The psychopathology of parents of children and adolescents with obsessive-compulsive disorder.

OBJECTIVE: Our purpose was to determine the rates of psychopathology in parents of children and adolescents with obsessive-compulsive disorder (OCD) and compare these with that found in parents of children with learning disorders of reading and written expression. METHOD: Thirty-one children with OCD, aged 8-15 years, and their parents (n = 62), aged 43-48 years, were studied and compared to 30 children with learning disorders, aged 7-16 years, and their parents (n = 58), aged 40-46 years. In order to investigate the parental psychopathology, the Symptom Checklist-90-R (SCL-90-R), the State and Trait Anxiety Inventory and the Yale-Brown Obsessive-Compulsive Scale were administered. The psychopathology of children was examined through the Schedule for Affective Disorders and Schizophrenia for school-aged children and other instruments. RESULTS: Both fathers and mothers of the probands differed from the controls in a variety of symptoms (i.e. anxiety, depression, obsessions, etc.). Both parents had increased severity of OC symptomatology in comparison to the controls. In addition, the probands' fathers had severe OC symptomatology at a higher percentage than the mothers and respective controls. CONCLUSION: The elevated scores of the parents of children with OCD in some SCL-90-R subscales can be perceived as an index of heightened psychopathology. More fathers in the OCD group, compared to mothers and controls, were found to have OC symptoms in the SCL-90-R and increased severity of OC symptoms on the Yale-Brown Obsessive-Compulsive Scale. The last finding requires further study. Parental psychopathology in children with OCD needs to be addressed clinically.

Plasmalogen levels in Gaucher disease.

Plasmalogens represent a unique type of phospholipids characterized by the presence of a vinyl-ether bond at the sn-1 position of the glycerol backbone. Peroxisomes are essential in their biosynthesis. Their suggested functions include protection against oxidative stress, participation in signal transduction, membrane fusion events, cholesterol transport and membrane trafficking, processes known to be disturbed in sphingolipidoses. We here report on red blood cell membrane plasmalogen levels in Gaucher disease patients. Plasmalogen levels were measured as their dimethylacetal derivatives (DMA) by gas chromatography in lipid extracts of erythrocytes from 15 patients. Their relative amount was estimated as the ratio between C18:0 DMA and methylstearate (C18:0), as well as C16:0 DMA and methylpalmitate (C16:0). Statistically significant lower levels of both plasmalogen species were observed in Gaucher disease patients compared to normal individuals. Furthermore, a negative correlation between plasmalogen levels and chitotriosidase was observed in the patients, which was statistically significant for the C18:0 species. Upon therapy, a significant rise of plasmalogen levels and fall in chitotriosidase activity was observed. However, C18:0 DMA/C18:0 was still significantly lower in Gaucher disease patients compared to controls and the negative correlation to chitotriosidase persisted. At both time points there was no indication of an overt peroxisomal dysfunction, very long chain fatty acid, phytanate and pristanate levels being normal. In conclusion, reduced plasmalogen levels that show a significant rise following treatment and a negative correlation to total disease burden, as expressed by chitotriosidase activity, are observed in Gaucher disease.

Linoleic and arachidonic acid in perinatal asphyxia and prematurity.

OBJECTIVES: Long-chain polyunsaturated fatty acids (LC-PUFA) are important for fetal and infant growth and development. The effects of prematurity and perinatal asphyxia on the levels of linoleic acid (LA) and arachidonic acid (AA) in plasma and red blood cell (RBC) membranes were investigated. METHODS: Fifty-five neonates were studied: 18 full term neonates with perinatal asphyxia (group A), nine preterm neonates (group B), and 28 healthy term neonates (group C). Non-esterified and total levels of LA and AA in plasma and RBC membranes were estimated using gas chromatography within the first day of life. Malondialdehyde (MDA) levels were measured using the thiobarbituric acid (TBA) reactivity method. RESULTS: Compared to group C, statistically significant lower levels of plasma free and total AA and free LA were observed in group A, whereas statistically significant higher levels of RBC total LA and AA were observed in RBC membranes of group B. A negative correlation between MDA and LC-PUFA levels was found. CONCLUSION: Perinatal asphyxia is associated with a reduction in LC-PUFA levels, most likely as a result of increased oxidative stress. Premature infants soon after birth have higher LC-PUFA levels than term neonates, probably reflecting the overall metabolic activity and/or intrauterine transport of LC-PUFA.

Pilot study of intrauterine exposure to methylmercury in Eastern Aegean islands, Greece.

A group of islands with a total population of about 200,000 was identified in the Eastern Aegean, where there was evidence to suggest possible increased exposure to methylmercury (MeHg) through consumption of fresh local fish and other seafood from seas bordered by mercury-bearing rock. A feasibility study was conducted to explore the possibility of defining a local population of mother-child pairs in whom to investigate the intrauterine exposure effect. Analysis of 246 hair samples collected from pregnant women and mothers of newborn babies and children under 5 years showed levels of total Hg from 0.046 microg/g to 17.5 microg/g, geometric mean 1.36 microg/g, and of MeHg from 0.031 microg/g to 16.2 microg/g, geometric mean 1.07 microg/g. About 5% of the mothers had hair total Hg levels in excess of 6.00 microg/g. Investigation of dietary habits showed that one-third of the mothers eat fresh local fish at least 3 times weekly, one-third once a week and 10% rarely or never. There was a close association between weekly rates of local fish consumption and hair levels of both total Hg and MeHg. A power calculation determined that a cohort of 3000 mother-child pairs would enable comparison of a high-exposure group (those with the upper 5% of hair MeHg) with a low exposure group (5%, selected from those with the lower 30% of hair MeHg, matched for confounding factors), in order to detect an effect size of 0.35 to 0.45 at a power of 85-95%. It is concluded that the mothers and children in the Eastern Aegean islands studied comprise a population suitable for an epidemiological study of the effects of intrauterine exposure to MeHg via maternal fresh local fish consumption.

Aiming at Tobacco Harm Reduction: a survey comparing smokers differing in readiness to quit.

BACKGROUND: Greece has the highest smoking rates (in the 15-nation bloc) in Europe. The purpose of this study was to investigate Greek smokers' intention and appraisal of capability to quit employing the theoretical frameworks of Decisional Balance (DB) and Cognitive Dissonance (CD). METHODS: A cross-sectional study including 401 Greek habitual smokers (205 men and 195 women), falling into four groups according to their intention and self-appraised capability to quit smoking was carried out. Participants completed a questionnaire recording their attitude towards smoking, intention and self appraised capability to quit smoking, socio-demographic information, as well as a DB and a CD scale. RESULTS: The most numerous group of smokers (38%) consisted of those who neither intended nor felt capable to quit and these smokers perceived more benefits of smoking than negatives. DB changed gradually according to smokers' "readiness" to quit: the more ready they felt to quit the less the pros of smoking outnumbered the cons. Regarding relief of CD, smokers who intended but did not feel capable to quit employed more "excuses" compared to those who felt capable. Additionally smokers with a past history of unsuccessful quit attempts employed fewer "excuses" even though they were more frequently found among those who intended but did not feel capable to quit. CONCLUSION: Findings provide support for the DB theory. On the other hand, "excuses" do not appear to be extensively employed to reduce the conflict between smoking and concern for health. There is much heterogeneity regarding smokers' intention and appraised capability to quit, reflecting theoretical and methodological problems with the distinction among stages of change. Harm reduction programs and interventions designed to increase the implementation of smoking cessation should take into account the detrimental effect of past unsuccessful quit attempts.

The development of adopted children after institutional care: a follow-up study.

BACKGROUND: Research suggests that institutional care has long-lasting effects on children. However, no study has longitudinally studied infants in an institution and their subsequent development at age four. METHODS: Sixty-one adopted children aged four years who had spent their first two years of life in an institution were compared to 39 children reared in their own two-parent families. Cognitive development, security of attachment, shyness, children's emotional understanding and behavioural problems were examined in both groups. Parental health and stress were also assessed. RESULTS: At four years adopted children still had lower scores on cognitive development, were less secure, and less able to understand emotions than family-reared children. Children with a secure attachment type in infancy were found to be less secure at age four, compared with those who were classified in infancy as having an insecure attachment type. Their physical development had recovered, they were less shy, had no behavioural problems and no problems in the relationship with their teacher. CONCLUSIONS: Early residential group care has long-lasting effects on important socio-emotional and cognitive aspects of preschool children's development.

Prevalence and determinants of exclusive breastfeeding during hospital stay in the area of Athens, Greece.

AIM: To assess breastfeeding practices, focusing on the prevalence and the determinants of exclusive breastfeeding during hospital stay. METHODS: A cross-sectional study of 1603 healthy women, who delivered healthy infants weighing more than 2500 g, was conducted in the area of Athens, Greece. Participants completed a self-administered questionnaire on the day they were discharged from the maternity ward. Classification of breastfeeding and recall period from birth to discharge were in accordance with the WHO criteria. Hierarchical logistic regression analysis was used to study determinants of exclusive breastfeeding initiation. RESULTS: Breastfeeding initiation was reported by 96.1% of the participants. However, exclusive breastfeeding was initiated only in 19.1% and predominant breastfeeding in 7.2% of the cases. The univariate analysis showed that maternal younger age, low educational level, unemployment, vaginal delivery, infant birthweight >3000 g, multiparity, early initiation of breastfeeding, rooming-in and awareness on the existence of breastfeeding centres were associated with higher rates of exclusive breastfeeding. Logistic regression analysis revealed that rooming-in (OR 3.72, p<0.01), demand feeding (OR 2.18, p<0.01), type of delivery (OR 1.61, p<0.01) and the source of information received about breastfeeding are more important determinants of exclusive breastfeeding than the socio-demographic parameters. CONCLUSIONS: Exclusive breastfeeding during hospital stay in the area of Athens is low. Demand feeding and rooming-in positively influence exclusive breastfeeding initiation, while caesarean section and information by mass media have a negative impact.

Cognitive development of 12 month old Greek infants conceived after ICSI and the effects of the method on their parents.

BACKGROUND: ICSI is widely used as a method of assisted reproduction in Greece. Research shows that children conceived after the application of ICSI develop normally. However, Bowen et al. (1998) reported that children conceived after ICSI had lower scores in the Mental Development Index (MDI) of the Bayley Scales of Infant Development compared with infants conceived naturally or by standard IVF treatment. This finding raised concerns about the effects of ICSI on infants' cognitive development. The aim of the present study was twofold. First to compare the cognitive development of Greek infants conceived after ICSI treatment to a control group of infants conceived after IVF treatment and to a further control group conceived naturally (NC). Second, to investigate the psychological effects of ICSI compared to IVF on Greek parents. METHODS: The Bayley Scales of Infant Development were employed to assess cognitive development of infants. A 37 item semi-structured interview was devised to obtain demographic information and to assess and compare the psychological effects of ICSI and IVF on parents. RESULTS: The mental development of infants in all three groups was within the normal range (ICSI 101.4, IVF 95.7, NC 98.9). The differences between the three groups were not statistically significant. The duration of pregnancy and the birthweight differed in the three groups. Furthermore, mothers in the IVF and the ICSI groups experienced anxiety during pregnancy. IVF mothers differed in the mode of delivery and a smaller number of these mothers breastfed their infants. CONCLUSIONS: This study has shown that Greek infants, born after the application of ICSI, have mental and motor scores within the normal range. With regard to the psychological effects, it appears that mothers in the ICSI and IVF groups experience greater anxiety during their pregnancies than those in the NC group.