bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Insights Into Neuropsychiatry
Authors: Trimble Michael 
Published: August 2016

A centenary is often an excuse for reminding people of la fin des siècles, and there seems to be recurrent revivals of interest in the psychological, the mysterious, and their related medical syndromes. Only history will tell if the same occurred at the turn of the millennium, but to date there does not appear to be a flood of novels equivalent to, for example, Dr. Jekyll and Mr. Hyde, in which the two opposing poles of the human psyche are laid out with dramatic effect. At that time there was much interest in hypnosis, automatisms, sonambulism, and their relationship to human happenstance. However, there have been recent novels about Tourette syndrome, such as Johnathan Letham's Motherless Brooklyn. There may also be a revival of interest about epilepsy, and two recently published novels are of particular neuropsychiatric relevance. The first is Lauren Slater's Spasm, and the second Mark Salzman's Lying Awake.The subtitle of Spasm hints at what is to come. It is a “Memoir With Lies.” Chapter 1 begins with the words “I exaggerate.” The tale is an autobiographical account of the growing up of a young girl with seizures, diagnosed as epilepsy, and who is put through all the traumas associated with the disorder. With auras of strange smells and seizure descriptions that would be called partial and secondarily generalized seizures, she gets examined by her pediatrician, given phenobarbital (600 mg!), has psychotherapy, and goes to a special school run by nuns. However, her seizures are relentless, she sees a neurologist who stimulates her cortex and recommends that she has a corpus callosotomy, which she then undergoes.
A Review of Common Sleep Disorders
Authors: Richert Allen C. , Baran Alp Sinan 
Published: August 2016

AbstractWhat should clinicians know about sleep disorders? This article briefly introduces the reader to sleep medicine and succinctly reviews common sleep disorders. First, the authors describe the diagnostic tools unique to sleep medicine: the over-night polysomnogram and the multiple sleep latency test. Next, the authors review essential features of a subset of the sleep, described in the International Classification of Sleep Disorders-Revised, that sleep disorder specialists commonly evaluate, diagnose, and treat. The disorders reviewed include the intrinsic and circadian rhythm subsets of the dyssomnias group and the parasomnia group of sleep disorders. The authors identify the core signs and symptoms, polysomnogram findings, multiple sleep latency test findings, and treatment of these disorders.
Venlafaxine Treatment of Obsessive-Compulsive Disorder: Case Reports
Authors: Marazziti Donatella 
Published: August 2016

ABSTRACTAbout one-third of patients affected by obsessive-compulsive disorder fail to respond to serotonergic drugs and different strategies have been proposed for these resistant cases. This article reports experiences with venlafaxine in patients with obsessive-compulsive disorder who did not respond or did not tolerate serotonergic drugs.
Mouse Genetic Approaches to Feeding Regulation: Serotonin 5-HT2C Receptor Mutant Mice
Authors: Tecott Laurence H. , Abdallah Luna 
Published: August 2016

ABSTRACTNeural mechanisms underlying the regulation of ingestive behavior and energy balance are well conserved among mammals. Many neural pathways, each reflecting the function of many genes, interact to regulate these processes. Systematic genetic perturbations are not feasible in humans—the examination of gene functions relevant to feeding regulation must be performed in other species. Many advances in this field have been made through molecular genetic studies of mice, the most genetically tractable of mammalian species. The relevance of mouse ingestive behavior to the mechanisms underlying the regulation of feeding in humans is discussed. Approaches for evaluating the contribution of genes to the regulation of energy balance and to the actions of anorectic drugs are described in the context of studies focused on a line of mice lacking the serotonin 5-HT2C receptor subtype. These animals display reduced responsiveness to serotonergic anorexic drugs and a late-onset obesity syndrome associated with features reminiscent of common forms of human obesity. Developmental studies of energy balance uncovered a novel age-dependent physiological process that may contribute generally to the predisposition of humans and other mammals to accumulate fat stores during “middle-age.” These findings are presented to illustrate considerations in the use of mouse molecular genetic technologies to investigate genetic influences on ingestive behavior and energy balance.
Methylphenidate-Induced Obsessive-Compulsive Symptoms in an Elderly Man
Authors: Serby Michael 
Published: August 2016

ABSTRACTAn 82-year-old man with treatment-resistant depression and early Alzheimer's disease was started on methylphenidate. Significant obsessive-compulsive behavior ensued but diminished over several weeks when methylphenidate was replaced by fluvoxamine. The patient had no prior psychiatric history, but he had a sister with obsessive-compulsive disorder. It appears that methylphenidate precipitated the patient's pathological behavior.
The Diagnosis, Symptomatology, and Epidemiology of Seasonal Affective Disorder
Authors: Magnusson Andres , Partonen Timo 
Published: August 2016

AbstractThe operational criteria for seasonal affective disorder (SAD) have undergone several changes since first proposed in 1984. SAD is currently included as a specifier of either bipolar or recurrent major depressive disorder in theDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition.TheInternational Classification of Diseases, Tenth Editionhas provisional diagnostic criteria for SAD. The most characteristic quality of SAD is that the symptoms usually present during winter and remit in the spring. Furthermore, the symptoms tend to remit when the patients are exposed to daylight or bright light therapy. The cognitive and emotional symptoms are as in other types of depression but the vegetative symptoms are the reverse of classic depressive vegetative symptoms, namely increased sleep and increased appetite. SAD is a common condition, but the exact prevalence rates vary between different studies and countries and is consistently found to be more common in women and in youth. SAD probably possibly occurs in children although not as commonly as in young adults. Some studies have found that certain ethnic groups who live at high northern latitudes may have adapted to the long arctic winter.
Auditory Abnormalities in Autism: Toward Functional Distinctions Among Findings
Authors: Kellerman Gabriella R. , Fan Jin , Gorman Jack M. 
Published: August 2016

AbstractRecently, findings on a wide range of auditory abnormalities among individuals with autism have been reported. To date, functional distinctions among these varied findings are poorly established. Such distinctions should be of interest to clinicians and researchers alike given their potential therapeutic and experimental applications. This review suggests three general trends among these findings as a starting point for future analyses. First, studies of auditory perception of linguistic and social auditory stimuli among individuals with autism generally have found impaired perception versus normal controls. Such findings may correlate with impaired language and communication skills and social isolation observed among individuals with autism. Second, studies of auditory perception of pitch and music among individuals with autism generally have found enhanced perception versus normal controls. These findings may correlate with the restrictive and highly focused behaviors observed among individuals with autism. Third, findings on the auditory perception of non-linguistic, non-musical stimuli among autism patients resist any generalized conclusions. Ultimately, as some researchers have already suggested, the distinction between impaired global processing and enhanced local processing may prove useful in making sense of apparently discordant findings on auditory abnormalities among individuals with autism.
Functional Disorders and Comorbidity
Authors: Gorman Jack M. 
Published: August 2016

It seems obvious to most people that the brain and the rest of the body interact. Stress seems to worsen most general medical conditions, mortality is higher among widowers than married men, and almost everyone becomes moody when he or she has a viral infection. However, these are mostly anecdotal observations. The precise ways in which mind and body relate in health and disease is more elusive and, at times, controversial.Perhaps the hardest evidence we have for a mind-body connection comes from studies showing that depression is an independent—and, surprisingly, quite a robust—risk factor for cardiovascular disease. Following acute coronary syndrome depression significantly worsens outcome, including increasing all-cause mortality rates.Another well-documented finding, going in the opposite direction, is the high rate of depression experienced by those receiving α-interferon for the treatment of hepatitis C or malignant melanoma. Less secure is whether depression increases risk or worsens prognosis for cancer; why patients with schizophrenia are at greater risk for heart disease and cancer than the general population; if it is true that stress plays a role in exacerbations of multiple sclerosis; and what is the relationship between depression and the risk for Alzheimer's disease. In each there are conflicting epidemiological data and difficulties understanding the neural mechanisms that would broker the relationship between brain and targeted peripheral organ.
Attenuation of Apparent New-Onset Ocular Tics with Successful Treatment of PTSD
Authors: Hayes Patrick C. , Weber Charles L. , Gallagher Michael B. , Drouillard Gary J. 
Published: August 2016

ABSTRACTThis case report describes a patient with reportedly new onset of tics, beginning at 21 years of age, in the context of posttraumatic stress disorder (PTSD) and comorbid alcohol abuse, with no known head injury. The setting is an American Society of Addiction Medicine intensive outpatient substance abuse rehabilitation program in an United States Army Medical Center. The patient is a 22-year-old male diagnosed with alcohol abuse and delayed PTSD who presented to the program's medical officer due to insomnia. We discovered he had a reportedly new ocular tic of ∼9 months duration, which he claimed developed at 21 years of age soon after returning from 1 year of combat duty. The patient was thoroughly evaluated, and we surmised the tic was a symptom of PTSD. After achieving full remission from alcohol, the tic persisted. However, as his PTSD symptoms remitted, so did his tic symptoms. At 6-month follow-up, the patient reported he was essentially free from PTSD symptoms, and his tic was significantly reduced.
Prevalence of Psychotic Disorders in Patients with Obsessive-Compulsive Disorder
Authors: de Haan Lieuwe , Dudek-Hodge Christine , Verhoeven Yolanda , Denys Damiaan 
Published: August 2016

ABSTRACTIntroduction:The co-occurrence of obsessive-compulsive disorder (OCD) in patients with schizophrenia and related disorders has been increasingly recognized. However, the rate of psychosis comorbidity in OCD patients has yet to be systematically evaluated.Methods:The prevalence of theDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychotic disorders was evaluated in 757 subjects consecutively referred to a specialised diagnostic and treatment facility for OCD. Demographic and clinical characteristics were assessed.Results:Thirteen OCD patients (1.7%) also met theDSM-IVcriteria for a psychotic disorder. We found no significant differences in clinical characteristic between OCD patients with and without a psychotic disorder, although patients with OCD and a psychotic disorder more likely used illicit substances and more likely were male.Conclusion:Relatively few patients referred to a specialized treatment OCD center suffer from a psychotic disorder.
Psychosocial Treatment of Depression and Suicidality in Adolescents
Authors: Klomek Anat Brunstein , Stanley Barbara 
Published: August 2016

ABSTRACTDepression is a common disorder among adolescents and is associated with a high risk of suicide. Suicide is the third leading cause of death among adolescents in the United States. Currently, there are only two evidence-based psychotherapies for adolescence depression: cognitive-behavioral therapy and interpersonal psychotherapy. Furthermore, psychosocial interventions that specifically target suicidal behavior in adolescents are even fewer in number than treatments for depression. This article will review the psychosocial interventions for depression and suicidality in adolescents and will describe a recently developed treatment that is under study for depressed suicidal adolescents.
What is the Self?A Psychobiological Perspective
Authors: Stein Dan J. 
Published: August 2016

ABSTRACTPhilosophers have long struggled with questions about the nature of personal identity and of the self, with some viewing the self as a transcendent entity, and others arguing that the self is a constructed fiction. An approach based in cognitive-affective neuroscience emphasizes that self-related structures and processes are based in the brain-mind, and emerge within the social processes of human development. Alterations in such structures and processes are present in a wide range of neurological and psychiatric disorders, and neuropsychiatric lesion and functional brain imaging studies have led to more detailed awareness of the precise neuronal circuitry underlying self-representations. A cognitive-affective neuroscience approach provides a conceptual basis from which clinical research can further explore how best to assess and treat a wide range of disruptions to the self.
5-HT2A:Its Role in Frontally Mediated Executive Function and Related Psychopathology
Authors: Stein Dan J. , Hemmings Sian , Moolman-Smook Hanlie , Audenaert Kurt 
Published: August 2016

ABSTRACTSerotonin (5-HT)2Areceptors are widely distributed, with high levels in the frontal cortex, where postsynaptic activation may increase activity in pyramidal glutamatergic neurons and mediate various executive functions. More specifically, reciprocal cortical-raphe pathways may allow the ventral prefrontal cortex to inhibit stress-induced neural activity in the brainstem when stressors are perceived as controllable. However, early adversity and negative attitudes may be associated with higher frontal 5-HT2Areceptor levels and greater risk for stress-induced psychopathology, and certain 5-HT2Agene variants have been associated with increased risk for impulsive behavior. Conversely, many antidepressants result in decreased levels of 5-HT2Areceptor levels, and blockade of 5-HT2Areceptors has proven useful in the treatment of a number of psychiatric disorders.
The Precuneus and Consciousness
Authors: Cavanna Andrea E. 
Published: August 2016

ABSTRACTThis article reviews the rapidly growing literature on the functional anatomy and behavioral correlates of the precuneus, with special reference to imaging neuroscience studies using hamodynamic techniques. The precuneus, along with adjacent areas within the posteromedial parietal cortex, is among the most active cortical regions according to the “default mode” of brain function during the conscious resting state, whereas it selectively deactivates in a number of pathophysiological conditions (ie, sleep, vegetative state, drug-induced anesthesia), and neuropsychiatric disorders (ie, epilepsy, Alzheimer's disease, and schizophrenia) characterized by impaired consciousness. These findings, along with the widespread connectivity pattern, suggest that the precuneus may play a central role in the neural network correlates of consciousness. Specifically, its activity seems to correlate with self-reflection processes, possibly involving mental imagery and episodic/autobiographical memory retrieval.
The PANDAS Subgroup: Recognition and Treatment
Authors: Swedo Susan E. , Garvey Marjorie , Snider Lisa , Hamilton Charlotte , Leonard Henrietta L. 
Published: August 2016

AbstractA subgroup of patients with childhood-onset obsessive-compulsive disorder (OCD) has been identified who share a common clinical course characterized by dramatic symptom exacerbations following Group A beta-hemolytic streptococcal (GABHS) infections. The term PANDAS has been applied to the subgroup, to indicate the postulated etiology of their symptoms: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. Five clinical characteristics define the PANDAS subgroup: presence of OCD and/or tic disorder, prepubertal symptom onset, sudden onset or abrupt exacerbations (sawtooth course), association with neurological abnormalities (presence of adventitious movements or motoric hyperactivity during exacerbations), and temporal association between symptom exacerbations and GABHS infections. Post-streptococcal symptom exacerbations are typically quite dramatic, with patients reporting that their symptoms “…came on overnight” or “…appeared all of a sudden a few days after I had a sore throat.” The post-streptococcal inflammatory nature of the neuropsychiatric symptoms provides novel opportunities for treatment and prevention, including immunomodulatory therapies such as therapeutic plasma exchange (TPE) and intravenous immunoglobulin (IVIG). A recently completed placebo-controlled trial revealed that both IVIG and TPE were effective in reducing neuropsychiatric symptom severity (40% to 55% reductions, respectively) for a group of severely ill children with OCD and/or tic disorders. Further research is required to determine why the treatments are helpful, as well as to ascertain whether or not antibiotic prophylaxis can help prevent post-streptococcal symptom exacerbations.
Neurosurgical Approaches to Intractable Obsessive-Compulsive Disorder
Authors: Rasmussen Steven , Greenberg Benjamin , Mindus Per , Friehs Gerhard , Noren George 
Published: August 2016

AbstractAlthough significant progress has been made over the last decade in the treatment of obsessive-compulsive disorder (OCD), approximately 20% of OCD patients remain refractory to nonsurgical therapies, including pharmacologic and cognitive-behavioral therapy. Because a number of neural circuits involving the basal ganglia, thalamus, limbic system, and frontal lobes have been implicated in the pathophysiology of OCD, the need for an effective intervention in these patients has brought the focus on surgical approaches, including cingulotomy and capsulotomy procedures. Unlike free-hand surgical approaches used in the past, current neurosurgical interventions have been greatly enhanced by advances in technology, which allow lesioning to an accuracy of 1 mm. Today's neurosurgical approaches have shown significant benefit in as many as 60% of refractory patients, while preserving personality and cognitive functioning and limiting morbidity. A study of gamma knife capsulotomy conducted at Brown University School of Medicine showed that 40% of patients undergoing two lesioning procedures were much or very much improved 2 years postsurgery. The inherent obstacles to conducting placebo-controlled studies in these severely ill patients mean that further study is required to identify optimal candidates for surgical intervention.
Remission-Oriented Treatment of Depression
Authors: Howland Robert H. , Trivedi Madhukar H. , Ninan Philip T. , Ginsberg David L. 
Published: August 2016

AbstractGiven the wide variety of available antidepressant therapies, an important question is how effective are we in treating depression? In clinical research trials of antidepressants, a treatment response is defined as a 50% or greater improvement in depressive symptoms, whereas remission is defined as having minimal or absent symptoms at the end of treatment. Approximately 50% of patients treated with antidepressants have a treatment response, but only about 25% have a complete remission. Many treatment responders therefore have residual symptoms despite adequate treatment. This is critically important because depressed patients with residual symptoms, even though mild in severity, still have significant functional impairment, have a high risk of relapsing into a more severe episode, and may have a more chronic course of illness. Such patients also do not show a full functional recovery from their depression. Recent comparative studies have found that remission rates are significantly higher with venlafaxine (Effexor) compared to serotonin reuptake inhibitors, which might be due to their different effects on neurotransmitter systems. The use of medication combinations, having additive and/or synergistic antidepressant effects, or adding psychotherapy following a course of pharmacotherapy also can be used to treat residual symptoms and lead to a more complete remission.
Affect Regulation, Brain Development, and Behavioral/Emotional Health in Adolescence
Authors: Dahl Ronald E. 
Published: August 2016

AbstractThis paper addresses the importance of affect regulation (AR) in relation to a broad range of behavioral and emotional health problems that emerge during adolescence. AR is defined as the adaptive modulation of emotional experience to serve a goal or purpose. This conceptualization of AR emphasizes the use of cognitive skills to guide, inhibit, or modify emotion and behavior, including the expression of emotional responses, in learned, strategic ways—skills that ultimately underpin adult levels of social maturity and the ability to show “responsible” behavior across a range of emotional situations. Neurobehavioral systems that subserve these AR skills include areas of the inferior and orbital prefrontal cortex (PFC), with rich interconnections to several limbic structures and other cortical areas, including the dorsolateral PFC. Adolescence represents an important developmental period in the functional maturation of adult AR skills; it is also a critical time in the development of clinical disorders of AR (eg, rates of depression increase dramatically and gender differences in depression emerge). Maturational changes in AR that occur during adolescence—particularly with respect to the role of emotions influencing responsible decision making—are also relevant to understanding key aspects of the developmental pathways of some behavioral health problems, such as alcohol use and nicotine dependence. A strong case is made for developmental research in affective neuroscience aimed at this important maturational period, particularly the kind of transdisciplinary research leading toward mechanistic understanding of the development of adolescent-onset disorders. Improving understanding in these areas could ultimately lead to the development of early interventions in targeted high-risk populations, and has enormous clinical and social policy relevance.
Borderline Personality Disorder:Toward Integration
Authors: Stein Dan J. 
Published: August 2016

ABSTRACTSeveral psychiatric disorders, including borderline personality disorder (BPD), are characterized by emotional dysregulation and impulse dyscontrol. More specifically, symptoms in patients with BPD often occur within the context of disruptions in attachment and related distortions in cognitive-affective processing of the self and others. From a neurocircuitry perspective, findings include prefrontal hypoactivity, amygdala hyperreactivity, and alterations in prefrontal-limbic interaction. Molecular pathways relevant to these circuits include the serotonergic, noradrenergic, and dopaminergic systems, and there is some evidence that pharmacotherapy with agents that act on these systems may be useful. Given the disruptions in attachment and schemas of the self and others in BPD, establishing a therapeutic alliance is crucial while psychotherapy remains the cornerstone of an integrated approach to management.