To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
It is not known with certainty how different phenotypes are transmitted in groups of families divided into three generations.
Having meticulously searched for terms of psychopathogic lexicon that best translated the sterile categorical diagnosis, we obtained three dimensional groups for all six families in the three generations.
We calculated the frequencies and percentages of the three dimensional groups for the three generations of families based on sex.
The chi-square TEST attests a p-value = 0.049, statistically significant for the dimensional group “A”. (Tab. 3)
The genetics, and above all the epigenetics, of the phenotypes are periodically transmitted in group “A” and group “C” in the female and male sex. (Graphs 2.1.1 and 2.3.1) Different phenotypes indicate that the complexity of the interactions of the regulatory mechanisms of genes with the environment is extremely significant for the group with the most severe psychiatric pathology.
Ed Zigler was a champion for underprivileged youth, one who worked alongside communities to fight for long-lasting systemic changes that were informed by his lifespan and ecological perspective on the development of the whole child. This paper reports on the development, implementation, and preliminary outcomes of an intervention that embodied the Zigler approach by adopting a community participatory research lens to integrate complementary insights across community-based providers (promotoras), Latinx immigrant families, and developmental psychologists in the service of promoting parent–child relationship quality and preventing youth aggression and violence. Analyses from the first 112 Latinx mother–youth dyad participants (46% female children, ages 8–17) in the resultant, Confía en mí, Confío en ti, eight-week intervention revealed significant pre–post increases in purported mechanisms of change (i.e., attachment security, reflective functioning) and early intervention outcomes (i.e., depressive, anxiety, and externalizing problems). Treatment responses varied by youth age. A case analysis illustrated the lived experiences of the women and children served by this intervention. We discuss future directions for the program, as well as challenges to its sustainability. Finally, we consider Ed's legacy as we discuss the contributions of this work to developmental science and our understanding of attachment relationships among low-income immigrant Latinx families.
Abnormalities of emotional processing have been reported in both anxiety and depressive disorders. Anxiety might be related to a hyperactive preattentive fear response or to a reduced efficiency of late regulatory processes, whereas depression might be related to a reduced response to positive emotions. In the present study event-related potentials (ERPs) were used to investigate involuntary processing of stimuli with different emotional valence in 33 healthy controls [HC] and 55 clinically stable patients (16 with panic disorder [PD], 15 with obsessive-compulsive disorder [OCD], 13 with unipolar depression [UD] and 11 with bipolar depression [BD]).
The ERPs were recorded during a target detection task, in which erotic, threatening, disgusting and neutral stimuli were used as distracters.
Patients showed abnormalities of the sequence, duration and topography of the ERP components related to emotional processing. Patients with anxiety disorders showed abnormalities of the early components in response to threatening stimuli. Patients with BD showed abnormalities of both early and late ERPs components. OCD and UD patients demonstrated similar abnormalities of the late ERP components in response to erotic stimuli.
According to our results, abnormalities of emotional processing are observed in both anxiety and affective disorders and might have both distinct and shared characteristics in these disorders.
The term “deficit syndrome” (DS) refers to a diagnostic subtype of schizophrenia characterized by the presence of primary and enduring negative symptoms. Several authors have supported the hypothesis that DS represents the more severe end of the schizophrenia spectrum; however, the empirical evidence did not clarify this interpretation. The present study is aimed to evaluate neuromorphological abnormalities in Deficit (DS) and Nondeficit Schizophrenia (NDS). We investigated a group of 18 patients with a DSM-IV diagnosis of schizophrenia, categorized as DS (N=10) and NDS (N=8), and 8 matched healthy controls. All subjects underwent a high resolution imaging protocol (MPRAGE) and an extensive psychopathological evaluation. Images were segmented by means of the algorithm implemented within the SPM2 software; quantitative measures of gray matter were manually obtained for hippocampal and dorso-lateral prefrontal (DLPF) regions. Gray matter in DLPF cortex was significantly reduced in the NDS group, with respect to both DS and healthy subjects. ANCOVA analyses revealed that the volumetric abnormalities found in DS vs. NDS patients were not related to dose or type of antipsychotic treatment. Our structural neuroimaging findings in subjects with schizophrenia, revealed significant differences between the DS and NDS subtypes, which were not influenced by antipsychotic medication, and suggested that DS does not simply represent the more severe end of the schizophrenia spectrum.
Alterations of biological rhythms are well recognized to play a crucial role in the origin and maintenance of depression, but little is known about the profile of circadian rhythms at a premorbid age in adult depressed patients. The present study was aimed at investigating the association, if any, of depressive disorders with biological and behavioural rhythm modifications both at the time of observation and at an earlier age than the clinical onset of depression. The hypothesis was that such modifications could be an early biological index of vulnerability to the illness.
Subjects and methods
One hundred and seventy-eight patients affected by DSM-IV Major Depressive Disorder were examined/observed, compared to a group of 178 matched healthy subjects. All the included subjects were asked to fill in a retrospective questionnaire reporting time of awakening and falling asleep and time of subjective peaks of appetite, energy and cognitive function during “Adolescence” (12–15 years), “Youth” (16–20 years) and “Present condition” periods.
An advance of awakening time by about 20 minutes during “Adolescence” was reported in the depressed subjects as compared to the controls. Awakening is also reported as significantly (P < 0.001) advanced by about 36 minutes during “Youth” in depressed patients, while time of falling asleep at the same age in the patients group shows 19 minutes delay. Regarding “Present condition” an advance of awakening time (33 minutes) in depressed patients was reported, in association with a delay of the subjective peak of cognitive functioning (62 minutes).
Depressed patients show clear-cut differences in sleep pattern as compared to controls, consisting in a constant and significant advance of awakening time, while the time of sleep onset never reaches any statistical difference between the groups throughout ages.
The results are consistent with the hypothesis that early alterations of the general circadian profile can contribute to the onset of adult life Major Depressive Disorders.
Epidemiological studies have reported that the increased risk of developing psychosis in cannabis users is dose related. In addition, experimental research has shown that the active constituent of cannabis responsible for its psychotogenic effect is Delta-9-Tetrahydrocannabinol (THC) (Murray et al, 2007). Recent evidence has suggested an increased in potency (% TCH) in the cannabis seized in the UK (Potter et al, 2007).
We predicted that first episode psychosis patients are more likely to use higher potency cannabis and more frequently than controls.
We collected information concerning socio-demographic, clinical characteristics and cannabis use (age at first use, frequency, length of use, type of cannabis used) from a sample of 191 first-episode psychosis patients and 120 matched healthy volunteers. All were recruited as part of the Genetic and Psychosis (GAP) study which studied all patients who presented to the South London and Maudsley Trust.
There was no significant difference in the life-time prevalence of cannabis use or age at first use between cases and controls. However, cases were more likely to be regular users (p=0.05), to be current users (p=0.04) and to have smoked cannabis for longer (p=0.01). Among cannabis users, 86.8% of 1st Episode Psychosis Patients preferentially used Skunk/Sinsemilla compared to 27.7% of Controls. Only 13.2 % of 1st Episode psychosis Patients chose to use Resin/Hash compared to 76.3% of controls. The concentration of TCH in these in South East London, ranges between 8.5 and 14 % (Potter et al, 2007). Controls (47%) were more likely to use Hash (Resin) whose average TCH concentration is 3.4% (Potter et al, 2007).
Patients with first episode psychosis have smoked higher potency cannabis, for longer and with greater frequency, than healthy controls.
Clinical studies on cognitive effects of second generation antipsychotics produced disappointing findings probably due to the heterogeneity of the clinical populations under investigation, as well as to poor sensitivity of neurocognitive indices. Event-Related Potentials (ERPs) provide a functional measure of electrical brain activity time-locked to discrete stages of information processing. They have been widely used as putative biological markers of cognitive abnormalities in schizophrenia and represent useful indices in the investigation of the cognitive effects of psychotropic drugs.
The present study investigated the effect of risperidone, haloperidol and placebo on N1 and P3 in male healthy subjects.
ERPs were recorded during a three-tone oddball task in which target, standard and rare-nontarget tones were randomly presented. Subjects had to press a button when hearing a target tone. Amplitude and topography of the ERP component maps at peak latencies were compared across conditions. If a significant drug effect was obtained, changes in the cortical sources of the corresponding ERP component were analyzed using Low-Resolution Electromagnetic Tomography (LORETA).
The amplitude of N1 for attended stimuli and of P3 for rare-nontargets (P3a) was significantly increased only by risperidone. No significant change was observed in overall topographic features and in LORETA cortical sources of the same components. No significant drug effect was demonstrated for the latency of all the investigated components and for P3b amplitude.
Our findings suggest that risperidone has a favorable effect on early attention processes and automatic attention allocation.
Body image distortion represents a key clinical feature of eating disorders (EDs), but its neurobiological underpinnings are poorly understood. Previous functional imaging studies yielded inconsistent findings, indicating a possible involvement of fronto-temporal and/or limbic abnormalities. Since these putative regions are highly interconnected and participate into functional networks, it might be useful to study the temporal evolution of their activation during the processing of body images.
The present study was aimed to explore the neurobiological correlates of body image processing in subjects with bulimia nervosa (BN), using the high-time resolution, electrical neuroimaging technique called LORETA.
Event-related potentials (ERPs) were recorded from 30 unipolar channels in 10 subjects with BN and 10 matched healthy controls, during the performance of an emotional counting Stroop task, in which the distorted, non-distorted and scrambled image of their own body and an unfamiliar body image were randomly presented on a computer screen.
Using the LORETA source imaging technique, we found that subjects with BN had a greater activation in frontal areas and anterior cingulate during late phases of body image processing, with respect to healthy controls.
Our results indicate that patients with BN need to allocate a greater amount of attentive and executive resources, than healthy controls, during the integrative stage of body shape processing.
Substance abuse and drug dependence are frequently observed among inmates. Clonazepam is a benzodiazepine approved only for treatment of epilepsy. Despite this, often correctional health care professionals inappropriately prescribed high doses of Clonazepam for the treatment of anxiety and insomnia in prison. It has therefore emerged as a drug of abuse in prison.
In this study we describe the pathway of removal of Clonazepam in an Italian prison.
First, all correctional health care professionals, together with psychiatrist, met to discuss the opportunity and the way to remove this drug from the formulary, considering the clinical and environmental impact on doing this. Psychiatrist recommended guidelines for substitution with others benzodiazepines if necessary.
During the next year (2012) we observed differences in the prescription of benzodiazepines and modifications in inmates behavior (as self-injury, aggressiveness or suicidal behavior), if any. Moreover, we registered if antipsychotics and antidepressant medications were necessary to manage the patients during the removal. We considered the mean number of the inmates in 2011 (n=348) and in 2012 (n=342). Drug doses are reported in number of tablets.
In 2012, the use of Clonazepam, limited to the treatment of epilepsy, reduced (from about 47.000 to 140 tablets) whereas the use of Delorazepam and Triazolam increased. The consumption of other benzodiazepines, antipsychotics and antidepressant medications remained substantially unchanged. Also frequency of suicidal and self-injurious behaviors did not change.
These conclusions support the decision to remove clonazepam for the treatment of anxiety or sleep disorders in prison.
Anorexia Nervosa (AN) is characterized by body-size overestimation that reflects a distortion of body-representation. Self-body recognition can be both implicit and explicit. The former is based on cognitive and perceptual mechanisms, the latter relies on motor simulation. Previous studies showed that participants, when submitted to a hand laterality judgment task (Implicit task) that required mental rotation showed better performances when the stimuli consisted of their own rather than other's hand (self-advantage). By contrast, the self-advantage was absent when self-recognition (Explicit task) was explicitly required.
This study aimed to investigate whether the overestimation of anorexic's own body size extended to the motor representation of the bodily-self influencing the implicit self-advantage. Furthermore, we assessed the possible relationship between the implicitly recognition of one's own body part and Interoceptive Sensitivity (IS; sensitivity to stimuli originating inside of the body).
Healthy Controls (HC) and restrictive AN patients were submitted both to Implicit and Explicit tasks with self and other's hands presented in the original size or modified to look fatter or thinner. We also assessed participants’ IS by means of a heartbeat perception task.
As previously reported, HC showed specific self-advantage effect only when a motor simulation is required. Furthermore higher IS is related to faster performances only in the implicit task in which a mental motor rotation. The differences between AN patients and HC concerning IS and bodily-self recognition will be also discussed.
This study investigates the effect of sex and childhood trauma on affective processing in bipolar disorder (BPD) patients.
In a sample of fifty-six BPD patients, we administered the Childhood Trauma Questionnaire (CTQ), and the Iowa Gambling Task (IGT) and the Affective Go/No-Go (AGNG) to measure affective processing. Analysis of Variance (ANOVA) was used to evaluate the effect of sex and childhood trauma on IGT; Repeated-Measures ANOVAs to measure accuracy and bias measures across conditions on the AGNG.
In the context of childhood abuse, females evidenced a more conservative cognitive style than males by selecting fewer cards from the disadvantageous decks [F(1, 49) = 14.218; P < 0.001] and showed an improvement throughout the task, as noted in a normal learning curve [F(1.49) = 4.385; P = 0.041)]. For the AGNG, an interaction specific to the negative valence stimuli on response bias measures was found. Abused females scored higher (mean = 8.38; SD = 6.39) than abused males (mean = 0.69; SD = 1.19) [F(1.46) = 6.348; P = 0.015].
Severity of childhood trauma was significantly different between sexes. In the context of a history of emotional abuse, male bipolar patients tended toward a more risk-taking behavior compared to female. Further investigations are needed to elucidate potential pathophysiological mechanisms underlying this interaction.
Eye Movement Desensitization and Reprocessing (EMDR) is a recognized first-line treatment for psychological trauma. However its neurobiological bases have not been disclosed yet.
Electroencephalography was used for the first time to fully monitor neuronal activation during whole EMDR sessions including the autobiographical script. Nine clients with major psychological trauma were investigated during the first EMDR session and during the last one performed after processing the index trauma. Comparisons between the EEG of the first and last EMDR session and between the EEG of the clients at the first session and those of 9 controls undergoing the same EMDR procedure were performed.
During both script listening and bilateral stimulation EEG showed significantly higher activity in the prefrontal limbic cortex (Brodmann Areas, BA 9–10) at the first as compared to the last EMDR session. The opposite comparison showed a shift of the prevalent activity towards temporal, parietal and occipital cortical regions (BAs 20, 21, 22, 37, 17, 18, 19) with leftward lateralisation. The comparison between the 9 clients and the 9 controls confirmed the maximal activation in the limbic cortex in the clients before processing the trauma.
The implemented methodology made possible to image for the first time the specific activations associated with the therapeutic actions contemplated by EMDR. The findings suggest cognitive processing of traumatic events following successful EMDR therapy supporting the evidence of distinct neurobiological patterns of brain activations during bilateral ocular stimulation associated with a significant relieve from negative emotional experiences.
This study investigated the relationship between severe childhood abuse and cognitive functions in first-episode psychosis patients and geographically-matched controls. Reports of any abuse were associated with lower scores in the executive function domain in the control group. However, in contrast with our hypothesis, no relationships were found amongst cases.
Hyperspectral soft X-ray emission (SXE) and cathodoluminescence (CL) spectrometry have been used to investigate a carbonaceous-rich geological deposit to understand the crystallinity and morphology of the carbon and the associated quartz. Panchromatic CL maps show both the growth of the quartz and the evidence of recrystallization. A fitted CL map reveals the distribution of Ti4+ within the grains and shows subtle growth zoning, together with radiation halos from 238U decay. The sensitivity of the SXE spectrometer to carbon, together with the anisotropic X-ray emission from highly orientated pyrolytic graphite, has enabled the C Kα peak shape to be used to measure the crystal orientation of individual graphite regions. Mapping has revealed that most grains are predominantly of a single orientation, and a number of graphite grains have been investigated to demonstrate the application of this new SXE technique. A peak fitting approach to analyzing the SXE spectra was developed to project the C Kα 2pz and 2p(x+y) orbital components of the graphite. The shape of these two end-member components is comparable to those produced by electron density of states calculations. The angular sensitivity of the SXE spectrometer has been shown to be comparable to that of electron backscatter diffraction.
Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.
Although psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Short stature caused by growth hormone (GH) deficiency is one of the causes of the “Failure to Thrive” (FTT) condition. In absence of clear organic causes, several different psychosocial conditions may play a role in explaining the FTT phenotype. Advances in developmental psychology have highlighted the role of emotions and caregiving behaviors in the organization of child's personality and psychobiology, with the mother–son attachment bond being considered a fundamental developmental experience. The objective of the present preliminary study was to assess whether there are significant correlations between attachment styles and GH levels in a sample of subjects with non-organic FTT.
We enrolled 27 children (mean age: 9.49 ± 2.63) with non-organic FTT. Perceived attachment security was assessed through the Security Scale (SS) and its subscales focused on maternal and paternal security. Pearson partial correlation was used to test associations between GH levels and SS measures adjusting for confounding factors (i.e. age, gender and BMI).
Across all subjects, GH was significantly positively correlated with general security (r = 0.425; P = 0.038) and maternal security (SSM) (r = –0.451; P = 0.027) and not significantly correlated with paternal security (SSP) (r = 0.237; P = 0.264).
These findings preliminarily suggest that perceived attachment security may play a role in the etiopathogenesis of non-organic GH deficiencies and add to the accumulating evidence that attachment styles are associated with specific psychoendocrine underpinnings.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Even though the scientific evidence supports the benefits of bariatric surgery, its indications and contraindications must be continually revised in order to avoid psychiatric complications. Substance use is more common in patients subjected to bariatric surgery than in the general population. There are reports of increased incidence of alcohol abuse in patients after bariatric surgery.
To review the available evidence, after treat the case of a 50-year-old man with addiction history whose addictive behaviour worsened after undergoing bariatric surgery, with decreased tolerance to alcohol effect and increase of the intake, as well as changes in the graduation of alcohol used (including antiseptic). As a result, a dangerous revolving door that led him to repeated admissions, including Intensive Care Unit.
The case is consistent with the literature that suggests that there is an increased risk of later alcohol-related problems after bariatric surgery. This risk is higher several years post surgery, in patients with previous history of problems related to alcohol, young, men, and Roux-en-Y Gastric Bypass procedure.
The indications for bariatric surgery should thoroughly consider the history of addiction, an adequate assessment of the patient's mental status and psychoeducation about the possible psychiatric side effects, in order to develop preventive strategies.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
A case of bilateral posterior vitreous detachment after electroconvulsive therapy (ECT) has been reported previously in the literature. There is not enough evidence about ocular side effects of this treatment. The literature supports a slight increase in intraocular pressure (IOP), although no ocular complications have been reported in normal, glaucomatous or postsurgical eyes. In this case report, we describe a 73-year-old female patient suffering a recurrent depressive disorder, who was admitted to acute psychiatric unit because a treatment-resistant major depressive episode (after an adequate trial of antidepressant drugs and transcranial magnetic stimulation) and clinical suspicion of visual delusions by her reference psychiatrist. The nonpsychiatric history consisted of hypertension, glaucoma and ulcerative colitis in treatment with azathioprine and mesalazine. After a careful examination in the emergency room, we consulted to ophthalmologist because miodesopsias and glaucoma history. The IOP was normal, but a bilateral posterior vitreous detachment (PVD) was identified. Because this entity is not an absolute contraindication for ECT, and there is scarce evidence, we informed the patient and her family. After that, and through informed consent, we decided to undergo ECT. After fourteen sessions, the patient could be discharged because significant clinical benefit and no ocular complications. Outpatient continuation ECT was indicated.
ECT can be a safe treatment choice in cases of PVD.
Disclosure of interest
The authors have not supplied their declaration of competing interest.