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Rambau S, Forstner AJ, Geiser F, Schumacher J, Conrad R. New insights into recalled parental behavior in social anxiety disorder: A cluster analytic approach. J Affect Disord 2024:S0165-0327(24)01113-3. [PMID: 39019224 DOI: 10.1016/j.jad.2024.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/08/2024] [Accepted: 07/14/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Social Anxiety Disorder (SAD) is a highly heterogeneous disorder. To enlighten its heterogeneity, this study focused on recalled parental behavior and aimed to empirically identify if there are subgroups of SAD based on recalled parental behavior by means of cluster analysis. Further, the study investigated whether those subgroups differed on clinical, trauma, and personality variables. METHODS This study included 505 individuals diagnosed with SAD and 98 adult controls who were asked to fill out the Parental Bonding Instrument (PBI), the Adverse Childhood Experiences Questionnaire (ACE), and the Temperament and Character Inventory (TCI). Cluster analysis determined whether there are meaningful SAD subgroups based on PBI. The clusters obtained were compared with each other and with the control group with regard to clinical, ACE, and TCI variables. RESULTS The cluster analysis revealed two SAD clusters based on recalled parental behavior. SAD individuals in the first cluster (49.3 %) perceived their parents as intermediately caring, but not as overcontrolling. SAD individuals in the second cluster (50.7 %) perceived their parents as less caring and overcontrolling, reported more severe clinical symptoms and trauma, and had lower values in Self-Directedness and Cooperativeness. LIMITATIONS The present study is cross-sectional, therefore unable to confirm causal interpretations. CONCLUSION Parenting is meaningful to enlighten the heterogeneity of SAD symptomatology and to specify treatment approaches as there are two meaningful subgroups in individuals with SAD corresponding to differences in clinical presentation, trauma, and personality.
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Affiliation(s)
- Stefanie Rambau
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Wilhelm-Johnen-Straße, Jülich, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Johannes Schumacher
- Center for Human Genetics, University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
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2
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Sep MSC, Sarabdjitsingh RA, Geuze E, Joels M. Pre-trauma memory contextualization as predictor for PTSD-like behavior in male rats. J Psychiatr Res 2024; 171:84-94. [PMID: 38262164 DOI: 10.1016/j.jpsychires.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
While many people experience potentially threatening events during their life, only a minority develops posttraumatic stress disorder (PTSD). The identification of individuals at risk among those exposed to trauma is crucial for PTSD prevention in the future. Since re-experiencing trauma elements outside of the original trauma-context is a core feature of PTSD, we investigate if the ability to bind memories to their original encoding context (i.e. memory contextualization) predicts PTSD vulnerability. We hypothesize that pre-trauma neutral memory contextualization (under stress) negatively relates to PTSD-like behavior, in a prospective design using the cut-off behavioral criteria rat model for PTSD. 72 male Sprague Dawley rats were divided in two experimental groups to assess the predictive value of 1) memory contextualization without acute stress (NS-group) and 2) memory contextualization during the recovery phase of the acute stress-response (S-group) for susceptibility to PTSD-like behavior. A powerful extension to regression analysis -path analysis-was used to test this specific hypothesis, together with secondary research questions. Following traumatic predator scent stress, 19.4% of the rats displayed PTSD-like behavior. Results showed a negative relation between pre-trauma memory contextualization and PTSD-like behavior, but only in the NS-group. Pre-trauma memory contextualization was positively related to fear association in the trauma environment, again only in the NS group. If the predictive value of pre-trauma contextualization of neutral information under non-stressful conditions for PTSD susceptibility is replicated in prospective studies in humans, this factor would supplement already known vulnerability factors for PTSD and improve the identification of individuals at risk among the trauma exposed, especially those at high trauma risk such as soldiers deployed on a mission.
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Affiliation(s)
- Milou S C Sep
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands; Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, the Netherlands; Department of Psychiatry, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, the Netherlands; GGZ inGeest Mental Health Care, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands.
| | - R Angela Sarabdjitsingh
- Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, the Netherlands
| | - Elbert Geuze
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Marian Joels
- Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, the Netherlands; University of Groningen, University Medical Center Groningen, the Netherlands
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3
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Fenlon EE, Pinciotti CM, Jones AC, Rippey CS, Wild H, Hubert TJJ, Tipsword JM, Badour CL, Adams TG. Assessment of Comorbid Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder. Assessment 2024; 31:126-144. [PMID: 37904505 DOI: 10.1177/10731911231208403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are commonly comorbid and share prominent features (e.g., intrusions, safety behaviors, and avoidance). Excellent self-report and clinician-administered assessments exist for OCD and PTSD individually, but few assess both disorders, and even fewer provide instruction on differential diagnosis or detection of comorbid OCD and PTSD. To address this gap in the literature, the current paper aims to (1) highlight diagnostic and functional similarities and differences between OCD and PTSD to inform differential diagnosis, (2) outline assessment recommendations for individuals with suspected comorbid OCD and PTSD, OCD with a significant trauma history or posttraumatic symptoms, or PTSD with significant obsessive-compulsive symptoms, and (3) explore future directions to evaluate and improve methods for assessing co-occurring OCD and PTSD.
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Affiliation(s)
| | | | - Alyssa C Jones
- Ralph H. Johnson VA Health Care System, Charleston, SC, USA
- Medical University of South Carolina, Charleston, USA
| | | | | | | | | | | | - Thomas G Adams
- University of Kentucky, Lexington, USA
- Yale School of Medicine, New Haven, CT, USA
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4
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Chung ML, Seib-Pfeifer LE, Elling C, Geiser F, Forstner AJ, Schumacher J, Conrad R. Personality subtypes in adults with social anxiety disorder - novelty seeking makes the difference. BMC Psychiatry 2022; 22:832. [PMID: 36575407 PMCID: PMC9793521 DOI: 10.1186/s12888-022-04484-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Up to now several subtypes of social anxiety disorder (SAD) have been proposed. METHODS In the present study, we used a cluster analytic approach to identify qualitatively different subgroups of SAD based on temperament characteristics, that is, harm avoidance (HA) and novelty seeking (NS) dimensions of Cloninger's Temperament and Character Inventory. RESULTS Based on a large, diverse clinical sample (n = 575), we found evidence for two distinct subgroups of SAD: a larger (59%) prototypic, inhibited cluster characterized by high HA and low NS, and a smaller atypic, and comparatively more impulsive cluster characterized by medium to high HA and increased NS. The subgroups differed regarding a variety of sociodemographic and clinical variables. While the prototypic SAD subtype suffered from more severe SAD and depressive symptoms, suicidal ideation, and reduced social functioning, the atypic NS subtype showcased higher reproductive behaviour, self-directedness and -transcendence, comparatively. Additional hierarchical logistic regression highlights the contribution of age and education. CONCLUSIONS Our results valuably extend previous evidence for the existence of at least two distinct subtypes of SAD. A better knowledge of the characteristic differences in prototypic behaviour, personality, coping strategies and comorbidities between the identified (and further) subtypes can contribute to the development of effective prevention interventions and promotes the conceptualization of tailored treatments.
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Affiliation(s)
- Man-Long Chung
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | - Laura-Effi Seib-Pfeifer
- grid.10388.320000 0001 2240 3300Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111 Bonn, Germany
| | - Christina Elling
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Franziska Geiser
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Andreas J. Forstner
- grid.10388.320000 0001 2240 3300Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany ,grid.8385.60000 0001 2297 375XInstitute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Wilhelm-Johnen-Straße, 52428 Jülich, Germany ,grid.10253.350000 0004 1936 9756Centre for Human Genetics, University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Johannes Schumacher
- grid.10253.350000 0004 1936 9756Centre for Human Genetics, University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Rupert Conrad
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany ,grid.16149.3b0000 0004 0551 4246Department of Psychosomatic Medicine and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
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Komasi S, Hemmati A, Rezaei F, Rahmani K, Miettunen J, Amianto F, Hopwood CJ. Comparison of the relative sensitivity of two dimensional personality models to the psychopathological symptoms: the section III DSM-5 maladaptive traits versus affective temperaments. BMC Psychiatry 2022; 22:503. [PMID: 35897003 PMCID: PMC9327203 DOI: 10.1186/s12888-022-04156-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Personality Inventory for DSM-5 (PID-5) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) are tools designed for personality dispositions for mental health symptoms. The present study was conducted to compare these models in terms of their relative sensitivity to the symptoms of personality disorders (PDs) and non-personality disorders (NPDs). METHODS Subjects in this cross-sectional study were 1232 (805 female; 63.5%) community samples in western Iran. Data were collected using the PID-5, the TEMPS-A, the Symptom Checklist-90 (SCL-90-R), and the Personality Diagnostic Questionnaire (PDQ-4). Correlations and Regression models were used to examine associations between traits and symptoms. RESULTS Maladaptive traits assessed by the PID-5 were more strongly associated with PD symptoms, whereas affective temperaments measured by the TEMPS-A were more strongly associated with NPD symptoms. CONCLUSION The present findings highlighted the practical utility of both the PID-5 and TEMPS-A indicating risk for psychopathology, but also suggest a distinction between PDs and NPDs in terms of underlying personality dispositions.
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Affiliation(s)
- Saeid Komasi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran. .,Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Azad Hemmati
- grid.411189.40000 0000 9352 9878Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Farzin Rezaei
- Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. .,Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Khaled Rahmani
- grid.484406.a0000 0004 0417 6812Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Jouko Miettunen
- grid.10858.340000 0001 0941 4873Center for Life Course Health Research, University of Oulu, & Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Federico Amianto
- grid.7605.40000 0001 2336 6580Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Christopher J. Hopwood
- grid.7400.30000 0004 1937 0650Department of Psychology, University of Zurich, Zurich, Switzerland
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PECULIARITIES OF THE COURSE OF SOMATIZED AND ANXIETY DISORDERS IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE ON THE BACKGROUND OF ABDOMINAL OBESITY. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-2-80-65-69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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7
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Komasi S, Rezaei F, Hemmati A, Rahmani K, Amianto F, Miettunen J. Comprehensive meta-analysis of associations between temperament and character traits in Cloninger's psychobiological theory and mental disorders. J Int Med Res 2022; 50:3000605211070766. [PMID: 34994240 PMCID: PMC8743952 DOI: 10.1177/03000605211070766] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To explore the relationship between temperament and character traits in Cloninger's psychobiological theory and mental disorders.Methods: A systematic literature search was conducted of five international databases for all articles published in English between January 1990 and April 2019 (PROSPERO-CRD42019133214). Owing to heterogeneity, pooled estimates of correlations for personality disorders and standardized mean differences for case-control studies related to other mental disorders were calculated using the random-effects method. RESULTS The pooled effect sizes obtained from 149 studies showed that high harm avoidance (related to 22/24 diagnostic categories), low self-directedness (21/23), low cooperativeness (17/23), high self-transcendence (14/23), low reward dependence (11/24), high novelty-seeking (10/24), low novelty-seeking (7/24), high persistence (2/23), low persistence (2/23) and high reward dependence (2/24) were related to psychopathology. CONCLUSIONS All traits provided unique psychobiological tools for differential diagnosis of mental disorders. However, high harm avoidance and low self-directedness played a canonical role in psychopathology. Despite the study limitations, additional studies are warranted to evaluate the differential diagnoses suggested by the present model.
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Affiliation(s)
- Saeid Komasi
- Student Research Committee,
Kurdistan University of Medical Sciences, Sanandaj, Iran
- Neurosciences Research Center,
Research Institute for Health Development, Kurdistan University of Medical
Sciences, Sanandaj, Iran
| | - Farzin Rezaei
- Neurosciences Research Center,
Research Institute for Health Development, Kurdistan University of Medical
Sciences, Sanandaj, Iran
| | - Azad Hemmati
- Department of Psychology, University of Kurdistan, University of Kurdistan, Sanandaj, Iran
| | - Khaled Rahmani
- Liver and Digestive Research
Center, Research Institute for Health Development, Kurdistan University of
Medical Sciences, Sanandaj, Iran
| | - Federico Amianto
- Department of Neurosciences,
Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of
Torino, Torino, Italy
| | - Jouko Miettunen
- Center for Life Course Health
Research, University of Oulu, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu
University Hospital, Oulu, Finland
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8
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Wiseman C, Croft J, Zammit S. Examining the relationship between early childhood temperament, trauma, and post-traumatic stress disorder. J Psychiatr Res 2021; 144:427-433. [PMID: 34749218 PMCID: PMC8670596 DOI: 10.1016/j.jpsychires.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 09/14/2021] [Accepted: 10/10/2021] [Indexed: 11/24/2022]
Abstract
A greater understanding of why some people are more at risk of developing PTSD is required. We examine the relationship between temperament traits in early childhood and subsequent trauma exposure and risk of PTSD. We used data on 2017 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC). Temperament was measured using the Carey Infant Temperament Scale (average score from ages 6 and 24 months). This provided data on 9 individuals traits, and Easy, Medium, and Difficult temperament clusters. Trauma exposure was measured from 0 to 17 years, and PTSD at age 23 years using the PTSD Checklist for DSM-V (PCL-5). Regression models were used to estimate associations between temperament and both trauma and PTSD, and to examine mediation (of temperament to PTSD pathway) and interaction (temperament X trauma on PTSD) effects. 1178 (58.4%) individuals were exposed to a trauma in childhood and 112 (5.5%) had PTSD. Higher levels of Intensity were associated with a small increase in trauma exposure (ORadjusted 1.23, 95% CI 1.12, 1.34; p < 0.001) and PTSD (ORadjusted 1.27, 95% CI 1.05, 1.54; p = 0.012). Higher levels of Activity, Adaptability, Mood and Threshold temperament traits were also associated with trauma exposure. Medium (ORadjusted 1.49, 95% CI 1.21, 1.84; p < 0.001) and Difficult (ORadjusted 1.47, 95% CI 1.18, 1.84; p = 0.001) temperament clusters were associated with increased trauma exposure compared to an Easy cluster, but were not associated with PTSD. The relationship between trait Intensity and adult PTSD was partially mediated by childhood/adolescent trauma (Indirect ORadjusted 1.08, 95% CI 1.01, 1.16, p = 0.024, proportion mediated 26.2%). There was some evidence that trait Intensity modified the relationship between trauma and PTSD (ORadjusted 1.66, 95% CI 1.07, 2.55, p = 0.023). PTSD in early adulthood is more common in those with intense stimuli responsiveness in childhood. Temperament traits might be useful predictors of trauma exposure and mental health outcomes and offer potential targets for supportive interventions.
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Affiliation(s)
- Chantelle Wiseman
- Population Health Sciences, School of Medicine, University of Bristol, United Kingdom; Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, United Kingdom.
| | - Jazz Croft
- Population Health Sciences, School of Medicine, University of Bristol, United Kingdom
| | - Stan Zammit
- Population Health Sciences, School of Medicine, University of Bristol, United Kingdom; Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, United Kingdom
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Predicting High-Risk Groups for COVID-19 Anxiety Using AdaBoost and Nomogram: Findings from Nationwide Survey in South Korea. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11219865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
People living in local communities have become more worried about infection due to the extended pandemic situation and the global resurgence of COVID-19. In this study, the author (1) selected features to be included in the nomogram using AdaBoost, which had an advantage in increasing the classification accuracy of single learners and (2) developed a nomogram for predicting high-risk groups of coronavirus anxiety while considering both prediction performance and interpretability based on this. Among 210,606 adults (95,287 males and 115,319 females) in South Korea, 39,768 people (18.9%) experienced anxiety due to COVID-19. The AdaBoost model confirmed that education level, awareness of neighbors/colleagues’ COVID-19 response, age, gender, and subjective stress were five key variables with high weight in predicting anxiety induced by COVID-19 for adults living in South Korean communities. The developed logistic regression nomogram predicted that the risk of anxiety due to COVID-19 would be 63% for a female older adult who felt a lot of subjective stress, did not attend a middle school, was 70.6 years old, and thought that neighbors and colleagues responded to COVID-19 appropriately (classification accuracy = 0.812, precision = 0.761, recall = 0.812, AUC = 0.688, and F-1 score = 0.740). Prospective or retrospective cohort studies are required to causally identify the characteristics of anxiety disorders targeting high-risk COVID-19 anxiety groups identified in this study.
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10
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Predictors of social anxiety disorder with major depressive episodes among Japanese university students. PLoS One 2021; 16:e0257793. [PMID: 34570818 PMCID: PMC8476026 DOI: 10.1371/journal.pone.0257793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
Background Social anxiety disorder (SAD) develops in the early teens and is a common disorder among university students. Understanding the predictive factors of SAD comorbid with major depressive episode (MDE) is important for student mental health care. The aim of this study was to identify the personality traits that predict SAD with MDE by analyzing longitudinal data of Japanese university students. Methods In this retrospective study, Japanese university students who visited the health care center of Hokkaido University for the first time were divided into the following four groups: “Control” (n = 43), “MDE” (n = 16), “SAD” (n = 28), and “SAD with MDE” (n = 61) based on the Patient Health Questionnaire-9 (PHQ-9), the Liebowitz Social Anxiety Scale, and core anxiety symptoms for SAD in the Mini International Neuropsychiatric Interview during screening. Predictors for SAD with MDE were identified by a four-group comparison of the Temperament and Character Inventory and PHQ-9 data previously obtained at the enrollment using analysis of variance and post-hoc tests. Results Upon comparing the four groups using analysis of variance, there were significant differences in the baseline PHQ-9 summary score, Harm-Avoidance (HA), and Self-Directedness (SD). According to results of the post-hoc test, all three showed a significant difference between the “Control” and “SAD with MDE.” Furthermore, there was a significant difference in HA scores between “SAD” and “Control.” In all the groups, the mean time from enrollment to the first visit to the center was >2 years. Conclusion A higher HA score at baseline is a predictor of SAD with or without MDE. Higher PHQ-9 summary and lower SD scores at baseline are predictive factors of SAD with MDE.
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11
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Belteczki Z, Rihmer Z, Rozsa S, Ujvari J, Pompili M, Gonda X, Dome P. Affective Temperaments, Panic Disorder and Their Bipolar Connections. ACTA ACUST UNITED AC 2021; 57:medicina57030289. [PMID: 33808711 PMCID: PMC8003512 DOI: 10.3390/medicina57030289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 01/21/2023]
Abstract
Background and Objectives: The role of affective temperament in the genesis and outcome of major mood disorders is well studied, but there are only a few reports on the relationship between panic disorder (PD) and affective temperaments. Accordingly, we aimed to study the distribution of affective temperaments (depressive (DE); cyclothymic (CT); irritable (IRR); hyperthymic (HT) and anxious (ANX)) among outpatients with PD. Materials and Methods: Affective temperaments of 118 PD outpatients (80 females and 38 males) with or without agoraphobia but without any other psychiatric disorder at the time of inclusion were evaluated using the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and compared with the affective temperament scores of control subjects. All patients were followed up for at least 1.5 years in order to detect the onset of any major affective disorders, substance use disorders and suicide attempts. Results: Among females, the dominant ANX and DE temperaments were four and three times as common as in a large normative Hungarian sample (for both cases p < 0.01). Among male PD patients, only the dominant DE temperament was slightly overrepresented in a non-significant manner. Females with PD obtained significantly higher scores on ANX, DE and CT subscales of the TEMPS-A, whereas males with PD showed significantly higher scores on ANX, DE and HT temperament subscales compared with the members of a large normative Hungarian sample and also with a gender- and age-matched control group. During the follow-up, newly developed unipolar major depression and bipolar spectrum (bipolar I or II and cyclothymic) disorders appeared in 64% and 22% of subjects, respectively. Conclusions: Our preliminary findings suggest that a specific, ANX-DE-CT affective temperament profile is characteristic primarily for female patients, and an ANX-DE-HT affective temperament profile is characteristic for male patients with PD, respectively. These findings are in line with expectations because PD is an anxiety disorder par excellence on the one hand, whereas, on the other hand, it is quite frequently comorbid with mood (including bipolar) disorders.
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Affiliation(s)
- Zsuzsanna Belteczki
- First Department of Psychiatry, University Hospital of Szabolcs-Szatmár-Bereg County, 4320 Nagykallo, Hungary; (Z.B.); (J.U.)
| | - Zoltan Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1085 Budapest, Hungary; (Z.R.); (X.G.)
- Nyiro Gyula National Institute of Psychiatry and Addictions, 1135 Budapest, Hungary
| | - Sandor Rozsa
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Julia Ujvari
- First Department of Psychiatry, University Hospital of Szabolcs-Szatmár-Bereg County, 4320 Nagykallo, Hungary; (Z.B.); (J.U.)
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1085 Budapest, Hungary; (Z.R.); (X.G.)
- Nyiro Gyula National Institute of Psychiatry and Addictions, 1135 Budapest, Hungary
| | - Péter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1085 Budapest, Hungary; (Z.R.); (X.G.)
- Nyiro Gyula National Institute of Psychiatry and Addictions, 1135 Budapest, Hungary
- Correspondence:
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12
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Song P, Tong H, Zhang L, Lin H, Hu N, Zhao X, Hao W, Xu P, Wang Y. Repetitive Transcranial Magnetic Stimulation Modulates Frontal and Temporal Time-Varying EEG Network in Generalized Anxiety Disorder: A Pilot Study. Front Psychiatry 2021; 12:779201. [PMID: 35095597 PMCID: PMC8795864 DOI: 10.3389/fpsyt.2021.779201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022] Open
Abstract
Generalized Anxiety Disorder (GAD) is a highly prevalent yet poorly understood chronic mental disorder. Previous studies have associated GAD with excessive activation of the right dorsolateral prefrontal cortex (DLPFC). This study aimed to investigate the effect of low-frequency repetitive transcranial magnetic stimulation (repetitive TMS, rTMS) targeting the right DLPFC on clinical symptoms and TMS-evoked time-varying brain network connectivity in patients with GAD. Eleven patients with GAD received 1 Hz rTMS treatment targeting the right DLPFC for 10 days. The severity of the clinical symptoms was evaluated using the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD) at baseline, right after treatment, and at the one-month follow-up. Co-registration of single-pulse TMS (targeting the right DLPFC) and electroencephalography (TMS-EEG) was performed pre- and post-treatment in these patients and 11 healthy controls. Time-varying brain network connectivity was analyzed using the adaptive directed transfer function. The scores of HAMA and HAMD significantly decreased after low-frequency rTMS treatment, and these improvements in ratings remained at the one-month follow-up. Analyses of the time-varying EEG network in the healthy controls showed a continuous weakened connection information outflow in the left frontal and mid-temporal regions. Compared with the healthy controls, the patients with GAD showed weakened connection information outflow in the left frontal pole and the posterior temporal pole at baseline. After 10-day rTMS treatment, the network patterns showed weakened connection information outflow in the left frontal and temporal regions. The time-varying EEG network changes induced by TMS perturbation targeting right DLPFC in patients with GAD were characterized by insufficient information outflow in the left frontal and temporal regions. Low-frequency rTMS targeting the right DLPFC reversed these abnormalities and improved the clinical symptoms of GAD.
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Affiliation(s)
- Penghui Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Central Laboratory, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Geriatric Medical Research Center, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Han Tong
- Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Luyan Zhang
- Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hua Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ningning Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xin Zhao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wensi Hao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peng Xu
- Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Beijing Institute for Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
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13
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Schiele MA, Herzog K, Kollert L, Böhnlein J, Repple J, Rosenkranz K, Leehr EJ, Ziegler C, Lueken U, Dannlowski U, Pauli P, Arolt V, Zwanzger P, Deckert J, Erfurth A, Domschke K. Affective temperaments (TEMPS-A) in panic disorder and healthy probands: Genetic modulation by 5-HTT variation. World J Biol Psychiatry 2020; 21:790-796. [PMID: 31852378 DOI: 10.1080/15622975.2019.1705999] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Temperamental traits as ascertained by the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-Questionnaire (TEMPS-A) have been suggested as promising intermediate phenotypes of mental disorders. In anxiety disorders, however, TEMPS scales and their genetic underpinnings are still understudied. METHODS TEMPS-A scores in 109 patients with panic disorder (PD) were compared to a sample of 536 healthy probands. All participants were genotyped for serotonin transporter gene variation (5-HTTLPR/rs25531). RESULTS PD patients displayed significantly increased scores on the dysthymic, cyclothymic, irritable and anxious subscales, and lower scores on the hyperthymic subscale, respectively (all ps < 0.001) compared to healthy probands. In the total sample, the less active 5-HTTLPR/rs25531 S/LG alleles were associated with higher scores on the dysthymic, cyclothymic, irritable and anxious temperaments (all ps < 0.01), but not the hyperthymic subscale. Mediation analyses revealed anxious temperament in particular to mediate the relationship between 5-HTT genotype and PD. CONCLUSIONS Dysthymic, cyclothymic, irritable and notably anxious temperament could serve as valuable intermediate phenotypes in efforts to unravel neurobiological, particularly serotonin system related genetic pathomechanisms associated with PD and potentially contribute to a panel of vulnerability markers guiding early targeted preventive interventions.
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Affiliation(s)
- Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Herzog
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), and Center of Mental Health, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Leonie Kollert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Joscha Böhnlein
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Jonathan Repple
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Karoline Rosenkranz
- Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elisabeth J Leehr
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Christiane Ziegler
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), and Center of Mental Health, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Peter Zwanzger
- kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Wasserburg, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Andreas Erfurth
- 1st Department of Psychiatry and Psychotherapeutic Medicine, Vienna, Austria
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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14
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Associations between (sub) clinical stress- and anxiety symptoms in mentally healthy individuals and in major depression: a cross-sectional clinical study. BMC Psychiatry 2020; 20:428. [PMID: 32873278 PMCID: PMC7466802 DOI: 10.1186/s12888-020-02836-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/24/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Responses to stressful circumstances have psychological and physiological dimensions, and are related to anxiety symptoms and mental disorders such as depression. Nonetheless, the relationship between subclinical stress and anxiety symptoms is still elusive. METHODS To explore possible associations between stress and anxiety symptoms, patients with major depression (N = 77) and mentally healthy individuals of different age clusters and occupations (N = 412) were enrolled into the study. Stress was assessed with the new subclinical stress symptom questionnaire (SSQ-25). Anxiety was studied with the Beck Anxiety Inventory (BAI), mainly focusing on clinical anxiety, whilst anxiety as a personality trait was assessed with the trait aspect of the State Τrait Αnxiety Ιnventory Y (STAI Y). Statistical analyses included ANOVA, Scheffe test, linear regression models and a two-step cluster analysis using Log-Likelihood Distance measure and fixed number of two clusters. RESULTS Age, stress symptoms and BAI scores differed significantly between among groups (P < 0.001), whilst STAI Y scores did not. Stress levels were found to be related to clinical anxiety (P < 0.001), while neither group identity nor age exerted any influence on anxiety levels (P > 0.05). The two Step Cluster analysis classified 76 out of 77 participants with milder stress (subclinical) symptoms into the cluster with moderate anxiety, as indicated by BAI scores, and all individuals with more severe stress into the severe anxiety cluster. CONCLUSIONS The observed associations between stress and anxiety shed light on the interrelations between even very mild (subclinical) stress and anxiety symptoms and may point to the potential of mild stress to serve as a target for early interventions aiming to prevent anxiety morbidity.
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15
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van Oudheusden LJB, van de Schoot R, Hoogendoorn A, van Oppen P, Kaarsemaker M, Meynen G, van Balkom AJLM. Classification of comorbidity in obsessive-compulsive disorder: A latent class analysis. Brain Behav 2020; 10:e01641. [PMID: 32403206 PMCID: PMC7375063 DOI: 10.1002/brb3.1641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Patients with OCD differ markedly from one another in both number and kind of comorbid disorders. In this study, we set out to identify and characterize homogeneous subgroups of OCD patients based on their comorbidity profile. METHODS In a cohort of 419 adult subjects with OCD, the lifetime presence of fifteen comorbid disorders was assessed. Latent class analysis was used to identify comorbidity-based subgroups. Groups were compared with regard to core clinical characteristics: familiality, childhood trauma, age at onset, illness severity, OCD symptom dimensions, personality characteristics, and course of illness. RESULTS The study sample could be divided in a large group (n = 311) with a low amount of comorbidity that could be further subdivided into two subgroups: OCD simplex (n = 147) and OCD with lifetime major depressive disorder (n = 186), and a group (n = 108) with a high amount of comorbidity that could be further subdivided into a general anxiety-related subgroup (n = 49), an autism/social phobia-related subgroup (n = 27), and a psychosis/bipolar-related subgroup (n = 10). Membership of the high-comorbid subgroup was associated with higher scores on childhood trauma, illness severity, and the aggression/checking symptom dimension and lower scores on several personality characteristics. CONCLUSION Grouping OCD patients based on their comorbidity profile might provide more homogeneous, and therefore, more suitable categories for future studies aimed at unraveling the etiological mechanisms underlying this debilitating disorder.
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Affiliation(s)
- Lucas J B van Oudheusden
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,GGZ inGeest, Amsterdam, The Netherlands
| | - Rens van de Schoot
- Department of Methods and Statistics, Utrecht University, Utrecht, The Netherlands
| | - Adriaan Hoogendoorn
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,GGZ inGeest, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,GGZ inGeest, Amsterdam, The Netherlands
| | - Maarten Kaarsemaker
- Vincent van Gogh Institute, Mental Health Care Centre Noord- en Midden-Limburg, Venray, The Netherlands
| | - Gerben Meynen
- GGZ inGeest, Amsterdam, The Netherlands.,Faculty of Humanities, VU University Amsterdam, Amsterdam, The Netherlands.,Willem Pompe Institute for Criminal Law and Criminology, Utrecht University, The Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,GGZ inGeest, Amsterdam, The Netherlands
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16
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De Berardis D, Vellante F, Fornaro M, Anastasia A, Olivieri L, Rapini G, Serroni N, Orsolini L, Valchera A, Carano A, Tomasetti C, Varasano PA, Pressanti GL, Bustini M, Pompili M, Serafini G, Perna G, Martinotti G, Di Giannantonio M. Alexithymia, suicide ideation, affective temperaments and homocysteine levels in drug naïve patients with post-traumatic stress disorder: an exploratory study in the everyday 'real world' clinical practice. Int J Psychiatry Clin Pract 2020; 24:83-87. [PMID: 31829763 DOI: 10.1080/13651501.2019.1699575] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective: The present exploratory study aimed to investigate relationships between alexithymia, suicide ideation, affective temperaments and homocysteine levels among drug-naïve adult outpatients with Post-Traumatic Stress Disorder (PTSD) in an everyday 'real world' clinical setting.Method: Sixty-four adult outpatients with PTSD were evaluated using the Davidson Trauma Scale (DTS), the Toronto Alexithymia Scale (TAS-20), the Scale of Suicide Ideation (SSI), the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego-Autoquestionnaire. As well, homocysteine levels were measured.Results: Alexithymic subjects showed higher values on all scales but not homocysteine levels. Partial correlations showed that almost all studied variables were correlated with each other, except homocysteine levels. Regression analysis showed that higher disorder severity as measured by DTS and TAS-20 'Difficulty in Identifying Feelings' dimension was associated with higher SSI scores.Conclusions: In conclusion, alexithymic PTSD outpatients may be characterised by higher disorder severity and difficulty in identifying feelings that may be linked to increased suicide ideation, regardless of affective temperaments or homocysteine levels. Homocysteine levels were not related to any studied variable. However, study limitations are discussed and must be considered. KeypointsPatients with alexithymia showed increased PTSD severity, a higher score on TEMPS-A subscales, and more severe suicide ideation.The Difficulty in Identifying Feelings (DIF) dimension of TAS-20 was associated with suicide ideation in patients with PTSD.Homocysteine did not correlate with any studied variables.This study was exploratory and cross-sectional: further larger and prospective studies are needed.
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Affiliation(s)
- Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy.,Department of Neurosciences and Imaging, University 'G. D'Annunzio, Chieti, Italy
| | - Federica Vellante
- Department of Neurosciences and Imaging, University 'G. D'Annunzio, Chieti, Italy
| | - Michele Fornaro
- Department of Psychiatry, Federico II University, Naples, Italy.,Polyedra, Teramo, Italy
| | | | - Luigi Olivieri
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy
| | - Gabriella Rapini
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy
| | - Nicola Serroni
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy
| | - Laura Orsolini
- Polyedra, Teramo, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Alessandro Valchera
- Polyedra, Teramo, Italy.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Alessandro Carano
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'Madonna Del Soccorso', NHS, Ascoli Piceno, Italy
| | - Carmine Tomasetti
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'SS. Annunziata' ASL, Giulianova, Italy
| | | | | | - Massimiliano Bustini
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'San Camillo de Lellis' ASL, Rieti, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, FoRiPsi, Albese con Cassano, Italy.,Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, Miami University, Miami, FL, USA
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, University 'G. D'Annunzio, Chieti, Italy
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The role of personality in posttraumatic stress disorder, trait resilience, and quality of life in people exposed to the Kiss nightclub fire. PLoS One 2019; 14:e0220472. [PMID: 31356601 PMCID: PMC6663027 DOI: 10.1371/journal.pone.0220472] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 07/16/2019] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate the relationship among personality (according to Cloninger’s psychobiological model), posttraumatic stress disorder (PTSD) symptoms, trait resilience and quality of life (QoL) in people who were exposed to the Kiss nightclub fire. Methods 188 participants were assessed with the Posttraumatic Checklist–civilian version (PCL-C), the Resilience Scale (RS), the Temperament and Character Inventory (TCI), the World Health Organization Quality of Life–Bref (WHOQOL-Bref), and the WHOQOL-100 Spirituality, religiousness, and personal beliefs (WHOQOL-100-SRPB). Data were analyzed in a dimensional approach, with correlation analysis, multiple linear regression and Structural Equation Modeling (SEM), with PCL-C, RS, and WHOQOL-Bref dimensions as dependent variables. Results Multiple linear regression showed that PTSD symptoms were predicted by harm avoidance (β = .34, p < .001), self-directedness (β = -.28, p < .01), and self-transcendence (β = .24, p < .01). Trait resilience was predicted by harm avoidance (β = -.38, p < .01), self-directedness (β = .20, p < .05), and self-transcendence (β = .18, p < .05). Also, PTSD symptoms had considerable negative effect on all dimensions of QoL. Self-transcendence was a positive predictor of subjective and spiritual QoL. SEM showed that QoL was predicted by PTSD symptoms (β = -.52, p < .001), trait resilience (β = .30, p < .001), cooperativeness (β = .135, p = 0.40), and self-directedness (β = .27, p < .01). The effect of self-directedness on QoL was mediated by PTSD symptoms and trait resilience. PTSD symptoms also mediated the relationship between trait resilience and QoL, and RS mediated the relationship of personality and PTSD symptoms. Conclusion The study gives insights on prediction of PTSD severity, trait resilience and QoL from temperament and character traits, in a sample of people exposed to the Kiss nightclub fire. Harm avoidance was the most influent trait on PTSD symptoms and trait resilience. Self-directedness was the most import trait related to QoL, still that it was more related to PTSD severity than personality traits. Self-transcendence had positive effects on both PTSD symptoms and trait resilience, indicating a coping style that may coexist with psychopathology.
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18
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Forrest LN, Sarfan LD, Ortiz SN, Brown TA, Smith AR. Bridging eating disorder symptoms and trait anxiety in patients with eating disorders: A network approach. Int J Eat Disord 2019; 52:701-711. [PMID: 30900758 DOI: 10.1002/eat.23070] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Anxiety is thought to influence the development and maintenance of eating disorders (EDs). However, little is known about how, specifically, anxiety influences ED symptoms and vice versa. Network analysis identifies how symptoms within and across disorders are interconnected. In a network, central nodes (i.e., symptoms) have the strongest relations to other nodes and are thought to maintain psychopathology. Bridge nodes are symptoms in one diagnostic cluster that are strongly connected to symptoms in another diagnostic cluster and are thought to explain comorbidity. We identified central and bridge nodes in a network of ED symptoms and trait anxiety features. METHOD We estimated a regularized partial correlation network in patients with mixed EDs (N = 296). ED symptoms were assessed with the Eating Disorder Examination-Questionnaire. Trait anxiety was assessed with the Trait subscale of the State-Trait Anxiety Inventory. Items to include in the network were selected with a statistical algorithm to ensure that all nodes represented unique constructs. Central and bridge nodes were identified with empirical calculations. RESULTS Central ED nodes were dietary restraint, as well as overvaluation of and dissatisfaction with shape and weight. The central trait anxiety node was low feelings of satisfaction. The strongest ED bridge node was avoidance of social eating. The strongest trait anxiety bridge node was low self-confidence. DISCUSSION Avoidance of social eating and low self-esteem may be routes through which EDs and trait anxiety are linked.
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Affiliation(s)
| | | | - Shelby N Ortiz
- Department of Psychology, Miami University, Oxford, Ohio
| | - Tiffany A Brown
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - April R Smith
- Department of Psychology, Miami University, Oxford, Ohio
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19
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La Buissonnière-Ariza V, Séguin JR, Nassim M, Boivin M, Pine DS, Lepore F, Tremblay RE, Maheu FS. Chronic harsh parenting and anxiety associations with fear circuitry function in healthy adolescents: A preliminary study. Biol Psychol 2019; 145:198-210. [PMID: 30935991 DOI: 10.1016/j.biopsycho.2019.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 01/01/2023]
Abstract
Previous studies have reported altered fear circuitry function during fear conditioning in highly anxious individuals and in adults with a history of severe childhood adversity; less is known regarding younger populations and more common forms of adversity. We investigated fear circuitry functioning in healthy youths with histories of high (HH) or low (LH) chronic harsh parenting and high (HA) or low (LA) anxiety levels. 84 youths aged 13-16 performed an fMRI fear conditioning task. HH displayed decreased selective medial temporal lobe deactivations to CS+> CS- relative to LH. In addition, we found less amygdala-insula connectivity in HH vs LH. Interestingly, we observed distinct patterns of anxiety differences in amygdala-rostral ACC connectivity and subjective fear ratings depending on harsh parenting levels, suggesting a history of harsh parenting is linked with unique neural and behavioral anxious manifestations, which are different from anxiety manifestations in a context of low adversity.
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Affiliation(s)
| | - Jean R Séguin
- CHU Sainte-Justine's Research Center, Canada; Research Unit on Children's Psychosocial Maladjustment, Canada; Psychiatry Department, University of Montreal, Canada
| | | | - Michel Boivin
- Research Unit on Children's Psychosocial Maladjustment, Canada; Psychology Department, Laval University, Canada
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, National Institute of Mental Health Intramural Research Program, USA
| | - Franco Lepore
- CHU Sainte-Justine's Research Center, Canada; Psychology Department, University of Montreal, Canada; Centre de recherche en neuropsychologie et cognition (CERNEC), Canada
| | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment, Canada; Departments of Pediatrics and Psychology, University of Montreal, Canada; School of Public Health, Physiotherapy and Population Science, University College Dublin, Ireland
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20
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(Z)-7,4′-Dimethoxy-6-hydroxy-aurone-4-O-β-glucopyranoside exerts neuroprotective effects in vitro and anxiolytic activity in vivo. Neuroreport 2019; 30:280-287. [DOI: 10.1097/wnr.0000000000001198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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21
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Uchino T, Nemoto T, Yamaguchi T, Katagiri N, Tsujino N, Murakami Y, Tanaka K, Mizuno M. Associations Of Personality Traits With The Capacity-Performance Discrepancy Of Functional Outcome In Patients With Schizophrenia. Neuropsychiatr Dis Treat 2019; 15:2869-2877. [PMID: 31632034 PMCID: PMC6781607 DOI: 10.2147/ndt.s218738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/13/2019] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Functional capacity, which indicates one's ability to perform everyday living tasks, contributes to real-world functional performance in patients with schizophrenia. However, functional capacity is sometimes not comparable with functional performance in clinical settings. We hypothesized that specific personality traits are related to this capacity-performance discrepancy of functional outcome. METHODS The measures in this study were the UCSD Performance-based Skills Assessment Brief (UPSA-B) for functional capacity, the Social Functioning Scale (SFS) for functional performance, and the Temperament and Character Inventory-140 (TCI-140) for personality traits. A total of 94 stable outpatients with schizophrenia were divided into four groups based on combinations of their UPSA-B and SFS cut-off points, as follows: a high capacity and high performance (HH) group, a high capacity but low performance (HL) group, a low capacity but high performance (LH) group, and a low capacity and low performance (LL) group. RESULTS There were no significant differences in demographics among the four groups. The LH group showed a significantly lower harm avoidance level than the LL group. The HL group showed a significantly lower persistence level than the HH group. CONCLUSION Lower harm avoidance may enhance functional performance, and lower persistence can limit functional performance, regardless of the primary levels of functional capacity in patients with schizophrenia. Novel and individualized psychosocial treatments considering the individual's personality traits seem to be helpful for maximizing their functional performance in the community.
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Affiliation(s)
- Takashi Uchino
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan.,Tokyo Adachi Hospital, Tokyo 121-0064, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, Toho University School of Medicine, Tokyo 143-8540, Japan
| | | | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
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Copetti ME, Lopes AC, Requena G, Johnson INS, Greenberg BD, Noren G, McLaughlin NCR, Shavitt RG, Miguel EC, Batistuzzo MC, Hoexter MQ. Obsessive-Compulsive Personality Symptoms Predict Poorer Response to Gamma Ventral Capsulotomy for Intractable OCD. Front Psychiatry 2019; 10:936. [PMID: 31998155 PMCID: PMC6962231 DOI: 10.3389/fpsyt.2019.00936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 11/25/2019] [Indexed: 11/13/2022] Open
Abstract
Gamma ventral capsulotomy (GVC) is a radiosurgical procedure which aims to create lesions in the ventral part of the anterior limb of the internal capsule (ALIC). It has been used as a treatment option for patients with intractable obsessive-compulsive disorder (OCD) who do not respond to several first-line treatments attempts. However, changes in personality disorder symptoms after GVC have not been investigated. The aims of this study are to investigate changes in personality disorder symptoms after GVC and to search for baseline personality disorder symptoms that may predict clinical response to GVC. Fourteen treatment-intractable OCD patients who underwent GVC completed the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) at baseline and one year after the procedure. Wilcoxon signed-rank test was performed to investigate personality disorder symptom changes before and after surgery. Linear regression models were utilized to predict treatment response, using baseline personality disorder symptoms as independent variables. We did not observe any quantitative changes in personality disorder symptoms after GVC, compared with baseline. Higher severity of obsessive-compulsive personality disorder symptoms at baseline was correlated with worse treatment response after GVC for OCD (β = -0.085, t-value = -2.52, p-value = 0.027). These findings advocate for the safety of the GVC procedure in this specific population of intractable OCD patients, in terms of personality disorder symptom changes. They also highlight the importance of taking into account the severity of obsessive-compulsive personality disorder symptoms when GVC is indicated for intractable OCD patients.
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Affiliation(s)
- Maria Eugênia Copetti
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Antonio C Lopes
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Guaraci Requena
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Isaac N S Johnson
- Yale School of Medicine, New Haven, CT, United States.,Child Study Center, Yale University, New Haven, CT, United States
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States.,Center of Neurorestoration and Neurology, Providence VA Medical Center, Providence, RI, United States
| | - Georg Noren
- Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Nicole C R McLaughlin
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Eurípedes C Miguel
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Q Hoexter
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Panitz C, Sperl MF, Hennig J, Klucken T, Hermann C, Mueller EM. Fearfulness, neuroticism/anxiety, and COMT Val158Met in long-term fear conditioning and extinction. Neurobiol Learn Mem 2018; 155:7-20. [DOI: 10.1016/j.nlm.2018.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 05/16/2018] [Accepted: 06/04/2018] [Indexed: 10/14/2022]
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Correlation of affective temperament and psychiatric symptoms in palliative care cancer patients. Wien Klin Wochenschr 2018; 130:653-658. [PMID: 30350187 PMCID: PMC6244865 DOI: 10.1007/s00508-018-1400-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/09/2018] [Indexed: 11/24/2022]
Abstract
Background Psychiatric symptoms are common in terminally ill patients. Studies linking temperamental traits and psychiatric disorders in patients suffering from advanced disease are rare. This study investigated the influence of temperament on depression and anxiety in palliative care cancer patients. Methods A total of 53 patients at the palliative care unit (PCU) of the Medical University of Vienna were enrolled in the study. Patients filled out the TEMPS-M and the brief PHQ-9 questionnaires to examine associations between temperament, psychiatric symptoms and sociodemographic parameters. Results Pain (67%), anorexia (58%), constipation (42%) and nausea/vomiting (40%) were the most prevalent self-reported symptoms. Self-reported symptoms of depression were less commonly reported (21.8%) than unveiled by the structured assessment by the PHQ-9 questionnaire: 26.4% (n = 14) showed mild symptoms of depression and 64.1% (n = 34) had a major depressive disorder (MDD) according to PHQ-9. The depressive and cyclothymic temperaments showed significant associations with depressive (both: p < 0.001) as well as symptoms of anxiety (p = 0.002; p = 0.036). Furthermore, the anxious temperament was significantly associated with symptoms of depression (p = 0.027). Conclusions Mood disorders are common in palliative care patients, as the majority of the patients were suffering from MDD. The depressive, cyclothymic and anxious temperaments were found to be correlated with depressive and anxious symptoms. A sensitization in this field might bring further improvements for the quality of life of palliative care patients and help to appropriately address psychiatric symptoms in palliative care.
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The anxiolytic-like effects of ginsenoside Rg3 on chronic unpredictable stress in rats. Sci Rep 2018; 8:7741. [PMID: 29773855 PMCID: PMC5958129 DOI: 10.1038/s41598-018-26146-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/02/2018] [Indexed: 12/28/2022] Open
Abstract
The present study is to evaluate the anxiolytic-like activities underlying ginsenoside Rg3 (GRg3). The anxiolytic-like activities were induced by GRg3 (20 and 40 mg/kg, i.g), evidenced by blocking the decreased time and entries in the open arms in elevated plus maze test and by reversing the increased latency to feed in novelty-suppressed feeding test. In addition, the decreased levels on progesterone, allopregnanolone, serotonin (5-HT) in the prefrontal cortex and hippocampus of chronic unpredictable stress (CUS) were blocked by GRg3 (20 and 40 mg/kg, i.g). Furthermore, the increased corticotropin releasing hormone, corticosterone and adrenocorticotropic hormone were blocked by GRg3 (20 and 40 mg/kg, i.g). Collectively, the anxiolytic-like effects produced by GRg3 were associated with the normalization of neurosteroids biosynthesis, serotonergic system as well as HPA axis dysfunction.
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Paiva RR, Batistuzzo MC, McLaughlin NC, Canteras MM, de Mathis ME, Requena G, Shavitt RG, Greenberg BD, Norén G, Rasmussen SA, Tavares H, Miguel EC, Lopes AC, Hoexter MQ. Personality measures after gamma ventral capsulotomy in intractable OCD. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:161-168. [PMID: 29100975 DOI: 10.1016/j.pnpbp.2017.10.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Neurosurgeries such as gamma ventral capsulotomy (GVC) are an option for otherwise intractable obsessive-compulsive disorder (OCD) patients. In general, clinical and neuropsychological status both improve after GVC. However, its consequences on personality traits are not well-studied. The objective of this study was to investigate personality changes after one year of GVC in intractable OCD patients. METHODS The personality assessment was conducted using the Revised NEO Personality Inventory (NEO PI-R) and Cloninger's Temperament and Character Inventory (TCI) in 14 intractable OCD patients before and one year after GVC. Comparisons of personality features between treatment responders (n=5) and non-responders (n=9) were performed. Multiple linear regression was also used for predicting changes in clinical and global functioning variables. RESULTS Overall, no deleterious effect was found in personality after GVC. Responders had a reduction in neuroticism (p=0.043) and an increase in extraversion (p=0.043). No significant changes were observed in non-responders. Increases in novelty seeking and self-directedness, and decreases in persistence and cooperativiness predicted OCD symptom improvement. Similary, improvement in functioning was also predicted by hgher novelty seeking and self-directedness after GVC, whereas better functioning was also associated with lower reward dependence and cooperativeness after surgery. CONCLUSIONS The pattern of changes in personality traits after GVC was generally towards that observed in nonclinical population, and does not raise safety concerns.
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Affiliation(s)
- Raquel R Paiva
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - Marcelo C Batistuzzo
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Nicole C McLaughlin
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Miguel M Canteras
- Institute of Neurological Radiosurgery, Hospital Santa Paula, São Paulo, Brazil
| | - Maria E de Mathis
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Guaraci Requena
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA; Center of Neurorestoration and Neurology, Providence VA Medical Center, RI, USA
| | - Georg Norén
- Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Steven A Rasmussen
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Hermano Tavares
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Eurípedes C Miguel
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Antonio C Lopes
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Marcelo Q Hoexter
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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