Women who have experienced childhood sexual abuse (CSA) have an increased risk of alcoholism and antisocial personality disorder (ASPD). Among male subjects, a functional polymorphism (MAOA-LPR, monoamine oxidase A linked polymorphic region) in the promoter region of the monoamine oxidase A gene (MAOA) appears to moderate the effect of childhood maltreatment on antisocial behavior. Our aim was to test whether MAOA-LPR influences the impact of CSA on alcoholism and ASPD in a sample of 291 women, 50% of whom have experienced CSA; we also tested whether haplotypes covering the region where both MAOA and monoamine oxidase B (MAOB) genes are located predict risk of alcoholism and ASPD better than the MAOA-LPR locus alone. Participants included 168 alcoholics (39 with ASPD (antisocial alcoholics) and 123 controls (no alcoholics, no ASPD). Antisocial behavior was also modeled as a continuous trait: ASPD symptoms count. The MAOA-LPR low activity allele was associated with alcoholism (P = 0.005), particularly antisocial alcoholism (P = 0.00009), only among sexually abused subjects. Sexually abused women who were homozygous for the low activity allele had higher rates of alcoholism and ASPD, and more ASPD symptoms, than abused women homozygous for the high activity allele. Heterozygous women displayed an intermediate risk pattern. In contrast, there was no relationship between alcoholism/antisocial behavior and MAOA-LPR genotype among non-abused women. The MAOA-LPR low activity allele was found on three different haplotypes. The most abundant MAOA haplotype containing the MAOA-LPR low activity allele was found in excess among alcoholics (P = 0.008) and antisocial alcoholics (P = 0.001). Finally, a MAOB haplotype, which we termed haplotype C, was significantly associated with alcoholism (P = 0.006), and to a lesser extent with antisocial alcoholism (P = 0.03). In conclusions, MAOA seems to moderate the impact of childhood trauma on adult psychopathology in female subjects in the same way as previously shown among male subjects. The MAOA-LPR low activity allele appears to confer increased vulnerability to the adverse psychosocial consequences of CSA. Haplotype-based analysis of the MAOA gene appeared to strengthen the association, as compared to the MAOA-LPR locus alone. A MAOB haplotype was associated with alcoholism independently from ASPD.

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Negative rather than affective symptomatology may be a useful construct to differentiate between schizophrenia or schizoaffective disorders from mood-incongruent psychotic mania or mixed mania.

Our results show a major finding that repeated, but not single, Duloxetine treatment increases the level of BDNF in the prefrontal cortex.

Background: Although life events have been consistently reported as precipitating factors for most psychiatric disorders, there is no comprehensive investigation of the relationship between severe life events and psychiatric disorders in the general population. Methods: This is a community-based study of psychiatric disorders among a cohort representative of adults in an Italian town. A total of 2,363 subjects out of 2,500 selected to be representative of the population living in Sesto Fiorentino, central Italy, were interviewed by their own general practitioner using the Mini International Neuropsychiatric Interview. Of the 613 subjects, 609 who resulted positive for any psychiatric disorders and 123 out of a random sample of 130 negatives were re-interviewed by the psychiatrists using the Florence Psychiatric Interview. The Florence Psychiatric Interview was used to explore each distinct psychiatric episode. Life events were recorded in detail by a specific interview. Results: During the year prior to the onset of the first psychiatric disorder, 35.8% of cases suffered from at least a severe event, compared with 12.2% of non-cases during a comparable period (OR = 4.0, 95% CI = 2.3–7.1). The excess of life events occurred for almost all the diagnostic categories. The same results were reproduced even when only the ‘independent’ life events were considered. The distribution of the events through the 12 months taken into account showed an even distribution of events among non-cases, whereas there was a clear accumulation in the last 3 months prior to the onset of the pathology in the cases. Conclusions: Life stress is one of the main precipitating factors of psychopathology.

The formation of social bonding is fundamental for several animals, including humans, for its relevant and obvious impact upon reproduction and, thus, survival of the species. Recent data would suggest that oxytocin might be one of the mediators of this process. Given the paucity of data on the possible involvement of oxytocin in human attachment, the present study was aimed to explore the possible relationships between the plasma levels of this neuropeptide and romantic attachment in healthy subjects. Forty-five healthy subjects who volunteered for the study, were included in the study. The romantic attachment was assessed using the Italian version of the so-called "Experiences in Close Relationships" (ECR), a self-report questionnaire for measuring this parameter in adults. The results showed that attachment anxiety and oxytocin are positively linked in romantic attachment to a statistically significant degree (r = 0.30, p = 0.04), that is, the higher the oxytocin levels the higher the score on the anxiety scale of the ECR. The authors suggest the hypothesis that this link represents one of the biological processes resulting in those rewarding emotions related to romantic attachment.

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Sir: There are many reasons why people with schizophrenia may have problems with food and weight. However, few empirical studies have examined the potential comorbidity between eating disorders and schizophrenia. Recent advances in the pharmacotherapy of schizophrenia have altered the side effect profiles of patients taking the newer generation of atypical antipsychotic drugs compared with older, conventional drugs. The older concerns with motor side effects have been replaced by problems even more relevant than before with overeating, obesity, and type 2 diabetes mellitus and its associated complications. 1 Considering that overeating and obesity can be the features of eating disorders, knowledge of an association between schizophrenia and these disorders can lead to earlier identification of the comorbid conditions and prevention of other likely complications. Method. We evaluated a sample of 31 outpatients (25 men with a mean ± SD age of 34.8 ± 9.2 years and 6 women with a mean ± SD age of 41.1 ± 10.1 years) after obtaining informed consent and institutional review board approval. All were diagnosed as having schizophrenia by experienced clinicians using the Structured Clinical Interview for DSM-IV. 2 Each of these subjects was administered the semistructured Binge Eating Clinical Interview (BEDCI) 3 to determine the presence or absence of binge-eating disorder. The diagnosis of bulimia nervosa was made by clinicians experienced in treating these conditions, again using the BEDCI. While we have suggested that the differentiation between binge-eating disorder and bulimia nervosa, nonpurging type (BN-NP), may be artificial, 4 for the purposes of this communication, we have relied on the existing classification system (DSM-IV). Additional assessment was performed with the Eating Disorders Inventory (EDI). 5 Data were gathered from September through December 2001. Results. Most patients (71%; N = 22) were overweight as defined by a body mass index (BMI) of > 25. Sixty-two percent (N = 19) were obese as defined by a BMI of > 27. Five of the obese subjects (all males), representing 16% of the sample, were diagnosed with binge-eating disorder or BN-NP. Three of these patients developed binge eating after the onset of treatment with atypical antipsychotics. Specific items on the BEDCI and the EDI reflected the subjects' attitudes toward eating and weight. All 5 patients with binge-eating disorder/BN-NP and 5 other patients (32% of the entire sample) had scores indicating that weight and shape affected their self-esteem. The patients with binge-eating disorder displayed low drive for thinness and body dissatisfaction scores on the EDI, reflecting either an attitude of giving up on dieting and concerns with the body or never having been concerned with these issues; this attitude is not unusual for males.