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Krcmar M, Wannan CMJ, Lavoie S, Allott K, Davey CG, Yuen HP, Whitford T, Formica M, Youn S, Shetty J, Beedham R, Rayner V, Murray G, Polari A, Gawęda Ł, Koren D, Sass L, Parnas J, Rasmussen AR, McGorry P, Hartmann JA, Nelson B. The self, neuroscience and psychosis study: Testing a neurophenomenological model of the onset of psychosis. Early Interv Psychiatry 2024; 18:153-164. [PMID: 37394278 DOI: 10.1111/eip.13448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/17/2023] [Accepted: 06/07/2023] [Indexed: 07/04/2023]
Abstract
AIM Basic self disturbance is a putative core vulnerability marker of schizophrenia spectrum disorders. The primary aims of the Self, Neuroscience and Psychosis (SNAP) study are to: (1) empirically test a previously described neurophenomenological self-disturbance model of psychosis by examining the relationship between specific clinical, neurocognitive, and neurophysiological variables in UHR patients, and (2) develop a prediction model using these neurophenomenological disturbances for persistence or deterioration of UHR symptoms at 12-month follow-up. METHODS SNAP is a longitudinal observational study. Participants include 400 UHR individuals, 100 clinical controls with no attenuated psychotic symptoms, and 50 healthy controls. All participants complete baseline clinical and neurocognitive assessments and electroencephalography. The UHR sample are followed up for a total of 24 months, with clinical assessment completed every 6 months. RESULTS This paper presents the protocol of the SNAP study, including background rationale, aims and hypotheses, design, and assessment procedures. CONCLUSIONS The SNAP study will test whether neurophenomenological disturbances associated with basic self-disturbance predict persistence or intensification of UHR symptomatology over a 2-year follow up period, and how specific these disturbances are to a clinical population with attenuated psychotic symptoms. This may ultimately inform clinical care and pathoaetiological models of psychosis.
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Affiliation(s)
- Marija Krcmar
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Cassandra M J Wannan
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Suzie Lavoie
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Kelly Allott
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher G Davey
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Thomas Whitford
- School of Psychology, University of New South Wales (UNSW), Kensington, New South Wales, Australia
| | - Melanie Formica
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Youn
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jashmina Shetty
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Beedham
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Victoria Rayner
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Graham Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Andrea Polari
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Dan Koren
- Psychology Department, University of Haifa, Haifa, Israel
| | - Louis Sass
- Department of Clinical Psychology, GSAPP-Rutgers University, Piscataway, New Jersey, USA
| | - Josef Parnas
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark
| | - Andreas R Rasmussen
- Orygen, Parkville, Parkville, Victoria, Australia
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Patrick McGorry
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica A Hartmann
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Barnaby Nelson
- Orygen, Parkville, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
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Atteneder C, Moayedifar R, Koren D, Fischer G, Nackenhorst M, Böhmig G, Laufer G, Zuckermann A. CD 38 Antibody Daratumumab in Allosensitized Recipients for Cardiac Transplantation - A Case Series. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Schwarz S, Fruhmann N, Benazzo A, Koren D, Fischer G, Jaksch P, Hoetzenecker K. Unlike the US-LAS, the Eurotransplant-LAS is Not a Risk Factor for De-Novo Donor Specific Antibodies. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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4
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Ben-gal Dahan A, Koren D. Basic learning functions among young adults coping with schizophrenia. International Journal of Mental Health 2022. [DOI: 10.1080/00207411.2022.2108988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
| | - Dan Koren
- Department of Psychology, University of Haifa, Haifa, Israel
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Koren D, Hegyesné Vecseri B, Kun-Farkas G. Evolution of folate content during barley malt production. AAlim 2021. [DOI: 10.1556/066.2020.00317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AbstractThe aim of this research was to study the effect of micro- and industrial scale malting on the folate content of barley. Two malting barley varieties (one spring and one winter) were studied, applying the same technology. Furthermore, a roasting experiment was carried out at given temperatures for different time periods. The total folate content was determined by microbiological method. The folate content of the barleys was between 10.1 and 23.4 µg/100 g dry matter. For micro- and industrial scale, malting folate content increased 6.5–8-fold and 4–7-fold, respectively, during the malting process. An unexpected result was observed during industrial malting: the folate content increased during kilning by 18–35%, unlike micro scale malting, where a 15–20% decrease was observed. Results obtained during roasting showed that folic acid content did not decrease when roasted for 20 min at 100 °C, but it decreased linearly with increasing temperature. Folate is completely degraded in 20 min at 200 °C. It can be stated that barley malt can serve as a relatively good source of folate, but barley variety and malting technology have significant impact on it.
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Affiliation(s)
- D. Koren
- Department of Brewing and Distilling, Faculty of Food Science, Szent István University, Ménesi street 45, 1118 Budapest, Hungary
| | - B. Hegyesné Vecseri
- Department of Brewing and Distilling, Faculty of Food Science, Szent István University, Ménesi street 45, 1118 Budapest, Hungary
| | - G. Kun-Farkas
- Department of Brewing and Distilling, Faculty of Food Science, Szent István University, Ménesi street 45, 1118 Budapest, Hungary
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Spark J, Gawęda Ł, Allott K, Hartmann JA, Jack BN, Koren D, Lavoie S, Li E, McGorry PD, Parnas J, Polari A, Sass LA, Whitford T, Nelson B. Distinguishing schizophrenia spectrum from non-spectrum disorders among young patients with first episode psychosis and at high clinical risk: The role of basic self-disturbance and neurocognition. Schizophr Res 2021; 228:19-28. [PMID: 33434729 DOI: 10.1016/j.schres.2020.11.061] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/14/2020] [Accepted: 11/27/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The distinction between the schizophrenia spectrum and other types of disorders may be clinically relevant in terms of its predictive validity as suggested by studies showing schizophrenia spectrum patients have more unfavourable outcomes compared to other psychotic disorders. The present study aimed to investigate whether basic self-disturbances and neurocognitive processes that have been linked to psychosis risk have discriminative power for schizophrenia spectrum disorders in patients presenting with first episode psychosis (FEP) and at ultra-high risk for psychosis (UHR). METHODS 38 FEP patients, 48 UHR patients, and 33 healthy controls were assessed for basic self-disturbances (using the Examination of Anomalous Self-Experience, EASE, interview), source monitoring and aberrant salience (behavioural tasks to measure neurocognitive constructs). Clinical groups were divided into patients with schizophrenia spectrum disorders and those with other non-spectrum disorders and were further compared on measures controlling for symptom severity and age. RESULTS Basic self-disturbances distinguished schizophrenia spectrum from non-spectrum disorders in the 'FEP only' sample, F = 19.76, p < 0.001, η2partial = 0.37, and also in the combined UHR/FEP sample, F = 23.56, p < 0.001, η2partial = 0.22. Additionally, some processes related to source monitoring deficits were elevated in schizophrenia spectrum disorders. In contrast, the two groups (schizophrenia spectrum vs other diagnoses) performed similarly in aberrant salience tasks. Comparable results were obtained for analyses performed with an FEP/UHR combined sample and the 'FEP only' sample. DISCUSSION Basic self-disturbances at the phenomenological level and source monitoring deficits on the neurocognitive level may be useful in identifying risk of schizophrenia spectrum disorders at the earliest clinical presentation.
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Affiliation(s)
- Jessica Spark
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Jessica A Hartmann
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Bradley N Jack
- School of Psychology, University of New South Wales, Sydney, Australia; Research School of Psychology, Australian National University, Canberra, Australia
| | - Dan Koren
- Psychology Department, University of Haifa, Haifa, Israel
| | - Suzie Lavoie
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Emily Li
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick D McGorry
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Andrea Polari
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen Youth Health Clinical Program, Melbourne, Australia
| | | | - Thomas Whitford
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Koren D, Vecseri BH, Kun-Farkas G. Evolution of Folate Content During Wort Production. AAlim 2020. [DOI: 10.1556/066.2020.49.4.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
There are numerous scientific publications about the folate content of several types of beers available in commercial trade, but there is limited information about the effect of raw materials and technological steps of brewing on folate content. In this study the aim was to investigate different raw materials and the evolution of folate content during laboratory and pilot scale brewing. For the determination of folate content of different malts, three types of barley malts (Pilsner, Caramel, and Coloring), wheat malt, rye malt, and oat malt were analysed. For the study of the evolution of folate content during the brewing process, worts were produced on laboratory and pilot scale. Among malts, Pilsner type barley malt had the highest folate content (44.7 μg/100 g d.m.). During brewing the protein rest seemed to dissolve the majority of the folate content, and with the increasing temperature of the β- and α-amylase rests there was a further dissolution. Filtration and sparging did not have negative effect on folate concentration related to the extract content of the wort. Hop boiling had no negative effect on folate content, folate seemed to be stable during the one-hour boiling. Natural folate of barley malt seemed to be stable through the technological steps of brewing, offering the possibility to produce a foodstuff with high natural folate content.
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Affiliation(s)
- D. Koren
- Department of Brewing and Distilling, Faculty of Food Science, Szent István University, H-1118 Budapest, Ménesi út 45. Hungary
| | - B. Hegyesné Vecseri
- Department of Brewing and Distilling, Faculty of Food Science, Szent István University, H-1118 Budapest, Ménesi út 45. Hungary
| | - G. Kun-Farkas
- Department of Brewing and Distilling, Faculty of Food Science, Szent István University, H-1118 Budapest, Ménesi út 45. Hungary
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Peskin N, Koren D, Gabay S. Subcortical neural tracks play an important role in executive function in schizophrenia: An experimental study among patients with schizophrenia and healthy comparisons. Schizophr Res Cogn 2020; 22:100185. [PMID: 32714847 PMCID: PMC7378687 DOI: 10.1016/j.scog.2020.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 06/10/2020] [Accepted: 07/08/2020] [Indexed: 11/11/2022]
Abstract
The literature has long emphasized the involvement of cortical and subcortical networks in executive function impairments among patients with schizophrenia. However, previous studies have not examined the relative involvement of monocular (mostly subcortical) versus binocular (mostly cortical) neural tracks in patients' EF deficits. Patients with schizophrenia and healthy comparisons were administered a dichotic version of the Stroop task, in which eye-of-origin manipulation was employed to isolate the involvement of monocular (mostly subcortical; thalamic regions) versus binocular (mostly cortical; extrastriate cortex) visual pathways. The eye-of-origin manipulation, in which a color patch (e.g., a green patch) was presented to one eye, and a word (e.g., “RED”) to the other eye, enabled a split of the conflicting information between the two monocular channels. This results in the presentation of conflicting information to the higher cortical regions, but not to the lower subcortical structures. In the Stroop color task, when the monocular neural channels were not exposed to the conflicting information, the differences in task performance between the patients and the HCs significantly increased, and only the patients exhibited larger task conflict. When monocular neural channels were not exposed to the conflicting information, a robust dysfunction of the patients' group was observed. This abnormality might result from impairments in cortical regions or reduced computational power available for solving the conflict. However, additional studies that take into account the resolution of monocular and binocular neural channels are needed to enrich our understanding of the interplay between cortical and subcortical mechanisms in patients' EF deficits.
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Affiliation(s)
- Noa Peskin
- Department of Psychology, University of Haifa, Haifa 3498838, Israel.,The Institute of Information Processing and Decision Making, University of Haifa, Haifa 3498838, Israel
| | - Dan Koren
- Department of Psychology, University of Haifa, Haifa 3498838, Israel.,Psychiatry Division, Rambam Medical Center, Haifa, Israel
| | - Shai Gabay
- Department of Psychology, University of Haifa, Haifa 3498838, Israel.,The Institute of Information Processing and Decision Making, University of Haifa, Haifa 3498838, Israel
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Koren G, Koren D. Retrograde Ejaculation-a Commonly Unspoken Aspect of Prostatectomy for Benign Prostatic Hypertrophy. Am J Mens Health 2020; 14:1557988320910870. [PMID: 32146870 PMCID: PMC7065283 DOI: 10.1177/1557988320910870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/05/2020] [Accepted: 01/13/2020] [Indexed: 01/13/2023] Open
Abstract
The vast majority of men undergoing prostatectomy experience permanent retrograde ejaculation (RE). While newer, selective techniques of prostatectomy result in lower rates of RE by preserving the innervation to the urethra, the vast majority of men undergoing the classical techniques experience permanent RE due to destruction of the natural mechanisms preventing backflow of the ejaculate into the urinary bladder. A review of online information available to men reveals a lack of information on the importance of RE and explanation of the methods used for prostatectomy. This review provides evidence that the true effects of RE in men can be serious. With the lack of studies aiming at the psychological effects of RE on men's response, it is important for practicing family physicians and urologists to present RE as a serious adverse effect and not to trivialize it.
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Affiliation(s)
- Gideon Koren
- Adelson Faculty of Medicine, Ariel University, Israel
| | - Dan Koren
- Koren Enterprise, Ramot Hashavim, Israel
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Koren D, Scheyer R, Reznik N, Adres M, Apter A, Parnas J, Seidman LJ. Basic self-disturbance, neurocognition and metacognition: A pilot study among help-seeking adolescents with and without attenuated psychosis syndrome. Early Interv Psychiatry 2019; 13:434-442. [PMID: 29052951 DOI: 10.1111/eip.12500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 07/19/2017] [Accepted: 08/20/2017] [Indexed: 11/29/2022]
Abstract
AIM The goal of this pilot study was to assess the association between basic self-disturbance (SD) and deficits in neurocognitive and metacognitive functioning among help-seeking adolescents with and without attenuated psychosis syndrome (APS). METHODS Sixty-one non-psychotic, help-seeking adolescents (age 13-18) were assessed with the examination of anomalous self-experience, the structured interview for prodromal syndromes and a new metacognitive approach to neurocognitive assessment applied to two non-social (executive functions and verbal memory) and two social (theory of mind and emotion recognition) domains. After each answer, subjects were also requested to indicate their level of confidence in the answer and to decide whether they desired it to be "counted" toward their total score on the task. Each volunteered answer earned a 5-cent gain if correct, but an equal fine if wrong. RESULTS As hypothesized, metacognitive monitoring and control had a significant contribution to the prediction of SD over and above neurocognitive functioning and attenuated psychotic symptoms. However, the direction of this association was positive rather than negative. Also, inconsistent with or hypothesis, it was not moderated by the presence of APS. CONCLUSIONS These pilot results provide preliminary support a modest association between SD and metacognition, which is not reducible to neurocognition and APS. In addition, they raise an intriguing possibility regarding metacognitive monitoring and control being indicators of hyper-reflectivity that characterizes individuals with SD. However, further research with larger samples and high-stress assessment conditions are needed to assess this possibility.
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Affiliation(s)
- Dan Koren
- Psychology Department, University of Haifa, Haifa, Israel
| | - Ravit Scheyer
- Psychology Department, University of Haifa, Haifa, Israel
| | - Noa Reznik
- Psychology Department, University of Haifa, Haifa, Israel
| | - Merav Adres
- Psychology Department, University of Haifa, Haifa, Israel
| | - Alan Apter
- Psychological Medicine Clinic, Schneider Children Medical Center, Petach Tikva, Israel
| | - Josef Parnas
- Psychiatric Center, Glostrup-Hvidovre, Faculty of Health and Medical Sciences, University of Copenhagen, Brøndby, Denmark.,Center for Subjectivity Research, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Larry J Seidman
- The Massachusetts Mental Health Center, Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Koren D, Rothschild-Yakar L, Lacoua L, Brunstein-Klomek A, Zelezniak A, Parnas J, Shahar G. Attenuated psychosis and basic self-disturbance as risk factors for depression and suicidal ideation/behaviour in community-dwelling adolescents. Early Interv Psychiatry 2019; 13:532-538. [PMID: 29164828 DOI: 10.1111/eip.12516] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/01/2017] [Accepted: 09/30/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Adolescents at clinical high risk (CHR) for psychosis, as defined by the presence of attenuated psychosis symptoms (APS), exhibit increased levels of suicidal ideation and behaviour. However, no research thus far has examined the link between basic self-disturbances (SDs), an established marker for CHR, and suicidality/self-harm in this population. The goal of this pilot study was to assess the association between SD, depression and suicidal ideation and behaviour among non-help-seeking adolescents from the community. METHOD A total of 100 community-dwelling adolescents (age range: 13-16) were assessed using the Examination of Anomalous Self-experience, Prodromal Questionnaire, Structured Interview for Prodromal Syndromes, Mood and Anxiety Symptom Questionnaire and the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). The K-SADS was used to derive a binary diagnosis of unipolar depression, as well as to measure suicidal ideation and behaviour and self-harm. RESULTS In a multiple regression analysis, SD accounted for variance in depressive symptoms and suicidality/self-harm over and above that accounted for by APS. Moreover, SD accounted for variance in suicidality/self-harm over and above that accounted for by depression symptoms. CONCLUSIONS These pilot results suggest that SD might be a unique dimension of vulnerability to depression and suicidality/self-harm in adolescence. Also, they encourage assessment of SD as part of a suicide risk assessment, particularly in the context of risk for subsequent psychosis.
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Affiliation(s)
- Dan Koren
- Department of Psychology, University of Haifa, Haifa, Israel.,Psychiatry Division, Rambam Medical Center, Haifa, Israel
| | | | - Liza Lacoua
- Department of Psychology, University of Haifa, Haifa, Israel
| | | | - Aya Zelezniak
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Josef Parnas
- Psychiatric Center, Glostrup-Hvidovre, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Subjectivity Research, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Golan Shahar
- Department of Psychology, Ben-Gurion University, Beer-Sheba, Israel
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Nelson B, Lavoie S, Gaweda L, Li E, Sass LA, Koren D, McGorry PD, Jack BN, Parnas J, Polari A, Allott K, Hartmann JA, Whitford TJ. Testing a neurophenomenological model of basic self disturbance in early psychosis. World Psychiatry 2019; 18:104-105. [PMID: 30600614 PMCID: PMC6313695 DOI: 10.1002/wps.20597] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Suzie Lavoie
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Lukasz Gaweda
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg‐Eppendorf, Hamburg, Germany,II Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Emily Li
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Dan Koren
- Psychology Department, University of Haifa, Haifa, Israel
| | - Patrick D. McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Bradley N. Jack
- School of Psychology, University of New South Wales, Sydney, Australia
| | | | - Andrea Polari
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia,Orygen Youth Health Clinical Program, Melbourne, Australia
| | - Kelly Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jessica A. Hartmann
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Bar-Sela G, Gruber R, Mitnik I, Lulav-Grinwald D, Koren D. Attachment Orientation and Relationships With Physicians and Nurses Among Israeli Patients With Advanced Cancer. Oncol Nurs Forum 2018; 45:631-638. [DOI: 10.1188/18.onf.631-638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bar-Sela G, Yochpaz S, Gruber R, Lulav-Grinwald D, Mitnik I, Koren D. The association between the strength of the working alliance and sharing concerns by advanced cancer patients: a pilot study. Support Care Cancer 2015; 24:319-325. [DOI: 10.1007/s00520-015-2794-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/01/2015] [Indexed: 11/28/2022]
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Bar-Sela G, Yochpaz S, Gruber R, Lulav- Grinwald D, Mitnik I, Koren D. The association between the working alliance and sharing concerns by advanced cancer patients. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e20553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Sivan Yochpaz
- Technion-Israel Institute of Technology, Haifa, Israel
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Koren D, Chirinos JA, Katz LEL, Mohler ER, Gallagher PR, Mitchell GF, Marcus CL. Interrelationships between obesity, obstructive sleep apnea syndrome and cardiovascular risk in obese adolescents. Int J Obes (Lond) 2015; 39:1086-93. [PMID: 25913504 PMCID: PMC4496293 DOI: 10.1038/ijo.2015.67] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 12/11/2014] [Accepted: 12/18/2014] [Indexed: 01/11/2023]
Abstract
Background/Objectives Obstructive sleep apnea syndrome (OSAS) may be a cardiovascular disease (CVD) risk factor independently of obesity in adults. Pediatric studies have associated OSAS with endothelial dysfunction, but few studies have examined relationships between OSAS and macrovascular sequelae. Our objective was to examine OSAS’s independent contribution to macrovascular CVD risk measures in obese adolescents. Subjects/Methods This cross-sectional observational study was conducted at Children’s Hospital of Philadelphia Clinical Research and Academic Sleep Centers, and University of Pennsylvania Vascular Research Unit. 31 obese non-diabetic adolescents underwent anthropometric measurements, overnight polysomnography, fasting laboratory draw, and cardiovascular imaging. Cardiovascular outcome measures included maximal carotid intima-media thickness (cIMTmax), a measure of carotid structural changes, and carotid-femoral pulse wave velocity (CFPWV), an aortic stiffness measure whose relationship vis-à-vis OSAS in children has not been previously examined. Carotid diameter and augmentation index (AIx, measuring central pressure augmentation from wave reflections) were assessed. Potential confounding variables examined included blood pressure, lipoproteins, high-sensitivity C-reactive protein, insulin and glucose. Results The apnea hypopnea index, a primary OSAS measure, was not associated with cIMTmax, carotid diameter, CFPWV or AIx. BMI associated positively with cIMTmax (r=0.52, p=0.006) and CFPWV (r=0.45, p=0.01). Mean asleep end-tidal CO2 was negatively associated with carotid diameter (r=−0.63, p<0.0005). Insulin levels were negatively associated with AIx (r=−0.53, p=0.02). Conclusions OSAS did not predict carotid structural changes or arterial stiffness independently of BMI in obese adolescents. Higher insulin levels associated with lower central pressure wave augmentation. Finally, long-term hypercapnia may predispose to carotid narrowing.
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Affiliation(s)
- D Koren
- Pediatrics-Section of Endocrinology, Diabetes and Metabolism, The University of Chicago, Chicago, IL, USA
| | - J A Chirinos
- Perelman School of Medicine and Philadelphia VA Medical Center, University of Pennsylvania, Philadelphia, PA, USA
| | - L E L Katz
- Pediatrics-Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - E R Mohler
- Department of Medicine, Cardiovascular Division, Vascular Medicine Section, Perelman School of Medicine at the University of Pennsylvania,Philadelphia, PA, USA
| | - P R Gallagher
- Biostatistics Core, Clinical and Translational Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - G F Mitchell
- Cardiovascular Engineering Inc, Norwood, MA, USA
| | - C L Marcus
- Pediatrics-Sleep Center, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
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Koren D, Reznik N, Adres M, Scheyer R, Apter A, Steinberg T, Parnas J. Disturbances of basic self and prodromal symptoms among non-psychotic help-seeking adolescents. Psychol Med 2013; 43:1365-1376. [PMID: 23084507 DOI: 10.1017/s0033291712002322] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The goal of this study was to explore the notion that anomalies of self-experience (ASE) are a core, 'not-yet-psychotic' clinical phenotype of emerging schizophrenia and its spectrum. Method To accomplish this goal, we examined the relationship between ASE and commonly accepted risk markers in a sample of 87 help-seeking, non-psychotic adolescents (aged 14-18 years). ASE were assessed with the Examination of Anomalous Self-Experience (EASE), subclinical psychotic symptoms were assessed with the Prodromal Questionnaire and the Structured Interview for Prodromal Syndromes, deterioration in psychosocial functioning was assessed with the Social and Role Functioning Scales, and level of distress with the Mood and Anxiety Symptoms Questionnaire. RESULTS About 82 participants completed the entire EASE interview. The number of participants who reported ASE at a clinically meaningful level (n = 18, 22%) was smaller than that who met diagnostic criteria for a prodromal syndrome (n = 28, 34%). The degree of overlap between the two conditions was moderate but statistically significant (χ2 (1) = 7.01, p = 0.008). An exploratory factor analysis revealed that ASE load on a different factor than prodromal symptoms and deterioration in functioning, but that there is a moderate correlation between the three factors. CONCLUSIONS These results suggest that ASE are prevalent among non-psychotic help-seeking adolescents, yet at a considerably lower rate than prodromal symptoms. In addition, they suggest that ASE and prodromal symptoms constitute distinct but moderately related dimensions of potential risk. Taken together, they provide preliminary support for the clinical usefulness of supplementing and refining the methods of early detection of risk with assessment of ASE.
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Affiliation(s)
- D Koren
- Department of Psychology, University of Haifa, Haifa, Israel.
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Panzer S, Badr Eslam R, Schneller A, Kaider A, Koren D, Eichelberger B, Rosenhek R, Budde U, Lang IM. Loss of high-molecular-weight von Willebrand factor multimers mainly affects platelet aggregation in patients with aortic stenosis. Thromb Haemost 2009; 103:408-14. [PMID: 20024494 DOI: 10.1160/th09-06-0391] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Accepted: 11/06/2009] [Indexed: 11/05/2022]
Abstract
Severe aortic stenosis is associated with a haemostatic abnormality that resembles acquired von Willebrand syndrome type 2. It is assumed that high shear conditions render large von Willebrand factor (VWF) multimers accessible to cleavage by ADAMTS-13. However, whether loss of these large multimers affects platelet function by impairing adhesion, aggregate formation, or both has not been evaluated in clinical studies. We prospectively enrolled 47 patients with severe aortic stenosis, and studied them prior to aortic valve surgery and at a median of six months after valve replacement. We investigated levels of large VWF multimers, platelet function under high shear conditions, and residual response to suboptimal concentrations of ADP to express P-selectin. As expected, there was a significant reduction of VWF large multimers before surgery that resolved thereafter in most patients (p<0.0001). The closure time of the ADP cartridge of the PFA-100 was also corrected in most patients after the operation (p<0.0001). We used the cone and plate(let) analyser Impact-R to differentiate between adhesion and aggregation. Both adhesion (p=0.03) and ADP-inducible platelet aggregation (p=0.002) improved considerably after valve replacement. Consequently, ADP-inducible expression of P-selectin was higher after valve replacement (p=0.001). We conclude that reduced levels of large VWF multimers associated with aortic stenosis lead to impairment of both adhesion and, especially, ADP-inducible platelet aggregation.
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Affiliation(s)
- S Panzer
- Department for Blood Group Serology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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Rubin SS, Nadav OB, Malkinson R, Koren D, Goffer-Shnarch M, Michaeli E. The two-track model of bereavement questionnaire (TTBQ): development and validation of a relational measure. Death Stud 2009; 33:305-333. [PMID: 19368062 DOI: 10.1080/07481180802705668] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The Two-Track Model of Bereavement Questionnaire (TTBQ) was designed to assess response to loss over time. Respondents were 354 persons who completed the 70-item self-report questionnaire constructed in accordance with the Two-Track Model of Bereavement. Track I focuses on the bereaved's biopsychosocial functioning and Track II concerns the bereaved's ongoing relationship to the range of memories, images, thoughts, and feeling states associated with the deceased. Factor analysis identified 5 factors that accounted for 51% of the variance explained. In accord with the theoretical and clinical model, 3 factors were primarily associated with the relationship to the deceased (Track II): Active Relational Grieving, Close and Positive Relationship, and Conflictual Relationship; and 2 factors with aspects of functioning (Track I): General Biopsychosocial Functioning and Traumatic Perception of the Loss. Construct and concurrent validity were examined and were found satisfactory. Differences by kinship, cause of death, gender, and time elapsed were examined across the 5 factors, the total TTBQ, and the ITG. The new measure is shown to have both construct and concurrent validity. Discussions of the results and implications for the measurement of response to loss conclude the article.
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Male C, Koren D, Eichelberger B, Kaufmann K, Panzer S. Monitoring survival and function of transfused platelets in Glanzmann thrombasthenia by flow cytometry and thrombelastography. Vox Sang 2006; 91:174-7. [PMID: 16907879 DOI: 10.1111/j.1423-0410.2006.00797.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Patients with Glanzmann thrombasthenia (GT) may form isoantibodies which induce refractoriness or inhibition of function of transfused platelets. We monitored the survival and function of transfused platelets by flow cytometry and thrombelastography in a patient with GT. Gating on CD42a+ allowed identification of even a few transfused platelets. Only by gating on these CD41+ CD42a+ cells were we able to demonstrate their capability to bind fibrinogen and PAC-1 upon activation. Platelets were rapidly cleared from the circulation as a result of boosted isoantibodies. The contribution of transfused platelets to clot formation was also demonstrated by thrombelastography by blocking their function with abciximab.
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Affiliation(s)
- C Male
- Department for Pediatrics, Medical University Vienna, Austria
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Abstract
OBJECTIVE Postpartum depressive disorders are common and symptoms may appear as early as the first 2 weeks postpartum. Data regarding hormone-related risk factors for depressive symptoms occurring in the very early postpartum period are scarce and may be of importance in identifying serious postpartum illness. We examined the association between the reported history of psychiatric symptoms of possible hormonal etiology and very early postpartum depressive symptoms. METHODS All women (n= 1,800) in a general hospital maternity ward were assessed during the first 3 days after parturition for potential risk factors for postpartum depressive disorders by a self-reported questionnaire and for present mood symptoms (Edinburgh Postnatal Depression Scale, EPDS). The associations between potential risk factors and postpartum depressive symptoms were analysed. RESULTS The incidence of women with an EPDS >or=10 was 6.8% (88/1,286). Significant risk factors for early postpartum depressive symptoms were a history of mental illness including past postpartum depression (PPD), premenstrual dysphoric disorder (PMDD), and mood symptoms during the third trimester. CONCLUSION In accordance with other studies, a history of depression was found to be a risk factor for early postpartum mood symptoms. An association was also found between some risk factors of possible hormone-related etiology such as PMDD and third trimester mood symptoms and early postpartum mood symptoms. As such, early postpartum symptoms may indicate vulnerability to subsequent PPD; it may be of importance to assess these risk factors and mood immediately after parturition. A prospective study is needed to determine which of these risk factors is associated with progression to PPD and which resolves as the blues.
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Affiliation(s)
- Miki Bloch
- Psychiatric Outpatient Department, Psychiatric Service, Tel Aviv Souraski Medical Center, Tel-Aviv, Israel, 64239.
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Bloch M, Rotenberg N, Koren D, Klein E. Risk factors associated with the development of postpartum mood disorders. J Affect Disord 2005; 88:9-18. [PMID: 15979150 DOI: 10.1016/j.jad.2005.04.007] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2004] [Revised: 04/25/2005] [Accepted: 04/25/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND Various factors have been reported to be associated with the development of postpartum mood disorders. The relationship between postpartum mood disorders and putatively hormone-related phenomena such as premenstrual dysphoric disorder (PMDD) is unclear. This study attempts to determine whether such mood phenomena are risk factors for postpartum mood disorders. METHODS Postpartum women (n=1800) were assessed for risk factors for postpartum mood disorders during the first 2-4 days after parturition. Of these, 133 were defined as "high risk" and 109 as "low risk" according to fixed criteria. A structured phone diagnostic interview was performed at 6-8 weeks postpartum to assess for the presence of postpartum depression or the blues. RESULTS Premenstrual dysphoric disorder (PMDD), mood symptoms during the first 2-4 days postpartum, a past history of depression and mood symptoms during past oral contraceptive use, were found to be significant risk factors for postpartum mood disorders. Women at high risk for postpartum mood disorders had a 9.3-, 1.5-, 1.6- and 2.6-fold increase in risk for major depression, minor depression, the blues and adjustment disorder respectively compared to women at low risk. LIMITATIONS While the study design is prospective, it is limited by the retrospective assessment of risk factors. CONCLUSIONS This study provides preliminary evidence that putatively hormone-related phenomena such as PMDD are related to the occurrence of postpartum mood disorders. The results go some way to support the hypothesis that the etiology for postpartum mood disorders may be related to differential hormonal sensitivity. Such risk factors should be included in any assessment of the risk for these disorders.
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Affiliation(s)
- Miki Bloch
- Psychiatric Service, Tel-Aviv Souraski Medical Center, Tel-Aviv, Israel.
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24
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Mandelbaum M, Koren D, Eichelberger B, Auerbach L, Panzer S. Frequencies of maternal platelet alloantibodies and autoantibodies in suspected fetal/neonatal alloimmune thrombocytopenia, with emphasis on human platelet antigen-15 alloimmunization. Vox Sang 2005; 89:39-43. [PMID: 15938738 DOI: 10.1111/j.1423-0410.2005.00662.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Serological evaluation of maternal sera for platelet antibodies in suspected fetal/neonatal alloimmune thrombocytopenia (FNAITP) discloses in only approximately 30% of individuals a platelet-specific antibody. Transfusion-induced alloimmunization against human platelet antigen-15 (HPA-15) has been reported to be about as common as against HPA-5, the second most common platelet antibody. Thus, anti-HPA-15 may also contribute significantly to yet-unclear cases of FNAITP. MATERIALS AND METHODS In this retrospective analysis, we provide data on maternal platelet antibodies from 309 mothers who delivered an offspring with suspected FNAITP. RESULTS Genotyping maternal and paternal samples (together n = 573) revealed a gene frequency of 0.496 for HPA-15a and a gene frequency of 0.504 for HPA-15b. HPA-15 antibodies were detected in 2% of all samples. Anti-HPA-15a and -15b were detected in two and three samples, respectively. One serum reacted equally with HPA-15a and -15b platelets. The most frequent platelet-specific antibodies were anti-HPA-1a (22%), but anti-HPA-5b (8.4%) were more frequent than anti-HPA-15. In addition, panreactive (5.5%) or autoreactive (5.2%) anti-GPIIb/IIIa or anti-GPIb/IX were detectable in maternal samples. CONCLUSIONS These data indicate that HPA-15 alloimmunization needs only to be considered in subjects with suspected FNAITP if no other platelet-specific antibody is detectable. The presence of panreactive or autoreactive antibodies should also be considered in neonatal thrombocytopenia.
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Affiliation(s)
- M Mandelbaum
- Clinic for Blood Group Serology, Medical University Vienna, Vienna, Austria
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Chistyakov A, Kaplan B, Häfner H, Koren D, Feinsod M, Klein E. Transcranial magnetic stimulation as a tool for assessment and modulation of cortical excitability in patients with major depression. Eur Psychiatry 2002. [DOI: 10.1016/s0924-9338(02)80196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Koren D, Arnon I, Klein E. Long term course of chronic posttraumatic stress disorder in traffic accident victims: a three-year prospective follow-up study. Behav Res Ther 2001; 39:1449-58. [PMID: 11758702 DOI: 10.1016/s0005-7967(01)00025-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of the present study was to gather prospective longitudinal data on the long-term course and outcome of chronic posttraumatic stress disorder (PTSD). The target population for this study was 74 injured traffic accident victims who had been previously followed-up for one year after the trauma. Nineteen of the original 24 PTSD subjects (79%) and 39 of the original 50 Non-PTSD subjects (78%) were available for this study, which took place during the fourth year after the accident. Our results show that 10 (53%) of the 19 patients with PTSD at one-year still suffered from PTSD after another two-year follow-up interval, while 9 recovered from PTSD during this follow-up period. Only 2 of the 39 without PTSD at one year developed delayed onset PTSD. The best predictor of recovery from chronic PTSD was the initial level of posttraumatic reaction immediately after the accident. These results demonstrate that spontaneous recovery from PTSD can occur even among patients who are currently considered chronic. Severity of initial reaction to the trauma appears to be a major risk factor for non-remitting chronic PTSD.
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Affiliation(s)
- D Koren
- Department of Psychiatry, Rambam Medical Center, B. Rappaport Faculty of Medicine Technion I.I.T., Haifa, Israel
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Koren D, Shefer O, Chistyakov A, Kaplan B, Feinsod M, Klein E. Neuropsychological effects of prefrontal slow rTMS in normal volunteers: a double-blind sham-controlled study. J Clin Exp Neuropsychol 2001; 23:424-30. [PMID: 11780943 DOI: 10.1076/jcen.23.4.424.1225] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Recent reports have suggested that repetitive transcranial magnetic stimulation (rTMS) is effective in major depression. Unlike ECT, rTMS does not involve a seizure and is associated with minimal side-effects, including cognitive difficulties. However, the effect of rTMS on cognitive functioning has not been systematically evaluated. This study was designed to examine the neuropsychological effects of slow rTMS in normal volunteers. Forty-six normal volunteers were randomly assigned to receive one session of right (N = 16) or left prefrontal (N = 15), or sham (N = 15) rTMS at 1 HZ. Patients were assessed before and after stimulation by a computerized neurospychological battery. All three groups showed significant improvement over time in processing speed (reaction time) and efficiency (correct responses per unit of time). However, no time by group interaction was found for any of the neuropsychological tests. These findings suggest that a single session of slow rTMS does not interfere with neurospychological functioning in normal volunteers, supporting clinical reports of no adverse cognitive effects.
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Affiliation(s)
- D Koren
- Department of Psychiatry, B. Rappaport Faculty of Medicine, Rambam Medical Center, Haifa, Israel
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Almagor M, Koren D. The adequacy of the MMPI-2 Harris-Lingoes subscales: a cross-cultural factor analytic study of Scales D, Hy, Pd, Pa, Sc, and Ma. Psychol Assess 2001; 13:199-215. [PMID: 11433795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The authors investigated cross-culturally the factor structure of Scales D, Hy, Pd, Pa, Sc, and Ma of the Minnesota Multiphasic Personality Inventory--2 (S. R. Hathaway & J. C. McKinley, 1989) to examine the adequacy of the Harris-Lingoes (HL) subscales developed for these scales. A combined sample of 1,896 Israeli outpatients and inpatients and a sample of 1,020 American outpatients were used. Each scale was factor analyzed separately in the Israeli and U.S. samples and, within each sample, by gender. The results did not support the structural adequacy of the HL subscales for Scales D, Pd, Sc, and Ma but generally supported their suitability for Scales Hy and Pa. In addition, the results also suggested that all clinical scales share a common element of general distress akin to A. Tellegen's (1985) negative affectivity. These findings highlight the need for developing and validating a new set of subscales for most of the clinical scales, using external measures of relevant clinical and personality domains for which the current scales may serve as a basis.
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Affiliation(s)
- M Almagor
- Department of Psychology, University of Haifa, Mount Carmel, Haifa, Israel.
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Koren D, Janisiw M, Eichelberger B, Panzer S. Anti-HPA1a antibodies induce CD62P and fibrinogen binding. Transfus Med 2000. [DOI: 10.1046/j.1365-3148.2000.00261-19.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Klein E, Kolsky Y, Puyerovsky M, Koren D, Chistyakov A, Feinsod M. Right prefrontal slow repetitive transcranial magnetic stimulation in schizophrenia: a double-blind sham-controlled pilot study. Biol Psychiatry 1999; 46:1451-4. [PMID: 10578460 DOI: 10.1016/s0006-3223(99)00182-1] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to extend our previous work on the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) in major depression to patients with schizophrenia. METHODS Thirty-five inpatients with schizophrenia were randomly assigned to either right prefrontal rTMS or sham treatment and were rated before and after treatment for positive, negative, and depressive symptoms. RESULTS Thirty-one subjects (rTMS = 16, sham = 15) completed a 2-week treatment protocol. No serious adverse effects were reported; however, rTMS was not superior to sham treatment on any of the clinical ratings. CONCLUSIONS In contrast to our previous positive findings in major depression, right prefrontal slow rTMS does not appear to have a beneficial effect for actively psychotic patients with schizophrenia.
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Affiliation(s)
- E Klein
- Department of Psychiatry, Rambam Medical Center, Haifa, Israel
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Klein E, Kreinin I, Chistyakov A, Koren D, Mecz L, Marmur S, Ben-Shachar D, Feinsod M. Therapeutic efficacy of right prefrontal slow repetitive transcranial magnetic stimulation in major depression: a double-blind controlled study. Arch Gen Psychiatry 1999; 56:315-20. [PMID: 10197825 DOI: 10.1001/archpsyc.56.4.315] [Citation(s) in RCA: 320] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS), a noninvasive technique for stimulation of the brain, has recently been suggested to be effective for the treatment of major depression. We conducted a double-blind, placebo-controlled study to assess the efficacy of slow repetitive TMS (rTMS) in patients with major depression. METHODS Seventy patients with major depression (53 women, 17 men; mean age, 58.7 years; SD, 17.2 years) were randomly assigned to receive rTMS or sham rTMS in a double-blind design. Treatment was administered in 10 daily sessions during a 2-week period. Severity of depression was blindly assessed before, during, and after completion of the treatment protocol. RESULTS All patients completed the first week of treatment and 67 completed the entire protocol. Patients who received rTMS had a significantly greater improvement in depression scores compared with those who received sham treatment. At the end of 2 weeks, 17 of 35 patients in the rTMS group, but only 8 of 32 in the sham-treated group, had an improvement of greater than 50% in their depression ratings. CONCLUSIONS This controlled study provides evidence for the short-term efficacy of slow rTMS in patients with recurrent major depression. Additional studies will be necessary to assess the efficacy of rTMS as compared with electroconvulsive therapy as well as the long-term outcome of this treatment in major depression and possibly other psychiatric disorders.
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Affiliation(s)
- E Klein
- Department of Psychiatry, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa
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Abstract
OBJECTIVE This study was designed to assess the natural course of posttraumatic symptoms formation, as well as the degree to which acute stress reactions predict later posttraumatic stress disorder (PTSD) in injured traffic accident victims. METHOD A prospective, 1-year follow-up study was carried out on 74 injured traffic accident victims and a comparison group of 19 patients who were hospitalized for elective orthopedic surgery. Participants were interviewed within the first week following the accident, and follow-up interviews were performed 1, 3, 6, and 12 months after the accident. At 12 months, a structured clinical interview was administered to determine a formal DSM-III-R diagnosis of PTSD. RESULTS Twenty-four (32%) of the 74 traffic accident victims, but none of the 19 comparison subjects, met DSM-III-R criteria for PTSD at 1 year. Traffic accident victims who developed PTSD had higher levels of premorbid and comorbid psychopathology. Levels of posttraumatic symptoms were significantly higher from the outset in the subjects who developed PTSD and worsened progressively over the first 3 months, in contrast to subjects without PTSD, who manifested gradual amelioration of symptoms during this time. Existence of posttraumatic symptoms immediately after the accident was a better predictor of later PTSD than was accident or injury severity. CONCLUSIONS In this study, a significant portion of injured traffic accident victims manifested PTSD 1 year after the event. The development of PTSD at 1 year can be predicted as early as 1 week after the accident on the basis of the existence and severity of early PTSD-related symptoms. However, the first 3 months following the accident appear to be the critical period for the development of PTSD.
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Affiliation(s)
- D Koren
- Department of Psychiatry of the Rambam Medical Center and the B. Rappaport Faculty of Medicine, Technion, I.I.T., Haifa, Israel
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Goldstein JM, Seidman LJ, Goodman JM, Koren D, Lee H, Weintraub S, Tsuang MT. Are there sex differences in neuropsychological functions among patients with schizophrenia? Am J Psychiatry 1998; 155:1358-64. [PMID: 9766767 DOI: 10.1176/ajp.155.10.1358] [Citation(s) in RCA: 168] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Studies of sex differences in neuropsychological performance in schizophrenia report inconsistent results, due in part to methodological artifacts. The study presented here was specifically designed to examine sex differences in neuropsychological performance. It was hypothesized that schizophrenic women would exhibit fewer neuropsychological deficits than schizophrenic men and that their performance would be more similar to that of normal women than schizophrenic men's performance would be to that of normal men. METHOD Thirty-one outpatients with DSM-III-R-defined schizophrenia were systematically sampled from an extensive service network serving a large urban catchment area for seriously mentally ill persons. Twenty-seven normal comparison subjects were matched within sex on the basis of age, parental socioeconomic status, ethnicity, and handedness. An extensive neuropsychological test battery was administered, and multivariate analysis of variance was used to test for the effects of sex and group and sex-by-group interactions. RESULTS Male patients were significantly impaired across all functions in comparison with normal male subjects and on tests of attention, verbal memory, and executive functions in comparison with female patients. Female patients performed significantly worse than female normal comparison subjects only on tests of attention, executive functions, visual memory, and motor functions. CONCLUSIONS The findings suggest that women with schizophrenia may be less vulnerable to particular cognitive deficits, especially those involving verbal processing, than schizophrenic men.
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Affiliation(s)
- J M Goldstein
- Harvard Institute of Psychiatric Epidemiology and Genetics, Department of Psychiatry, Harvard Medical School at Massachusetts Mental Health Center, Boston 02115, USA.
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Janisiw M, Eichelberger B, Koren D, Panzer S. Screening for platelet auto-antibodies by flow cytometry and their evaluation by the MAIPA technique. Wien Klin Wochenschr 1998; 110:531-4. [PMID: 9782571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The determination of platelet antibodies assists in the diagnosis of immune thrombocytopenia. Among the various techniques which have been used two major ways for the determination of these antibodies have entered the routine use, determination of in vivo platelet bound total IgG, termed platelet-associated IgG, PAIgG, and that of specifically to particular platelet glycoproteins bound IgG, GP-IgG. The former has been found to be non-specific, and the evaluation of the latter is rather laborious. Furthermore, both require a large number of platelets. By flowcytometry, however, PAIgG can be determined even if platelet counts are very low. We therefore evaluated in 30 patients' samples if the flowcytometric determination of PAIgG can serve to screen for platelet antibodies. Positive samples subsequently are evaluated by a glycoprotein-specific detection technique (MAIPA). We show that in patients with suspected autoimmune thrombocytopenia (AITP) and in secondary AITP PAIgG is elevated in 83%. However, only 30% of patients' samples have detectable antibodies by the MAIPA technique. Based on the findings that by the MAIPA technique antibodies were only detectable in samples which had also elevated levels of PAIgG we consider the flowcytometric determination of PAIgG useful for screening, prior to the more laborious investigation by the MAIPA assay.
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Affiliation(s)
- M Janisiw
- Clinic for Blood Group Serology, University of Vienna, Austria
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Koren D, Seidman LJ, Harrison RH, Lyons MJ, Kremen WS, Caplan B, Goldstein JM, Faraone SV, Tsuang MT. Factor structure of the Wisconsin Card Sorting Test: dimensions of deficit in schizophrenia. Neuropsychology 1998. [PMID: 9556775 DOI: 10.1037//0894-4105.12.2.289] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to explore the factorial structure of the Wisconsin Card Sorting Test (WCST) and to identify the dimensions of deficit in schizophrenia. WCST scores in patients with schizophrenia and schizophrenia-related psychosis (n = 292), 1st degree relatives of schizophrenic patients (n = 91), and normal controls (n = 141) were subjected to a principal factor analysis followed by orthogonal rotation. This led to 3 factors, perseveration, failure to maintain set, and idiosyncratic sorting. The detected factor structure was found to be invariant across the schizophrenic and control subsamples. Moreover, it replicated previous findings from 2 smaller samples. Only perseverations and, to a lesser degree, idiosyncratic sorting appeared to differentiate schizophrenic patients from comparisons. Only perseveration had good sensitivity and specificity, as well as the most robust significant correlations with estimates of IQ, attention, and other measures of executive functioning. Thus, perseveration appears to be the most diagnostically useful and characteristic WCST feature of schizophrenia.
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Affiliation(s)
- D Koren
- Department of Psychology, Boston University, Massachusetts, USA
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Kremen WS, Buka SL, Seidman LJ, Goldstein JM, Koren D, Tsuang MT. IQ decline during childhood and adult psychotic symptoms in a community sample: a 19-year longitudinal study. Am J Psychiatry 1998; 155:672-7. [PMID: 9585720 DOI: 10.1176/ajp.155.5.672] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The goal of this study was to examine cognitive antecedents of psychosis by determining whether variability in IQ during childhood was predictive of psychotic symptoms in adulthood. METHOD Deviant responder analyses were used to examine prospectively the relationship of IQ at ages 4 and 7 to psychotic symptoms at age 23 in 547 offspring from a community sample (National Collaborative Perinatal Project) that was unselected for psychiatric illness. The authors compared three hypotheses: that 1) low IQ, 2) large IQ fluctuations regardless of direction, or 3) large IQ declines would predict the presence of adult psychotic symptoms. RESULTS The 10% of individuals with substantially larger than expected IQ declines from age 4 to 7 had a rate of psychotic, but not other psychiatric, symptoms at age 23 that was nearly seven times as high as the rate for other persons. Parental socioeconomic status and IQ at age 7 also predicted adult psychotic symptoms. However, when IQ at age 7, IQ decline between ages 4 and 7, and socioeconomic status were all included in a logistic regression analysis, only IQ decline remained significant. CONCLUSIONS There is an increased likelihood of developing psychotic symptoms in adulthood for a subgroup of individuals with substantially greater than expected IQ declines during childhood. IQ decline is specific for psychotic symptoms, but follow-up assessment when the study participants are further into the age of risk will be necessary to determine specificity for schizophrenia. The authors discuss the implications of this early cognitive downturn for a neurodevelopmental view of schizophrenia.
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Affiliation(s)
- W S Kremen
- Department of Psychiatry, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA.
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Koren D, Seidman LJ, Harrison RH, Lyons MJ, Kremen WS, Caplan B, Goldstein JM, Faraone SV, Tsuang MT. Factor structure of the Wisconsin Card Sorting Test: dimensions of deficit in schizophrenia. Neuropsychology 1998; 12:289-302. [PMID: 9556775 DOI: 10.1037/0894-4105.12.2.289] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to explore the factorial structure of the Wisconsin Card Sorting Test (WCST) and to identify the dimensions of deficit in schizophrenia. WCST scores in patients with schizophrenia and schizophrenia-related psychosis (n = 292), 1st degree relatives of schizophrenic patients (n = 91), and normal controls (n = 141) were subjected to a principal factor analysis followed by orthogonal rotation. This led to 3 factors, perseveration, failure to maintain set, and idiosyncratic sorting. The detected factor structure was found to be invariant across the schizophrenic and control subsamples. Moreover, it replicated previous findings from 2 smaller samples. Only perseverations and, to a lesser degree, idiosyncratic sorting appeared to differentiate schizophrenic patients from comparisons. Only perseveration had good sensitivity and specificity, as well as the most robust significant correlations with estimates of IQ, attention, and other measures of executive functioning. Thus, perseveration appears to be the most diagnostically useful and characteristic WCST feature of schizophrenia.
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Affiliation(s)
- D Koren
- Department of Psychology, Boston University, Massachusetts, USA
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Seidman LJ, Goldstein JM, Goodman JM, Koren D, Turner WM, Faraone SV, Tsuang MT. Sex differences in olfactory identification and Wisconsin Card Sorting performance in schizophrenia: relationship to attention and verbal ability. Biol Psychiatry 1997; 42:104-15. [PMID: 9209727 DOI: 10.1016/s0006-3223(96)00300-9] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We investigated the hypothesis that different prefrontal brain systems (i.e., dorsal vs. ventral) and sex contribute differentially to cognitive deficit in schizophrenia. Performance was assessed among clinically stable, chronic schizophrenic outpatients and matched normal control subjects on olfactory identification [on the University of Pennsylvania Smell Identification Test (UPSIT)] and on executive functions [using the Wisconsin Card Sorting Test (WCST)]. Patients were impaired on both tests compared to controls, and male schizophrenics were impaired on the WCST compared to female schizophrenics. The pattern of results suggests that gender differences on the UPSIT are mildly accentuated in schizophrenia. The data support our previous study indicating that UPSIT performance is largely independent of the executive or attentional deficits typically associated with schizophrenia, with the exception of verbal ability. Further research with larger samples is required to test the hypothesis that there is a severely impaired subgroup of male patients with diffuse prefrontal dysfunctions.
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Affiliation(s)
- L J Seidman
- Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center, Boston 02115, USA
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Westen D, Muderrisoglu S, Fowler C, Shedler J, Koren D. Affect regulation and affective experience: individual differences, group differences, and measurement using a Q-sort procedure. J Consult Clin Psychol 1997. [PMID: 9170766 DOI: 10.1037//0022-006x.65.3.429] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This article describes the development of, and preliminary findings with, the Affect Regulation and Experience Q-Sort (the AREQ), an observer-based assessment of affect regulation and experience. In Study 1, 31 clinicians provided Q-sort descriptions of 90 patients. Factor scores correlated in predicted ways with criteria such as suicide attempts and hospitalizations, as well as with clinicians' ratings of functioning in a variety of domains. Correlations between prototype Q-sorts and actual Q-sort profiles for patients sharing a diagnosis (dysthymia, borderline personality disorder, and narcissistic personality disorder) also provided evidence for convergent and discriminant validity. The data also suggested the importance of distinguishing 2 kinds of negative affect that have very different correlates. Study 2 showed that the AREQ can be applied reliably using an interview that avoids many of the problems of self-report.
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Affiliation(s)
- D Westen
- Department of Psychiatry, Cambridge Hospital, Massachusetts 02139, USA.
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Westen D, Muderrisoglu S, Fowler C, Shedler J, Koren D. Affect regulation and affective experience: individual differences, group differences, and measurement using a Q-sort procedure. J Consult Clin Psychol 1997; 65:429-39. [PMID: 9170766 DOI: 10.1037/0022-006x.65.3.429] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This article describes the development of, and preliminary findings with, the Affect Regulation and Experience Q-Sort (the AREQ), an observer-based assessment of affect regulation and experience. In Study 1, 31 clinicians provided Q-sort descriptions of 90 patients. Factor scores correlated in predicted ways with criteria such as suicide attempts and hospitalizations, as well as with clinicians' ratings of functioning in a variety of domains. Correlations between prototype Q-sorts and actual Q-sort profiles for patients sharing a diagnosis (dysthymia, borderline personality disorder, and narcissistic personality disorder) also provided evidence for convergent and discriminant validity. The data also suggested the importance of distinguishing 2 kinds of negative affect that have very different correlates. Study 2 showed that the AREQ can be applied reliably using an interview that avoids many of the problems of self-report.
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Affiliation(s)
- D Westen
- Department of Psychiatry, Cambridge Hospital, Massachusetts 02139, USA.
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Abstract
The release of gonadotropin-releasing hormone (GnRH) from the median eminence (ME) in cyclic rats was stimulated to a significant extent by the selective muscarinic antagonists 11[(2)(diethylamino)methyl][-1-piperidinyl]-acetyl-5, 11-dihydro-6H-pyrido[2,3-b][1,4]benzodiazepine-6-one (AF-DX-116) and methoctramine, and to a lesser extent also by other ligands selectively antagonistic to m1 and m3 receptors. Such stimulation was estrous-cycle-dependent and was not achieved by muscarinic agonists. We suggest that the effect is induced via the m4 receptor subtype. Attempts to block the muscarinic-antagonist-induced stimulation of GnRH release with a variety of drugs were successful only in the presence of prazosin, an antagonist to alpha 1-adrenergic receptors. One possible explanation for this muscarinically mediated stimulation of GnRH release is that it results from cross-talk between the muscarinic and the alpha 1-adrenergic receptors, i.e., muscarinic agonists might inhibit the release induced by alpha 1-agonists, and muscarinic antagonists, by cancelling this inhibitory effect, might thus allow the endogenous alpha 1-agent, norepinephrine, to induce the release of GnRH.
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Affiliation(s)
- D Koren
- Department of Biochemistry, George S. Wise Faculty of Life Sciences, Tel Aviv University, Israel
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