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Lennertz L, Grabe HJ, Ruhrmann S, Rampacher F, Vogeley A, Schulze-Rauschenbach S, Ettelt S, Meyer K, Kraft S, Reck C, Pukrop R, John U, Freyberger HJ, Klosterkötter J, Maier W, Falkai P, Wagner M. Perceived parental rearing in subjects with obsessive–compulsive disorder and their siblings. Objective: Perceived parenting in patients suffering from obsessive–compulsive disorder (OCD) is examined. We attempted to overcome some methodological limitations of prior studies by taking age of onset, parental OCD and comorbid depression into consideration. In addition, we included data from unaffected siblings to corroborate information on parental rearing. Method: One hundred and twenty-two cases with OCD and 41 of their siblings as well as 59 healthy controls and 45 of their siblings completed the German short-version of the EMBU (FEE). Results: Obsessive–compulsive disorder cases reported less parental warmth and more parental rejection and control. Further analyses indicated that parenting is also associated with OCD in cases with late onset and cases without parents affected by OCD. OCD cases with comorbid depression described their parents particularly negatively. Data from siblings indicated good validity of perceived parenting in OCD. Conclusion: This study provides further evidence for dysfunctional child rearing being relevant to the development of OCD and depression. [ABSTRACT FROM AUTHOR]

Objective: Subjective quality of life (sQoL) and potentially contributing factors were investigated in individuals putatively in an early (EIPS) or late initial prodromal state (LIPS) and healthy controls (HC). Method: Participants comprised 58 EIPS individuals, 157 LIPS individuals and 87 HC individuals. sQoL was assessed together with locus of control (LoC), coping, demography and psychopathology. Results: Putatively prodromal groups exhibited markedly lower sQoL than HC (all domains P < 0.00001). EIPS and LIPS individuals did not differ significantly. Depression was the most consistent explaining variable of sQoL in EIPS and LIPS individuals. In EIPS individuals, LoC emerged as an additional predictor. Conclusion: Individuals at risk for psychosis experienced a marked impairment of sQoL across all domains. This was evident even in the early state, showed no significant further deterioration during the late state and was predominantly explained by non-specific symptoms. [ABSTRACT FROM AUTHOR]

Objective: Although obsessive–compulsive disorder (OCD) is usually conceptualized as an anxiety disorder some studies suggested it to be a deficit of impulse control. The purpose of this study was to assess impulsiveness in OCD families and compare it to control families. Method: Seventy cases and their 139 relatives were compared with 70 controls and their 134 relatives from a German family study on OCD (German Epidemiologic Network for OCD Studies). All subjects were interviewed and diagnosed according DSM-IV criteria and were administered the Barratt Impulsiveness Scale (BIS) and PADUA-Inventory to assess obsessive-compulsive symptoms. Results: OCD subjects had significantly higher scores of cognitive impulsiveness. However, first-degree relatives of OCD cases and of controls had comparable BIS-11 scores. Significant associations of aggressive obsessions and checking with cognitive impulsiveness were found. Conclusion: OCD is a severe mental disorder that is characterized by a lack of cognitive inhibition. However, impulsiveness does not represent a familial trait in families of OCD subjects. [ABSTRACT FROM AUTHOR]

In children with nocturnal enuresis, a higher rate of minor neurological dysfunction has been found. The aim of this study was to assess timed performance (a measure of motor performance speed) and associated movements using a standardized and reliable instrument. The motor function of 37 children with nocturnal enuresis (27 males, 10 females; mean age 10y 7mo [SD 1y 10mo]; age range 8y-14y 8mo) and 40 comparison children without enuresis (17 males, 23 females; mean age 10y 7mo [SD 1y 6mo]; age range 8y-14y 8mo) was assessed using the Zurich Neuromotor Assessment. Children with nocturnal enuresis showed a slower motor performance than comparison children, particularly for repetitive hand and finger movements. This study provides evidence for a maturational deficit in motor performance in children with nocturnal enuresis. In addition to a maturational deficit of the brainstem, it is proposed that there is a possible maturational deficit of the motor cortex circuitry and related cortical areas in children with nocturnal enuresis. [ABSTRACT FROM AUTHOR]

Nocturnal enuresis is a genetically determined maturational disorder of the central nervous system. Lack of arousal and an inhibition deficit of the micturition reflex have been found as the main dysfunctions leading to wetting during sleep. Both are mediated by nuclei in the brainstem. Therefore, evoked potentials (brainstem auditory evoked potential [BAEP], visual evoked potential [VEP], event-related late acoustic-evoked potential [P300]), and the prepulse inhibition (PPI) of the startle reflex were assessed to further evaluate the brainstem deficit compared with cortical function. Thirty-seven children with nocturnal enuresis, aged 8 years to 14 years 8 months (mean age 10y 7mo [SD 1y 10mo]; 27 males, 10 females) were compared with 40 controls (mean age 10y 7mo [SD 1y 6mo]; 17 males, 23 females). Left interpeak latencies I-III and I-V of the BAEP were increased in children with nocturnal enuresis. VEP measures did not differ between patients and controls. However, children with a positive family history of enuresis showed a shorter latency towards N75 and P100 than children without such a family history. P300 and PPI measures did not differ. We conclude that this strongly supports the postulation of a maturational deficit of the brainstem in nocturnal enuretic children. The increased interpeak latencies I-III and I-V of the BAEP support the hypothesis of an arousal deficit mediated by delayed maturation of brainstem function. Differences in VEP latencies might point towards functional cortical differences in children with a family history of nocturnal enuresis. [ABSTRACT FROM AUTHOR]

Bechdolf A, Köhn D, Knost B, Pukrop R, Klosterkötter J. A randomized comparison of group cognitive-behavioural therapy and group psychoeducation in acute patients with schizophrenia: outcome at 24 months. Acta Psychiatr Scand 2005: 1–7. © 2005 Blackwell Munksgaard. We compared the effects of a brief group cognitive-behavioural therapy (CBT) and a group psychoeducational (PE) programme in acute patients with schizophrenia 2 years after treatment. At 6-month follow-up, the CBT group had shown significantly less re-hospitalization rates and on a descriptive level higher compliance with medication. Eighty-eight in-patients with acute schizophrenia were randomized to receive a therapy envelope of 8 weeks including either 16 sessions of CBT or eight sessions of PE. From the initial sample, 43 patients (48.9%) completed the 24-month follow-up. There were no significant group differences regarding re-admission, symptoms or compliance with medication. However, on a descriptive level patients who received CBT on average experienced 21.8% less re-hospitalizations, 71 days less in hospital and higher compliance ratings at the 24-month follow-up. The significant advantages of CBT at short-term follow-up were lost at long-term follow-up. However, on a descriptive level some advantages for CBT remained after 2 years. [ABSTRACT FROM AUTHOR]

Bechdolf A, Knost B, Kuntermann C, Schiller S, Klosterkötter J, Hambrecht M, Pukrop R. A randomized comparison of group cognitive-behavioural therapy and group psychoeducation in patients with schizophrenia. Acta Psychiatr Scand 2004: 110: 21–28. © Blackwell Munksgaard 2004. Although the efficacy of cognitive-behavioural therapy (CBT) in schizophrenia has been established in a number of studies, no information is available on the differential efficacy of CBT in comparison with patient psychoeduction (PE). Eighty-eight in-patients with schizophrenia were randomized to receive a therapy envelope of 8 weeks including either 16 sessions group CBT or 18 sessions group PE treatment. Assessments took place at baseline, post-treatment and 6 month follow-up. Patients, who received CBT were significantly less rehospitalized than patients in the PE group during the follow-up period. On a descriptive level, CBT resulted in lower relapse rates and higher compliance ratings at post-treatment and at follow-up than PE. Both forms of therapy led to significant psychopathological improvement at post-treatment and at follow-up. The brief group CBT intervention showed some superiority to the PE programme, which could be of considerable clinical and economical importance. [ABSTRACT FROM AUTHOR]

Objective: To compare the lifetime consumption patterns of patients with schizophrenia and multiple substance abuse and multiple substance abusers without schizophrenia. Method: Two hundred and thirty in-patients of a specialized rehabilitation facility for young drug abusers were assessed with regard to their lifetime consumption patterns of 16 different classes of psychoactive drugs. While 110 patients had no diagnosis of a schizophrenic disorder, 120 patients had a comorbidity of multiple substance abuse and schizophrenia. Results: Comorbid patients reported a higher lifetime consumption of hallucinogens, whereas multiple substance abusers without schizophrenia showed a higher lifetime consumption rate of cocaine. Conclusion: The differences found in lifetime consumption patterns between comorbid patients and substance abusers without psychotic disorder do not support the so-called self-medication hypothesis. Instead, the differences in lifetime consumption of certain drugs might be a result of lower social competence and standing in schizophrenic patients and lower ability to procure certain illicit drugs. [ABSTRACT FROM AUTHOR]

Aim: Improvement of social adjustment is a major aim of indicated prevention in young people at risk of developing psychosis. The present study explores the effect of specific cognitive behaviour therapy (CBT) as compared with supportive counselling (SC) on social adjustment in people in a potential early initial prodromal state of psychosis (EIPS) primarily defined by self-experienced cognitive thought and perception deficits (basic symptoms)., Methods: A total of 128 help-seeking outpatients in the EIPS were randomized to receive either specific CBT or SC for 12 months. Social adjustment was assessed with the Social Adjustment Scale II (SAS II) at baseline, time of transition or post treatment, Results: From 113 patients, who completed the SAS II at intake, 67 (59.3%) completed the SAS assessments at time of transition or post treatment. Both specific CBT and SC resulted in improvements in scales of SAS II, with no significant between-group differences post treatment., Conclusions:   Although treatment in specially designed early detection and intervention centres improves functioning of people in the EIPS, specific CBT was not superior to SC. One could hypothesize that additional vocational rehabilitation, case management and involvement of multidisciplinary teams are needed to further improve short-term outcome of specific interventions on this dimension.