BD and healthy control subjects and investigated its relationship with residual symptomatology in patients. Patients with schizophrenia and BD showed comparable APP impairments despite being symptomatically remitted. In comparison to healthy control subjects, overall APP deficits were found in BD but not in schizophrenia patients. Both patient groups were particularly impaired in the identification of anger and confounded it with neutral prosody. In addition, schizophrenia patients frequently confused sadness with happiness, anger, or fright. There was an inverse association between the degree of residual positive symptoms and the ability to correctly recognize happiness in schizophrenia patients. Overall, these data indicate that impairments in APP represent an enduring deficit and a trait marker of both schizophrenia and BD and that the level of impairment is comparable between disorders.