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The quality of life in dysthymic and major depressive disorders
256S
Poster session IV
BIOL. PSYCIDATRY 1997;42:15-2975
\ 90-115 \ The quality of life In dysthymic and major depressive disorders F. Cavaglia. A. Matos-Pires, M. Botelho. M. Oliveira, F. Arriaga. Department of Psychiatry, Hospital de Santa Maria, Lisbon. Portugal The aim of this study is to compare the quality of life in dysthymia and non-melancholic depression. Methods: Subjects with dysthymic disorder (n = 19) and non-melancholic major depressive disorder (n = 20) were selected according to DSM-IV criteria. A group of healthy subjects (n .21) was also used as a control group. All patients were studied using the Hamilton scales for anxiety and depression. the Beck Depression Inventory and the Eysenck Personality Questionnaire. "Quality of Ufe in Depression Scale" (QLDS) and "satisfaction with Ufe Domains Scale" were used for evaluation of quality of life. Results: Measures of quality of life provide a clear discrimination between depressive patients and normal controls. However only the total scores of QLDS provide a separation between the groups of depressive patients. The same does not held true for the SLDS measures. Conclusions: These results suggest difficulties in the assessment of quality of life In depressive disorders. Indeed contradictory results emerge when two different scales are used. This may be due to a contamination of self-assessment of well-being by depression itself. Both methodological and conceptual issues are implicated, deserving further research.
190-1161 Abnormal neuroendocrine responses to clomipramine challenge test In major depression V. Ida I, V. Mizuki 1 , S. Tsujimaru 2, N. Mastuguchi 2. 1 Department of Psychiatry, Shimonosekl Hospital, Shlmonoseki, Japan. 2 Department of Neuropsychiatry, Kurume University School 01 Medicine, Kurume. Japan We investigated the functional state of serotonergic systems of major de• pression by using neuroendocrine challenge paradigms. Methods: Either 100 ml saline containing 10 mg of clomipramine (CMI), selective serotonin reuptake Inhibitor, or 100 ml saline alone were Intra• venously Infused from 15:30 to 16:00 in 12 depressed patients and 12 healthy control subjects. Blood samples were obtained 20 and 0 min before, and 30.60,90. 120 and 150 min aller the start of the infusion. Results: The plasma ACTH and serum cortisol responses of the de• pressed patients were significantly lower than those of the control SUbjects. The serum prolactin responses did not show significant difference between the patients and the controls. The paradoxical increase responses in serum growth hormone were observed shown In the patients. but not In the controls. Conclusion: These findings that depressed patients have the abnormal neuroendocrine responses to the CMI challenge test. might be related with the dysfunction of serotonergic systems.
190-1171 Ontogenetic polymorphism of paraphilias G.E. Vvedensky. Laboratory of Forensic Sexology. Serbsky National Research Center of Social & Forensic Psychiatry, Moscow; Russia ObJective: The purpose of present research is the definition of ontogenetic criteria of the clinical dynamics of paraphilias. 79 male w~h verified diagnosis of paraphilia according to ICOol0 criteria were examined. Methods: Study of statistic correlation between type of sexual disonto• genesis (total retardation. disharmony of psychosexual and somatosexual development, precocious sexual development) and particularities of dynam• ics of paraphilic syndroms (representation of sensonc modality (according to phylo-ontogenesis - tactile, smell, visual, audial) with account of psychiatric diagnoses. Results: Three types of dynamics of paraphillc syndrome were distin• gUished: 1) upright (according to phylo-ontogenesis of sensoric modality; 2) reverse; 3) mixed. In first group positive correlation (p < 0.05) was determlOated between the type of sexual disontogenesls (disharmonla and precocious sexual development) and psychiatric diagnosis (organic brain damage). Conclusion: Dynamics of syndromes of paraphilias reflect the features of both individual sexual disontogenesis and conformity to biological laws of species development. Possibly. the type of clinical dynamics Is a certain criterion of nosological origin of paraphillas. Work was done with the finance support of the Russian Humanitarian Research Fund (Grant No 96-03-044-24).
\90-11 B\ serotonin levels In paraphiliac men with Infrigements of sexual Identity B.M. Kogan. LO. Perezhogin, A.Z. Drosdow. Laboratory of Neurochemistry & Laboratory of Forensic Sexology of SertJsky Nafional Research Center for Social & Forensic Psychiatry, Moscow, Russia ObJective: to discover pathogenic paraphiliac mechanisms. Method: examination of 104 persons, making sexual deliC!S. by own scale for founding the infringements of sexual identity In comparison with serotonine levels. Results: four groups were allocated. In first group was no Infringements of sexual identity (29 persons), In second one was persons with insignificant Infringements (47), third have light (23) and fourth group - expressed infringements of sexual identity (5). Increase of quantity of the persons with paraphilias in accordance with infringements of sexual identity was marked: In first group paraphilias met in 37.9%. in second - In 48.9%, In third • in 73.9%, in fourth one - at all patients. Serotonine levels was measured at 48 men. At all persons was revealed increase of plasma serotonine level in comparison with healthy people (3.68 ::l: 1.10 nglml). In first group the serotonine level was lower. than In second and third (6.54 ::l: 1.67 nglml against 24.04 ::l: 7.38 nglml and 18.48 ::l: 6.59 nglml). Contents of serotonine in trombocells in the first group In comparison with norm was reduced (325.82 ::l: 50.75 ngl109 cells and 709.48 ::l: 64.87 ngl109 cells). In accordancs with sexual Identity frustration, contents of serotonine in trombocells was Increased and has made 520.10 ::l: 52.85 ngll Q9 cells in second group and 614.85 ::l: 110.61 ngll09 cells In third. Speed of capture serotonlne by trombocells consistently increased with first 9rouP up to third. Conclusion: our results indicating, that paraphilias arise on changed biological ground In result of disonthogenesis, and show, that persons with no infringements of sexual identity have more expressed serotonine actiVity defects. but persons with expressed frustration of sexual Identity have normal serotonine levels that, probably, has a compensatory character.
190-1191 Biologic explanation of psychologic peculiarities In paraphilia N. Dvoraynchicov, A. Gerasimov, A. Tkachenko. Laborafory ofForensic Sexology of SertJsky State Research Center for Social and Forensic Psychiatry, MoscoW; Russia ObJective: Investigation of psychological arguments of an evolutionary concept of paraphilias, according wich their represent the actualization of archaic phyllogenetlc and the earlier ontogenetic types of behaviour. Method: Was examined 75 sex offenders (34 persons with different kinds of paraphilia) by psychological projective methods. directed on study to a gender identity and an aggressiveness. The control groups have made 90 men and 20 women. Results: Significant prevalence of feminine psyhological features over masculine at the persons with paraphilias in comparison with persons with abnormal sexual behaviour, and also control group of men Is revealed. At research of peculiarities of understanding and perception of situations of agressive character has come to light following: at the persons with a sadism specific distinctions in comparison with control group of men were marked, that was displayed in a lower representation in consciousness of agressive images-experiences, described by activity. purposefulness. completeness of actions. In comparison with control group of the women the similar tendencies to fixing on an own emotional - significant condition, have at the sadists, intense and conflict character In a combination to need for domination and suppression were marked. Conclusion: Demonstrated was the psychological results of dysontho• genetic gender identity disorders. wich determinate mechanisms of fixation of Juvenile and feminine reaction forms and peculiarities of clinical picture In paraphilia. Work was done with the finance support of the Russian Humanitarian Research Fund (Grant No 96-03-044-24).
I
190-120 The effect of administration of paroxetlne In elderly patients suffering from depression
M. Tsolakl. K. Fountoulakis, A. Kazls. 3rd Department of Neurology. Aristotle University of Thessalonlkl, Greece ' Introduction: Geriatric depression Is considered a distinct nosological entity by many researchers. Traditionally It Is believed to be more refractory to
Poster session IV
BIOL. PSYCIDATRY 1997;42:15-2975
\ 90-115 \ The quality of life In dysthymic and major depressive disorders F. Cavaglia. A. Matos-Pires, M. Botelho. M. Oliveira, F. Arriaga. Department of Psychiatry, Hospital de Santa Maria, Lisbon. Portugal The aim of this study is to compare the quality of life in dysthymia and non-melancholic depression. Methods: Subjects with dysthymic disorder (n = 19) and non-melancholic major depressive disorder (n = 20) were selected according to DSM-IV criteria. A group of healthy subjects (n .21) was also used as a control group. All patients were studied using the Hamilton scales for anxiety and depression. the Beck Depression Inventory and the Eysenck Personality Questionnaire. "Quality of Ufe in Depression Scale" (QLDS) and "satisfaction with Ufe Domains Scale" were used for evaluation of quality of life. Results: Measures of quality of life provide a clear discrimination between depressive patients and normal controls. However only the total scores of QLDS provide a separation between the groups of depressive patients. The same does not held true for the SLDS measures. Conclusions: These results suggest difficulties in the assessment of quality of life In depressive disorders. Indeed contradictory results emerge when two different scales are used. This may be due to a contamination of self-assessment of well-being by depression itself. Both methodological and conceptual issues are implicated, deserving further research.
190-1161 Abnormal neuroendocrine responses to clomipramine challenge test In major depression V. Ida I, V. Mizuki 1 , S. Tsujimaru 2, N. Mastuguchi 2. 1 Department of Psychiatry, Shimonosekl Hospital, Shlmonoseki, Japan. 2 Department of Neuropsychiatry, Kurume University School 01 Medicine, Kurume. Japan We investigated the functional state of serotonergic systems of major de• pression by using neuroendocrine challenge paradigms. Methods: Either 100 ml saline containing 10 mg of clomipramine (CMI), selective serotonin reuptake Inhibitor, or 100 ml saline alone were Intra• venously Infused from 15:30 to 16:00 in 12 depressed patients and 12 healthy control subjects. Blood samples were obtained 20 and 0 min before, and 30.60,90. 120 and 150 min aller the start of the infusion. Results: The plasma ACTH and serum cortisol responses of the de• pressed patients were significantly lower than those of the control SUbjects. The serum prolactin responses did not show significant difference between the patients and the controls. The paradoxical increase responses in serum growth hormone were observed shown In the patients. but not In the controls. Conclusion: These findings that depressed patients have the abnormal neuroendocrine responses to the CMI challenge test. might be related with the dysfunction of serotonergic systems.
190-1171 Ontogenetic polymorphism of paraphilias G.E. Vvedensky. Laboratory of Forensic Sexology. Serbsky National Research Center of Social & Forensic Psychiatry, Moscow; Russia ObJective: The purpose of present research is the definition of ontogenetic criteria of the clinical dynamics of paraphilias. 79 male w~h verified diagnosis of paraphilia according to ICOol0 criteria were examined. Methods: Study of statistic correlation between type of sexual disonto• genesis (total retardation. disharmony of psychosexual and somatosexual development, precocious sexual development) and particularities of dynam• ics of paraphilic syndroms (representation of sensonc modality (according to phylo-ontogenesis - tactile, smell, visual, audial) with account of psychiatric diagnoses. Results: Three types of dynamics of paraphillc syndrome were distin• gUished: 1) upright (according to phylo-ontogenesis of sensoric modality; 2) reverse; 3) mixed. In first group positive correlation (p < 0.05) was determlOated between the type of sexual disontogenesls (disharmonla and precocious sexual development) and psychiatric diagnosis (organic brain damage). Conclusion: Dynamics of syndromes of paraphilias reflect the features of both individual sexual disontogenesis and conformity to biological laws of species development. Possibly. the type of clinical dynamics Is a certain criterion of nosological origin of paraphillas. Work was done with the finance support of the Russian Humanitarian Research Fund (Grant No 96-03-044-24).
\90-11 B\ serotonin levels In paraphiliac men with Infrigements of sexual Identity B.M. Kogan. LO. Perezhogin, A.Z. Drosdow. Laboratory of Neurochemistry & Laboratory of Forensic Sexology of SertJsky Nafional Research Center for Social & Forensic Psychiatry, Moscow, Russia ObJective: to discover pathogenic paraphiliac mechanisms. Method: examination of 104 persons, making sexual deliC!S. by own scale for founding the infringements of sexual identity In comparison with serotonine levels. Results: four groups were allocated. In first group was no Infringements of sexual identity (29 persons), In second one was persons with insignificant Infringements (47), third have light (23) and fourth group - expressed infringements of sexual identity (5). Increase of quantity of the persons with paraphilias in accordance with infringements of sexual identity was marked: In first group paraphilias met in 37.9%. in second - In 48.9%, In third • in 73.9%, in fourth one - at all patients. Serotonine levels was measured at 48 men. At all persons was revealed increase of plasma serotonine level in comparison with healthy people (3.68 ::l: 1.10 nglml). In first group the serotonine level was lower. than In second and third (6.54 ::l: 1.67 nglml against 24.04 ::l: 7.38 nglml and 18.48 ::l: 6.59 nglml). Contents of serotonine in trombocells in the first group In comparison with norm was reduced (325.82 ::l: 50.75 ngl109 cells and 709.48 ::l: 64.87 ngl109 cells). In accordancs with sexual Identity frustration, contents of serotonine in trombocells was Increased and has made 520.10 ::l: 52.85 ngll Q9 cells in second group and 614.85 ::l: 110.61 ngll09 cells In third. Speed of capture serotonlne by trombocells consistently increased with first 9rouP up to third. Conclusion: our results indicating, that paraphilias arise on changed biological ground In result of disonthogenesis, and show, that persons with no infringements of sexual identity have more expressed serotonine actiVity defects. but persons with expressed frustration of sexual Identity have normal serotonine levels that, probably, has a compensatory character.
190-1191 Biologic explanation of psychologic peculiarities In paraphilia N. Dvoraynchicov, A. Gerasimov, A. Tkachenko. Laborafory ofForensic Sexology of SertJsky State Research Center for Social and Forensic Psychiatry, MoscoW; Russia ObJective: Investigation of psychological arguments of an evolutionary concept of paraphilias, according wich their represent the actualization of archaic phyllogenetlc and the earlier ontogenetic types of behaviour. Method: Was examined 75 sex offenders (34 persons with different kinds of paraphilia) by psychological projective methods. directed on study to a gender identity and an aggressiveness. The control groups have made 90 men and 20 women. Results: Significant prevalence of feminine psyhological features over masculine at the persons with paraphilias in comparison with persons with abnormal sexual behaviour, and also control group of men Is revealed. At research of peculiarities of understanding and perception of situations of agressive character has come to light following: at the persons with a sadism specific distinctions in comparison with control group of men were marked, that was displayed in a lower representation in consciousness of agressive images-experiences, described by activity. purposefulness. completeness of actions. In comparison with control group of the women the similar tendencies to fixing on an own emotional - significant condition, have at the sadists, intense and conflict character In a combination to need for domination and suppression were marked. Conclusion: Demonstrated was the psychological results of dysontho• genetic gender identity disorders. wich determinate mechanisms of fixation of Juvenile and feminine reaction forms and peculiarities of clinical picture In paraphilia. Work was done with the finance support of the Russian Humanitarian Research Fund (Grant No 96-03-044-24).
I
190-120 The effect of administration of paroxetlne In elderly patients suffering from depression
M. Tsolakl. K. Fountoulakis, A. Kazls. 3rd Department of Neurology. Aristotle University of Thessalonlkl, Greece ' Introduction: Geriatric depression Is considered a distinct nosological entity by many researchers. Traditionally It Is believed to be more refractory to