Silia Vitoratou

The Brain-derived Neurotrophic Factor (BDNF) modulates cognitive processes and is associated with increased risk of schizophrenia. Childhood trauma (CT) is frequent in patients with psychosis and severely affects course and outcome. We investigated the hypothesis that BDNF is associated with both CT and cognitive deficits in a sample of first-episode psychosis (FEP) cases and unaffected controls. Participants with FEP and healthy controls were recruited between August 2008 and July 2011 from South London, UK. Childhood traumatic events were detected using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q). Neuropsychological data were also collected. BDNF plasma levels were measured from fasting blood samples. Data were available on 87 FEP patients and 152 controls. Our results showed a significant effect of separation (F=5.5; df=1,115; p=.02), physical (F=4.7; df=1, 118; p=.03) and sexual abuse (F=5.4; df=1,117; p=.02) on BDNF levels with lower levels among those who experienced the traumatic event compared to those who did not. Physical abuse predicted lower plasma levels of BDNF (β=-.30; p=.03) whereas sexual and/or physical abuse showed a trend (β=-.26; p=.06) in FEP patients but not in unaffected controls. No association between BDNF plasma levels and cognitive functions was found among patients with FEP and controls. Our findings suggest the possible involvement of BDNF in the onset of first-episode psychosis in individuals exposed to early trauma and propose BDNF as a potential clinical biomarker to detect the detrimental effects of CT on human brain plasticity.

Evaluation of mental health services based on patients' needs assessments has never taken place in Greece, although it is a crucial factor for the efficient use of their limited resources. To examine the inter-rater and test-retest reliability and the concurrent/convergent validity of the Greek research version of the Camberwell Assessment of Need-Research (CAN-R). A total of 53 schizophrenic patient-staff pairs were interviewed twice to test the inter-rater and test-retest reliability of the Greek version of the CAN-R. The World Health Organization Quality of Life-Brief Form (WHOQOL-BREF) and World Health Organization Disability Assessment Schedule-2.0 (WHODAS-2.0) were administered to the patients to examine concurrent validity. The inter-rater and test-retest reliability of patient and staff interviews for the 22 individual items and the eight summary scores of the instrument's four sections were good to excellent. Significant correlations emerged between CAN scores and the WHOQOL-BREF and WHODAS-2.0 domains for both patient and staff ratings, indicating good concurrent validity. Our results suggest that the Greek version of the CAN-R is a reliable instrument for assessing mental health patients' needs. Moreover, it is the first CAN-R validity study with satisfactory results using WHOQOL-BREF and WHODAS-2.0 as criterion variables.

In this work we consider Cloninger's psychobiological model, which measures two dimensions of personality: character and temperament. Temperament refers to the biological basis of personality and its characteristics, while character refers to an individual's attitudes towards own self, towards humanity and as part of the universe. The Temperament and Character Inventory-Revised-140 (TCI-R-140) was administered to 3 divergent samples: a general population sample, a sample of male conscripts and a sample of individuals attending a substance abuse rehabilitation programme. Score differences among the three samples were assessed controlling for age and gender and reliability coefficients are reported. The latent structure was studied in all samples, using exploratory and confirmatory factor analysis methods (EFA and CFA respectively). The proposed structure was partially replicated via EFA. CFA however indicated less than satisfactory fit, as in previously reported results. To i...

There is growing interest in the connection between neurological soft signs (NSS) and schizophrenia spectrum disorders such as schizotypal personality disorder. The association between NSS and schizotypy was investigated in a subgroup of 169 young healthy male military conscripts included in the Athens Study of Psychosis Proneness and Incidence of Schizophrenia. During their first 2 weeks in the National Basic Air Force Training Centre (T(1)-first assessment), subjects completed the Schizotypal Personality Questionnaire (SPQ), the Symptom Checklist-90-Revised (SCL-90-R), and the Raven's Progressive Matrices (RPM). Then, 2 years later (T(2)-second assessment), at the time of military discharge, they were tested for NSS with the Neurological Evaluation Scale (NES) and reevaluated with the SPQ, the SCL-90-R and additionally the Structured Clinical Interview for Personality Disorders (SCID-II) for the Diagnostic and Statistical Manual of Mental Disorders Third Edition, Revised (DSM-III-R). NSS were more prominent in conscripts with high schizotypy; scores on Sequencing of Complex Motor Acts (SCMA) and the "Other Soft Signs" (OSS) subscales were correlated with high schizotypy at both T(1) and T(2). Increased levels of SCMA as well as the total NSS score were correlated at both T(1) and T(2) with the interpersonal SPQ factor (reflecting negative schizotypy). The findings support the proposal that negative schizotypy might be associated with subtle neurodevelopmental abnormalities.

Background
In this work we consider Cloninger's psychobiological model, which measures two dimensions of personality: character and temperament. Temperament refers to the biological basis of personality and its characteristics, while character refers to an individual's attitudes towards own self, towards humanity and as part of the universe.

Methods
The Temperament and Character Inventory-Revised-140 (TCI-R-140) was administered to 3 divergent samples: a general population sample, a sample of male conscripts and a sample of individuals attending a substance abuse rehabilitation programme. Score differences among the three samples were assessed controlling for age and gender and reliability coefficients are reported. The latent structure was studied in all samples, using exploratory and confirmatory factor analysis methods (EFA and CFA respectively).

Results
The proposed structure was partially replicated via EFA. CFA however indicated less than satisfactory fit, as in previously reported results. To improve the fit, the path diagram was augmented to account for multiple factor complexity, as suggested by the EFA results in all samples. While retaining the original seven-factor structure, the augmented model provided adequate fit. The consistency of the inventory was satisfactory in all samples. Evidence for the construct validity was found in relation to aggression.

Conclusions
This is the first study to conclude in adequate fit, after allowing for the indicators to load on more than one factor within each dimension. While cross-national differences apply, our results were similar (when comparable) with previously reported ones in the literature.

Within the ASPIS (Athens Study of Psychosis Proneness and Incidence of Schizophrenia) we sought out to examine in accordance with previous reports if a deviation from dextrality is associated with an augmented endorsement of self rated schizotypal personality traits in a large population of 1129 young male army recruits. Schizotypal traits were assessed using the Schizotypal Personality Questionnaire and hand preference membership was determined by applying stringent criteria derived from the Annett Handedness Questionnaire and the Porac–Coren questionnaire of lateral preferences. By adopting three different definitions of hand preference membership, we confirmed an association between mixed handedness and increased schizotypal personality traits, and in particular with Disorganization schizotypy that encompasses aspects of self perceived difficulties in verbal communication. Non-verbal cognitive ability, as indexed by measurement of non-verbal IQ, sustained attention and working memory was not associated with hand preference. We argue that a deviation from normal cerebral lateralization, as indexed by mixed handedness, is associated with mild sub clinical language dysfunction, rather than non-verbal cognitive ability, and this might be relevant to the expression of psychosis phenotype.

There is growing interest in the connection between neurological soft signs (NSS) and schizophrenia spectrum disorders such as schizotypal personality disorder. The association between NSS and schizotypy was investigated in a subgroup of 169 young healthy male military conscripts included in the Athens Study of Psychosis Proneness and Incidence of Schizophrenia. During their first 2weeks in the National Basic Air Force Training Centre (T(1)-first assessment), subjects completed the Schizotypal Personality Questionnaire (SPQ), the Symptom Checklist-90-Revised (SCL-90-R), and the Raven's Progressive Matrices (RPM). Then, 2years later (T(2)-second assessment), at the time of military discharge, they were tested for NSS with the Neurological Evaluation Scale (NES) and reevaluated with the SPQ, the SCL-90-R and additionally the Structured Clinical Interview for personality disorders (SCID-II) for Diagnostic and Statistical Manual of Mental Disorders Third Edition, Revised (DSM-III-R) personality disorders. NSS were more prominent in conscripts with high schizotypy; scores on Sequencing of Complex Motor Acts (SCMA) and the "Other Soft Signs" (OSS) subscales were correlated with high schizotypy at both T(1) and T(2). Increased levels of SCMA as well as the total NSS score were correlated at both T(1) and T(2) with the interpersonal SPQ factor (reflecting negative schizotypy). The findings support the proposal that negative schizotypy might be associated with subtle neurodevelopmental abnormalities.

The present study assesses the psychometric properties and factor structure of the Greek version of the Cardiac Anxiety Questionnaire (CAQ). The questionnaire was administered to 598 healthy individuals from 15 different regions of Greece with a measure of socioeconomic characteristics and the Symptom Checklist-90-Revised (SCL-90-R). The sample was split into two random halves, and exploratory factor analysis indicated a three-factor solution. This solution was tested using a confirmatory factor analysis on the second half of the sample. In terms of latent dimensions, the Greek version retains the three-factor structure as proposed by the initial authors. However, adequate fit was achieved only after omitting eight items. The shorter (10-item) version was submitted to further analysis. The shorter version provided satisfactory internal reliability and evidence indicating the validity of the scale with respect to SCL-90-R subscales. The stability of the questionnaire was verified by a high test-retest reliability over a 3-mo. period (r = .86). Sex and age differences were assessed. The 10-item version appears to be a practical, brief tool for clinical use.

n view of ICD-11 revision, we evaluate whether the 18 DSM-IV diagnostic items retained by DSM-5 could be further improved (i) in predicting ADHD 'caseness' and 'impairment' and (ii) discriminating ADHD without CD (ADHD - CD) cases from ADHD with CD (ADHD + CD) cases. In a multi-centre study sample consisting of 1497 ADHD probands and 291 unaffected subjects, 18 diagnostic items were examined for redundancy; then each item was evaluated for association with caseness, impairment and CD status using Classical Test Theory, Item-Response Theory and logistic regression methods. First, all 18 DSM-IV items contributed significantly and independently to the clinical diagnosis of ADHD. Second, not all the DSM-IV items carried equal weighting. "Often loses things", "forgetfulness" and "difficulty sustaining attention" mark severity for Inattentiveness (IA) items and "often unduly noisy", "exhibits a persistent pattern of restlessness", "leaves seat in class" and "often blurts out answers" for Hyperactivity/Impulsivity (HI) items. "Easily distracted", "inattentive to careless mistakes", "often interrupts" and "often fidgets" are associated with milder presentations. In the IA domain, "distracted" yields most information in the low-severity range of the latent trait, "careless" in the mid-severity range and "loses" in the high-severity range. In the HI domains, "interrupts" yields most information in the low-severity range and "motor" in the high-severity range. Third, all 18 items predicted impairment. Fourth, specific ADHD items are associated with ADHD + CD status. The DSM-IV diagnostic items were valid and not redundant; however, some carried more weight than others. All items were associated with impairment.

According to the stress-diathesis hypothesis, depression and suicidal behavior may be precipitated by psychosocial stressors in vulnerable individuals. However, risk factors for mental health are often gender-specific. In the present study, we evaluated common risk factors for female depression in association with depressive symptoms and suicidal ideation in a community sample of women. The sample was composed by 415 women evaluated for mood disorders (MDs), depressive symptoms and suicidal ideation by structured interviews and the Beck depression inventory II (BDI II). All women also filled in the Eysenck personality questionnaire to evaluate neuroticism and were interviewed for social contact frequency and stressful life events (SLEs). In the whole sample, 19% of the women satisfied criteria for MD and suicidal ideation was reported by 12% of the women. Though stressful life events, especially personal and interpersonal problems, and poor social network were associated with all the outcome variables (mood disorder, depressive symptomatology and suicidal ideation), neuroticism survived to all multivariate analyses. Social network, together with neuroticism, also showed strong association with depressive severity, independently from current depressive state. Though we were unable to compare women and men, data obtained from the present study suggest that in women neurotic traits are strongly related to depression and suicidal ideation, and potentially mediate reporting of stressful life events and impaired social network. Independently from a current diagnosis of depression, impaired social network increases depressive symptoms in the women.