bluuebunny/crossref_metadata_2025 huggingface dataset:
S12-03 Individual differences in social affiliation: The role of the A118G polymorphism of the mu-opioid receptor gene (OPRM1)
Authors: Troisi A.
Published: May 2011

Introduction

Most of us find social encounters rewarding, especially when we encounter those with whom we are familiar and have built up a relationship. From an evolutionary point of view, this is not surprising considering that human beings are fundamentally social organisms. Considering that endogenous opioids mediate hedonic responses to a variety of natural rewards, the common A118G polymorphism in the mu-opioid receptor gene (OPRM1) might also modulate individual differences in the capacity to experience social reward.

Aims

In the present study, we hypothesized that, compared to individuals with the A118A genotype, individuals expressing the minor 118G allele had an increased need for affiliation and an increased capacity to experience social reward.

Methods

In a mixed sample (N = 214) of adult healthy volunteers and psychiatric patients, we analyzed the association between the A118G polymorphism of the OPRM1 and two different psychological constructs reflecting individual differences in the capacity to experience social reward.

Results

Compared to individuals expressing only the major allele (A) of the A118G polymorphism, subjects expressing the minor allele (G) had an increased tendency to become engaged in affectionate relationships, as indicated by lower scores on a self-report measure of avoidant attachment, and experienced more pleasure in social situations, as indicated by lower scores on a self-report measure of social anhedonia.

Conclusions

The results reported here are in agreement with the brain opioid hypothesis of social attachment and raise several questions about the maintenance of the A118G polymorphism in the evolution of human social behavior.
Dietary supplementation in alzheimer's disease prevention
Authors: Rymaszewska J. , Jakubik M. , Stanczykiewicz B.
Published: May 2011

Concerning aging society problem of dementia is getting more and more significant. The causes of Alzheimer Disease (AD) are still not well known. The potential role of diet in the prevention of dementia including AD arouses increasing interest. Poly-unsaturated fatty acids (PUFA) are essential for brain growth and development playing an important role as critical modulators of neuronal function and regulation of oxidative stress mechanisms, in brain health and disease. Behavioral research studies with animals proved that ω-3 acids have antioxidant protection on neurons during pathogenesis of AD. DHA diet supplementation in animal models proved that ω-3 acids have positive influence on memory, attention, concentration and locomotor abilities in battery of tests such as 5/9 choice, X- or T-maze and activity wheel. DHA is obtained mainly through dietary intake being not produced by mammals, whereas DHA makes up 60% of fatty acids building neuronal cell membranes. These acids have beneficial effect on cardio-vascular system and may also reduce pathology processes of dementia diseases other than AD. Updated scientific data of ω-3 acids dietary intake in elderly will be presented and discussed.
Dialogue and challenge among different specialities
Authors: Atti A.R.
Published: May 2011

Introduction

Thanks to social, technological, and medical advances occurred during the last century, the aging of the population has become a worldwide phenomenon (Kinsella, 2002). The high socio-economic impact of this demographic transition has recently stimulated a growing interest for the aging process (Lunenfeld, 2008) and elderly mental health has been receiving increasing attention (Mental Health in Older People. Consensus, 2008).

Objective

Old age psychiatry, or psychogeriatric, deals with psychiatric conditions that predate the ageing process such as schizophrenia or depression, and with diseases occurring later in life like dementia and other cognitive disorders. To cope with the increased workload due to older people, Psychiatric Services are required to provide multidisciplinary, comprehensive and integrated care.

Aims

To investigate the attitude of Bologna's Psychiatric Services in the care of elderly affected by psychiatric disorders.

Methods

Self-completed questionnaires administered to psychiatrists.

Results

Psychogeriatric is the second main priority of psychiatry for the new millennium. Psychiatrists working in liason-consultation settings take care of around 20 elderly patients per weeek. Sedation, insomnia and resistant-depression treatment are the most frequent interventions required to psychiatrists by colleagues of other specialities. Psychiatrists report feelings of un-satisfaction and worries for potential drugs side-effects. They “don't like much” dealing with elderly people especially with patients affected by un-treatable conditions such as dementia (narcissistic wound?).

Conclusion

Accessible and responsive services working in liason with other medical specialists, gero-psychiatric nurses, case manager and social workers might be a good response to the increasing needs of elderly with mental health disorders.
Depressive symptoms and quality of life in patients with coronary artery disease after percutaneous coronary interventions
Authors: Dudek D.
Published: May 2011

Depression contributing to cardiovascular disease is a major clinical problem both due to frequent occurrence and serious health effects. Studies confirm a relationship between depressive disorders and risk for the development and unfavorable course of coronary artery disease (CAD) and myocardial infarction.The aim of the study was to assess how the comorbidity of depressive symptoms and CAD influences the quality of life (QoL) in patients after the successful coronary angioplasty (PCI). 227 patients with CAD selected for PCI were enrolled. 156 patients with full clinical and angiographic success and without restenosis within 4 weeks after the interventions were included in one year follow-up. Patients’ status was assessed four times (one day before and at 1, 6 and 12 months after the intervention). Polish version of SF-36, Beck Depression Inventory (BDI), Rosenberg's Self-esteem Scale (RS), Beck's Hopelessness Scale (HS) and Authomatic Thoughts Questionnaires (ATQ) were used.In the whole group QoL after one months after PCI was significantly improved. This tendency persisted in further examinations. There was a significant correlation between SF-36, which measures QoL, severity of depressive symptoms (BDI) and parameters describing depressive thinking style (HS, RS and ATQ). The presence of depressive symptoms at each assessment during follow-up, was associated with the poorer quality of life.Presenting study indicate that depressive symptoms in patients with coronary artery disease significantly affect the quality of life, despite of the successful coronary angioplasty. Optimized comprehensive approach to CAD patients may require psychological assessment and inclusion of adequate psychological or psychiatric interventions.
Measuring the effectiveness of sex offender treatment
Authors: Endrass J. , Rossegger A. , Urbaniok F.
Published: May 2011

Depending on the subject of the evaluation different outcome measures are necessary. Generally recidivism rates are considered to be state of the art in the assessment of forensic therapy effectiveness. In this context, recidivism can be defined differently. Thus a definition may include only new convictions for a specific type of offense or any offense or may even include new charges as well. In the evaluation of sex offender treatments it is often considered to be self-evident to define recidivism as a reconviction or new charge for a sex offense. Some authors however argue - not without reason - to include any type of violent offense in the definition. The evaluation of treatment effectiveness suggests however, also including therapeutic criteria such as level of openness of the patient. Especially openness about sexual fantasies relevant to the sex offense may be a key factor in the treatment of sex offenders. It is suggested that future research in the area include such ‘softer’ criteria as well.
Routine Outcome Monitoring (ROM) in Belgian and Dutch forensic patients
Authors: Goethals K.
Published: May 2011

Introduction

By means of ROM, the efficacy of forensic psychiatric treatment can be measured in domains of risk of recidivism, level of psychopathology, and quality of life. Although, research of the efficacy of this treatment has several methodological pitfalls.

Objectives

To review the literature of ROM in forensic psychiatry; to consider the way of implementing ROM; to present relevant instruments in the domains as mentioned above.

Aims

To investigate whether forensic psychiatric treatment leads to less symptoms, and a decrease of reoffending; to investigate the correlation between degrees of psychopathology and quality of life.

Methods

Patients are recruited from the University Forensic Center (UFC), Antwerp, Belgium, which is a outpatient facility for treatment of sex offenders. In the future patients from other facilities will be included. Several instruments are used to measure the degree of psychopathology, risk of recidivism, and quality of life.

Results

Preliminary results are presented and discussed in this paper.
Definitions of reality
Authors: Oyebode F.
Published: May 2011

Introduction

The nature of reality is an age-old problem. The distinction to be drawn between the external world and our subjective experience raises questions about how far our experience of the phenomenal world corresponds to the objective external world.

Aims

In this talk I will describe Plato's simile of the cave, and use this to examine the nature of reality and of illusion. I will then turn to how reality and illusion are dealt with in literature, drawing examples from Cervantes' Don Quixote, Jose Samarago's Blindness, Sophocles' Oedipus The King, and the works of Borges' & Kafka. I will also critically examining Baudrillard's simulacrum.

Method

This will involve conceptual analysis of the ideas and notions in the texts described above.

Results

We can never be sure of the accuracy and validity of our experiences. This problem is even more acute in the modern world because of the difficulty that consciousness has in distinguishing reality from fantasy.

Conclusion

The philosophical and literary ideas and concepts about reality are of great importance to psychiatrists, not least because of the distortions of reality that many patients experience. I will conclude by emphasizing the implications of these notions for psychiatrists.
Reality in depression
Authors: Cutting J.
Published: May 2011

The presentation will cover 3 aspects of reality:

1)

Reality as resistance;

2)

Reality as actuality;

3)

Reality as correct insight.

A brief consideration of the nature of these in normals will be given.

A descriptive account of the psychopathology of each aspect will be then discussed, with particular emphasis on:

a)

undue resistance in depressive illness;

b)

qualitative differences in actuality, i.e experience of external world and body in schizophrenia;

c)

so-called “depressive realism” as a more correct insight into ones owen actions than is possessed in normals.
Frozen and floating reality in drug addiction
Authors: Di Petta G.
Published: May 2011

Drug abuse is able to modify the state of consciousness and, as a consequence, the sense of reality. The author describes two fundamental modifications of the sense of reality under drug effect: “floating” and “frozen”. The first, “floating” is induced by acute intoxication; the second, “frozen”, is produced by chronic drug dependence. These two reality modifications are described from a phenomenological and a psychopathological perspective. Intentionality, space, time, otherness are described in their different “floating” and frozenstructure. “Floating” patients need of adaequate medical treatment. In conclusion, the author introduces the dasein-group treatment, based upon shared emotions, as a concrete possibility to cure frozen patient.
Primary and enduring negative symptoms in first episode and chronic patients with schizophrenia
Authors: Galderisi S.
Published: May 2011

Negative symptoms of schizophrenia have often been associated with poor functional outcome and poor response to antipsychotic treatment. Studies reporting drug induced significant reduction of negative symptoms after treatment actually refer to negative symptoms secondary to positive, depressive and/or extrapyramidal symptoms. Negative symptoms that do not improve following antipsychotic treatment represent a real challenge for future development of effective treatments. Two approaches have been so far proposed to improve research on these negative symptoms. The first one is based on the identification of primary and enduring negative symptoms, that characterize a schizophrenia subtype known as deficit schizophrenia (DS). The prevalence of DS is 15%–20% in population based samples, but tends to be much lower in first-episode patients. Individuals with DS have worse long-term outcome and poorer response to antipsychotics than those with other forms of schizophrenia. The second approach is based on the identification of persistent negative symptoms, which are likely to be primary, but may be secondary. Few data are available on the prevalence of persistent negative symptoms in patients with schizophrenia. In first episode subjects from the EUFEST study 11% of the study sample showed persistent negative symptoms (PNS). They had poorer functional outcome and lower remission rates than those without PNS after 1 year of treatment. Research on clinical and biological correlated of primary and/or persistent negative symptoms might help in reducing schizophrenia heterogeneity and developing new treatments.
Relationships between negative symptoms and abnormalities in the anticipatory component of reward
Authors: Schlagenhauf F. , Juckel G. , Heinz A.
Published: May 2011

A dysfunction of the dopaminergic reward system has been postulated in the pathophysiology of schizophrenia. A subcortical hyperdopaminergic state in unmedicated schizophrenia patients has been associated with the pathogenesis of positive symptoms and a prefrontal hypodopaminergic state with cognitive and negative symptoms. But negative symptoms like anhedonia have also been hypothesized to be associated with a dysfunction of the mesolimbic dopaminergic system. However, preclinical studies indicate that the mesolimbic dopaminergic system mediates motivation and incentive salience of reward-indicating stimuli rather than the ability to experience pleasure.

Recent neuroimaging findings in schizophrenia patients confirmed dysfunctional activation during reinforcement learning. We used functional magnetic resonance imaging (fMRI) to assess the BOLD response in the ventral striatum of unmedicated schizophrenia patients during presentation of reward-indicating stimuli and during reversal learning. Compared with healthy controls, unmedicated schizophrenics showed reduced ventral striatal activation during presentation of reward-indicating cues, which was negatively correlated with the severity of negative symptoms. During reversal learning unmedicated schizophrenia patients displayed behavioral impairments and reduced activation in the ventral striatum and the ventrolateral PFC. In unmedicated schizophrenic patients, a high striatal dopamine turnover may interfere with neuronal processing of reward-indicating stimuli by phasic dopamine release, thus contributing to negative symptoms as such as loss of drive and motivation.
Assessing functionality in Schizophrenia: The psychosocial remission in Schizophrenia scale (PSRS)
Authors: Barak Y.
Published: May 2011

Background

Remission, both symptomatic and psychosocial, is now an achievable goal in a substantial proportion of schizophrenia patients.

Objective

to develop a brief, clinician rated scale for the assessment of psychosocial remission in schizophrenia (the PSRS). The scale is to match the quantification of symptomatic remission as delineated by the American Psychiatric Association (APA) task force.

Method

a “bank” of 124 questions pertaining to psychosocial remission was derived from published scales reflecting two domains: quality of life (QoL) and activities of daily living (ADL). Psychiatrists, residents, psychiatric nurses and community nurses were presented with the questions. All were asked to choose the 8 items they considered as reflecting the essence of psychosocial remission. Inter-rater reliability of the final scale version was assessed amongst psychiatrists.

Results

the questions' “bank” was reviewed by 429 mental health professionals. The four items found to be most frequently sanctioned in the QoL domain were: a. familial relations (endorsed by 78% of participants), b. understanding and self-awareness (46%), c. energy (58%) and d. interest in every-day life (38%). The four items sanctioned in the I-ADL domain were: a. self-care (86%), b. activism (65%), c. responsibility for medications (54%) and d. use of community services (32%). Inter-rater reliability amongst 70 psychiatrists ranged from 0.67 to 0.83.

Conclusion

the PSRS is an 8-item scale quantifying psychosocial remission in schizophrenia in a manner that complements symptomatic assessment of remission. The PSRS may be useful for both research and clinical evaluation.
The Functional Recovery Scale in Schizophrenia (FRSS): Relationship to panss
Authors: Llorca P.-M. , Samalin L. , Blanc O. ,   EGOFORS Group
Published: May 2011

Schizophrenia is a severe and disabling disorder, which affects multiple functional domains adversely.

Several factors like premorbid functioning and psychopathological symptoms can affect functional outcome. Residual psychopathology after an acute exacerbation has a variable influence, going from a weak correlation to positive symptoms to clear association of negative symptoms with reduced social functioning to widespread influence of cognitive symptoms.

We performed a cross-sectional evaluation in a sample of 296 schizophrenic patients for demographic, functional characteristics (using different scales: Functional Recovery Scale in Schizophrenia (FRSS), Subjective Well-being Scale (SWN-K), Quality of Life Scale (QLS)) and symptomatic (using the Positive and Negative Syndrome Scale (PANSS)). Exploratory multivariate analyses were conducted and a model with “functioning” as a latent variable was proposed and tested. Results: Using the 5 clinical dimensions of the PANSS, negative, cognitive and excitation factors are significant predictors of functioning. The model was constructed with “functioning” defined as a latent variable; indicators are sub-scores on FRSS, SWN-K, QLS and exogenous variables included symptomatology, Duration of Untreated Psychosis and educational level. The negative and cognitive dimensions are highly correlated via the latent variable to the 3 dimensions of functioning evaluated by the FRSS: “daily life”, “social functioning” and “treatment” and the QLS sub-scores (“interpersonal”, “common object”, “instrumental role”). Educational level is significantly linked to functioning but not DUP. The model emphasizes the need for treatment strategies that have an effect on negative and cognitive factors, to improve functioning in schizophrenia.
Patient reported measures and functional remission
Authors: Naber D.
Published: May 2011

Only recently success criteria became more ambitious and include a more thorough consideration of the patient's perspective. Recent data indicate that in addition to the positive influence of a good relationship between doctor and patient, the subjective experience of antipsychotic treatment is a major predictor of compliance.

Among other scales, a self-report instrument has been constructed to evaluate “subjective well-being under neuroleptics” (SWN). Data indicate: a) schizophrenic patients, if no longer acutely psychotic or suffering from severe cognitive deficits, are able to reliably assess their subjective well-being, b) high SWN is correlated with high compliance, c) atypical antipsychotics increase SWN, d) individual improvements of SWN and of PANSS are not strongly related (r = -.30 - -.40), and e) dopamine D2 receptor blockade is highly correlated to reduced SWN (r = .66–.76).

Recent trials reveal the relevance of early improvement of subjective well-being: In a 12-week trial 95% of those with early subjective response (within 4 weeks) showed later subjective and/or psychopathological improvement, but only 9% without early subjective response showed later improvement. In another 3-year trial again psychopathological response as well as symptomatic and functional remission were not only related to young age and treatment with atypical antipsychotics, but mostly to early (within the first 3 months) subjective improvement. Moreover in a five year trial of first episode patients, marked improvement of SWN within the first 6 weeks of antipsychotic treatment was found to be related to enduring remission, while early improvement of PANSS did not predict outcome.
Case presentation on a childhood homicide offender
Authors: Zalsman G.
Published: May 2011

A case presentation of a young homicide offender from Israel will be presented. This young man murdered three adults and 500 cats claiming it was part of a Satanist ritual. Psychiatric assessment of him and his family will be presented.

The neurobiology of aggression in the young will be briefly discussed. Aggression in adolescents has neurobiological, psychological and social roots. Greater aggression is reported in male KO mice which have increased levels of serotonin, dopamine and norepinephrine. A mutation in the MAO A gene is associated with impulsive-aggressive behaviour in males while higher MAO A expression appears to protect against the effects of childhood abuse on development of aggressive behaviors or impulsivity in adulthood in males but not females.
Interventions for childhood behaviour problems
Authors: Resch F.
Published: May 2011

Oppositional defiant disorder and conduct disorder are classified as disruptive disorders. However, they show a wide range of associations with other psychopathological features. Disturbances of emotional regulation, impulse control, narcissism, and paranoid cognitive style may shape the behavioural picture. On the basis of the Heidelberg School Study (n = 6085) those 15 yr old students with externalising behaviour disturbances were analysed regarding internalising behaviour problems, deliberate self harm, suicidal behaviour, living situation, and family problems. Developmental trajectories from infant temperament to adolescent behaviour will be outlined and therapeutic measures like parent training, patient focused cognitive behavioural therapy and multisystemic family interventions will be described on the basis of meta-analytic reviews.
Juvenile sex offenders: Mental health and reoffending
Authors: Hart-Kerkhoffs L.’t , Vermeiren R. , Jansen L. , Doreleijers T.
Published: May 2011

Background

Juvenile sex offending all too often is the reason of public commotion and concern. About 20% of all rapes and 20–50% of cases of child abuse are perpetrated by juveniles. However little is known on the psychiatric characteristics and recidivism rates of these youths. In the present study the prevalence of psychopathology in (subgroups of) juvenile sex offenders and its relation with criminal recidivism two to four years later were investigated.

Methods

Semi-structured psychiatric interviews (K-SADS-PL) and a parent-report questionnaire (CSBQ) were carried out with 106 adolescent sex offenders (mean age 15.0 ± 1.5 years, 60 group offenders, 27 solo rapists, and 19 child molesters) referred to the Dutch child protection agency and juvenile justice institutions. Recidivism was ascertained from registration systems.

Results

Three quarters of juvenile sex offenders met criteria for at least one psychiatric disorder and comorbidity was found in more than half of the subjects. Child molesters showed the highest rates of internalizing disorders and showed most pronounced autism spectrum disorder core symptomatology. Forty percent of juvenile sex offenders had committed multiple sexual offenses, but none recidivated sexually within the 2–4 years after the study. Compared to one time sex offenders, multiple sex offenders were higher in DBD and anxiety disorder.

Conclusion

Child and adolescent psychiatric care should be given to juvenile sex offenders, with particular attention to multiple sex offenders and child molesters. However, the predictive value of psychopathology for sexual recidivism remains unclear and warrants further research.
The usefulness of mood stabilizers in the treatment of bipolar depression
Authors: Cruz N. , Nivoli A. , Vieta E.
Published: May 2011

Aims

Considering bipolar depression a diagnostic and therapeutic challenge, distinct from unipolar depression and associated with significant morbidity and mortality, we aim to systematically review guidelines, consensus meetings and treatment algorithms on the acute treatment of bipolar depression to critically underline the role of mood-stabilizers.

Method

The MEDLINe/PubMed/Index Medicus, PsycINFO/PsycLIT, Excerpta Medica/EMBASE, databases were searched using “depression”, “bipolar”, “mood-stabilizers”, “manic-depressive” and “treatment guidelines” as key words since 2005 onward.

Results

Among mood-stabilizers, the use of lamotrigine is overall recommended as first-line choice. Monotherapy is suggested on the basis of several positives clinical trials, however, pooled data analysis showed that lamotrigine was only modestly useful. Valproate monotherapy is suggested as first-line treatment option in the WFSBP and BAP guidelines, and in combination with lithium or antidepressants, but it is not mentioned among first-line choices neither in monotherapy nor as adjunctive treatment in two guidelines (ICG, NICE).

Lithium monotherapy is suggested in three of all guidelines (ICG, BAP, CANMAT and ISBD) as first-line treatment on the basis of positive evidence, but it is not recommended as first-choice by WFSBP and NICE guidelines. Its combination with lamotrigine, valproate and other agents is instead recommended as first choice treatment.

Conclusions

In summary, mood-stabilizers are considered a key point in the management of bipolar depression, preferably in combination. Despite algorithms evidence-based could be helpful to guide clinicians, they always need the case by case pharmacotherapeutic consideration.
Antipsychotics in the treatment of bipolar depression
Authors: Pacchiarotti I.
Published: May 2011

The Food and Drug Administration (FDA) has not approved any antidepressant for the treatment of bipolar depression. To date, the only antidepressant drug that showed evidence of efficacy in bipolar depression is fluoxetine but only when given combined with olanzapine, which allowed the FDA, but not the EMEA (European Medicines Agency), to approve a fixed dose olanzapine-fluoxetine combination for the treatment of acute bipolar I depression. Quetiapine monotherapy is at present the only both FDA- and EMEA-approved treatment for bipolar depression. In a recent metanalysis on treatment options for bipolar depression, quetiapine and the olanzapine-fluoxetine combination showed the greatest symptomatic improvements.

Aripiprazole showed a 6-week limited superiority compared to placebo, decreasing its effect size at endpoint. The very early onset of action of all tested atypical antipsychotics in the treatment of bipolar depression, even as monotherapy, may highlight an overlapping mechanism of action of these drugs as a potential class effect with independence of the monoaminergic pathways. Results suggest some atypical antipsychotics (quetiapine and olanzapine) may be considered as first line management option in acute bipolar I and/or II depression, even for poor responders subgruoups such as rapid cyclers and patients with psychotic feature.
Meta-analytic studies in depression and the role of placebo response
Authors: Fountoulakis K.
Published: May 2011

During the last few years there is a growing concern about the increasing response to placebo seen in trials of antidepressants and the ever increasing difficulty in detecting the therapeutic signal. Even worse, recently there was much debate on the true usefulness of antidepressant therapy itself, especially after the publication of a meta-analysis by Kirsch et al in 2008. However the re-analysis of these data suggested that the correct drug-placebo difference is 2.18 or 2.68 instead of 1.80. Kirsch et al failed to report that that the change in HDRS score was 3.15 or 3.47 points for venlafaxine and 3.12 or 3.22 for paroxetine, which are above the NICE threshold. It is of prime importance that although a large percentage of the placebo response is due to expectancy this is not true for the active drug and effects are not additive. This might mean a distinct mechanism underlying the placebo and the drug effect. Also, the drug effect is always present and is unrelated to depression severity, while this is not true for placebo. It is interesting that by passing the years there seems to be an increasing absolute both placebo and drug effect but the effect size of the difference remains stable. Meta-analytic studies in larger data sets are necessary in order to further elucidate the relationship between the drug and the placebo response and the nature of the latter.
Functional consequences of genome wide risk variants for neuropsychiatric disordes in the human brain
Authors: Lancaster T. , Linden D.
Published: May 2011

Introduction

Recent advances in DNA sequencing have allowed large neuropsychiatric populations to be screened for genetic variants that may influence the progression of mental disorders. Recent GWAS (Genome Wide Association Studies) have identified risk loci for schizophrenia (SZ), Bipolar disorder (BD) and Alzheimer's disease (AD). Objectives

A major concern is to understand how these recently identified risk variants influence vulnerability to neuropsychiatric disorders.

Aims

Common risk variants may contribute to intermediate phenotypes associated with neuropsychiatric disorders. A key aim is to investigate whether individuals expressing susceptibility loci demonstrate similar deficits to those of patients. This may help to elucidate new pharmacological pathways.

Methods

A combination of neuroimaging (fMRI & EEG) and behavioural studies (emotional working memory task, visual encoding efficiency and decision-making ability) were used to probe risk carriers for GWAS validated risk loci associated with SZ, BD and AD. The paradigms were previously validated as methods that neuropsychiatric populations displayed deficits in.

Results

GWAS risk SNP carriers displayed patterns of behavioural/neurophysiology typically seen in their respective neuropsychiatric populations. The risk carrier populations display less overt phenotypes than patients or first-degree relatives, nevertheless displayed small but significant trait effects typically observed in individuals with high levels of genetic risk.

Conclusions

GWAS risk carriers display small but significant effects that reflect a sub-clinical phenotype typically seen in individuals with high genetic risk. Imaging techniques such as fMRI are useful in measuring these subtle differences. Behavioural testing requires larger populations or more penetrant risk alleles for overt phenotypic effects to be witnessed.
Follow up of schizophrenia gwas based on cognitive performance, high density eeg, and structural brain imaging
Authors: Donohoe G. , Rose E. , Morris D. , Hargreaves A. , Gill M. , Corvin A.
Published: May 2011

The advent of genome wide association studies have resulted in the identification of a number of novel genetic loci for schizophrenia and related disorders. Understanding the functional impact of these variants on brain structure and function is crucial to understand their role in disease pathology. We presents data based on our genetic and neuropsychological assessment of almost 700 patients and healthy participants for a number of these variants and replication of our findings in independent samples of almost 1500 cases and controls. Specifically, we will use this data to suggest that the risk associated with some genetics variants (e.g. NOS1) is being mediated by an influence on variation in intelligence and other cognitive phenotypes, while other risk variants (e.g. ZNF804A) delineate illness subtypes in which cognitive deficits are a less prominent feature.
Neurogenetics of emotion processing in major depression
Authors: Dannlowski U.
Published: May 2011

Converging lines of research suggest that major depression is characterized by abnormalities in different stages of emotion processing (e.g., automatic emotion processing, emotion regulation, or reward processing). Using functional neuroimaging, the neurobiological correlates of these emotion processing biases have been intensively investigated during the last decade. Depressed patients appear to be characterized by a hyper-responsive amygdala to negative stimuli, dysfunctional prefrontal activity during emotion regulation and blunted activity of the ventral striatum in response to positive cues or reward.

We present a series of studies investigating genetic underpinnings of these neurobiological abnormalities frequently observed in depression. We demonstrate a consistent pattern of serotonergic and neuropeptide genes that bias automatic amygdala responsiveness towards subliminally presented negative stimuli. Other genes were shown to impact prefrontal engagement during conscious emotion processing, e.g. genetic variants in the interleukin 1 beta gene. Further polymorphisms, e.g. in the endocannabinoid system rather seem to influence striatal responsiveness to positive social cues.

We conclude that the neurobiological abnormalities in major depression which are linked to biased emotional processes are strongly under genetic influence. The investigation of neurogenetic pathways to different aspects of depression psychopathology might help to better characterize patients according to their neurobiological dysfunctions and might ultimately lead to individualized therapy plans.
Predictors of persistence of ultrahigh risk symptoms and predictors of transition into psychosis
Authors: van der Gaag M. , Rietdijk J. , Ising H. , Dragt S. , Klaassen R. , Nieman D. , Wunderink L. , Linszen D.H.
Published: May 2011

Aims

To determine predictors of transition from ultrahigh risk into psychosis.

Method

The Dutch EDIE trial has included 201 people with an ultrahigh risk for psychosis. These were included with both a referral based strategy and a screening all help-seeking people strategy. The study had a 24 month inclusion period and an 18 mont follow-up period with each patient. The preliminary results are presented.

Results

A loogistic regression was performed over 164 cases. 29 patients developed a psychosis.

Predictor variables were depression, social intercation anxiety, positive symptoms on the CAARMS, negative symptoms on the CAARMS, quality of life, social functioning, genetic risk, and the personal beliefs about illness.

The backward logistice regression (likelyhood ratio) discarded four variables. Predictors of psychosis were depression, positive symptoms, genetic liability and beliefs about illness at basline.

Conclusions

People with hihd scores on depression and positive symptoms are likely to develop a psychosis. Also those who have a psychotic parent and positive symptoms a more lekly to make a transition. Interestingly people that consider their condition as hopeless, feel entrapped by their condition, excluded by other pople and not in control of symptoms also have a heightened chance for developing psychosis in this sample.
The structure of the ultra high risk mental state for psychosis. A latent class cluster analysis study
Authors: Valmaggia L. , Stahl D. , Yung A. , Nelson B. , McGorry P. , McGuire P.
Published: May 2011

Introduction

Individuals at Ultra High Risk (UHR) for psychosis typically present with attenuated psychotic symptoms. However it is difficult to predict which individuals will later develop frank psychosis when their mental state is rated in terms of individual symptoms.

The objective of the study was to examine the phenomenological structure of the UHR mental state and identify symptom profiles that predict later transition to psychosis.

Method

Psychopathological data from a large sample of UHR subjects were analysed using latent class cluster analysis.

A total of 318 individuals with a UHR for psychosis. Data were collected from two specialised community mental health services for people at UHR for psychosis: OASIS in London and PACE, in Melbourne.

Results

Latent class cluster analysis produced 4 classes: Class 1 - Mild was characterized by lower scores on all the CAARMS items. Subjects in Class 2 - Moderate scored moderately on all CAARMS items and was more likely to be in employment. Those in Class 3 - Moderate-Severe scored moderately-severe on negative symptoms, social isolation and impaired role functioning. Class 4 - Severe was the smallest group and was associated with the most impairment: subjects in this class scored highest on all items of the CAARMS, had the lowest GAF score and were more likely to be unemployed. This group was also characterized by the highest transition rate (41%).

Conclusions

Different constellations of symptomatology are associates with varying levels of risk to of transition to psychosis.
Stress in people at high risk for psychosis
Authors: Day F. , Valmaggia L. , Pariante C. , Papadopoulos A. , Papadopoulos I. , McGuire P.
Published: May 2011

Background

Stress is a key feature of many aetiological models of psychosis and there is considerable empirical evidence implicating stress in the development of psychosis. This paper investigates the role of psychosocial stress in the onset of psychosis by examining the relationship between current and lifetime exposure to traumatic experiences and psychosocial stressors, HPA axis function, and psychopathology in people at high risk of developing psychosis.

Methods

Sixty ‘high risk’ (HR) participants were compared with 50 healthy control (HC) participants on measures of exposure to psychosocial stressors. Subgroups of HR and HC participants which provided saliva samples were compared regarding measures of HPA axis function.

Results

HR participants were exposed to greater levels of psychosocial stress than HC participants. Specifically, HR participants were more likely to have been separated from their parents (p = .003), report severe parental antipathy (p = .011), and have been bullied while growing up (p = .024). HR participants experienced greater levels of perceived stress than HC participants (p = .001) and were more likely to have had a negative life event in the previous 6 months (p < .001). Positive correlations were found between current stress and number of life events and attenuated psychotic symptoms (r = .585, p < .001, and r = .384, p = < .001, respectively) in the HR participants.

Discussion

This study shows that people at high risk of developing psychosis experience greater levels of psychosocial stress than matched healthy control participants throughout the lifetime, from early childhood to the present day, and that current stress is strongly associated with psychotic symptomatology.
Fatty acid metabolism and the onset of psychotic disorder
Authors: Amminger P. , Mossaheb N. , Schlögelhofer M. , Schäfer M.
Published: May 2011

Introduction

Potentially chronic diseases often have a critical point in their course beyond which treatment becomes less effective. In support of this, early treatment in schizophrenia and other psychoses has been linked to better outcome.

Objectives

The emergence of simultaneous brain volume changes in those ultra-high-risk individuals who develop psychosis indicate an active biological process, and underline the importance of pre-onset treatment. However, pre-psychotic intervention has also been questioned as, using current criteria, only 20–50% of individuals classified as prodromal develop a psychotic disorder within a 1–2 years period.

Aims

Treatment agents in the pre-psychotic phase should, therefore, not have major side effects. Bioactive lipids are molecules that have both intra- and intercellular roles, including mediation, modulation and control of neurobiological processes, such as ion channel and receptor activity, neurotransmitter release, synaptic plasticity, second messenger pathways and neuronal gene expression.

Methods

Long-chain omega-3 polyunsaturated fatty acids (PUFAs) have been shown effective for both, mood and psychotic symptoms, and they have neuroprotective properties. Because of the controversy concerned with the extent to which an intervention may produce harm which outweighs its benefits, omega-3 PUFAs are prime candidates for evaluation in putatively prodromal individuals.

Results

We report on the first randomized, placebo-controlled trial on the preventive use of omega-3 fatty acids in 81 ultra-high-risk individuals.

Conclusions

Supplementation with long-chain omega-3 PUFAs reduces the risk of progression to psychotic disorder, and offers a safe and efficacious strategy for indicated prevention in individuals at ultra-high-risk of developing a psychotic illness.
Immune activation in psychiatric and pre-psychiatric disease
Authors: Drexhage H.A. , Drexhage R.C. , Mesman E. , van Beveren N. , Hillegers M. , Nolen W.A.
Published: May 2011

Accumulating evidence indicates an activated immune system as a vulnerability factor for the development of schizophrenia (SCZ) and bipolar disorder (BD). In support we detected:

1.

Monocytosis and monocyte activation (e.g. a specific gene expression signature of inflammation related genes in a coherent pattern) in naturalistically treated SCZ and BD patients, and

2.

T cell activation in the same patients, be it that it were Treg cells that were more numerous in BD, while in SCZ Treg and Th17 cells numbers were raised.

We also tested 70–80 children at ages of 16 and 21 yrs, having1-2 parent(s) with BD. This offspring has a higher chance of developing a mood disorder and over 25% had developed a mood disorder at 21 yrs. Not only the offspring with a lifetime diagnosis of mood disorder had activated monocytes and more Treg cells (similar as BD patients), but also around 40–50% of euthymic offspring had this immune activation profile. Importantly children who were psychiatrically healthy at 16yrs, and had developed a mood disorder at 21 yrs of age, all had activated monocytes at 16yrs.

Our data show that both the monocyte and T cell arm of the immune system are activated in SCZ and BD, this activation preceding the onset of first episodes in individuals at risk. Our approach opens new avenues for early detection of psychiatric disease based on the immune state of individuals at risk, enabling possible selection of those individuals who might benefit from an immune modulation treatment to prevent disease.
The effect of antidepressants on inflammatory markers in animal models of depression
Authors: Harkin A. , Connor T.J.
Published: May 2011

Considering the evidence that pro-inflammatory cytokines play a causal role in depressive illness, the ability of antidepressants to induce anti-inflammatory effects is a subject of considerable interest. In an in vivo context we observe that antidepressants that enhance noradrenaline availability are the most effective anti-inflammatory agents; a fact consistent with the established anti-inflammatory actions of noradrenaline. Specifically, we have observed that noradrenaline reuptake inhibitors (NRIs) inhibit microglial activation and inhibit expression of pro-inflammatory cytokines (IL-1beta and TNF-alpha), iNOS, and inflammatory chemokines (IP-10 and RANTES) in rat brain following a systemic inflammatory challenge. These in vivo anti-inflammatory actions of NRIs are mimicked by in vitro exposure of primary glial cells to noradrenaline, but not by in vitro exposure of glial cells to the drugs themselves. These data suggest that NRIs promote an anti-inflammatory environment in rat brain in vivo by increasing noradrenaline availability at glial cells. We have also observed that even in the absence of any overt inflammation, chronic treatment with the NRI reboxetine promotes an anti-inflammatory phenotype in the CNS characterised by reduced expression of pro-inflammatory cytokine IFN-gamma, and increased expression of the anti-inflammatory cytokine IL-10. Current experiments are focused on the activation of the inflammatory response system in animal models of depression secondary to inflammation. The models are used subsequently to assess the anti-inflammatory effects of antidepressants in vivo.
Cytokines and tryptophan metabolites in peripheral blood cells of patients with mood disorders: Role of antidepressants
Authors: Myint A.M. , Schwarz M.
Published: May 2011

Background

Mild immune activation is well documented in major depressive disorders. The imbalance in kynurenines in the plasma of patients with MDD was also reported. However, how the blood cells of the patients would respond to external challenge and what would be the effects of different antidepressants is still needed to be explored.

Material and methods

Altogether 20 patients and 40 age and gender matched healthy controls are recruited. Interviews were performed with HAM-D17 and early morning blood was withdrawn. Serum was separated and whole blood culture and peripheral blood mononuclear cell culture were performed with and without stimulation with lipopolysaccharide (LPS) or PolyI:C to activate TLR-4 and TLR-3 respectively. The cytokines and kynurenines are measured in supernatants and serum.

Results

The LPS showed clear immune activation whereas PolyI:C showed various responses. The selective serotonin reuptake inhibitor showed advantage in controlling immune activation induced by TLR-4 stimulation. The tryptophan breakdown showed higher in depressed patients.

Discussion

The immune activation is enhanced in depressed patients and SSRIs showed advantage in controlling immune activation. The details interaction between TLRs and antidepressants in depression will be discussed.
Anti-inflammatory treatment approaches in major depression
Authors: Müller N. , Schwarz M.J.
Published: May 2011

Proinflammatory cytokines, such as IL-6, IL-1 and TNF-a appear to be elevated at least in the peripheral blood of depressed patients. Thus, the activity of the enzyme IDO, which is driven by pro-inflammatory cytokines and regulates the tryptophan/kynurenine metabolism may be enhanced in depressed patients through these cytokines. Although IL-6 does not directly act on IDO, its elevated levels in serum may contribute to IDO activation within the CNS by the stimulatory effect on PGE2, which acts as cofactor in the activation of IDO. This fits with a report on the correlation of increased in vitro IL-6 production with decreased tryptophan levels in depressed. Due to the increase of proinflammatory cytokines and PGE2 in some psychiatric patients, antiinflammatory treatment would be expected to show advantagous effects in schizophrenic and depressed patients. Cyclo-oxygenase-2 inhibitors have been evaluated in major depression. We were able to demonstrate a statistically significant therapeutic effect of the COX-2 inhibitor on depressive symptoms in a randomized double blind pilot add-on study using the selective COX-2 inhibitor celecoxib in MD. Another randomized double-blind study in fifty depressed patients suffering from MD also showed an statistically significant better outcome of the COX-2 inhibitor celecoxib plus fluoxetine compared to fluoxetine alone. Additionally, results of the clinical study of celecoxib add-on to sertraline and the effects of this anti-inflammatory therapy approach to inflammatory markers planned by the MOODINFLAME consortium will be presented as far as available. Further on, alternative therapeutic strategies based on immune-modulatory effects will be discussed.