Volume 21, Issue 2, June 2019

Editoral in Hungarian

Addiktofóbia: a gyógyszerre szokástól való félelem Lazáry Judit

Abstract

A pszichiátriai betegek ellátása során talán a legritkább esetben találkozunk a pontos gyógyszersze­ déssel, hiszen betegeink legtöbbször túlszedik, vagy nem szedik az általunk javasolt gyógyszert. A gyógyszerabúzus vagy ­dependencia jól ismert probléma, melynek etiológiájával, következmé­ nyeivel széleskörben foglalkozik az irodalom. További gyakori szituáció, amikor a kezelés elutasítása olyan kórképekhez társul, mely esetekben a betegségbelátás hiánya áll a háttérben (pl.: szkizofrénia). Ugyanakkor pszichiáterként igen gyakran szembesülünk egy harmadik betegcsoporttal, amikor a páciens elutasítja vagy bizalmatlan a javasolt gyógyszerrel szemben, és arra hivatkozik, hogy „fél, hogy rászokik a gyógyszerre”, vagy „attól tart, hogy függővé válik a gyógyszerektől”. Az esetek több­ ségében ez az érzés vagy előítélet az addiktofóbia jelenségkörébe tartozik, mely fogalmat néhány éve írták le először a szakirodalomban. Ebben az esetben az együttműködés nem a betegséghez köthető (az elnevezésben a „fóbia” szó nem egy specifikus kórképre utal), sokkal inkább tájékozatlanság, illetve társadalmi, kulturális hatások következménye. A negatív attitűddel jellemezhető ellenérzés lényege, hogy irracionális, vagy legalábbis túlértékelt tartalmak és/vagy elégtelen információ alapján hoz döntést a páciens a tudományosan megalapozott szakmai javaslatot figyelmen kívül hagyva. Emellett szintén jellemző, hogy azok a pszichés zavarok, melyek jelentős szenvedést okozva orvoshoz fordulásra késztették a beteget, progrediálnak az addiktofóbia okán vesztett idő miatt. A páciensek ilyenkor jellemzően hónapokig, akár évekig próbálkoznak általuk kevésbé addiktívnak tartott techni­ kák alkalmazásával a gyógynövényes készítményektől a diétákon át a csontkovácsig, igen komoly anyagi áldozatot vállalva.

Gene-sex interaction in Hypercompetitive Attitude suggests beneficial effect of the DRD4 7-repeat allele in adaptation

Julianna Bircher, Eszter Kotyuk, Marta Fulop, Andrea Vereczkei, Zsolt Ronai, Katalin VArga and Anna Szekely

Abstract

1 Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
2 Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
3 Department of Clinical Psychology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
4 MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary 5 Institute for Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary
6 Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary

Twin studies provide evidence for the heritability of social attitudes, e.g. competitiveness, however, there are no psychogenetic association results linking competitive attitudes to ge- netic polymorphisms. Candidate gene studies report association with competitiveness-related phenotypes, risk taking for example was linked with the 7-repeat allele of the dopamine D4 receptor gene. This polymorphism has been studied extensively with novelty seeking and certain psychiatric disorders, as it plays a crucial role in molecular genetic mechanisms driving behavioral responses to the environment, especially modulating behavior through the reward circuitry. In the present study, we examined association of the DRD4 48-bp VNTR and competitiveness using self-report data from 399 non-related Caucasians. We found an interesting gene-sex interaction: 7-carrier males were more hypercompetitive as compared to non-carriers, while 7-carrier females were less hypercompetitive as compared to non-carriers. This finding remained significant after Bonferroni correction for multiple testing. Interestingly, among females we observed a significant positive correlation between hypercompetitiveness and mood characteristic variables, however, no such relationship could be detected in males. In 7-carrier females the association of hypercompetitiveness and anxiety or depression was more robust as compared to non-carrier females. These results highlight the importance of cultural influences in interpreting gene-sex interaction effects. Our results underlies interaction between genes and the environment; suggesting that the 7-repeat allele plays an important role in adaptivity, enabling sex-specific behavior to social expectations.

(Neuropsychopharmacol Hung 2019; 21(2): 47–58)

Keywords: DRD4 polymorphism, 7-repeat allele competitive attitudes, hypercompetitiveness, self-development competitiveness, gene-sex interaction, adaptivity

Abstract

1 Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
2 Medicinal Plant and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran 3 Department of Pharmacology, School of Pharmacy, Hamadan University of medical sciences, Hamadan, Iran
* These authors contributed equally to this work

Objective: The aim of this study was to investigate the effect of buspirone, as a partial agonist of 5-HT1A receptors, 8-hydroxy-2-[di-n-propylamino]-tetralin (8-OH-DPAT) as an agonist of 5-HT1A receptors and fluoxetine as a selective serotonin reuptake inhibitor on haloperidol-induced extrapyramidal symptoms (EPS) in male Wistar rats. Materials and methods: The experi- ments were performed on 66 male Wistar rats weighing 200-240g. The rats were divided into 11 groups (n=6). Extrapyramidal symptoms were induced by haloperidol injection 1mg/kg intraperitoneally (i.p.). To investigate the effect of serotonergic drugs on haloperidol-induced extrapyramidal symptoms, 8-OHDPAT (1 mg/kg), buspirone (10 mg/kg), and fluoxetine (1 mg/kg) were injected before haloperidol in an acute and 7 consecutive day’s pre-treatment injection(s) mode. Extrapyramidal symptoms such as catalepsy and motor balance were assessed by the bar test and rotarod, respectively. Findings: The results demonstrated that i.p. injection of haloperidol induced significant motor imbalance and catalepsy (p≤0.001) in rats. Data analysis showed that i.p. injection of buspirone (10 mg/kg) significantly decreased catalepsy compared with the control group. The attenuation of haloperidol-induced extrapy- ramidal symptoms was observed with 8-OHDPAT treatment. Treatment with fluoxetine did not affect the motor coordination caused by haloperidol. Conclusion: It may be concluded that buspirone and 8-OHDPAT improves extrapyramidal symptoms in a haloperidol-induced Parkinsonism model probably via activation of 5-HT1A receptors. However, further investiga- tions should be carried out to clarify the exact mechanism of interaction between 5-HT1A and DA receptors.

(Neuropsychopharmacol Hung 2019; 21(2): 59–68)

Keywords: haloperidol, fluoxetine, buspirone, catalepsy, 8-OHDPAT, motor balance, extrapy- ramidal symptoms

Abstract

There is a growing body of data on encephalopathy-related psychiatric syndromes in the literature, however, clinical management of them still remains a great challenge. Although organic background of the rarely identified Cotard-syndrome has been reported in numerous pathological states, Hashimoto-encephalopathy has not been published in association with this clinical phenotype so far. In this paper we present a case of a 44 year old woman, who previously never had a psychiatric disorder and her clinical symptoms corresponded to Cotard II syndrome. She produced psychotic depression with nihilistic doxasmas related to shutting down, clogging and rotting of her organs. These psychiatric symptoms were accompanied by cognitive, motor and vegetative signs, therefore we systematically excluded all organic brain disorders described in the literature. Besides the bizarre mental symptoms we found significantly increased anti-TPO levels in her serum, aspecific pathological signs on  cull MR scans and thyreoid disease in the medical history. After differential diagnostic analyses we diagnosed Hashimoto-encephalopathy (HE), which was confirmed by positive clinical response to steroid therapy. Certain forms of HE (also named as steroid-responsive encephalopathy associated with autoimmune thyreoiditis, SREAT) are frequently associated with psychiatric syndromes but Cotard-syndrome has not been described so far in relation with this disease.
This case raises attention on the significance of autoimmune diseases in the pathomechanism of psychiatric disorders and further highlights the importance of interdisciplinary diagnostic methods in the psychiatry.

Keywords: Cotard symptom, Cotard syndrome, Hashimoto-encephalopathy, SREAT, anti-TPO,
organic psychiatric disorder

Abstract

IQ is a psychological indicator with exceptional psychometric properties and substantial real-life predictive power. Behavior genetic results have long suggested that IQ is strongly heritable, that is, inter-individual IQ differences are mostly due to genetic differences, and that the effects of the environment shared by siblings, such as the family’s place of residence or socioeconomic status, is minimal. Recently these observations were confirmed by quantitative genetic studies of unprecedented sample sizes, SNP heritability studies combining quantitative and molecular genetic approaches, and genome-wide association studies identifying specific genetic variants underlying IQ. Genome-wide association studies enable the creation of polygenic scores which correlate with actual cognitive ability at approximately r=0.3.
The increasing understanding of the genetic basis of IQ, especially the use of polygenic scores validates previous quantitative genetic paradigms and clears the path for several applications in psychology, but it may also be the source of bioethical dilemmas.

Keywords: IQ, intelligence, heritability, genetics, GWAS, GCTA, genome-wide association study,
genome-wide complex trait study, polygenic score