Publications by authors named "Nenad Jaksic"

51 Publications

Association of polygenic risk scores, traumatic life events and coping strategies with war-related PTSD diagnosis and symptom severity in the South Eastern Europe (SEE)-PTSD cohort.

J Neural Transm (Vienna) 2021 Nov 27. Epub 2021 Nov 27.

Department of Psychiatry, University Clinical Center, Sarajevo, Bosnia and Herzegovina.

Objectives: Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses polygenic risk scores (PRS) derived from the UK Biobank (UKBB) mega-cohort analysis as part of the PGC PTSD GWAS effort to determine the heritable basis of PTSD in the South Eastern Europe (SEE)-PTSD cohort. We further analyzed the relation between PRS and additional disease-related variables, such as number and intensity of life events, coping, sex and age at war on PTSD and CAPS as outcome variables.

Methods: Association of PRS, number and intensity of life events, coping, sex and age on PTSD were calculated using logistic regression in a total of 321 subjects with current and remitted PTSD and 337 controls previously subjected to traumatic events but not having PTSD. In addition, PRS and other disease-related variables were tested for association with PTSD symptom severity, measured by the Clinician Administrated PTSD Scale (CAPS) by liner regression. To assess the relationship between the main outcomes PTSD diagnosis and symptom severity, each of the examined variables was adjusted for all other PTSD related variables.

Results: The categorical analysis showed significant polygenic risk in patients with remitted PTSD and the total sample, whereas no effects were found on symptom severity. Intensity of life events as well as the individual coping style were significantly associated with PTSD diagnosis in both current and remitted cases. The dimensional analyses showed as association of war-related frequency of trauma with symptom severity, whereas the intensity of trauma yielded significant results independently of trauma timing in current PTSD.

Conclusions: The present PRS application in the SEE-PTSD cohort confirms modest but significant polygenic risk for PTSD diagnosis. Environmental factors, mainly the intensity of traumatic life events and negative coping strategies, yielded associations with PTSD both categorically and dimensionally with more significant p-values. This suggests that, at least in the present cohort of war-related trauma, the association of environmental factors and current individual coping strategies with PTSD psychopathology was stronger than the polygenic risk.
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http://dx.doi.org/10.1007/s00702-021-02446-5DOI Listing
November 2021

Results of the COVID-19 mental health international for the general population (COMET-G) study.

Eur Neuropsychopharmacol 2022 01 15;54:21-40. Epub 2021 Oct 15.

Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia. Electronic address:

Introduction: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study.

Material And Methods: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively.

Statistical Analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables.

Results: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed.

Conclusions: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them.
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http://dx.doi.org/10.1016/j.euroneuro.2021.10.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609892PMC
January 2022

Contemporary psychological perspectives of personality disorders.

Curr Opin Psychiatry 2021 09;34(5):497-502

Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb.

Purpose Of Review: The aim of this study was to review the recent literature on contemporary psychological perspectives of personality disorders, including novel psychotherapeutic interventions aimed at these vulnerable individuals.

Recent Findings: Among the various psychological theories and models of personality disorders, still the most popular and researched are psychodynamic, cognitive and interpersonal perspectives. More specifically, object relations theory, cognitive schema conceptualization and interpersonal circumplex model have produced the most empirical investigations of personality disorders in recent years. Latest work has suggested that all three perspectives have contributed to and are compatible with the dimensional personality disorders framework in DSM-5-AMPD and ICD-11 (including level of personality functioning and personality traits). These models have yielded specific psychological treatments of personality disorders; although most psychotherapies have been constructed for patients with borderline personality disorder (BPD), there is an increasing number of treatment modalities aimed at individuals with other forms of personality disorder, such as those with narcissistic or antisocial traits/disorders. More research into their effectiveness and long-term benefits is necessary.

Summary: Novel research keeps updating our knowledge on the cause, manifestations and psychological treatments of personality disorders, particularly from psychodynamic, cognitive and interpersonal perspectives.
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http://dx.doi.org/10.1097/YCO.0000000000000732DOI Listing
September 2021

Distinct association of plasma BDNF concentration and cognitive function in depressed patients treated with vortioxetine or escitalopram.

Psychopharmacology (Berl) 2021 Jun 9;238(6):1575-1584. Epub 2021 Feb 9.

Rudjer Boskovic Institute, Bijenicka cesta 54, 10000, Zagreb, Croatia.

Rationale: Cognitive dysfunction is frequent in major depressive disorder (MDD), and brain-derived neurotrophic factor (BDNF) is involved both in regulation of cognition and in therapeutic response in MDD.

Objectives: The aim of this study was to determine if baseline plasma BDNF might predict change in cognitive function in MDD patients treated with vortioxetine or escitalopram, and whether the alterations in BDNF levels correlate with changes in cognitive performance during treatment.

Methods: Drug-naive or drug-free patients with MDD (N=121) were sampled and evaluated at baseline and 4 weeks after treatment initiation with vortioxetine or escitalopram. Cognitive function was evaluated using the F-A-S test, Digit Span test, and Digit Symbol Coding test. Plasma BDNF was determined using ELISA.

Results: The results of the study indicate that both vortioxetine (V) and escitalopram (E) improved cognitive functions evaluated with F-A-S test (V: p<0.001; r=-0.427, E: p<0.001; r=-0.370), Digit Symbol Coding test (V: p<0.001; r=-0.706, E: p<0.001; r=-0.435), and Digit Span test-backward span (V: p=0.001; r=-0.311, E: p=0.042; r=-0.185), while only vortioxetine (p<0.001; r=-0.325) improved cognition evaluated with the Digit Span test-forward span. A moderate positive correlation between pretreatment plasma BDNF levels and improvement in cognitive performance was only detected in patients treated with vortioxetine (delta F-A-S test: p=0.011; r=0.325, delta Digit Span test-forward span: p=0.010, r=0.326).

Conclusions: These results suggest that higher baseline plasma BDNF levels might be associated with improvements in verbal fluency and working memory in vortioxetine, but not escitalopram treated patients. Vortioxetine treatment was superior in simple attention efficiency.
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http://dx.doi.org/10.1007/s00213-021-05790-2DOI Listing
June 2021

Pathological Narcissism, Negative Parenting Styles and Interpersonal Forgiveness among Psychiatric Outpatients.

Psychiatr Danub 2020 Autumn - Winter;32(3-4):395-402

Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,

Background: Pathological narcissism has previously been investigated with regard to negative parenting and interpersonal forgiveness, but inconsistent findings have been obtained in relation to its two phenotypic forms - grandiosity and vulnerability. Moreover, the role of negative parenting in the lack of forgiveness within narcissistic pathology has not been explored thus far. The aim of the current research was to investigate the complex relations among pathological narcissism, negative parenting, and interpersonal forgiveness in psychiatric outpatients.

Subjects And Methods: A sample of 250 adult psychiatric outpatients (61% female; mean age 39.15 years) were enrolled in this study. The participants filled out the Pathological Narcissism Inventory (PNI), the Tendency to Forgive Scale (TTF), the Measure of Parental Styles (MOPS), and the Depression, Anxiety, Stress Scales (DASS21).

Results: Narcissistic grandiosity and narcissistic vulnerability were positively correlated with mothers' and fathers' negative parenting, but this association was significantly stronger in the case of narcissistic vulnerability. Only narcissistic vulnerability was related to interpersonal forgiveness. In the mediation analysis, negative parenting was not directly related to interpersonal forgiveness, however, this association became significant after introducing narcissistic vulnerability. Narcissistic vulnerability served as a full mediator of the mothers' and fathers' negative parenting - interpersonal forgiveness relationships.

Conclusions: Narcissistic vulnerability seems to be more strongly related to negative parenting and interpersonal forgiveness than narcissistic grandiosity, while it also represents one of the underlying mechanisms of the negative parenting - interpersonal forgiveness relationship. The clinical implications of these findings are discussed in relation to pathological narcissism and lack of forgiveness.
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http://dx.doi.org/10.24869/psyd.2020.395DOI Listing
January 2021

Pathological Narcissism, Negative Parenting Styles and Interpersonal Forgiveness among Psychiatric Outpatients.

Psychiatr Danub 2020 Autumn - Winter;32(3-4):395-402

Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,

Background: Pathological narcissism has previously been investigated with regard to negative parenting and interpersonal forgiveness, but inconsistent findings have been obtained in relation to its two phenotypic forms - grandiosity and vulnerability. Moreover, the role of negative parenting in the lack of forgiveness within narcissistic pathology has not been explored thus far. The aim of the current research was to investigate the complex relations among pathological narcissism, negative parenting, and interpersonal forgiveness in psychiatric outpatients.

Subjects And Methods: A sample of 250 adult psychiatric outpatients (61% female; mean age 39.15 years) were enrolled in this study. The participants filled out the Pathological Narcissism Inventory (PNI), the Tendency to Forgive Scale (TTF), the Measure of Parental Styles (MOPS), and the Depression, Anxiety, Stress Scales (DASS21).

Results: Narcissistic grandiosity and narcissistic vulnerability were positively correlated with mothers' and fathers' negative parenting, but this association was significantly stronger in the case of narcissistic vulnerability. Only narcissistic vulnerability was related to interpersonal forgiveness. In the mediation analysis, negative parenting was not directly related to interpersonal forgiveness, however, this association became significant after introducing narcissistic vulnerability. Narcissistic vulnerability served as a full mediator of the mothers' and fathers' negative parenting - interpersonal forgiveness relationships.

Conclusions: Narcissistic vulnerability seems to be more strongly related to negative parenting and interpersonal forgiveness than narcissistic grandiosity, while it also represents one of the underlying mechanisms of the negative parenting - interpersonal forgiveness relationship. The clinical implications of these findings are discussed in relation to pathological narcissism and lack of forgiveness.
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http://dx.doi.org/10.24869/psyd.2020.395DOI Listing
January 2021

Personality and Stigma in Lung Cancer Patients.

Psychiatr Danub 2020 Nov;32(Suppl 4):528-532

Department of Psychiatry, University Hospital Sestre Milosrdnice, Vinogradska cesta 29, 10000 Zagreb, Croatia,

Background: Stigma in lung cancer has been associated with diagnostic and treatment delay and with poor outcomes. Personality has impact on the perception of someone's life situation and interacts with psychosocial variables and coping strategies. The vulnerability to stigma is still under-researched. The aim of this study was to investigate this vulnerability by examining the associations between stigma and personality dimensions (i.e., temperament and character traits).

Subjects And Methods: Seventy six (76) inpatients of the two teaching hospitals with the diagnosis of non-small-cell lung cancer were consecutively included in the study. Patients were assessed with self-reporting scales: Cataldo Lung Cancer Stigma Scale (CLCSS) and Temperament and Character Inventory (TCI). Sociodemographic and clinical data were also collected.

Results: Personality dimensions Self-directedness and Persistence showed to be significant predictors of stigma in the linear regression (R=0.519; F=3.104; P=0.007). Stigma and personality dimensions were not associated with age, gender, tumor stage and smoking status.

Conclusion: Stigma is associated with particular character (i.e., Self-directedness) and temperament (i.e., Persistence) dimensions. Given the negative clinical outcomes of stigma in lung cancer patients, personality should be taken into account during screening and treatment planning phases.
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November 2020

Depression and Hopelessness as Possible Predictors of Weight Change among Obese Day-Hospital Patients: A 6-Months Follow-Up Study.

Psychiatr Danub 2020 ;32(2):217-218

Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,

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January 2021

Symptom continuum reported by affective disorder patients through a structure-validated questionnaire.

BMC Psychiatry 2020 05 7;20(1):207. Epub 2020 May 7.

Department of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.

Background: Affective disorders, such as major depressive (MDD), bipolar I (BD I) and II (BD II) disorders, are overlapped at a continuum, but their exact loci are not clear. The self-reports from patients with affective disorders might help to clarify this issue.

Methods: We invited 738 healthy volunteers, 207 individuals with BD I, 265 BD II, and 192 MDD to answer a 79 item-MATRIX about on-going affective states.

Results: In study 1, all 1402 participants were divided random-evenly and gender-balanced into two subsamples; one subsample was used for exploratory factor analysis, and another for confirmatory factor analysis. A structure-validated inventory with six domains of Overactivation, Psychomotor Acceleration, Distraction/ Impulsivity, Hopelessness, Retardation, and Suicide Tendency, was developed. In study 2, among the four groups, MDD scored the highest on Retardation, Hopelessness and Suicide Tendency, whereas BD I on Distraction/ Impulsivity and Overactivation.

Conclusion: Our patients confirmed the affective continuum from Suicide Tendency to Overactivation, and described the different loci of MDD, BD I and BD II on this continuum.
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http://dx.doi.org/10.1186/s12888-020-02631-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206809PMC
May 2020

The Importance of Psychodynamic Approach during COVID-19 Pandemic.

Psychiatr Danub 2020 ;32(1):15-21

Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,

The coronavirus (COVID-19) outbreak was labeled a global pandemic by the WHO in March of 2020. Understanding how crisis influence an individual's reactions to stressful events (and vice versa) is important in order to create meaningful and effective interventions. Our literature search have revealed lack of the papers related to psychodynamic approach to recent crisis. Psychodynamic places a large emphasis on defense mechanisms and unconscious mind, where upsetting feelings, urges, and thoughts that are too painful for us to directly look at are housed. Even though these painful feelings and thoughts are outside of our awareness, they still influence our behavior in many ways. Optimal application of psychodynamic approach offers the frame for acceptance of psychological stress in a more positive way and benefits psychological growth. We believe that including psychodynamic approach in the national public and mental health emergency system will empower Croatia and the world during (and after) COVID-19 pandemic crisis.
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http://dx.doi.org/10.24869/psyd.2020.15DOI Listing
April 2020

COVID-19 Pandemia and Public and Global Mental Health from the Perspective of Global Health Securit.

Psychiatr Danub 2020 ;32(1):6-14

Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,

The Coronavirus disease 2019 (COVID-19) pandemic emerged in Wuhan, China and has spread all over the world and has caused huge threats to health and lives. It has affected different frontiers of lives and induced many psychiatric individual and collective problems such as panic, anxiety, depression, post-traumatic stress disorders, suspiciousness, infodemia, cacophony, xenophobia, racisms, etc. The COVID-19 outbreak has induced public and global mental health crisis as well as a huge psycho-social experiment. Psychiatry and other mental health sciences can play very useful role in supporting the well-being of COVID-19 patients and their families, healthcare personnel and the society. For successful fighting with present and future pandemics we have to learn more about psychiatric and psychological aspects of COVID-19 from the perspectives of public and global mental health.
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http://dx.doi.org/10.24869/psyd.2020.6DOI Listing
April 2020

Temperament, Character, and Subjective Well-Being in Croatian War Veterans Suffering From Posttraumatic Stress Disorder.

J Nerv Ment Dis 2020 04;208(4):340-343

Department of Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia.

Subjective well-being is decreased in war-affected populations. However, no previous research has investigated the role of temperament and character dimensions in life satisfaction among war veterans with posttraumatic stress disorder (PTSD). This study enrolled 148 Croatian male war veterans being treated for combat-related PTSD. The participants completed the Beck Depression Inventory-Second Edition, Satisfaction with Life Scale, and Temperament and Character Inventory-Revised. Two multivariate regression analyses with life satisfaction as a dependent variable and temperament and character dimensions, respectively, as predictor variables, were performed. Temperament dimensions harm avoidance and novelty seeking as well as character dimensions self-directedness and cooperativeness were unique predictors of life satisfaction, while controlling for the influence of depressive symptoms, education level, and employment status. Given the influence of personality dimensions on life satisfaction, the routine assessment of these dimensions might help to establish the individually tailored treatment among war veterans with PTSD.
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http://dx.doi.org/10.1097/NMD.0000000000001127DOI Listing
April 2020

Gender differences in early onset of chronic physical multimorbidities in schizophrenia spectrum disorder: Do women suffer more?

Early Interv Psychiatry 2020 08 14;14(4):418-427. Epub 2019 Aug 14.

Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.

Aim: The association between various physical illnesses and schizophrenia spectrum disorder (SSD) is well-established. However, the role of gender remains unclear. The present study explored the gender-based differences in the prevalence and early onset of chronic physical multimorbidities (CPM) in patients with SSD and the general population (GEP).

Methods: We recruited 329 SSD patients and 837 GEP controls in this nested cross-sectional study. The primary outcome was the prevalence of the chronic physical multimorbidities, especially in the youngest age group (<35 years).

Results: Women with SSD had more than double the odds for having CPM than men (OR = 2.47; 95% CI 1.35-4.50), while the gender-related burden of chronic diseases in controls was nearly the same (OR = 0.89; 95% CI 0.65-1.22). Furthermore, the prevalence of chronic disease in younger women patients was significantly higher than in controls (P = .002), while younger men did not seem to experience this increased comorbidity burden.

Conclusions: This study suggests that women with SSD are at increased physical comorbidity risk compared to men, particularly early in the course of psychiatric illness. Tailored and individualized treatment plans must consider this, aiming to deliver holistic care and effective treatment outcomes.
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http://dx.doi.org/10.1111/eip.12867DOI Listing
August 2020

A Candidate Gene Association Study of FKBP5 and CRHR1 Polymorphisms in Relation to War-Related Posttraumatic Stress Disorder.

Psychiatr Danub 2019 Jun;31(2):269-275

Department of Psychiatry, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia,

Background: Posttraumatic stress disorder (PTSD) is a highly frequent and disabling psychiatric condition among war-affected populations. The FK506-binding protein 5 (FKBP5) gene and the corticotropin-releasing hormone receptor 1 (CRHR1) gene have previously been implicated in an elevated risk of peritraumatic dissociation and PTSD development. Our aim was to investigate the association between FKBP5 and CRHR1 genotypes and PTSD diagnosis and severity among individuals who were affected by the Balkan wars during the 1990s.

Subjects And Methods: This study included participants with current PTSD, remitted PTSD and healthy volunteers (N=719, 487 males), who were recruited between 2013 and 2015 within the framework of the South Eastern Europe (SEE) - PTSD Study. Psychometric methods comprised the Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administrated PTSD Scale (CAPS), and the Brief Symptom Inventory (BSI). FKBP5 rs1360780 and CRHR1 rs17689918 genotypes were determined using a KASP genotyping assay.

Results: Tests for deviation from Hardy Weinberg equilibrium showed no significant results. Logistic and linear regression was used to examine the associations between the FKBP5 SNP rs1360780 and the CRHR1 SNP rs17689918 with PTSD diagnosis and severity, as well as general psychiatric symptom severity, separately for current and remitted PTSD patients. There were nominally significant associations under a dominant model between the rs1360780 C allele and PTSD diagnosis as well as symptom severity, which however, were not significant anymore after Bonferroni adjustment (α=0.002). For CRHR1 rs17689918 no significant associations were detected.

Conclusion: We found nominally, but not Bonferroni corrected significant associations between the FKBP5 polymorphism rs1360780 and PTSD susceptibility among individuals affected by the Balkan wars. For elucidating this gene's real resilience/vulnerability potential, environmental influences should be taken into account.
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http://dx.doi.org/10.24869/psyd.2019.269DOI Listing
June 2019

The Role of TaqI DRD2 (rs1800497) and DRD4 VNTR Polymorphisms in Posttraumatic Stress Disorder (PTSD).

Psychiatr Danub 2019 Jun;31(2):263-268

Department of Psychiatry, University Clinical Centre of Kosovo, Prishtina, Kosovo,

Background: Posttraumatic stress disorder (PTSD) is a complex stress related disorder, that follows a severe traumatic experience, characterized with an intense sense of terror, fear, and helplessness. The aim of this study is to identify associations of genetic variations within candidate genes DRD2 and DRD4 with various PTSD related phenotypes. PTSD lifetime and PTSD current subjects were analyzed separately, each of them were analyzed in a Case/Control design, as well as regarding BSI and CAPS within cases only.

Subjects And Methods: 719 (487 male, 232 female) participants who had experienced war-related trauma between 1991 and 1999 in Bosnia and Hercegovina, Kosovo and Croatia were included in the study. Sociodemographic questionnaire, Clinician Administered PTSD Scale (CAPS) and the Brief Symptom Inventory (BSI) were used to collect clinical data.

Results: The DRD2 rs1800497 variant and a variable number tandem repeat (VNTR) located in exon three of DRD4 were investigated for association with PTSD. In case control analyses we did not identify any significant associations. Within the PTSD current patients, we identified an association of DRD2 rs1800497 with BSI in the genotypic and the recessive model with the T allele as the risk allele.

Conclusion: Our findings suggest that rs1800497 of DRD2 gene is involved in pathogenesis of PTSD.
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http://dx.doi.org/10.24869/psyd.2019.263DOI Listing
June 2019

Role of the Allelic Variation in the 5-Hydroxytryptamine Receptor 1A (HTR1A) and the Tryptophan Hydroxylase 2 (TPH2) Genes in the Development of PTSD.

Psychiatr Danub 2019 Jun;31(2):256-262

Department of Psychiatry, University Clinical Centre of Kosovo, Str, Hile Mosi, nr 11, 10000 Prishtina, Kosovo,

Background: Post-traumatic stress disorder (PTSD) is a stress related disorder which can occur in an individual after exposure to a traumatic event. It most commonly co-occurs with depression. The two disorders share not only overlapping symptoms, but also genetic diathesis. The aim of this study was to investigate the potential role of single nucleotide polymorphisms (SNPs) of the two serotonergic candidate genes 5-hydroxytryptamine receptor 1A (HTR1A) and tryptophan hydroxylase 2 (TPH2) in the pathogenesis of PTSD and comorbid psychopathology.

Subjects And Methods: 719 (487 males, 232 females) participants who had experienced war-related trauma between 1991 and 1999 in Bosnia and Herzegovina, Kosovo and Croatia were included in the study. The Sociodemographic questionnaire, Mini International Neuropsychiatric Interview (M.I.N.I.), Clinician Administered PTSD Scale (CAPS) and Brief Symptom Inventory (BSI) were used to collect clinical data. The SNPs rs6295 (HTR1A), rs11178997 and rs1386494 (TPH2) were investigated for their association with PTSD and comorbid psychopathology.

Results: A nominal significant association was found between the BSI total score in Lifetime PTSD with the SNP rs6295 of the HTR1A gene. The best result was seen in the dominant model (P=0.018), with the minor allele (C) being the risk allele. Several BSI subscores were also associated with the minor (C) allele in Lifetime PTSD. No association was found for the TPH2 SNPs rs11178997 and rs1386494 in relation to PTSD or comorbid psychopathology.

Conclusions: Our findings suggest that rs6295 in the HTR1A gene may contribute to the psychopathology of PTSD.
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http://dx.doi.org/10.24869/psyd.2019.256DOI Listing
June 2019

Association of Neuropeptide S Receptor 1 and Glutamate Decarboxylase 1 Gene Polymorphisms with Posttraumatic Stress Disorder.

Psychiatr Danub 2019 Jun;31(2):249-255

Institute of Kosovo Forensic Psychiatry, University Clinical Centre of Kosovo, Prishtina, Kosovo.

Background: Posttraumatic stress disorder (PTSD) is an anxiety disorder caused by highly traumatic experiences. The aim of this study was to investigate the influence of single nucleotide polymorphisms (SNPs) in the neuropeptide S receptor 1 (NPSR1) and the glutamate decarboxylase 1(GAD1) gene on PTSD and its psychopathological aspects among individuals affected by the Balkan wars during the 90s.

Subjects And Methods: This study was conducted as part of the South Eastern Europe (SEE) study on molecular mechanisms of PTSD. It comprised 719 participants (539 males), including those with current PTSD, remitted PTSD and healthy volunteers. Psychometric evaluation was performed using the Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administrated PTSD Scale (CAPS) andthe Brief Symptom Inventory (BSI). We examined NPSR1 single nucleotide polymorphism (SNP) rs324981 and GAD1 variant rs3749034 genotypes. Case-control analyses were carried out using logistical regression to determine genotype differences between all patients that had either current or remitted PTSD and control individuals. To analyse the influence of the analysed SNPs on PTSD severity, we performed linear regression analyses with CAPS and BSI within each of the two patient groups separately. All of the calculations were performed for additive allelic, recessive, dominant and genotypic models.

Results: We observed a nominally significant association for the major allele (G) of GAD1 rs3749034 with an increased risk to develop PTSD in a case control analysis in the recessive model (P=0.0315, odds ratio=0.47, SE=0.35). In contrast, a nominally significant association of the minor allele (A) with higher CAPS scores was identified within the patient group with lifetime PTSD in the dominant model (P=0.0372, β=6.29, SE=2.99). None of these results did withstand correction for multiple tests. No nominal significant results of GAD1 rs3749034 were found with regard to the intensity of psychological BSI symptoms. Case-control analyses of NPSR1 rs324981 revealed a nominally significant higher risk for homozygous T allele carriers to develop PTSD (P=0.0452) in the recessive model. On the other hand, the T allele showed a nominally significant association with higher BSI scores in patients suffering from lifetime PTSD in the recessive model (P=0.0434). Again, these results were not significant anymore after correction for multiple tests. No associations of NPSR1 rs324981 and CAPS score was identified.

Conclusion: The findings of this study provide some evidence that the NPSR1 and GAD1 polymorphisms might play a role in the development of war-related PTSD and its related psychological expressions. Further research is needed to elucidate the interactions of specific gene variants and environmental factors in the development of PTSD.
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http://dx.doi.org/10.24869/psyd.2019.249DOI Listing
June 2019

The Association of Catechol-O-Methyl-Transferase and Interleukin 6 Gene Polymorphisms with Posttraumatic Stress Disorder.

Psychiatr Danub 2019 Jun;31(2):241-248

Department of Clinical Biochemistry, University Clinical Centre of Kosovo, Prishtina, Kosovo.

Background: Posttraumatic stress disorder (PTSD) is a disorder that occurs in some people who have experienced a severe traumatic event. Several genetic studies suggest that gene encoding proteins of catechol-O-methyl-transferase (COMT) may be relevant for the pathogenesis of PTSD. Some researchers suggested that the elevation of interleukin-6 (IL6) correlates with major depression and PTSD. The aim of this study was to investigate whether the single nucleotide polymorphisms COMT rs4680 (Val158Met) and IL6 rs1800795 are associated with PTSD and contribute to the severity of PTSD symptoms.

Subjects And Methods: This study comprised 747 participants that experienced war between 1991 and 1999 in the South Eastern Europe conflicts. COMT rs4680 (Val158Met) and IL6 rs1800795 genotypes were determined in 719 participants (369 with and 350 without PTSD). The Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administrated PTSD Scale (CAPS) questionnaire and the Brief Symptom Inventory (BSI) were used for data collection.

Results: Regarding the COMT gene polymorphism, the results of the regression analyses for BSI total score were significant in the lifetime PTSD group in the dominant (P=0.031) and the additive allelic model (P=0.047). Regarding the IL6 gene, a significant difference was found for the recessive model predicting CAPS total score in the lifetime PTSD group (P=0.048), and indicated an association between the C allele and higher CAPS scores. n the allelic, genotypic and rezessive model, the results for BSI total score were significant in the lifetime PTSD group (P=0.033, P=0.028 and P=0.009), suggesting a correlation of the C allele with higher BSI scores.

Conclusion: Although our nominally significant results did not withstand correction for multiple tests they may support a relevance of the COMT (Val158Met) and IL6 rs1800795 polymorphism for aspects of PTSD in war traumatized individuals.
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http://dx.doi.org/10.24869/psyd.2019.241DOI Listing
June 2019

Associations between Polymorphisms in the Solute Carrier Family 6 Member 3 and the Myelin Basic Protein Gene and Posttraumatic Stress Disorder.

Psychiatr Danub 2019 Jun;31(2):235-240

Community Health Center Zivinice, Alije Izetbegovica 17, 75270 Zivinice, Bosnia & Herzegovina,

Background: Previous research showed inconsistent results concerning a possible association between solute carrier family 6 member 3 (SLC6A3) gene polymorphisms and dopamine symptoms of posttraumatic stress disorder (PTSD). Several studies also indicate that the myelin basic protein (MBP) gene is of importance in the etiology of several psychiatric disorders. The aim of this study was to investigate the relation of distinct SLC6A3 and MBP gene polymorphisms with PTSD and whether SLC6A3 and MBP genotypes contribute to PTSD symptom severity.

Subjects And Methods: The study included 719 individuals who had experienced war trauma in the South Eastern Europe (SEE). Genotypes of variable number tandem repeat (VNTR) polymorphism within the SLC6A3 gene were assessed in 696 participants, and the single nucleotide polymorphism (SNP) rs12458282 located within the MBP gene region was genotyped in a total of 703 subjects. The Mini International Neuropsychiatric Interview, the Clinical Administrated PTSD Scale (CAPS) and Brief Symptom Inventory (BSI), were used for data collection.

Results: No significant differences concerning the investigated SLC6A3 and MBP polymorphisms was identifiable between PTSD and non PTSD participants. Also we could not detect significant influence of these distinct SLC6A3 and MBP alleles on the severity of PTSD symptoms (CAPS) or BSI scores. However, the results of MBP rs12458282 within the patients with lifetime PTSD may point to a possible correlation of the major allele (T) with elevated CAPS scores.

Conclusions: Our results do not support an association of the analysed SLC6A3 and MBP gene polymorphisms with PTSD in war traumatized individuals. We found that there is a possibility for a correlation of the T allele rs12458282 within the MBP gene with higher CAPS scores in lifetime PTSD patients which would need to be tested in a sample providing more statistical power.
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http://dx.doi.org/10.24869/psyd.2019.235DOI Listing
June 2019

Associations of Gene Variations in Neuropeptide Y and Brain Derived Neurotrophic Factor Genes with Posttraumatic Stress Disorder.

Psychiatr Danub 2019 Jun;31(2):227-234

International Burch University, Department of Genetics and Bioengineering, Francuske revolucije bb, 71000 Sarajevo, Bosnia and Herzegovina,

Background: Individuals who are exposed to traumatic events are at an increased risk of developing posttraumatic stress disorder (PTSD), a condition during which an individual's ability to function is impaired by emotional responses to memories of those events. The gene coding for neuropeptide Y (NPY) and the gene coding for brain-derived neurotrophic factor (BDNF) are among the number of candidate gene variants that have been identified as potential contributors to PTSD. The aim of this study was to investigate the association between NPY and BDNF and PTSD in individuals who experienced war-related trauma in the South Eastern Europe (SEE) conflicts (1991-1999).

Subjects And Methods: This study included participants with current and remitted PTSD and healthy volunteers (N=719, 232 females, 487 males), who were recruited between 2013 and 2015 within the framework of the South Eastern Europe (SEE) - PTSD Study. Psychometric methods comprised the Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administered PTSD Scale (CAPS), and the Brief Symptom Inventory (BSI). DNA was isolated from whole blood and genotyped for NPY rs5574 via PCR - RFLP and NPY rs16147 and BDNF rs6265 using the KASP assay.

Results: Tests for deviation from Hardy-Weinberg equilibrium showed no significant results. Analyses at the categorical level yielded no associations between the affected individuals and all three SNPs when compared to controls. Within lifetime PTSD patients, the major alleles of both NPY variants showed a nominally significant association with higher CAPS scores (p=0.007 and p=0.02, respectively). Also, the major allele of rs5574C>T was associated with higher BSI scores with a nominal significance among current PTSD patients (p=0.047). The results did not withstand a Bonferroni adjustment (α=0.002).

Conclusion: Nominally significant associations between NPY polymorphisms and PTSD susceptibility were found that did not withstand Bonferroni correction.
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http://dx.doi.org/10.24869/psyd.2019.227DOI Listing
June 2019

Genetic Susceptibility to Posttraumatic Stress Disorder: Analyses of the Oxytocin Receptor, Retinoic Acid Receptor-Related Orphan Receptor A and Cannabinoid Receptor 1 Genes.

Psychiatr Danub 2019 Jun;31(2):219-226

Department of Psychiatry, Clinical Center University Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina,

Background: Exposure to life-threatening events is common and everyone will most likely experience this type of trauma during their lifetime. Reactions to these events are highly heterogeneous and seems to be influenced by genes as well. Some individuals will develop posttraumatic stress disorder (PTSD), while others will not. In this study, our aim was to analyze the correlation between single nucleotide polymorphisms (SNPs) within the oxytocin receptor (OXTR) gene (rs53576 and rs2254298), the RAR-related orphan receptor A (RORA) gene (rs8042149) and the cannabinoid receptor 1 (CNR1) gene (rs1049353) and PTSD. All candidate genes have been previously associated with stress related disorders and the reaction to traumatic events.

Subjects And Methods: Participants (N=719) have been exposed to war-related trauma during the war in South-Eastern Europe (Bosnia and Herzegovina, Croatia and Kosovo). We correlated the presence and absence of current and lifetime PTSD as well as PTSD severity (Clinician Administered PTSD scale (CAPS)) and current psychopathology (Brief Symptom Inventory (BSI) score) with the mentioned SNPs. DNA was isolated from whole blood and genotyped for OXTR rs2254298 and rs53576 following previously published protocols, for RORA rs8042149 via PCR-RFLP and CNR1 rs1049353 via KASP.

Results: Nominally significant results were found for OXTR rs53576 in connection with the CAPS and BSI scores within lifetime PTSD patients. The additive allelic model indicated that G allele carriers achieved lower CAPS (p=0.0090) and BSI (p=0.0408) scores than participants carrying one or two copies of the A allele. These results did not withstand correction for multiple tests. No significant results were observed for OXTR rs2254298, RORA rs8042149 and CNR1 rs1049353 although the results for RORA showed a slight tendency that rs8042149 may influence the level of BSI scores in current PTSD patients.

Conclusions: This study points to a role of the OXTR gene in PTSD and the related psychopathology following war related trauma.
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http://dx.doi.org/10.24869/psyd.2019.219DOI Listing
June 2019

Association Analysis of Maoa and Slc6a4 Gene Variation in South East European War Related Posttraumatic Stress Disorder.

Psychiatr Danub 2019 Jun;31(2):211-218

Department of Psychiatry, University Clinical Centre Tuzla, Rate Dugonjića bb, 75000 Tuzla, Bosnia and Herzegovina,

Background: The aim of this study is to investigate the association of gene variations of the monoamine oxidase A (MAOA) and the serotonin transporter solute carrier family 6 member 4 (SLC6A4) gene with posttraumatic stress disorder (PTSD) severity and coping strategies in patients with war related PTSD.

Subjects And Methods: The study included 747 individuals who had experienced war trauma in the South Eastern Europe conflicts between 1991 and 1999. Genotyping of the MAOA VNTR and SLC6A4 tandem repeat polymorphism in combination with rs25531 was done in 719 participants: 232 females and 487 males. Among them, 369 have had current or lifetime PTSD and 350 have had no PTSD symptoms. For psychometric approach we used the Clinician Administrated PTSD Scale (CAPS), the Brief Symptom Inventory (BSI), the adapted Hoffman-Lazarus Coping scale and a basic socio-demographic data questionnaire.

Results: There were no significant intergroup (PTSD versus non PTSD) differences in the genotype distribution of MAOA and SLC6A4 gene polymorphisms. The primary finding of our study was that the MAOA short allele (MAOA-S) was nominally significantly associated with the severity of PTSD symptoms in the total subgroup of participants with lifetime PTSD; males for symptoms of hyperarrousal and females with symptoms of re-experience and hyperarousal. In our research the male subsample with current PTSD and MAOA-S genotype had nominally significantly higher scores for some positive coping strategies compared to those carrying the long allele genotype (MAOA-L). There was no significant association between the severity of PTSD symptoms, BSI phenotype, coping scores and the SLC6A4 genotype.

Conclusion: The present results support the notion that MAOA VNTR gene variation modulates development and recovery of posttraumatic stress disorder in a war traumatised population, but did not support a connection between SLC6A4 gene variations and war related PTSD.
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http://dx.doi.org/10.24869/psyd.2019.211DOI Listing
June 2019

Utilization of somatic healthcare in Croatian patients with schizophrenia spectrum disorder, major depression, PTSD and the general population.

BMC Psychiatry 2019 06 28;19(1):203. Epub 2019 Jun 28.

Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.

Background: Utilization of somatic healthcare services is highly predictive of the development of chronic physical illnesses and increased mortality risks. The objective of this study was to assess the differences in healthcare utilization among patients with schizophrenia spectrum disorders (SSD), major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) and the general population in Croatia.

Methods: We enrolled 566 Croatian participants from the general population, 282 with SSD, 178 with MDD, and 86 with PTSD. The primary outcome was a self-reported specialist consultation for non-psychiatric (e.g., somatic) causes within the previous 12 months.

Results: Although SSD patients with chronic physical illnesses were significantly more often hospitalized for physical illness than the general population, the proportion of patients who had a specialist consultation were equal in SSD and the general population. MDD and PTSD patients had significantly higher adjusted odds for specialist consultation than the general population and SSD patients (MDD compared to SSD: OR = 2.14; 95% CI 1.27-3.59; PTSD compared to SSD: OR = 2.03; 95% CI 1.00-4.10).

Conclusions: SSD patients' utilization of somatic healthcare is equal to the general population, despite their increased healthcare needs. However, their utilization is lower than in MDD and PTSD patients and, therefore, probably not adequate.

Trial Registration: The study protocol was registered at ClinicalTrials.gov ( NCT02773108 ) on May 16, 2016.
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http://dx.doi.org/10.1186/s12888-019-2190-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599369PMC
June 2019

Anhedonia in Schizophrenia: Mini-Review.

Psychiatr Danub 2019 Jun;31(Suppl 2):143-147

University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia.

The perception of reward exerts a powerful influence on human behavior. While anhedonia might occur in healthy individuals, its prevalence and severity are much higher in psychiatric patients, particularly those with depression and schizophrenia. Anhedonia is a negative symptom, and presumably a trait marker in schizophrenia. Recent research confirmed that anhedonia is a complex construct, consisting of anticipatory, consummatory, and reward learning components. In general, schizophrenia patients show anticipation deficits, and a substantial portion of them have physical (PA) and social anhedonia (SA). The relationship between anhedonia and psychopathology appears bidirectional. While gene-environment interactions affect reward circuity, anhedonia modulates clinical features, such as suicidality and nicotine consumption. Future clinical research employing longitudinal designs may shed more light on the dynamics and treatment of anhedonia in schizophrenia.
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June 2019

Smoking in Schizophrenia: an Updated Review.

Psychiatr Danub 2018 Jun;30(Suppl 4):216-223

Department of Psychiatry, University Hospital Centre Zagreb, Kispaticeva 12, 10 000 Zagreb, Croatia,

Patients with schizophrenia continue to have the highest rate of both smoking and heavy nicotine dependence. The interaction between smoking and schizophrenia is complex. There is evidence of the shared genetic background. Recent preclinical and clinical research has further investigated self-medication hypothesis, given that nicotine might alleviate cortical dysfunction. While prior research indicated some favorable effects of smoking on cognitive performance, particulatly on attention/vigilance, recent studies did not confirm those findings. Lower severity of negative symptoms in smokers was not confirmed across studies. Cigarette smoking decreases clozapine and olanzapine concentrations. There is no consistent evidence of favorable effects of nicotine on symptoms in schizophrenia, but the evidence of detrimental effects of smoking on general health is highly consistent. Smoking cessation should be a priority in patients with schizophrenia.
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June 2018

Nicotine dependence in Croatian male inpatients with schizophrenia.

BMC Psychiatry 2018 01 22;18(1):18. Epub 2018 Jan 22.

Department of Clinical Psychology and Psychiatry, Zhejiang University College of Medicine, Hangzhou, China.

Background: Patients with schizophrenia have the highest known rates of cigarette smoking, but less is known about their smoking behavior and the differences across geographical regions, including Croatia. The aim of this study was to compare patterns of nicotine dependence between patients with schizophrenia and healthy individuals, and to determine the relationship between clinical presentation and the severity of smoking.

Methods: This cross-sectional study included 182 recently hospitalized male inpatients and 280 healthy males, who were daily smokers. All participants have fulfilled the Fagerstrom Test for Nicotine Dependence (FTND). Patients were also evaluated by the Positive and Negative Syndrome Scale (PANSS).

Results: Patients had higher FTND total score (p = 0.010), smoked their first cigarette earlier in the morning (p = 0.000), consumed higher number of cigarettes (p = 0.000), while healthy subjects had more difficulties to refrain from smoking in places where it is forbidden (p = 0.000) and smoked more even when they were sick (p = 0.000). While severe dependence was more prevalent in the patient group, light dependence was more frequent in control subjects (p = 0.04). Smoking behavior was not associated with either PANSS total score or any of its subscales and items.

Conclusions: Smokers with schizophrenia differ from healthy smokers in both smoking behavior and level of dependence. Longitudinal studies are needed to shed more light on the complex relationship between smoking and psychopathology in schizophrenia.
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http://dx.doi.org/10.1186/s12888-018-1606-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778660PMC
January 2018

Cardiovascular Disease Risk Factors in Patients with Posttraumatic Stress Disorder (PTSD): A Narrative Review.

Psychiatr Danub 2017 Dec;29(4):421-430

School of Medicine, University of Zagreb, Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia, Croatia.

Posttraumatic stress disorder (PTSD) is a chronic condition related to severe stress and trauma. There is a mounting evidence about increased prevalence and mortality from cardiovascular diseases (CVD) in patients with PTSD. This review summarizes the current data on possible relations between PTSD and increased risks of CVD, including biological, psychological and behavioral factors. Biological factors refer to increased prevalence of metabolic syndrome (MetS), hypertension, elevation of pro-inflammatory cytokines and homocysteine levels. Peripheral Brain-derived neurotropic factor (BDNF), serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and quantitative electroencephalogram (qEEG) are promising surrogate markers of increased cardiovascular risk. Among psychological factors, some personality traits, such as neuroticism and trait impulsivity/hostility, contribute to the development of PTSD, and are associated with general cardiovascular distress. Recently, type-D (distressed) personality is usually investigated in relation to cardiovascular morbidity, but in populations other than PTSD patients. Behavioral factors refer to unhealthy life-styles, encompassing high smoking rate, drug substances abuse and addiction, physical inactivity and unhealthy diet. The relationships among all these factors are complex and yet incompletely taken into consideration. Because of a high prevalence of CVD in patients with PTSD, there is a strong need for a more intensive focus on this vulnerable population in both primary and secondary cardiovascular prevention as well as in effective treatment possibilities.
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http://dx.doi.org/10.24869/psyd.2017.421DOI Listing
December 2017

Monoamine Oxidase A Gene Methylation and Its Role in Posttraumatic Stress Disorder: First Evidence from the South Eastern Europe (SEE)-PTSD Study.

Int J Neuropsychopharmacol 2018 05;21(5):423-432

Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.

Background: Posttraumatic stress disorder is characterized by an overactive noradrenergic system conferring core posttraumatic stress disorder symptoms such as hyperarousal and reexperiencing. Monoamine oxidase A is one of the key enzymes mediating the turnover of noradrenaline. Here, DNA methylation of the monoamine oxidase A gene exonI/intronI region was investigated for the first time regarding its role in posttraumatic stress disorder risk and severity.

Methods: Monoamine oxidase A methylation was analyzed via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells in a total sample of N=652 (441 male) patients with current posttraumatic stress disorder, patients with remitted posttraumatic stress disorder, and healthy probands (comparison group) recruited at 5 centers in Bosnia-Herzegovina, Croatia, and the Republic of Kosovo. Posttraumatic stress disorder severity was measured by means of the Clinician-Administered Posttraumatic Stress Disorder Scale and its respective subscores representing distinct symptom clusters.

Results: In the male, but not the female sample, patients with current posttraumatic stress disorder displayed hypermethylation of 3 CpGs (CpG3=43656362; CpG12=43656514; CpG13=43656553, GRCh38.p2 Assembly) as compared with remitted Posttraumatic Stress Disorder patients and healthy probands. Symptom severity (Clinician-Administered Posttraumatic Stress Disorder Scale scores) in male patients with current posttraumatic stress disorder significantly correlated with monoamine oxidase A methylation. This applied particularly to symptom clusters related to reexperiencing of trauma (cluster B) and hyperarousal (cluster D).

Conclusions: The present findings suggest monoamine oxidase A gene hypermethylation, potentially resulting in enhanced noradrenergic signalling, as a disease status and severity marker of current posttraumatic stress disorder in males. If replicated, monoamine oxidase A hypermethylation might serve as a surrogate marker of a hyperadrenergic subtype of posttraumatic stress disorder guiding personalized treatment decisions on the use of antiadrenergic agents.
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http://dx.doi.org/10.1093/ijnp/pyx111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932467PMC
May 2018

The Effects of Electroconvulsive Therapy Augmentation of Antipsychotic Treatment on Cognitive Functions in Patients With Treatment-Resistant Schizophrenia.

J ECT 2018 03;34(1):31-34

Objectives: Treatment-resistant schizophrenia (TRS) continues to be a challenge in modern psychiatry. Most of these patients have severe neurocognitive deficits. Electroconvulsive therapy (ECT) has proved effective and safe in the treatment of TRS, but because of potential neurocognitive adverse effects, it is associated with many controversies. The aim of this prospective, open study was to evaluate the effects of ECT augmentation of antipsychotics on cognitive functions in patients with TRS.

Methods: Overall, 31 inpatients with TRS were included, 16 men, with an average (SD) age of 34.1 (11.187) years. The evaluation of clinical symptoms and global impression, as well as verbal memory, visual memory, working memory, psychomotor speed, verbal fluency, and executive functioning, was conducted before and after the completion of ECT treatment.

Results: We ran a series of paired-samples t tests, and the Bonferroni adjustment for multiple comparisons reduced the significance level to P = 0.004. The neurocognitive domains that demonstrated statistically significant improvement were immediate and delayed verbal memory, and executive functioning, whereas statistical trend was observed for visual memory and psychomotor speed. None of the neurocognitive functions exhibited significant deterioration after the ECT treatment. Electroconvulsive therapy was effective in reducing general symptoms of schizophrenia, resulting in more than 30% decrease in the overall symptom severity measured by the Positive and Negative Syndrome Scale.

Conclusions: Notwithstanding some limitations of this study, the combination of ECT and antipsychotics has improved several neurocognitive domains, without evidence of worsening of any cognitive functions.
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http://dx.doi.org/10.1097/YCT.0000000000000463DOI Listing
March 2018
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