doi: 10.1001/archpsyc.1994.03950010006001pmid: N/A
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Kessler, Ronald C.;McGonagle, Katherine A.;Zhao, Shanyang;Nelson, Christopher B.;Hughes, Michael;Eshleman, Suzann;Wittchen, Hans-Ulrich;Kendler, Kenneth S.
doi: 10.1001/archpsyc.1994.03950010008002pmid: 8279933
Abstract Background: This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. Methods: The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Results: Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. Conclusions: The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. 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Virkkunen, Matti;Rawlings, Robert;Tokola, Riitta;Poland, Russell E.;Guidotti, Alessandro;Nemeroff, Charles;Bissette, Garth;Kalogeras, Konstantine;Karonen, Sirkka-Liisa;Linnoila, Markku
Virkkunen, Matti;Kallio, Eila;Rawlings, Robert;Tokola, Riitta;Poland, Russell E.;Guidotti, Alessandro;Nemeroff, Charles;Kalogeras, Konstantine;Karonen, Sirkka-Liisa;Linnoila, Markku
Nielsen, David A.;Goldman, David;Virkkunen, Matti;Tokola, Riitta;Rawlings, Robert;Linnoila, Markku
doi: 10.1001/archpsyc.1994.03950010034005pmid: 7506517
Abstract Background: To examine whether the tryptophan hydroxylase (TPH) gene, which codes for the rate-limiting enzyme in the biosynthesis of serotonin, may be a factor influencing serotonin turnover and behaviors controlled by serotonin. Methods: Using a polymerase chain reaction—based method, TPH genotype was determined in DNA samples from 56 impulsive and 14 nonimpulsive, alcoholic, violent offenders and 20 healthy volunteers. Results: In the behaviorally extreme impulsive group, we observed a significant association between TPH genotype and cerebrospinal fluid 5-hydroxyindoleacetic acid (5-HIAA) concentration. No association of TPH genotype with impulsive behavior was detected. The polymorphism was also associated with a history of suicide attempts in all violent offenders, independent of impulsivity status and cerebrospinal fluid 5-HIAA concentration. 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Maj, Mario;Janssen, Robert;Starace, Fabrizio;Zaudig, Michael;Satz, Paul;Sughondhabirom, Bhirom;Luabeya, Mesu'A-Kabwa;Riedel, Rolf;Ndetei, David;Calil, Helena M.;Bing, Eric G.;Louis, Michael;Sartorius, Norman
Rauch, Scott L.;Jenike, Michael A.;Alpert, Nathaniel M.;Baer, Lee;Breiter, Hans C. R.;Savage, Cary R.;Fischman, Alan J.
doi: 10.1001/archpsyc.1994.03950010062008pmid: 8279930
Abstract Background: The study was designed to determine the mediating neuroanatomy of obsessive-compulsive disorder (OCD). Methods: The short half-life tracer oxygen 15—labeled carbon dioxide was used to allow for repeated positron emission tomographic determinations of regional cerebral blood flow on each of eight patients with OCD during a resting and a provoked (symptomatic) state. Results: Individually tailored provocative stimuli were successful in provoking OCD symptoms, in comparison with paired innocuous stimuli, as measured by selfreport on OCD analogue scales (P=.002). Omnibus subtraction images demonstrated a statistically significant increase in relative regional cerebral blood flow during the OCD symptomatic state vs the resting state in right caudate nucleus (P<.006), left anterior cingulate cortex (P<.045), and bilateral orbitofrontal cortex (P<.008); increases in the left thalamus approached but did not reach statistical significance (P=.07). Conclusions: These findings are consistent with results of previous functional neuroimaging studies and contemporary neurocircuitry models of OCD. The data further implicate orbitofrontal cortex, caudate nucleus, and anterior cigulate cortex in the pathophysiology of OCD and in mediating OCD symptoms. References 1. Jenike M. Obsessive-compulsive disorder: a question of a neurologic lesion . Compr Psychiatry . 1984;25:298-304.Crossref 2. Schwartz JM, Baxter LR, Mazziotta JC, Gerner RH, Phelps ME. The differential diagnosis of depression: relevance of positron emission tomography studies of cerebral glucose metabolism to the bipolar-unipolar dichotomy . JAMA . 1987;258:1368-1374.Crossref 3. Jenike MA, Baer L, Minichiello WE, eds. Obsessive Compulsive Disorder: Theory and Management . 2nd ed. Chicago, Ill: Year Book Medical Publishers; 1990. 4. Modell J, Mountz J, Curtis G, Greden J. 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Baxter LR Jr, Schwartz JM, Bergman KS, Szuba MP, Guze BH, Mazziotta JC, Alazraki A, Selin CE, Ferng H-K, Munford P, Phelps ME. Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder . Arch Gen Psychiatry . 1992;49:681-689.Crossref 14. Swedo SE, Pietrini P, Leonard HL, Schapiro MB, Rettew DC, Goldberger EL, Rapoport SI, Rapoport JL, Grady CL. Cerebral glucose metabolism in childhoodonset obsessive-compulsive disorder: revisualization during pharmacotherapy . Arch Gen Psychiatry . 1992;49:690-694.Crossref 15. Machlin S, Harris G, Pearslon G, Hoehn-Saric R, Jeffery P, Camargo E. Elevated medial-frontal cerebral blood flow in obsessive-compulsive patients: a SPECT study . Am J Psychiatry . 1991;148:1240-1242. 16. Rubin RT, Villanueva-Meyer J, Anath J, Trajmar PG, Mena I. Regional xenon 133 cerebral blood flow and cerebral technetium Tc 99m-HMPAO uptake in unmedicated patients with obsessive-compulsive disorder and matched normal control subjects: determination by high-resolution single-photon emission computed tomography . Arch Gen Psychiatry . 1992;49:695-702.Crossref 17. Insel TR. Toward a neuroanatomy of obsessive-compulsive disorder . Arch Gen Psychiatry . 1992;49:739-744.Crossref 18. Zohar J, Insel T, Berman K, Foa E, Hill J, Weinberger D. Anxiety and cerebral blood flow during behavioral challenge: dissociation of central from peripheral and subjective measures . Arch Gen Psychiatry . 1989;46:505-510.Crossref 19. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 20. Kops ER, Herzog H, Schmid A, Holte S, Feinendegen LE. Performance characteristics of an eight-ring whole body PET scanner . J Comput Assist Tomogr . 1990;14:437-445.Crossref 21. Talairach J, Szikla Z. Atlas of Stereotactic Anatomy of the Telencephalon . Paris, France: Masson et Cie; 1967. 22. Talairach J, Tournoux P. Co-Planar Stereotaxic Atlas of the Human Brain . New York, NY: Thieme Medical Publishers Inc; 1988. 23. Friston K, Frith C, Liddle P, Franckowiak R. Comparing functional (PET) images: the assessment of significant change . J Cerebral Blood Flow Metab . 1991;11:690-699.Crossref 24. Baxter LR. Neuroimaging studies of obsessive compulsive disorder . Psychiatr Clin North Am . 1992;15:871-884. 25. Papez JW. Proposed mechanism of emotion . Arch Neurol Psychiatry . 1937;38:725-743.Crossref 26. Mountz J, Modell J, Wilson M, Curtis G, Lee M, Schmaltz S, Kuhl D. Positron emission tomographic evaluation of cerebral blood flow during state anxiety in simple phobia . Arch Gen Psychiatry . 1989;46:501.Crossref
doi: 10.1001/archpsyc.1994.03950010071010pmid: N/A
Abstract In reply Unraveling the relationships between major mental disorders, substance abuse and dependence, and criminality is not easy because existing data suggest that they are rather complex. Assuming that they are linear and causal, as does Weiler, oversimplifies the problem and thereby limits the type of explanatory models that will be developed and the statistical analyses that can be performed.1There is now good evidence to suggest that among persons who develop schizophrenia, major depression, and bipolar disorder, rates of substance abuse and dependence are elevated compared with rates in persons without disorders.2-4(chap 9) As well, persons with major mental disorders are at increased risk for personality disorders4 (chap12),5 (S.H., J. Toupin, PhD, and L. Tremblay, PhD, unpublished data, 1991). Is the increased vulnerability for substance abuse related to the major disorder, to the personality disorder, or to both, or is it independent of the two? Is criminality related References 1. Magnusson D, Bergman L. A pattern approach to the study of pathways from childhood to adulthood . In: Robins LN, Rutter M, eds. Straight and Devious Pathways From Childhood to Adulthood . Cambridge, England: Cambridge University Press; 1990:101-115. 2. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. Comorbity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) Study . JAMA . 1990;264:2511-2518.Crossref 3. Mueser KT, Yarnold PR, Levinson DF, Singh H, Bellack AS, Keey K, Morrison RL, Yadalam KG. Prevalence of substance abuse in schizophrenia: demographic and clinical correlates . Schizophr Bull . 1990;16:31-56.Crossref 4. Goodwin FK, Jamison KR. Manic Depressive Illness . New York, NY: Oxford University Press; 1990:chap 9, chap 12. 5. Leveillee S. Le Support Social Chez les Schizophrenes Dans la Communaute. Montreal, Quebec: Universite de Montreal; 1993. Doctoral thesis. 6. Carlson G, Strober M. Affective disorders in adolescence . Psychiatr Clin North Am . 1979;2:511-526. 7. Bowden CL, Sarabia F. Diagnosing manic depressive illness in adolescents . Compr Psychiatry . 1980;21:263-269.Crossref 8. Cote G, Hodgins S. Co-occurring mental disorders among criminal offenders . Bull Am Acad Psychiatry Law . 1990;18:271-281. 9. Abrams KM, Teplin LA. Co-occurring disorders among mentally ill jail detainees: implications for public policy . Am Psychol . 1991;46:1036-1045.Crossref 10. Bukstein OG, Brest DA, Kaminer Y. Co-morbidity of substance abuse and other psychiatric disorders in adolescents . Am J Psychiatry . 1989;146:1131-1141. 11. Hodgins S. Mental disorder, intellectual deficiency, and crime . Arch Gen Psychiatry . 1992;49:476-483.Crossref 12. Hodgins S. The criminality of mentally disordered persons . In: Hodgins S, ed. Mental Disorder and Crime . Newbury Park, Calif: Sage Publications; 1993:3-21. 13. Lindquist P. Criminal homicide in northern Sweden . Int J Law Psychiatry . 1989;8:19-37.Crossref 14. Gottlieb P, Gabrielsen G, Kramp P. Psychotic homicides in Copenhagen from 1959 to 1983 . Acta Psychiatr Scand . 1987;76:285-292.Crossref 15. Beaudoin MN, Hodgins S. Homicide, schizophrenia and substance abuse or dependency . Can J Psychiatry . In press.
doi: 10.1001/archpsyc.1994.03950010071009pmid: 8279931
Abstract The article by Hodgins1 in the June 1992 issue of the Archives is important because it appears to contradict the notion that patients with major memtal illness are no more likely than the general population to commit violent and nonviolent crime. Hodgins reported that men and women with severe mental illness were 2.5 and 5.0 times more likely than the general population to be convicted of crime, respectively, and concluded that "the findings raise fundamental questions about these disorders, their etiology, and their treatment." The problem with this conclusion is that 49% of men and 43% of women with major mental disorders also had a diagnosis of substance abuse or dependence. Given that men and women with substance-abuse problems alone were 20 and 32 times more likely to be convicted, respectively, it could be concluded that the tendency to commit crime may be a function of substance abuse or References 1. Hodgins S. Mental disorder, intellectual deficiency, and crime: evidence from a birth cohort . Arch Gen Psychiatry . 1992;49:476-483.Crossref
Showing 1 to 10 of 14 Articles
Abstract Background: There is an extensive literature describing a central serotonin deficit in alcoholic, impulsive, violent offenders and fire setters. In the present study, we investigated biochemical concomitants of impulsivity and aggressiveness, and the physiological consequences of reduced central serotonin turnover. Methods: Forty-three impulsive and 15 nonimpulsive alcoholic offenders and 21 healthy volunteers were studied in the forensic psychiatry ward of a university psychiatric department. The subjects underwent lumbar punctures and oral glucose and aspartame challenges, and their diurnal activity rhythm was measured with physical activity monitors. Discriminant function analyses were used to investigate psychophysiological and biochemical concomitants of aggressive and impulsive behaviors. Results: Alcoholic, impulsive offenders with antisocial personality disorder had low mean cerebrospinal fluid (CSF) 5-hydroxyindoleaceticacid (5-HIAA) and corticotropin levels and high mean CSF testosterone concentrations. Compared with healthy volunteers, they showed increased physical activity during the daytime. Alcoholic, impulsive offenders with intermittent explosive disorder had a low mean CSF 5-HIAA concentration and blood glucose nadir after an oral glucose challenge, and desychronized diuranalactivityrhythm. Healthy volunteers had mean CSF 5-HIAA concentrations that were intermediate between those of alcoholic, impulsive and nonimpulsive offenders. Alcoholic, nonimpulsive offenders had a significantly higher mean CSF 5-HIAA concentration than all the other groups, including healthy volunteers. In the present sample, a low CSF 5-HIAA concentration was primarily associated with impulsivity and high CSF testosterone concentration, with aggressiveness or interpersonal violence. Conclusions: In the present sample, a low CSF 5-HIAA concentration was primarily associated with impulsivity and high CSF testosterone concentration, with aggressiveness or interpersonal violence. References 1. Roy A, Virkkunen M, Linnoila M. Serotonin in suicide, violence, and alcoholism . In: Coccaro E, Murphy D, eds. Serotonin in Major Psychiatric Disorders . Washington, DC: American Psychiatric Association; 1991:187-208. 2. Linnoila M, Virkkunen M, Scheinin M, Nuutila A, Rimon R, Goodwin FK. Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentration differentiates impulsive from nonimpulsive violent behavior . Life Sci- 1983;33:2609-2614.Crossref 3. Virkkunen M, Nuutila A, Goodwin FK, Linnoila M. Cerebrospinal fluid monoamine metabolites in male arsonists . Arch Gen Psychiatry . 1987;44:241-247.Crossref 4. Roy A, Virkkunen M, Guthrie S, Linnoila M. Indices of serotonin and glucose metabolism in violent offenders, arsonists and alcoholics . In: Mann JJ, Stanley M, eds. Psychobiology of Suicidal Behavior . New York, NY: New York Academy of Science; 1986:202-220. 5. Linnoila M, Virkkunen M, Roy A. Biochemical aspects of aggression in man . In: Bunney WE Jr, Costa E, Potkin SG, eds. Clinical Neuropharmacology . New York, NY: Raven Press; 1986;(suppl 1):377-379. 6. Palkovits M, Saavedra JM, Jacobovits DM, Kizer JS, Zaborsky L, Brownstein MJ. Serotonergic innervation of the forebrain: effects of lesions on serotonin and tryptophan hydroxylase levels . Brain Res . 1977;130:121-134.Crossref 7. Moore RY, Eichler VB. Loss of a circadian adrenal corticosterone rhythm following suprachiasmatic lesions in the rat . Brain Res . 1972;42:201-206.Crossref 8. Yamamoto H, Nagai K, Nagakava H. Additional evidence that the suprachiasmatic nucleus is the center for regulation of insulin secretion and glucose homeostasis . Brain Res . 1984;304:237-241.Crossref 9. Virkkunen M, DeJong J, Bartko J, Goodwin FK, Linnoila M. Relationship of psychobiological variables to recidivism in violent offenders and impulsive fire setters: a follow-up study . Arch Gen Psychiatry . 1989;46:600-603.Crossref 10. Virkkunen M, DeJong J, Bartko J, Linnoila M. Psychobiological concomitants of history of suicide attempts among violent offenders and impulsive fire setters . Arch Gen Psychiatry . 1989;46:604-606.Crossref 11. Linnoila M, DeJong J, Virkkunen M. Family history of alcoholism in violent offenders and impulsive fire setters . Arch Gen Psychiatry . 1989;46:679-681.Crossref 12. Roy A, Virkkunen M, Guthrie S, Poland R, Linnoila M. Monoamines, glucose metabolism, suicidal and aggressive behaviors . Psychopharmacol Bull . 1986;22:661-665. 13. Virkkunen M. Urinary free cortisol secretion in habitually violent offenders . Acta Psychiatr Scand . 1985;72:40-44.Crossref 14. Spitzer R, Endicott J. Schedule ofAffective Disorders and Schizophrenia—Lifetime Version . Third Edition. New York, NY: New York State Psychiatric Institute; 1978. 15. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 16. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 17. Scheinin M, Chang W-H, Kirk K, Linnoila M. Simultaneous determination of 3-methoxy-4-hydroxyphenylglycol, 5-hydroxyindoleacetic acid, and homovanillic acid in cerebrospinal fluid with high performance liquid chromatography using electrochemical detection . Anal Biochem . 1983;131:246-253.Crossref 18. Barbaccia M, Costa E, Ferrero P, Guidotti A, Roy A, Sunderland T, Pickar D, Paul S, Goodwin FK. Diazepam binding inhibitor: a brain neuropeptide present in human spinal fluid: studies in depression, schizophrenia and Alzheimer's disease . Arch Gen Psychiatry . 1986;43:1143-1147.Crossref 19. Smith MA, Bissette G, Slotkin TA, Kwight DL, Nemeroff CB. Release of corticotropin releasing factor from rat brain regions in vitro . Endocrinology . 1986;118:1997-2001.Crossref 20. Altemus M, Pigott T, Kalogeras KT, Demitrack M, Dubbert B, Murphy DL, Gold PW. Abnormalities in the regulation of vasopressin and corticotropin releasing factor secretion in obsessive compulsive disorder . Arch Gen Psychiatry . 1992;49:9-20.Crossref 21. Kling MA, Roy A, Doran AR, Calabrese JR, Rubinow DR, Whitfield HJ Jr, May C, Post RM, Chrousos GP, Gold PW. Cerebrospinal fluid immunoreactive corticotropin-releasing hormone and adrenocorticotropin secretion in Cushing's disease and major depression: potential clinical implications . J Clin Endocrinol Metab . 1991;72:260-271.Crossref 22. Rahe RH, Karson S, Howard NS Jr, Rubin RT, Poland RE. Psychological and physiological assessments on American Hostages freed from captivity in Iran . Psychosom Med . 1990;52:1-16.Crossref 23. Wehr TA, Wirz-Justice A, Goodwin FK, Breitmeir J, Craig C. 48 hour sleepwake cycles in manic-depressive illness: naturalistic observations and sleep deprivation experiments . Arch Gen Psychiatry . 1982;39:559-565.Crossref 24. BMDP Statistical Software Manual. Los Angeles: University of California Press; 1990. 25. Cotter LB, Helzer JE, Mager D, Spitznagel EM, Compton WM. Agreement between DSM-III and-III-R substance use disorders . Drug Alcohol Depend . 1991;29:17-25.Crossref 26. Morin LP, Blanchard J. Depletion of brain serotonin by 5,7-DHT modifies hamster circadian rhythm response to light . Brain Res . 1991;566:173-185.Crossref 27. Porrino LJ, Rapoport JL, Behar D, Sceery W, lsmond DR, Bunney WE Jr. A naturalistic assessment of motor activity of hyperactive boys . Arch Gen Psychiatry . 1983;40:681-687.Crossref 28. Virkkunen M. Reactive hypoglycemic tendency among habitually violent offenders . Nutr Rev . 1986;44( (suppl) ):94-103.Crossref 29. Brewerton RD, Berrettini WH, Nurnberger JI, Linnoila M. Analysis of seasonal fluctuations of CSF monoamine metabolites and neuropeptides in normal controls: findings with 5-HIAA and HVA . Psychiatry Res . 1988;23:257-265.Crossref 30. Roy A, Adinoff B, Linnoila M. Cerebrospinal fluid variables among alcoholics lack seasonal variation . Acta Psychiatr Scand . 1991;24:187-194. 31. Soubrie P. Reconciling the role of central serotonin neurons in human and animal behavior . Behav Brain Sci . 1986;9:319-364.Crossref 32. Stanley M, Traskman-Benz L, Dorovini-Zis K. Correlations between aminergic metabolites simultaneously obtained from human CSF and brain . Life Sci . 1985;37:1279-1286.Crossref 33. Miller LA. Impulsivity, risk-taking, and the ability to synthesize fragmented information after frontal lobectomy . Neuropsychologia . 1992;30:69-79.Crossref 34. Agren H, Mefford IN, Rudorfer MV, Linnoila M, Potter WZ. Interacting neurotransmitter systems: a non-experimental approach to the 5-HIAA-HVA correlation in human CSF . Psychiatry Res . 1986;20:175-193.Crossref 35. Ellsworth JD, Leahy DJ, Roth RH Jr, Redmond D Jr. Homovanillic acid concentration in brain, CSF and plasma as indicators of central dopamine function in primates . J Neural Transm . 1987;68:51-62.Crossref 36. Weinberger D, Berman KF, Illowsky BP. Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia . Arch Gen Psychiatry . 1988;45:609-615.Crossref 37. Roy A, Pickar D, DeJong J, Karoum F, Linnoila M. Suicidal behavior in depression: relationship to noradrenergic function . Biol Psychiatry . 1989;25:341-350.Crossref 38. Higley JD, Mehlman PT, Taub DM, Higley SB, Suomi SJ, Vickers D, Linnoila M. Cerebrospinal fluid monoamine and adrenal correlates of aggression in freeranging rhesus monkeys . Arch Gen Psychiatry . 1992;49:436-441.Crossref 39. Coccaro EF, Lawrence T, Trestman R, Gabriel S, Klar HM, Siever LJ. Growth hormone responses to intravenous clonidine challenge correlate with behavior irrtability in psychiatric patients and healthy volunteers . Psychiatry Res . 1991;39:129-139.Crossref 40. Steiger A, von Bardeleben V, Wiedeman K, Holsboer F. Sleep EEG and nocturnal secretion of testosterone and cortisol in patients with major endogenous depression during acute phase and after remission . J Psychiatr Res . 1991;25:169-177.Crossref 41. Mason JW, Giller EL, Kosten TR. Serum testosterone differences between patients with schizophrenia and those with affective disorder . Biol Psychiatry . 1991;82:1-28. 42. Archer J. The influence of testosterone on human aggression . Br J Psychol . 1991;82:1-28.Crossref 43. Ehrenkranz J, Bliss E, Sheard MH. Plasma testosterone: correlation with aggressive behavior and social dominance in man . Psychosom Med . 1976;36:469-475.Crossref 44. Dabbs JM Jr, Frady RL, Carr TS, Besh NF. Saliva testosterone and criminal violence in young adult prison inmates . Psychosom Med . 1987;49:174-182.Crossref 45. Sapolsky RM, Plotsky PM. Hypercortisolism and its possible neural bases . Biol Psychiatry . 1990;27:937-952.Crossref 46. Berrettini WH, Nurnberger JI Jr, Zerbe RL, Gold PW, Chrousos GP, Tomai T. CSF neuropeptides in euthymic bipolar patients and controls . Br J Psychiatry . 1987;150:208-212.Crossref 47. De Wied D, Jolles J. Neuropeptides derived from proopiocortin: behavioral, physiological and neurochemical effects . Physiol Rev . 1982;62:976-1059.
Abstract Background: Based on clinical observations in a series of studies on Finnish alcoholic, violent offenders, we asserted that the impulsive offenders represented an extreme group of type 2 alcoholics. We also observed that these subjects were vulnerable to hypoglycemia after the administration of oral glucose load. Furthermore, we believe that while being hypoglycemic, the impulsive offenders are particularly irritable and aggressive. In the present study, we addressed these issues by studying psychological trait and state variables in a new group of violent offenders and fire setters, and age- and sex-matched healthy volunteers. Methods: Fifty-eight alcoholic, violent offenders and impulsive fire setters and 21 healthy volunteers were administered the Karolinska scales of personality and the Rosenzweig picture frustration test after an oral aspartame and glucose challenge. Results: The psychological test results and the criminal histories of the offenders, together with biochemical measurements, suggest that a low 5-hydroxyindoleacetic acid concentration in cerebrospinal fluid in the alcoholic offenders is associated with irritability and impaired impulse control, and a high free testosterone concentration in cerebrospinal fluid is associated with increased aggressiveness, monotony avoidance, sensation seeking, suspiciousness, and reduced socialization. Conclusion: Finnish alcoholic, impulsive offenders have personality profiles characteristic of Scandinavian earlyonset male alcoholics with antisocial traits, who have been also referred to as type 2 alcoholics. References 1. Linnoila M, Virkkunen M, Scheinin M, Nuutila A, Rimon R, Goodwin FK. Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentration differentiates impulsive from nonimpulsive violent behavior . Life Sci . 1983;33:2609-2614.Crossref 2. Virkkunen M, Nuutila A, Goodwin FK, Linnoila M. Cerebrospinal fluid monoamine metabolites in male arsonists . Arch Gen Psychiatry . 1987;44:241-247.Crossref 3. Virkkunen M, Rawlings R, Tokola R, Poland RE, Guidotti A, Nemeroff C, Bissette G, Kalogeras K, Karonen SL, Linnoila M. CSF biochemistries, glucose metabolism, and diurnal activity rhythms in alcoholic, violent offenders, fire setters, and healthy volunteers . Arch Gen Psychiatry . 1994;51:20-27.Crossref 4. Schalling D, Asberg M, Edman G, Oreland L. Markers for vulnerability to psychopathology: temperament traits associated with platelet MAO- activity . Acta Psychiatr Scand . 1987;76:172-182.Crossref 5. Perris C, Eiseman M, von Knorring L, Oreland L, Perris H. Personality traits and monomine oxidase activity in platelets in depressed patients . Neuropsychobiology . 1984;12:201-205.Crossref 6. von Knorring L, Oreland L, von Knorring A-L. Personality traits and platelet MAO activity in alcohol and drug abusing teenage boys . Acta Psychiatr Scand . 1987;75:305-314. 7. von Knorring L, von Knorring A-L, Smigan L, Lindberg U, Edholm M. Personality traits in subtypes of alcoholics . J Stud Alcohol . 1987;48:523-527. 8. von Knorring L, Almay BGL, Johansson F. Personality traits in patients with idopathic pain disorder . Acta Psychiatr Scand . 1987;76:490-498.Crossref 9. Roy A, Virkkunen M, Guthrie S, Linnoila M. Indices of serotonin and glucose metabolism in violent offenders, arsonists and alcoholics . In: Mann JJ, Stanley M, eds. Psychobiology of Suicidal Behavior . New York, NY: New York Academy of Science; 1986:202-220. 10. Linnoila M, Virkkunen M, Roy A. Biochemical aspects of aggression in man . In: Bunney WE Jr, Costa E, Potkin SG, eds. Clinical Neuropharmacology . New York, NY: Raven Press; 1986;(suppl 1):377-379. 11. Rosenzweig S. The current status of the Rosenzweig picture frustration study as a measure of aggression in personality . In: Brain PF, Benton D, eds. Multidisciplinary Approaches to Aggression Research . Amsterdam, the Netherlands: Elsevier Science Publishers; 1981:113-115. 12. Benton D, Kumari N, Brain PF. Mild hypoglycemia and questionnaire measures of aggression . Biol Psychol . 1982;14:129-135.Crossref 13. Wechsler D. The Measurement of Adult Intellingence . 3rd ed. Baltimore, Md; Williams & Williams; 1950. 14. Dahlstrom WM, Welch GS. MMPI Handbook: A Guide to Use in Clinical Practice Research . Minneapolis: University of Minnesota Press; 1960. 15. Buss AH. The Psychology of Aggression . New York, NY: John Wiley & Sons Inc; 1961. 16. BMDP Statistical Software Manual. Los Angeles: University of California Press; 1990. 17. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 18. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 19. Wilson IC, Prange AJ, Lara PP. Methyltestosterone and imipramine in men: conversion of depression to paranoid reaction . Am J Psychiatry 1974;131:21-24. 20. Barbaccia M, Costa E, Ferrero P, Guidotti A, Roy A, Sunderland T, Pickar D, Paul S, Goodwin FK. Diazepam binding inhibitor: a brain neuropeptide present in human spinal fluid—studies in depression, schizophrenia and Alzheimer's disease . Arch Gen Psychiatry . 1986;43:1143-1147.Crossref 21. De Wied D, Jolles J. Neuropeptides derived from proopiocortin: behavioral, physiological and neurochemical effects . Physiol Rev . 1982;62:976-1059. 22. Brown GL, Goodwin FK. Diagnostic, clinical and personality characteristics of aggressive men with low CSF 5-HIAA . Clin Neuropharmacol . 1984;7:756-757.Crossref 23. Virkkunen M. Insulin secretion during the glucose tolerance test among habitually violent and impulsive offenders . Aggres Behav . 1986;12:303-310.Crossref 24. Klinteberg af B, Schalling D, Edman G, Oreland L, Asberg M. Personality correlates of platelet monoamine oxidase (MAO) activity in female and male subjects . Neuropsychobiology . 1987;18:89-96.Crossref 25. Oreland L, Wiberg A, Asberg M, Traskman L, Sjostrand L, Thoren P. Platelet MAO activity and monoamine metabolites in cerebrospinal fluid in depressed and suicidal patients and in healthy controls . Psychiatry Res . 1981;4:21-33.Crossref 26. Oreland L, Shaskan EG. Monomine oxidase activity as a biological marker . Trends Pharmacol Sci . 1983;4:21-33.Crossref 27. Young W, Laws E, Sharbrough F, Weinshilbonm RM. Human monoamine oxidase, lade of brain and platelet correlation . Arch Gen Psychiatry . 1986;43:604-609.Crossref 28. Redmond E, Baulu J, Murphy D, Loriaux L, Ziegler M, Lake R. The effects of testosterone on plasma and platelet monoamine oxidase (MAO) and plasma dopamine beta hydroxylase (DBH) activity in the male rhesus monkey . Psychosom Med . 1976;38:315-326.Crossref 29. Hoff KM. Interactions of testosterone with monoamine oxidase in mouse brain maturation . Gen Pharmacol . 1977;8:55-57.Crossref 30. Virkkunen M, Linnoila M. Serotonin in early onset, male alcoholics with violent behavior . Ann Med . 1990;22:327-331.Crossref 31. Apter A, von Pragg H, Plutchik R, Sevy S, Korn M, Brown SL. Interrelationships among anxiety, aggression, impulsivity, and mood: a serotonergically linked cluster? Psychiatry Res . 1990;32:191-199.Crossref
doi: 10.1001/archpsyc.1994.03950010039006pmid: 8279928
Abstract Background: Most available studies on the psychiatric, neuropsychological, and neurological complications of HIV-1 infection and AIDS have been conducted in Western countries, on samples of well-educated, mostly white, homosexual men. Concerns about generalizability of the results of those investigations prompted the WHO to implement the cross-cultural venture called WHO Neuropsychiatric AIDS study. Methods: This project aims to assess the prevalence and natural history of HIV-1-associated psychiatric, neuropsychological, and neurological abnormalities in representative subject samples enrolled in the five geographic areas predominantly affected by the HIV-I epidemic. Assessment is made by a data collection instrument including six modules. The intercenter and intracenter reliability in the use of each module has been formally evaluated. The study consists of a cross-sectional phase and a longitudinal follow-up. Results: The cross-sectional phase was completed in five centers. This paper reports on the results of psychiatric assessment, which revealed a significantly higher prevalence of current mental disorders in symptomatic seropositive persons compared with seronegative controls among intravenous drug users in Bangkok and homosexuals/bisexuals in São Paulo. The mean global score on the Montgomery-Asberg Depression Rating Scale was significantly higher in symptomatic seropositive individuals than in matched seronegative controls in all centers. Conclusions: These results suggest that the significance of the psychopathological complications of symptomatic HIV-1 infection may have been underestimated by previous studies conducted on self-selected samples of well-educated, middle-class, mostly white, homosexual men. References 1. Global Programme on AIDS. Current and Future Dimensions of the HIV/AIDS Pandemic: A Capsule Summary (January 1992). Geneva, Switzerland: World Health Organization; 1992. 2. Atkinson JH, Grant I, Kennedy CJ, Richman DD, Spector SA, McCutchan JA. Prevalence of psychiatric disorders among men infected with human immunodeficiency virus: a controlled study . Arch Gen Psychiatry . 1988;45:859-864.Crossref 3. Robins LN, Helzer JE, Croughan J, Williams JVW, Spitzer RL. NIMH Diagnostic Interview Schedule: Version III (May 1981) . Rockville, Md: National Institute of Mental Health; 1981. 4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 5. Perry S, Jacobsberg LB, Fishman B, Frances A, Bobo J, Kaplan Jacobsberg B. Psychiatric diagnosis before serological testing for the human immunodeficiency virus . Am J Psychiatry . 1990;147:89-93. 6. Spitzer RL, Williams JVW, Gibbon M, First MB. Structured Clinical Interview for DSM-III-R (SCID) . New York, NY: New York State Psychiatric Institute; 1987. 7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 8. Williams JVW, Rabkin JG, Remien RH, Gorman JM, Ehrhardt AA. Multidisciplinary baseline assessment of homosexual men with and without human immunodeficiency virus infection, II: standardized clinical assessment of current and lifetime psychopathology . Arch Gen Psychiatry . 1991;48:124-130.Crossref 9. Maj M, Satz P, Janssen R, Zaudig M, Starace F, D'Elia L, Sughondhabirom B, Mussa M, Naber D, Ndetei D, Schulte G, Sartorius N. WHO Neuropsychiatric AIDS Study, cross-sectional phase II: neuropsychological and neurological findings . Arch Gen Psychiatry . 1993;51:51-61.Crossref 10. Global Programme on AIDS. Current and Future Dimensions of the HIV/AIDS Pandemic: A Capsule Summary (September 1990) . Geneva, Switzerland: World Health Organization; 1990. 11. Centers for Diseases Control. 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