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Despite a rapidly growing understanding of hoarding disorder (HD), there has been relatively limited systematic research into the impact of hoarding on children and adolescents. The goal of this paper is to suggest future research directions, both for children with hoarding behaviours and children living in a cluttered home. Key areas reviewed in this paper include (1) the need for prospective studies of children with hoarding behaviours and those who grow up with a parent with HD; (2) downward extensions of cognitive-behavioural models of adult HD that emphasise different information processing and behavioural biases in youth HD; (3) developmental research into the presentation of emerging HD in childhood compared with adulthood presentations of the disorder, with consideration of typical childhood development and unique motivators for childhood saving behaviours; (4) developmentally sensitive screening and assessment; and (5) the development of evidence-based treatments for this population. The paper concludes with a discussion of methodological suggestions to meet these aims.
Primary objective was to evaluate the influence of atomoxetine on standard variables of a computer-based Continuous Performance Test (cb-CPT) that reflects executive function and inhibitory control in children with ADHD.
Two-arm, 8-week, placebo-controlled, randomized, double-blind study in ADHD patients (6-12yrs). Atomoxetine was initiated at 0.5 mg/kg qd for 1 week, followed by 7 weeks on the target dose of 1.2 mg/kg qd. Primary outcome were the q-scores of the cb-CPT standard variables after 8 weeks using mixed models for repeated measurement. Additionally, ADHD-RS scores, WREMB (Weekly Ratings of Evening and Morning Behavior) and CGI-S-ADHD were assessed (weeks 0,1,2,4,6,8).
N=128 patients were randomized, N=125 evaluated (atomoxetine/placebo: 63/62). Baseline characteristics were comparable (77.6% boys; 40.0% patients with ODD/CD; 24.8% prior stimulant treatment; mean (±SD) age 9.0±1.79yrs; mean ADHD-RS total score 36.99±11.56). At Week 8, all primary outcomes (cb-CPT q-scores) were significantly reduced vs. placebo (all p< 0.001) for mean (effect size [ES] 0.41), variance (ES=0.71), and normalized variance (ES=0.50) of “Reaction time”, “Number of microevents” (ES=1.00), “Commission errors” (ES=0.50), “Omission errors” (ES=0.70), “Distance of movement” (ES=0.90) and “Area of movement” (ES=1.08), “Time active” (ES=0.69), and “Motion simplicity” (ES=0.38). Secondary endpoints at Week 8 improved significantly in favor of atomoxetine: ADHD-RS: total score ES=1.30, p< 0.001; hyperactive/impulsive subscore ES=1.37, p< 0.001; inattentive subscore ES=1.07, p< 0.001). WREMB: total score ES=1.00, p< 0.001; morning subscore ES=0.59, p=0.002.; evening subscore ES=1.02, p< 0.001. CGI-S-ADHD: ES=1.11; p< 0.001.
Atomoxetine for 8 weeks significantly reduced ADHD symptoms as measured by the objective cb-CPT.
Aim was to evaluate influencing factors of response and symptomatic remission in first-episode schizophrenia patients treated with risperidone or haloperidol.
229 first-episode schizophrenic patients were examined within a double blind controlled trial of the German Study Group on first-episode schizophrenia with biweekly PANSS ratings. Response was defined according to the definition by Lieberman et al. (2003) and symptomatic remission as the severity component of the consensus remission criteria by the Remission in Schizophrenia Working Group. Sociodemographic, psychopathological and functional variables as well as the treatment applied were evaluated regarding their potential predictive validity for treatment outcome. Univariate tests, logistic regression and CART-analyses were consulted as statistical methods.
126 patients (55%) achieved response and 118 patients (52%) symptomatic remission at discharge with no significant differences between the risperidone (51%) and haloperidol (49%) treated patients. Better baseline functioning, early treatment response, less depressive symptoms and a shorter duration of untreated psychosis were revealed significant predictors of response. Patients with symptomatic remission also had a significantly shorter duration of untreated psychosis and significantly less depressive symptoms at baseline. Logistic regression and CART-analyses revealed low general psychopathology, early treatment response and a high score in the Strauss-Carpenter-Prognostic-Scale at admission to be significantly positive predictive for symptomatic resolution.
Early treatment response, depressive symptoms and the level of psychosocial functioning were revealed to significantly predict outcome, with no significant differences between risperidone and haloperidol. The importance of an early adequate symptom control and the implementation of early intervention programs is highlighted.
Recent investigations into motor cortex excitability with paired pulse transcranial magnetic stimulation technique (ppTMS), have shown inhibition deficits in ADHD which correlate with the clinical symptomatology. Methylphenidate effects on cortical excitability in adults with ADHD are contradictory. Therefore, we use long-acting methylphenidate (LA-Mph) to consider cortical excitability effects under stable medication conditions.
Systematic evaluation of the effects of LA-Mph on motor cortex excitability in adult patients with ADHD with the ppTMS technique.
Investigation of the putative influence of LA-Mph on motor inhibition and facilitation in adults with ADHD.
Thirteen drug naïve adult ADHD patients were included in this ppTMS study. Measurements took place before and under treatment with LA-Mph (30–54 mg daily dose). Statistical analyses were performed to investigate treatment effects and correlations with clinical symptomatology.
LA-Mph significantly decreased the relative short intracortical motor inhibition (SICI) magnetically evoked potential (MEP) amplitude at 3ms interstimulus interval (conditioned/ unconditioned MEP amplitude: 0.84 ± 0.76 drug-free vs. 0.29 ± 0.19 with LA-Mph; p = 0.020). The relative intracortical facilitation (ICF) MEP amplitude at 11ms interstimulus interval (conditioned/ unconditioned MEP amplitude: 1.51 ± 0.92 drug-free vs. 1.79 ± 0.95 with LA-Mph) was not significantly increased. The decrease of the relative SICI MEP amplitude with LA-Mph correlated significantly with the improvement of the psychopathological ADHD self-rating total scores (p = 0.034) and hyperactivity/impulsivity subscores (p = 0.029). These results show that in adult patients with ADHD, LA-Mph significantly improves motor disinhibition without influencing motor facilitation.
LA-Mph might have differential stabilizing effects on motor hyperexcitability in adults with ADHD and correlates with the clinical improvements.
Second-generation antipsychotics (SGAs) are a frequently and effectively used treatment in schizophrenia and psychotic disorders. Other than First-generation antipsychotics (FGAs), which mainly exert their pharmacologic effect in subcortical dopaminergic systems, SGAs additionally affect partly serotonergically innervated structures within prefrontal areas, such as the Anterior Cingulate Cortex (ACC). However, only few controlled, randomized studies have so far investigated direct and indirect effects of SGAs on the ACC.
The present study investigated differential effects of one SGA (quetiapine) and one FGA (flupentixol) on the human action monitoring system.
ACC function in 18 quetiapine-medicated patients and 13 flupentixol-treated patients suffering from schizophrenia was assessed by means of the error-related negativity (ERN), a neurophysiological marker of ACC function, in a pre-post design. Results Between-group comparisons revealed different effects of quetiapine and flupentixol on ACC function despite similar improvement in psychopathology, cognitive performance and quality of life. Whereas SGA treatment was associated with an increase in amplitudes over time, there were prolonged ERN peak latencies in patients treated with the FGA. Moreover, treatment effects depended on baseline PFC function in both groups.
We conclude that both flupentixol and quetiapine improve prefrontal function especially in patients with weak initial ACC function which might be due to their shared affinity for 5HT-receptors in frontal brain regions. However, since this affinity is more pronounced for SGAs, patients treated with quetiapine seemed to profit more evidently concerning PFC function compared to patients of the flupentixol group, who exhibited a compensatory prolongation of processes.
Cycloid psychoses (CP) as described by Leonhard comprise the subtypes anxiety-happiness, confusion and motility psychoses. CP presents with an acute onset and have a favourable prognosis. The operational criteria by Perris and Brockington (P&B, 1981) are partly incorporated in ICD-10 as acute polymorphic psychosis (APP). The DSM-IV category Brief Psychotic Disorder (BPD) includes all psychoses with short duration.
Establishing concordance of Leonhard's CP with DSM-IV and ICD-10 categories.
This study was aimed to investigate the clinical characteristics of CP and to determine the prevalence of CP in patients with psychotic disorders.
80 patients with psychotic disorders were assessed by means of CASH, PANSS and CGI at baseline and after six weeks of treatment. CP's were identified according to Leonhard's descriptions. Furthermore, patients were classified using DSM-IV, ICD-10 and P&B criteria.
A diagnosis of Leonhard's CP was present in 12 patients. Overlap between Leonhard's and P&B-CP was modest. ICD-10 and DSM-IV classification showed considerable heterogeneity. Diagnoses of ICD-APP and DSM-BPD were mostly assigned to CP patients. Concordance between Leonhard's CP and these categorical diagnoses was small. Leonhard CP patients showed, compared to non-CP patients, more atypical symptoms like perplexity, pananxiety and psychomotor disturbances.
The estimated prevalence of CP in patients with psychotic disorders is 15 percent. Although identification of CP is of heuristic value, this is not warranted by current classification systems or operational criteria. Thorough clinical evaluation of psychotic disorders is required, especially in patients presenting with perplexity, psychomotor disturbances or severe anxieties.
In the course of demographic change an increasing number of dementia patients is predicted. More elderly desire to remain longer self-determined at their familiar domestic surroundings while declining disposability of nursing staff is prognosticated. Modern AAL-systems offer the opportunity to tackle this challenge.
In order to meet the needs of dementia patients, a prospective AAL-system should discern people's activities of daily living (ADLs). Regarding to their complexity, in order to generate sophisticated assistance, the system needs to integrate harmonically into the domestic environment without any interference on ongoing activities of those concerned.
OPDEMIVA ascertains possibilities in real-time-recognizing of ADLs applying innovative contactless optical measurement sensors with focusing on the detection of high-risk behavioural patterns.
An interdisciplinary research team of technical and health-care experts was involved in the mutual project. Based on examination of the list of ADLs and preconceiving both aspects of medical importance and technical feasibility, a subset of relevant behavioural patterns was identified. An appropriate technical system based on optical smart sensor technology for ADLs detection was developed and preliminarily tested.
In preliminary tests several fundamental ADLs, e.g. movement and recreation could be detected with high reliability while possible deficits like motionlessness over a defined period became derivable.
Smart sensor based detection of dementia-related high-risk behavioural patterns requires extensive detailed examination of capabilities and needs of persons concerned. Patient's privacy and ethic concerns are of high relevance. Results gained as yet imperatively demand further research.
Postoperative cognitive impairment is among the most common medical complications associated with surgical interventions – particularly in elderly patients. In our aging society, it is an urgent medical need to determine preoperative individual risk prediction to allow more accurate cost–benefit decisions prior to elective surgeries. So far, risk prediction is mainly based on clinical parameters. However, these parameters only give a rough estimate of the individual risk. At present, there are no molecular or neuroimaging biomarkers available to improve risk prediction and little is known about the etiology and pathophysiology of this clinical condition. In this short review, we summarize the current state of knowledge and briefly present the recently started BioCog project (Biomarker Development for Postoperative Cognitive Impairment in the Elderly), which is funded by the European Union. It is the goal of this research and development (R&D) project, which involves academic and industry partners throughout Europe, to deliver a multivariate algorithm based on clinical assessments as well as molecular and neuroimaging biomarkers to overcome the currently unsatisfying situation.
When people interact, aspects of their speech and language patterns often converge in interactions involving one or more languages. Most studies of speech convergence in conversations have examined monolingual interactions, whereas most studies of bilingual speech convergence have examined spoken responses to prompts. However, it is not uncommon in multilingual communities to converse in two languages, where each speaker primarily produces only one of the two languages. The present study examined complexity matching and lexical matching as two measures of speech convergence in conversations spoken in English, Spanish, or both languages. Complexity matching measured convergence in the hierarchical timing of speech, and lexical matching measured convergence in the frequency distributions of lemmas produced. Both types of matching were found equally in all three language conditions. Taken together, the results indicate that convergence is robust to monolingual and bilingual interactions because it stems from basic mechanisms of coordination and communication.
With the recent discovery of a dozen dusty star-forming galaxies and around 30 quasars at z > 5 that are hyper-luminous in the infrared (μ LIR > 1013 L⊙, where μ is a lensing magnification factor), the possibility has opened up for SPICA, the proposed ESA M5 mid-/far-infrared mission, to extend its spectroscopic studies toward the epoch of reionisation and beyond. In this paper, we examine the feasibility and scientific potential of such observations with SPICA’s far-infrared spectrometer SAFARI, which will probe a spectral range (35–230 μm) that will be unexplored by ALMA and JWST. Our simulations show that SAFARI is capable of delivering good-quality spectra for hyper-luminous infrared galaxies at z = 5 − 10, allowing us to sample spectral features in the rest-frame mid-infrared and to investigate a host of key scientific issues, such as the relative importance of star formation versus AGN, the hardness of the radiation field, the level of chemical enrichment, and the properties of the molecular gas. From a broader perspective, SAFARI offers the potential to open up a new frontier in the study of the early Universe, providing access to uniquely powerful spectral features for probing first-generation objects, such as the key cooling lines of low-metallicity or metal-free forming galaxies (fine-structure and H2 lines) and emission features of solid compounds freshly synthesised by Population III supernovae. Ultimately, SAFARI’s ability to explore the high-redshift Universe will be determined by the availability of sufficiently bright targets (whether intrinsically luminous or gravitationally lensed). With its launch expected around 2030, SPICA is ideally positioned to take full advantage of upcoming wide-field surveys such as LSST, SKA, Euclid, and WFIRST, which are likely to provide extraordinary targets for SAFARI.
The Moscow Syneclise on the East European Platform is an important area for the study of the continental biota of late Permian to Early Triassic age in continuous sections. This study attempts a taxonomic description of the late Permian conchostracan fauna of this area. The rich, new material was collected, bed by bed, during geological and paleontological excavations of lacustrine and fluvial deposits of the Obnora Formation and Vokhma Formation of the late Permian Zhukovian Regional Stage near the towns of Vyazniki and Gorokhovets. The conchostracan fauna of the Zhukovian Regional Stage consists predominantly of Pseudestheria and less frequently of Palaeolimnadiopsis. In the earliest Triassic Vokhmian Regional Stage, a more diverse fauna including Euestheria, Magniestheria, Cornia, Palaeolimnadiopsis, and Rossolimnadiopsis was already recorded. The preliminary taxonomic determination of the pseudestheriids from the Zhukovian Regional Stage is intended to serve as a prerequisite for future studies of late Permian conchostracan biostratigraphy on the regional to interregional scale.
Recent theories on the formation of the Solar System turned the attention to the study of low mass cloud cores in massive star forming regions. The Rosette Molecular Cloud is a well-known star forming area having highly filamentary structure with dense cores covering a wide range of masses. These pre- and protostellar cores were observed by Herschel and key core properties were derived from its data. With the Effelsberg 100m telescope a sample of these cores with masses ranging between 3-40 M⊙ were observed in ammonia inversion lines. In this work we are examining the correlations between these two datasets with the aim of gaining insight of the processes behind the star formation of the region.