- Email: [email protected]
Psychiatric comorbidity in patients with dementia: alzheimer disease versus mixed dementia and vascular dementia
S16
Poster A. Clinical
especially me ones with telephone numbers. Occasionally, the only way to contact a patient was to actually go to the address noted in the record. Fortunately, only a small number of patients refused to be interviewed. More prominent were difficulties of patients and relatives to recall details pertaining to section B. Despite the above mentioned difficulties, we hope that we will soon be able to present the preliminary findings of our study.
El
A-25
The combination of biological, psychotherapeutic and sociotherapeutic approaches in a therapeutic community
I. Mantonakis,
K. Kattan, K. Theohari. Department University Medical School, Eginition Hospital, Avenue, Athens 11528, Greece.
ofPsychiatry, Athens 72-74
Vas. Sophias
The Therapeutic Community in reference is the Day Hospital of the Eginition Psychiatric Clinic, which has already completed 20 years of operation. This unit treats mainly schizophrenic patients. The therapeutic principles and rules that govern the o$eration of this Therapeutic Community are the following: 1. Patient’s consent and willingness to participate in the program. 2. Equality in privileges and obligations. 3. Participation in the community’s administration (Self administration). 4. Creation of an atmosphere of trust and mutual respect. 5. Use of group processes towards socialization. 6. Active and constant interaction between therapists and patients. 7. Coresponsibility in the treatment decision and the therapeutic program. 8. Prohibition of violence. 9. Prohibition of use and abuse of psychoactive substances. 10. Regularity in the attendance of the therapeutic program. Within this frame a rational combination of biological, psychotherapeutic and sociotherapeutic approaches is being achieved: a) The biological approach includes high (hospital) drug dosages and, if necessary, ECT, since most of the patients have an active psychotic symptomatology. b) The psychotherapeutic approach includes a daily group psychotherapy (based on a theoretical model combining principles drawn from psychodynamic, supportive and transactional psychotherapy) and a weekly or biweekly therapeutic approach of the patients’ families. c) The sociotherapeutic approach includes art therapy, drama therapy, relaxation sessions, ergotherapy, social events, etc. The combination of the previous therapeutic approaches with the principles of the Therapeutic Community cited: 1) Ensures the creation of a therapeutic environment which protects the patient from retrogression and strengthens his self esteem and his trust to the external reality. 2) Improves the cooperation and compliance not only of the patient but also of his family environment. 3) Aims at a global and more effective confrontation of the patient’s problems and psychopathology.
IA-26
GABRAl receptor polymorphism and unipoiar affective disorder
I. Massat”, 0. Lipp”, D. Souery”, B. Mahieu”, G. Verheyenh, C. Van Broeckhovenh and J. Mendlewicz”. aDept. of Psychiatry, University Clinics of Brussels, Erasme Hospital, Free University of Brussels bLab. of Neurogenetics, Flanders Interuniversity Institute of Biotechnology (VIB), Born Bunge Foundation (BBS), University of Anhverp @IA), Dept. of Biochemistry, Antwerp. The y-aminobutyric acid (GABA) receptor polymorphisms are important candidate genes for mood disorders. GABA interacts both with norepinephrine and serotonin, two neurotransmitters involved in the neurochemistry of affective disorders. The involvement of y-aminobutyric acid (GABA) in affective disorder pathophysiology has first been proposed in 1980, when a GABA agonist (valproic acid) was found to be effective in the treatment of bipolar affective disorder (BPAD). The purpose of this study was to test the potential role in BPAD and UPAD of 3 candidate genetic markers involved in GABA neurotransmission. An association study between patients and normal controls was conducted, with simple tandem repeat polymorphisms in the genes coding for GABRAl, GABRA3 and GABRAS. We tested 90 unrelated patients with BPAD, 44 with UPAD and 75 matched controls for association and linkage disequilibrium with the
following DNA markers: GABRAl, GABRAS and GABRAS receptor genes. A significant association was observed between GABRAl polymorphism and allele frequency of UPAD patients (p=O.O027)(StatXact3, exact-test). Since controls were first compared with BPAD and secondly with UPAD, a Bonfenoni correction was made. After correcting for multiple analyses (n=2), the difference between the UPAD group and controls remained significant (p=O.O054). Allele 5 was more frequently observed in the patient group (p=O.O23). However, this p value did not resist for multiple testing. For the 10 alleles detected for GABRAI polymorphism, the critical p value testing for an allele separately is therefore 0.005 (n= 10). On the other hand, allele 13 was significantly more observed in the control group (p=O.OOOOS), which remains significant after correction for multiple testing (p=O.OOOS). No significant association was observed between UPAD and genotypes and homozygoteheterozygote distributions for GABRAl polymorphism. There was also no significant association between UPAD and GABRA3, GABRAS polymorphisms. When allele frequencies, genotypes and homozygoteheterozygote distributions were compared, there were no significant associations betwebn BPAD and GABRAl, GABRA3 and GABRAS polymorphisms). Genotypes for both populations were in Hardy-Weinberg equilibrium. These findings indicate that GABRAI may be implicated in the etiology of UPAD.
IA-27
Psychiatric comorbidity in patients with dementia: aizheimer disease versus mixed dementia and vascular dementia
CA. de Mendonca Lima, V. Camus, S. Leon Sanchez, I. Tschan, I. Simeone. Service Universitaire de Psychoge’riatrie Rte. du Mont CH1008 Lausanne Introduction: Psychiatrists caring for elderly patients very often face up to complex situations. This can be illustrated by the multiple physical, psychological and social problems that these patients can present (1). Polypathologies are frequently observed associated to mental disorders, changing their expression and difficulting their treatment. In particular, dementia can be associated to different psychiatric symptoms or other mental disorders able to change its course. Methods: retrospective study comparing the frequency and the nature of mental disorders associated to dementia in three groups of patients hospitalized in the Geriatric Psychiatry Hospital of Lausanne in 1995, 1996 and 1997. Diagnostics were made according to ICD-10 criteria (2). The first group was of patients with Alzheimer Disease (AD), the second one of patients with Mixed Dementia (MD), and the last one of patients with Vascular Dementia (VD). Results: 285 patients were included: 168 with AD, 85 with MD and 32 with VD. The distribution of patients by sex was equivalent among the 3 groups. The total mean age +/SD was 82.3 +/7.2 years, without any significant difference among the 3 groups. The total mean number of mental disorders per patient was 1.67 + / - 0.62. without any significant difference among the 3 groups. The table below presents the frequency (%) of mental disorders associated to each one of the 3 types of dementias.
DEMENTIA
AlCOOl
SCLZO-
Ad&W
Personahty
phren,r
men,
dnorders
wth Deprewve
disorders Delinum
SylllptCGTlb
schuoid
dw_wl
Dehwxal Sylllpt0ms
I
AD
25
9
7
9
3
7
MD
38
6
5
4
0
II
2 ?
I
VD
38
I6
0
9
0
0
3
1
Discussion:
The most interesting preliminary results were: -the highest frequency of depressive symptoms in patients with MD and VD than AD -the highest frequency of delirium in patients with VD -the absence of delusional symptoms in patients with VD -the exclusive presence of previous schizophrenia in the group with AD
Poster A. Clinical
-the absence of adjustment disorders in the group with VD Conclusion: Previous history of mental disorder before dementia onset has interested few authors (3). Concomitant mental disorders seems better studied and in general points to the interest of their treatment in order to prevent complications of dementia. To make the right diagnosis becomes necessary to offer the best treatment available. This study confirms the relative high frequency of psychiatric comorbidity in patients with dementia and point to some differences among the 3 types of dementia studied.
References 1. WHO-Psychiatry
s17
(1.13) was found in the smaller family (family 2) for the TH polymorphism. A combined lod score of 1.76 in the two pedigrees was found for marker GABRAl with the broad definition of the phenotype. Linkage to DRD2 and DRD3 could be excluded in these families. The findings support the hypothesis that there are susceptibility genes for affective disorder at or near the TH and GABRAl loci in at least a small proportion of pedigrees.
Kalaydjieva, L., Hallmayer, .I., Chandler, D., Savov, A., Nikolova, A., Angelichkova, D. et al. (1996) Gene mapping in Gypsies identifies a novel demyelinating neuropathy on chromosome Xq24. Nature genet 14, 214-217
of the elderly: a consensus statement. WHO/MNH/ MND/96.7. Geneva. 2. AS. HENDERSON. Epidemiology of mental disorders and psychosocial problems: dementia, WHO, Geneva 1994. 3. WHO-The ICD-10 Classification of Mental and Behavioural Disorders. WHO, Geneva, 1992.
IA-30
IA 28
T.T.G. Mouraoio”, L.N.G. Mourb”, A.L. Siqueirab, N.R. Louzsl Neto”. “Department of Psychiatry, University of Sao Paulo, SP, Brazil. hDepartment of Statistics, Federal University of Minas Gerais.
Anxiety, depression and hostility in patients with psoriasic arthritis and rheumatoid arthritis
Michelidakis, K.r’, Myriokefalitakis, .I.“, Akkizidou A.“, Papadimitriou, E.G.*, Boubougiani, A.“, Nanou, G.“, Vlyssides, D.!‘, Vezyroglou, G:” “Department of Rheumatology, Asklipeion Hospital, Voula Athens, “Department of Psychiatry, Asklipeion Hospital, Voula Athens
It is well known that patients with Rheumatic Diseases present psychiatric symptomatology to various degrees of intensity. Sixty nine patients (thirty men and thirty nine women middle aged were evaluated for psychiatric symptomatology and personality and personality attitude 57.35+17.01). 54 patients suffered from Rheumatoid Arthritis and 15 from Psoriasic Arthritis, compared with twenty three normals. The psychometric instruments measuring the structure and expression of hostility, somatization and depression are: a) HDH (Hostility and Direction of Hostility) Measures non-physical aggressiveness b) The SCL-90R (symptom check list 9OR) and DSSI/SAD (Delusions Symptoms States Inventory-State of Anxiety and Depression) measures psychiatric symptomatology. Results: The patients with Rheumatoid Arthritis or with Psoriasic Arthritis present higher scores of somatization. The patients with Psoriasic Arthritis present significant higher scores of introverted hostility and depression. A-29 El
Two Bulgarian Gipsy Pedigrees with Affective Disorders: clinic features. Linkage analysis with TH, DRDP, DRD3 and GABAA-Receptor Subunite Genes
V. Milanova, R. Kaneva, G. Onchev, V. Stoyanova, A. Nikolova, T. Milenska, A. Jablensky. First Psychiatric Clinic, Alexander University Hospital, Sofia, Bulgaria In Bulgaria the Gipsies constitute up to 10% of the total population of 8 millions. We describe two large Bulgarian Gipsy pedigrees with multiple cases of bipolar affective disorder (BP) and unipolar depression (UP), fitting a dominant model of transmission. Bulgarian Gipsies comprise several major groups, which differ in their lifestyle, traditions, religion. Many subgroups have been endogamous over generations and share characteristics of isolate populations (Kalaydjieva et al, 1996). The total number of affected individuals in both families is 24, including 8 males and I6 females (11 cases of BP, I type and 13 cases of UP). Family 1 contained 17 individuals with affective disorders (8 BB and 9 UP). Family 2 contained 7 affected individuals (3 BP and 4 UP). Venous blood was collected from all living patients and relevant unaffected persons (36 samples from family 1 and 11 samples from family 2). The clinical presentation of all affected individuals conformed well with the ICD-10 diagnostic criteria for BP or UP and there were no marked a atypical features. Only 5 patients were hospitalized for affective symptoms. The patients were supported by their relatives. Linkage analysis results are presented, using polymorphisms at the following candidate genes: tyrosine hydroxylase (TH), the dopamine D2 receptor (DRD2), the dopamine D3 receptor (DRD3) and cul, (~5, cY6-subunits of the gammaraminobutiric acid receptor (GABRAl,5,6). A small positive lad score
Symptomatologic profile of the depressive patients with Systemic Lupus Erythematosus (SLE)
Objectives: The DSM-IV brought a paradigmatic change in the diagnosis of depressive disorders due to a medical condition. DSM-IV organizers, specially Tucker and Popkin, suggest that these depressions are different pathologies with specific physiopathology and symptomatologic profiles. This paper’s objective is to compare the depressive symptoms of the depressive disorders due to SLE with the symptoms of the primary depressive disorders, to determine if the new premise corresponds with the reality in this situation: in other words, we want to know if the two groups of depressive patients may be differentiated by their psychopathologic spectrum. Methods: 53 patients admitted in the Lupus service of the Clinicas’ Hospital of the Medical School of the Federal University of Minas Gerais, Brazil who meet the American College of Reumathology’s diagnosis criteria for SLE, were submitted to a psychiatric evaluation using the SCAN (Schedules for Assessment of Neuropsychiatric Diagnosis) and the Hamilton-MES (Ham-MES) scale. They were divided into two groups, using the cut point of 18 in the Hamilton-MES scale. The group of SLE depressive patients (Ham-MES>18) were then compared with a control group, constituted by 25 patients from the Psychiatric Clinic of the same hospital, pareated by sex, civil state, profession, ethnic group and formal instruction. The patients of the control group presented the same level of depression, measured by the Ham-MES scale. Results: The Pearson’s Exact Test of Chi-Square showed that the symptomatologic profile is significantly different between the two groups, mainly concerning the loss of self esteem (p
IA-31
The assessment of heritability of magnetic resonance imaging (HRI) parameters in schizophrenia and their relationship with psychotropic therapy
Orlova, V.A., Trubnikov, VI., Odintsova, S.A., Savvateeva, N.Yu., Kozlova, LA. Preventive Genetics Laboratory, Natronal Mental Health Research Centre, 2, Zagerodnoe shosse. Moscow, Russia. Fundamental question about the origin of brain changes found in schizophrenics by MRI method remains nuclear, although their connection with environmental factors (including neuroleptics) have been supposed. There are also data on the possible effect of genetic predisposition. The aim of the study was an assessment of impact of genetic and environmental factors on individual differences in MRI parameters in the families of schizophrenics. MRI was done in 26 families of schizophrenics (26 probands, 47 parents and 15 sibs).
Poster A. Clinical
especially me ones with telephone numbers. Occasionally, the only way to contact a patient was to actually go to the address noted in the record. Fortunately, only a small number of patients refused to be interviewed. More prominent were difficulties of patients and relatives to recall details pertaining to section B. Despite the above mentioned difficulties, we hope that we will soon be able to present the preliminary findings of our study.
El
A-25
The combination of biological, psychotherapeutic and sociotherapeutic approaches in a therapeutic community
I. Mantonakis,
K. Kattan, K. Theohari. Department University Medical School, Eginition Hospital, Avenue, Athens 11528, Greece.
ofPsychiatry, Athens 72-74
Vas. Sophias
The Therapeutic Community in reference is the Day Hospital of the Eginition Psychiatric Clinic, which has already completed 20 years of operation. This unit treats mainly schizophrenic patients. The therapeutic principles and rules that govern the o$eration of this Therapeutic Community are the following: 1. Patient’s consent and willingness to participate in the program. 2. Equality in privileges and obligations. 3. Participation in the community’s administration (Self administration). 4. Creation of an atmosphere of trust and mutual respect. 5. Use of group processes towards socialization. 6. Active and constant interaction between therapists and patients. 7. Coresponsibility in the treatment decision and the therapeutic program. 8. Prohibition of violence. 9. Prohibition of use and abuse of psychoactive substances. 10. Regularity in the attendance of the therapeutic program. Within this frame a rational combination of biological, psychotherapeutic and sociotherapeutic approaches is being achieved: a) The biological approach includes high (hospital) drug dosages and, if necessary, ECT, since most of the patients have an active psychotic symptomatology. b) The psychotherapeutic approach includes a daily group psychotherapy (based on a theoretical model combining principles drawn from psychodynamic, supportive and transactional psychotherapy) and a weekly or biweekly therapeutic approach of the patients’ families. c) The sociotherapeutic approach includes art therapy, drama therapy, relaxation sessions, ergotherapy, social events, etc. The combination of the previous therapeutic approaches with the principles of the Therapeutic Community cited: 1) Ensures the creation of a therapeutic environment which protects the patient from retrogression and strengthens his self esteem and his trust to the external reality. 2) Improves the cooperation and compliance not only of the patient but also of his family environment. 3) Aims at a global and more effective confrontation of the patient’s problems and psychopathology.
IA-26
GABRAl receptor polymorphism and unipoiar affective disorder
I. Massat”, 0. Lipp”, D. Souery”, B. Mahieu”, G. Verheyenh, C. Van Broeckhovenh and J. Mendlewicz”. aDept. of Psychiatry, University Clinics of Brussels, Erasme Hospital, Free University of Brussels bLab. of Neurogenetics, Flanders Interuniversity Institute of Biotechnology (VIB), Born Bunge Foundation (BBS), University of Anhverp @IA), Dept. of Biochemistry, Antwerp. The y-aminobutyric acid (GABA) receptor polymorphisms are important candidate genes for mood disorders. GABA interacts both with norepinephrine and serotonin, two neurotransmitters involved in the neurochemistry of affective disorders. The involvement of y-aminobutyric acid (GABA) in affective disorder pathophysiology has first been proposed in 1980, when a GABA agonist (valproic acid) was found to be effective in the treatment of bipolar affective disorder (BPAD). The purpose of this study was to test the potential role in BPAD and UPAD of 3 candidate genetic markers involved in GABA neurotransmission. An association study between patients and normal controls was conducted, with simple tandem repeat polymorphisms in the genes coding for GABRAl, GABRA3 and GABRAS. We tested 90 unrelated patients with BPAD, 44 with UPAD and 75 matched controls for association and linkage disequilibrium with the
following DNA markers: GABRAl, GABRAS and GABRAS receptor genes. A significant association was observed between GABRAl polymorphism and allele frequency of UPAD patients (p=O.O027)(StatXact3, exact-test). Since controls were first compared with BPAD and secondly with UPAD, a Bonfenoni correction was made. After correcting for multiple analyses (n=2), the difference between the UPAD group and controls remained significant (p=O.O054). Allele 5 was more frequently observed in the patient group (p=O.O23). However, this p value did not resist for multiple testing. For the 10 alleles detected for GABRAI polymorphism, the critical p value testing for an allele separately is therefore 0.005 (n= 10). On the other hand, allele 13 was significantly more observed in the control group (p=O.OOOOS), which remains significant after correction for multiple testing (p=O.OOOS). No significant association was observed between UPAD and genotypes and homozygoteheterozygote distributions for GABRAl polymorphism. There was also no significant association between UPAD and GABRA3, GABRAS polymorphisms. When allele frequencies, genotypes and homozygoteheterozygote distributions were compared, there were no significant associations betwebn BPAD and GABRAl, GABRA3 and GABRAS polymorphisms). Genotypes for both populations were in Hardy-Weinberg equilibrium. These findings indicate that GABRAI may be implicated in the etiology of UPAD.
IA-27
Psychiatric comorbidity in patients with dementia: aizheimer disease versus mixed dementia and vascular dementia
CA. de Mendonca Lima, V. Camus, S. Leon Sanchez, I. Tschan, I. Simeone. Service Universitaire de Psychoge’riatrie Rte. du Mont CH1008 Lausanne Introduction: Psychiatrists caring for elderly patients very often face up to complex situations. This can be illustrated by the multiple physical, psychological and social problems that these patients can present (1). Polypathologies are frequently observed associated to mental disorders, changing their expression and difficulting their treatment. In particular, dementia can be associated to different psychiatric symptoms or other mental disorders able to change its course. Methods: retrospective study comparing the frequency and the nature of mental disorders associated to dementia in three groups of patients hospitalized in the Geriatric Psychiatry Hospital of Lausanne in 1995, 1996 and 1997. Diagnostics were made according to ICD-10 criteria (2). The first group was of patients with Alzheimer Disease (AD), the second one of patients with Mixed Dementia (MD), and the last one of patients with Vascular Dementia (VD). Results: 285 patients were included: 168 with AD, 85 with MD and 32 with VD. The distribution of patients by sex was equivalent among the 3 groups. The total mean age +/SD was 82.3 +/7.2 years, without any significant difference among the 3 groups. The total mean number of mental disorders per patient was 1.67 + / - 0.62. without any significant difference among the 3 groups. The table below presents the frequency (%) of mental disorders associated to each one of the 3 types of dementias.
DEMENTIA
AlCOOl
SCLZO-
Ad&W
Personahty
phren,r
men,
dnorders
wth Deprewve
disorders Delinum
SylllptCGTlb
schuoid
dw_wl
Dehwxal Sylllpt0ms
I
AD
25
9
7
9
3
7
MD
38
6
5
4
0
II
2 ?
I
VD
38
I6
0
9
0
0
3
1
Discussion:
The most interesting preliminary results were: -the highest frequency of depressive symptoms in patients with MD and VD than AD -the highest frequency of delirium in patients with VD -the absence of delusional symptoms in patients with VD -the exclusive presence of previous schizophrenia in the group with AD
Poster A. Clinical
-the absence of adjustment disorders in the group with VD Conclusion: Previous history of mental disorder before dementia onset has interested few authors (3). Concomitant mental disorders seems better studied and in general points to the interest of their treatment in order to prevent complications of dementia. To make the right diagnosis becomes necessary to offer the best treatment available. This study confirms the relative high frequency of psychiatric comorbidity in patients with dementia and point to some differences among the 3 types of dementia studied.
References 1. WHO-Psychiatry
s17
(1.13) was found in the smaller family (family 2) for the TH polymorphism. A combined lod score of 1.76 in the two pedigrees was found for marker GABRAl with the broad definition of the phenotype. Linkage to DRD2 and DRD3 could be excluded in these families. The findings support the hypothesis that there are susceptibility genes for affective disorder at or near the TH and GABRAl loci in at least a small proportion of pedigrees.
Kalaydjieva, L., Hallmayer, .I., Chandler, D., Savov, A., Nikolova, A., Angelichkova, D. et al. (1996) Gene mapping in Gypsies identifies a novel demyelinating neuropathy on chromosome Xq24. Nature genet 14, 214-217
of the elderly: a consensus statement. WHO/MNH/ MND/96.7. Geneva. 2. AS. HENDERSON. Epidemiology of mental disorders and psychosocial problems: dementia, WHO, Geneva 1994. 3. WHO-The ICD-10 Classification of Mental and Behavioural Disorders. WHO, Geneva, 1992.
IA-30
IA 28
T.T.G. Mouraoio”, L.N.G. Mourb”, A.L. Siqueirab, N.R. Louzsl Neto”. “Department of Psychiatry, University of Sao Paulo, SP, Brazil. hDepartment of Statistics, Federal University of Minas Gerais.
Anxiety, depression and hostility in patients with psoriasic arthritis and rheumatoid arthritis
Michelidakis, K.r’, Myriokefalitakis, .I.“, Akkizidou A.“, Papadimitriou, E.G.*, Boubougiani, A.“, Nanou, G.“, Vlyssides, D.!‘, Vezyroglou, G:” “Department of Rheumatology, Asklipeion Hospital, Voula Athens, “Department of Psychiatry, Asklipeion Hospital, Voula Athens
It is well known that patients with Rheumatic Diseases present psychiatric symptomatology to various degrees of intensity. Sixty nine patients (thirty men and thirty nine women middle aged were evaluated for psychiatric symptomatology and personality and personality attitude 57.35+17.01). 54 patients suffered from Rheumatoid Arthritis and 15 from Psoriasic Arthritis, compared with twenty three normals. The psychometric instruments measuring the structure and expression of hostility, somatization and depression are: a) HDH (Hostility and Direction of Hostility) Measures non-physical aggressiveness b) The SCL-90R (symptom check list 9OR) and DSSI/SAD (Delusions Symptoms States Inventory-State of Anxiety and Depression) measures psychiatric symptomatology. Results: The patients with Rheumatoid Arthritis or with Psoriasic Arthritis present higher scores of somatization. The patients with Psoriasic Arthritis present significant higher scores of introverted hostility and depression. A-29 El
Two Bulgarian Gipsy Pedigrees with Affective Disorders: clinic features. Linkage analysis with TH, DRDP, DRD3 and GABAA-Receptor Subunite Genes
V. Milanova, R. Kaneva, G. Onchev, V. Stoyanova, A. Nikolova, T. Milenska, A. Jablensky. First Psychiatric Clinic, Alexander University Hospital, Sofia, Bulgaria In Bulgaria the Gipsies constitute up to 10% of the total population of 8 millions. We describe two large Bulgarian Gipsy pedigrees with multiple cases of bipolar affective disorder (BP) and unipolar depression (UP), fitting a dominant model of transmission. Bulgarian Gipsies comprise several major groups, which differ in their lifestyle, traditions, religion. Many subgroups have been endogamous over generations and share characteristics of isolate populations (Kalaydjieva et al, 1996). The total number of affected individuals in both families is 24, including 8 males and I6 females (11 cases of BP, I type and 13 cases of UP). Family 1 contained 17 individuals with affective disorders (8 BB and 9 UP). Family 2 contained 7 affected individuals (3 BP and 4 UP). Venous blood was collected from all living patients and relevant unaffected persons (36 samples from family 1 and 11 samples from family 2). The clinical presentation of all affected individuals conformed well with the ICD-10 diagnostic criteria for BP or UP and there were no marked a atypical features. Only 5 patients were hospitalized for affective symptoms. The patients were supported by their relatives. Linkage analysis results are presented, using polymorphisms at the following candidate genes: tyrosine hydroxylase (TH), the dopamine D2 receptor (DRD2), the dopamine D3 receptor (DRD3) and cul, (~5, cY6-subunits of the gammaraminobutiric acid receptor (GABRAl,5,6). A small positive lad score
Symptomatologic profile of the depressive patients with Systemic Lupus Erythematosus (SLE)
Objectives: The DSM-IV brought a paradigmatic change in the diagnosis of depressive disorders due to a medical condition. DSM-IV organizers, specially Tucker and Popkin, suggest that these depressions are different pathologies with specific physiopathology and symptomatologic profiles. This paper’s objective is to compare the depressive symptoms of the depressive disorders due to SLE with the symptoms of the primary depressive disorders, to determine if the new premise corresponds with the reality in this situation: in other words, we want to know if the two groups of depressive patients may be differentiated by their psychopathologic spectrum. Methods: 53 patients admitted in the Lupus service of the Clinicas’ Hospital of the Medical School of the Federal University of Minas Gerais, Brazil who meet the American College of Reumathology’s diagnosis criteria for SLE, were submitted to a psychiatric evaluation using the SCAN (Schedules for Assessment of Neuropsychiatric Diagnosis) and the Hamilton-MES (Ham-MES) scale. They were divided into two groups, using the cut point of 18 in the Hamilton-MES scale. The group of SLE depressive patients (Ham-MES>18) were then compared with a control group, constituted by 25 patients from the Psychiatric Clinic of the same hospital, pareated by sex, civil state, profession, ethnic group and formal instruction. The patients of the control group presented the same level of depression, measured by the Ham-MES scale. Results: The Pearson’s Exact Test of Chi-Square showed that the symptomatologic profile is significantly different between the two groups, mainly concerning the loss of self esteem (p
IA-31
The assessment of heritability of magnetic resonance imaging (HRI) parameters in schizophrenia and their relationship with psychotropic therapy
Orlova, V.A., Trubnikov, VI., Odintsova, S.A., Savvateeva, N.Yu., Kozlova, LA. Preventive Genetics Laboratory, Natronal Mental Health Research Centre, 2, Zagerodnoe shosse. Moscow, Russia. Fundamental question about the origin of brain changes found in schizophrenics by MRI method remains nuclear, although their connection with environmental factors (including neuroleptics) have been supposed. There are also data on the possible effect of genetic predisposition. The aim of the study was an assessment of impact of genetic and environmental factors on individual differences in MRI parameters in the families of schizophrenics. MRI was done in 26 families of schizophrenics (26 probands, 47 parents and 15 sibs).