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The aim was to analyse invasive pneumococcal disease (IPD) serotypes in children aged ⩽17 years according to clinical presentation and antimicrobial susceptibility. We conducted a prospective study (January 2012–June 2016). IPD cases were diagnosed by culture and/or real-time polymerase chain reaction (PCR). Demographic, microbiological and clinical data were analysed. Associations were assessed using the odds ratio (OR) and 95% confidence intervals (CI). Of the 253 cases, 34.4% were aged <2 years, 38.7% 2–4 years and 26.9% 5–17 years. Over 64% were 13-valent pneumococcal conjugate vaccine (PCV13) serotypes. 48% of the cases were diagnosed only by real-time PCR. Serotypes 3 and 1 were associated with complicated pneumonia (P < 0.05) and non-PCV13 serotypes with meningitis (OR 7.32, 95% CI 2.33–22.99) and occult bacteraemia (OR 3.6, 95% CI 1.56–8.76). Serotype 19A was more frequent in children aged <2 years and serotypes 3 and 1 in children aged 2–4 years and 5–17 years, respectively. 36.1% of cases were not susceptible to penicillin and 16.4% were also non-susceptible to cefotaxime. Serotypes 14, 24F and 23B were associated with non-susceptibility to penicillin (P < 0.05) and serotypes 11, 14 and 19A to cefotaxime (P < 0.05). Serotype 19A showed resistance to penicillin (P = 0.002). In conclusion, PCV13 serotypes were most frequent in children aged ⩽17 years, mainly serotypes 3, 1 and 19A. Non-PCV13 serotypes were associated with meningitis and occult bacteraemia and PCV13 serotypes with pneumonia. Non-susceptibility to antibiotics of non-PCV13 serotypes should be monitored.
One of the great challenges in the use of nanomaterials is their production at low costs and high yields. In this work aluminum nanoparticles, from aluminum powder, were produced by wet mechanical milling through a combination of different attrition milling conditions such as ball-powder ratio (BPR) and the amount of solvent used. It was observed that at 600 rpm with a BPR of 500/30 g for 12 h, it was possible to produce nanoparticles with a size close to 20 nm, while at 750 rpm with a BPR of 380/12.6 g for 12 h, nanoparticles of approximately 10 nm were obtained. Scanning and transmission electron microscopy confirmed that the milling product is an agglomeration of nanoparticles with different sizes. These results show the feasibility of obtaining aluminum nanoparticles by mechanical milling using only ethanol as solvent, avoiding hazardous by-products obtained from chemical routes, and the use of complicated methods such as laser ablation and arc discharge.
The COVID-19 pandemic has created an unprecedented global crisis, necessitating drastic changes to living conditions, social life, personal freedom and economic activity. No study has yet examined the presence of psychiatric symptoms in the UK population under similar conditions.
We investigated the prevalence of COVID-19-related anxiety, generalised anxiety, depression and trauma symptoms in the UK population during an early phase of the pandemic, and estimated associations with variables likely to influence these symptoms.
Between 23 and 28 March 2020, a quota sample of 2025 UK adults aged 18 years and older, stratified by age, gender and household income, was recruited by online survey company Qualtrics. Participants completed standardised measures of depression, generalised anxiety and trauma symptoms relating to the pandemic. Bivariate and multivariate associations were calculated for demographic and health-related variables.
Higher levels of anxiety, depression and trauma symptoms were reported compared with previous population studies, but not dramatically so. Anxiety or depression and trauma symptoms were predicted by young age, presence of children in the home, and high estimates of personal risk. Anxiety and depression were also predicted by low income, loss of income and pre-existing health conditions in self and others. Specific anxiety about COVID-19 was greater in older participants.
This study showed a modest increase in the prevalence of mental health problems in the early stages of the pandemic, and these problems were predicted by several specific COVID-related variables. Further similar surveys, particularly of those with children at home, are required as the pandemic progresses.
In this work, low-Pt content nanocatalysts (≈ 5 wt. %) supported on Hollow Carbon Spheres (HCS) were synthesized by two routes: i) colloidal conventional polyol, and ii) surfactant-free Bromide Anion Exchange (BAE). The nanocatalysts were labelled as Pt/HCS-P and Pt/HCS-B for polyol and BAE, respectively. The physicochemical characterization of the nanocatalysts showed that by following both methods, a good control of chemical composition was achieved, obtaining in addition well dispersed nanoparticles of less than 3 nm TEM average particle size (d) on the HCS. Pt/HCS-B contained more Pt0 species than Pt/HCS-P, an effect of the synthesis method. In addition, the structure of the HCS remains more ordered after BAE synthesis, compared to polyol. Regarding the catalytic activity for the Oxygen Reduction Reaction (ORR) in 0.5 M KOH, Pt/HCS-P and Pt/HCS-B showed a similar performance in terms of current density (j) at 0.9 V vs. RHE than the benchmark commercial 20 wt. % Pt/C. However, Pt/HCS-P and Pt/HCS-B demonstrated a 6 and 5-fold increase in mass catalytic activity compared to Pt/C, respectively. A positive effect of the high specific surface area of the HCS and its interactions with metal nanoparticles and electrolyte, which promoted the mass transfer, increased the performance of Pt/HCS-P and Pt/HCS-B. The high catalytic activity showed by Pt/HCS-B and Pt/HCS-P for the ORR, even with a low-Pt content, make them promising cathode nanocatalysts for Anion Exchange Membrane Fuel Cells (AEMFC).
We investigate the late-time Richtmyer–Meshkov instability (RMI) growth of sinuous perturbations on an air/sulphur hexafluoride interface (Atwood number,
$A \sim 0.67$
) subjected to a Mach 1.2 planar shock wave at Los Alamos National Laboratory's vertical shock tube facility. Interface perturbations are established using a novel membraneless technique where cross-flowing air and SF
separated by an oscillating splitter plate create a perturbed density interface. The interface formed has multi-modal features and residual small perturbations, however, a dominant mode is still noticeable. The late-time perturbation growths scale with
initial conditions (where
is the wavenumber and
is the initial amplitude of the dominant mode) as measured at the pre-shock interface. Past nonlinear models based on potential-flow theory, heuristic/interpolation approaches, Padé approximants and numerical simulations are evaluated against present experimental results. Accounting for an explicit
dependence in Sadot et al.'s (Phys. Rev. Lett., vol. 80, issue 8, 1998, pp. 1654–1657) model, we propose an empirical rational function that captures the asymptotic behaviour of perturbation growth for a broad range of initial conditions (
$0.30 \leq ka_0 \leq 0.86$
). The onset of mixing transition and its initial condition dependence are investigated with respect to the minimum state criterion (
$Re = 1.6 \times 10^5$
) for unsteady flows by Zhou (Phys. Plasmas, vol. 14, 2007, 082701). Earlier mixing transitions for higher
initial conditions are noted from local and global Reynolds number estimates which are corroborated by the existence of an inertial sub-range and formation of mixing regions indicating the physical significance of the minimum state criterion in RMI flows. The transition is accompanied by the increasing teapot-like appearance of joint probability density functions of
(invariants of the reduced velocity gradient tensor), establishing the technique as a useful tool for turbulence detection in two-dimensional diagnostics.
Prior theory and research has implicated disgust as relevant to some, but not all phobias.
The current study examined whether anxiety sensitivity is more relevant to certain specific phobias and whether disgust sensitivity is more relevant to other specific phobias.
Participants (n = 201) completed measures of anxiety sensitivity, disgust sensitivity and measures of aversive reactions in the presence of two fear-relevant stimuli (i.e. heights and small, enclosed spaces) and two disgust-relevant stimuli (i.e. spiders and blood/injury).
Results of multiple linear regression analyses revealed that disgust sensitivity showed significant associations with aversive reactions in all four stimulus domains after controlling for anxiety sensitivity. After controlling for disgust sensitivity, anxiety sensitivity showed associations with the two fear-relevant phobias but not with the two disgust-relevant phobias included in this study. Anxiety sensitivity also showed an association with variance specific to one of the two fear-relevant specific phobias included in the study. Disgust sensitivity also showed associations with variance specific to both of the disgust-relevant phobias included in the study but not with variance specific to either of the fear-relevant specific phobias.
These results provide evidence that the distinction between fear-relevant and disgust-relevant specific phobias is meaningful and also implicate disgust sensitivity as relevant to aversive reactions to all stimuli included in this study.
In 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America.
We searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela.
The number of psychiatric beds decreased in 15 out of 17 Latin American countries (median −35%) since 1991. Our findings indicate the total removal of 69 415 psychiatric beds. The prison population increased in all countries (median +181%). Panel data regression analyses showed a significant inverse relationship −2.70 (95% CI −4.28 to −1.11; p = 0.002) indicating that prison populations increased more when and where more psychiatric beds were removed. This relationship held up when introducing per capita income and income inequality as covariates −2.37 (95% CI −3.95 to −0.8; p = 0.006).
Important numbers of psychiatric beds have been removed in Latin America. Removals of psychiatric beds were related to increasing incarceration rates. Minimum numbers of psychiatric beds need to be defined and addressed in national policies.
To propose malnutrition screening methods for the elderly population using predictive multivariate models. Due to the greater risk of nutrition deficiencies in ageing populations, nutritional assessment of the elderly is necessary in primary health care.
This was a cross-sectional study. Multivariate models were obtained by means of discriminant analysis and binary logistic regression. The diagnostic accuracy of each multivariate model was determined and compared with the Chang method based on receiver operating characteristic curves. The optimal cut-point, sensitivity, specificity and Youden index were estimated for each of the models.
The province of Cordoba, Spain.
Two hundred fifty-five patients over the age of 65 years from three health centres and three nursing homes.
Fourteen models for predicting risk of malnutrition were obtained, six by discriminant multivariate analysis and eight by binary logistic regression. Sensitivity ranged from 55·6 to 93·1 % and specificity from 64·9 to 94 %. The maximum and minimum Youden indexes were 0·77 and 0·49, respectively. We finally selected a model which does not require a blood test.
The proposed models simplify nutritional assessment in the elderly and, except for number 2 of those calculated by binary logistic regression, have better diagnostic accuracy than the Spanish version of the Mini Nutritional Assessment screening tool. The selected model, whose validation is necessary for the future with other different samples, provides good diagnostic accuracy, and it can be performed by non-medical personnel, making it an accessible, easy and rapid tool in daily clinical practice.
Impairments in social cognition contribute significantly to disability in schizophrenia patients (SzP). Perception of facial expressions is critical for social cognition. Intact perception requires an individual to visually scan a complex dynamic social scene for transiently moving facial expressions that may be relevant for understanding the scene. The relationship of visual scanning for these facial expressions and social cognition remains unknown.
In 39 SzP and 27 healthy controls (HC), we used eye-tracking to examine the relationship between performance on The Awareness of Social Inference Test (TASIT), which tests social cognition using naturalistic video clips of social situations, and visual scanning, measuring each individual's relative to the mean of HC. We then examined the relationship of visual scanning to the specific visual features (motion, contrast, luminance, faces) within the video clips.
TASIT performance was significantly impaired in SzP for trials involving sarcasm (p < 10−5). Visual scanning was significantly more variable in SzP than HC (p < 10−6), and predicted TASIT performance in HC (p = 0.02) but not SzP (p = 0.91), differing significantly between groups (p = 0.04). During the visual scanning, SzP were less likely to be viewing faces (p = 0.0001) and less likely to saccade to facial motion in peripheral vision (p = 0.008).
SzP show highly significant deficits in the use of visual scanning of naturalistic social scenes to inform social cognition. Alterations in visual scanning patterns may originate from impaired processing of facial motion within peripheral vision. Overall, these results highlight the utility of naturalistic stimuli in the study of social cognition deficits in schizophrenia.
The Centers for Disease Control and Prevention (CDC), Division of State and Local Readiness (DSLR), Public Health Emergency Preparedness(PHEP) program funds 62 recipients to strengthen capability standards to prepare for and respond to public health emergencies. Recipients use these PHEP resources in addition to CDC’s administrative and scientific guidance to support preparedness and response program planning and requirements. It is expected that public health agencies develop and maintain comprehensive emergency preparedness and response plans in preparation for disasters such as hurricanes. The 2017 historic hurricane season highlighted how emergency planning and collaborative operational execution is important for public health agencies to effectively prepare for and respond to both the immediate and long-term population health consequences of these disasters. In 2017, the southeastern United States (US) and US Caribbean territories experienced 3 Category 4 or higher Atlantic hurricanes (Harvey, Irma, and Maria) within a 5-week period. This paper highlights selected case studies that illustrate the contributions and impact of jurisdictional emergency management planning and operational capacity supported by capability standards during the 2017 hurricane season. Although the magnitude of the 2017 hurricanes required public health officials to seek additional assistance, the following case studies describe the use of public health preparedness systems and recovery resources supported by the PHEP program.
The COVID-19 outbreak could be considered as an uncontrollable stressful life event. Lockdown measures have provoked a disruption of daily life with a great impact over older adults’ health and well-being. Nevertheless, eudaimonic well‐being plays a protective role in confronting adverse circumstances, such as the COVID-19 situation. This study aims to assess the association between age and psychological well-being (personal growth and purpose in life). Young–old (60–70 years) and old–old (71–80 years) community-dwelling Spaniards (N = 878) completed a survey and reported on their sociodemographic characteristics and their levels of health, COVID-19 stress-related, appraisal, and personal resources. Old–old did not evidence poorer psychological well-being than young–old. Age has only a negative impact on personal growth. The results also suggest that the nature of the COVID-19 impact (except for the loss of a loved one) may not be as relevant for the older adults’ well-being as their appraisals and personal resources for managing COVID-related problems. In addition, these results suggest that some sociodemographic and health-related variables have an impact on older adults’ well-being. Thus, perceived-health, family functioning, resilience, gratitude, and acceptance had significant associations with both personal growth and purpose in life. Efforts to address older adults’ psychological well-being focusing on older adults’ personal resources should be considered.
Studies have shown that there are overlapping traits and symptoms between autism and psychosis but no study to date has addressed this association from an epidemiological approach in the adult general population. Furthermore, it is not clear whether autistic traits are associated with specific symptoms of psychosis or with psychosis in general. We assess these associations for the first time by using the Adult Psychiatric Morbidity Survey (APMS) 2007 and the APMS 2014, predicting an association between autistic traits and probable psychosis, and specific associations between autistic traits and paranoia and strange experiences.
Participants (N = 7353 in 2007 and 7500 in 2014) completed the Psychosis Screening Questionnaire (PSQ) and a 20-item version of the Autism Quotient (AQ-20). Binomial logistic regressions were performed using AQ-20 as the independent variable and probable psychosis and specific symptoms as dependent variables.
In the APMS 2007 dataset, significant associations were found between autism traits and probable psychosis, paranoia, thought insertion, and strange experiences. These results were replicated in APMS 2014 but with the additional significant association between autistic traits and hallucinations. Participants in the highest quartile of the AQ-20, compared with the lowest quartile, had an increased risk of probable psychosis of odds ratio (OR) = 15.5 [95% confidence interval (CI) 4.57–52.6] in APMS 2007 and OR = 22.5 (95% CI 7.64–66.3) in APMS 2014.
Autistic traits are strongly associated with probable psychosis and psychotic experiences with the exception of mania. Limitations such as the cross-sectional nature of the study are discussed.
Nowadays several authors defend the existence of an obsessive-compulsive (OC) spectrum in which eating disorders (ED), especially anorexia nervosa, would be include. We investigated the presence of OC symptoms in bulimic and anorexic patients and its relationships with personality traits.
The Maudsley Obsessive Compulsive Questionnaire (MOCQ) and the revised version of the Temperament and Character Inventory (TCI-R) were administered to patients and healthy controls.
Patients show higher scores than controls in the global punctuation of de MOCQ, and in the checking and doubt subscales. Cases also score higher in harm avoidance (dimension associated with personality disorders of cluster C) and in its subscale anticipatory worry. No differences were found between patients subgroups.
Restricting Anorexia Nervosa (RAN, n = 21)
Binging-Purging Anorexia Nervosa (BPAN, n = 29)
Bulimia Nervosa (BN, n = 34)
Control (C, n = 52)
RAN, BPAN, BN > C
Checking subscale (MOCQ)
BPAN, BN > C
RAN, BPAN, BN > C
Harm avoidance (TCI-R)
BPAN, BN > C
Anticipatory worry vs optimism (TCI-R)
RAN, BPAN, BN > C
Patients present more OC behaviours in comparison with healthy population but measures of obsessivity do not differ between the types of ED. Traits of personality characteristically associated to cluster C and to anxiety disorders seem to be also common features. These results do not support a separated classification of RAN into the OC spectrum.
The aim of this study is to assess the personality traits in a sample of Spanish anorexic and bulimic outpatients.
The revised version of the Temperament and Character Inventory was administered to 76 women attended in an Eating Disorders Unit and to 46 healthy controls. Both groups were matched by gender, age and instruction.
Diagnoses in the sample were distributed as follows: bulimia nervosa (BN) 33, binging-purging type anorexia nervosa (BPAN) 23 and restricting anorexia nervosa (RAN) 18. RAN patients were significantly younger (21.6 vs. 26.3 p < 0.01). Differences in the harm avoidance, persistence and selfdirectedness subscales of the TCI were found (see table).
BPAN, BN > C
RAN > C
C > RAN, BPAN, BN
In concordance with previous reports, compared with healthy controls, patients show lower scores in self-directedness. Persistence seems to be associated with restricting behaviours, whereas harm avoidance with binging and purging. RAN trends to have low scores in novelty seeking items and BN shows lower reward dependence, but this differences are not statistically significant, perhaps because of sample size.
Oxidative stress suposses an imbalance between oxidants and antioxidants molecules. Negative and positive family environment have been related with worse and better outcomes respectively in schizophrenic patients.
Our objetive is to determine antioxidant defense in healthy controls and unaffected relatives of early onset psychosis patients and to asses its relationship with familiar environment.
We included 82 healthy controls (HC) and 14 healthy controls with second degree family history of psychosis (HCWFHP), aged between 9 to 17.
Total antioxidant status and lipid peroxidation test were determined in plasma and antioxidant enzime activities and glutathione levels were determined in erytrocytes.
We used the Global Assesment Functioning scale (GAF) and the Family Environment Scale (FES). The FES is made up of ten subscales: cohesion, expressiveness, conflict, independence, achievement, intellectual-cultural, social, moral, organization and control.
The analyses showed a significant decrease in total antioxidant level in HCWFHP compared with the HC (U Mann Withney = 281.00, p=0.009, effect size= -0.78).
HC and HCWFHP did not differ in the GAF scale, nevertheless the scores of HCWFHP were significantly higher in cohesion and intellectual-cultural dimensions of the FES (p=0.007, p=0.025).
Adjusting by this two FES dimensions, antioxidant status remained significantly different between groups: OR= 10.86, p=0.009.
Although we cannot induce causative relations, we can state that family environment is not playing a role in inducing oxidative stress in these subjects. It could be hypothesized that families with affected relatives protect themselves with positive envionmental factors such as cohesion and intellectual-cultural activities.
Numerous reports have pointed out the risks adverse hematological effects associated with psychotropic drugs. We report a severe case of thrombocytopenia in a healthy 79 year-old patient happened after mirtazapine administration. Suggesting an immune mechanism.
Report a case of mirtazapina-induced inmuno tromnbocitopenia, review of bibliography and to propose monitoring and management strategies.
Aims and methods
Care report: PPD (n°HC 16996) treatment with mirtazapina 15 mg/d.Clinical: equimosis cutaneous multiple. Without focalidad. From the point of view etiológico discards organicity (aplasia megacariocítica, processes linfoproliferativos and infectious). An analytical previous examination supports normal platelets until April, 2009, in February the dose doubles from 15 to 30 mg (of mirtazapina). Fatal conclusion: exitus for hemorrhage intracraneal in September, 2009. Clinical judgment: Several Trombopenia, uncertain origin.
Literature review: The first well-documented case of mirtazapine-induced immune thrombocytopenia is “Glycoprotein IIb/IIIa complex is the target in mirtazapine-induced immune thrombocytopenia” (Blood Cells, Molecules, and Diseases, 2003).The analysis “Proportion of drug-related serious rare blood dyscrasias” (American Journal of Hematology, 2004) suggests that a substantial fraction of blood dyscrasias may be attributable to drug therapy.
Hematologic side effects from psychotropics may present as serious or even fatal consequences of treatment. Incidences of hematological changes for antidepressants were much lower (about 0.01%).
Before initiating therapy with antidepressants, a carefully case history, with special attention to heart disease, family record and medical treatments, should be obtained. Clinical best practice regarding the safe and effective use of psychotropic medications is based on appropriate monitoring of drug-related problems.
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric disorders in children (5.29%) worldwide, and highly comorbid with other psychiatric disorders.
To evaluate ADHD symptoms prevalence/frequency in young ambulatory patients diagnosed with other psychiatric disorders.
Non-interventional, multicentre, and cross-sectional, retrospective study. Patients aged 15-24 having a primary diagnosis of: Substance Use (SUD), Borderline personality (BPD), Anxiety (AD), Affective, Antisocial Personality (APD), or Conduct Disorders(CD) or Bulimia, giving inform consent were included (not previously treated/diagnosed with ADHD). ADHD symptoms prevalence was captured following DSM-IV criteria and moderate ADHD symptoms was considered as scoring >24 in the ADHD RS (DuPaul).
795 patients meeting in- and exclusion criteria were analyzed in the study. Mean age was 21.12 (SD: 2.64), and the majority were men (57.5%).A probable ADHD diagnosis (6 or more DSMIV symptoms and ADHD RS moderate symptoms) was apparent in: 40.3% of SUD patients, 23.7% of AD, 21.7% of Affective Disorders, 30.3% of Bulimia, 48.3% of BPD, 41.7% of CD and 57.1% of APD. Moreover, patients with SUD (ODD: 1.54) and BPD (ODD: 2.2) had significantly more risk vs. rest of population studied of having moderate ADHD symptoms. Also, patients having a probable ADHD diagnosis were significantly rated more severe in the GCI-Severity scale than the rest of population studied.
This cross-sectional study showed that ADHD symptoms are highly prevalent in young ambulatory patients diagnosed primarily with other psychiatric disorders, what seems to worse patient outcome if not diagnosed/managed on time. ADHD comorbidity risk varied significantly depending on the primary diagnosis.
Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.
78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).
ADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.
ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.
The ADHD prevalence in our sample of BD and relatives weren’t higher than general population.
- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.
- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.
Obsessive compulsive-disorder (OCD) is a group of highly debilitating condition characterized by intrusive troubling thoughts, repetitive, compulsive behaviors or mental rituals. A notable percentage of patients are refractory to pharmacological treatment and cognitive behaviour therapy. Increasing attention has been paid to the efficacy of Deep Brain Stimulation (DBS) therapies in alleviating pharmacoresistant psychiatric disorders including OCD.
The aim of this prospective study was to determine the efficacy of DBS using several targets in a pharmacoresistant OCD population with heterogeneous symptoms.
Five patients (3 males) have been included in the study. Patients were classified according to their prominent features as follows: contamination/cleaning, symmetry/checking, exactness/counting and forbidden thoughts.
The entire surgical procedure was performed under general anaesthesia. Direct targeting based on stereotactic MRI without microelectrode recordings was done. A combination of two of the following targets was simultaneously implanted for all patients: subthalamic nucleus, accumbens nucleus and bed nucleus of stria terminalis, limbic globus pallidus internus.
Patients were assessed pre-and postoperatively using the Yale-Brown Obsessive Compulsive Scale.
Mean age at surgery was of 42.6±12.68 years. Mean follow-up with DBS was of 21±14.88 months.
Mean preoperative Y-BOCS scores was 31.6±2.70 and of 11±7.97 (p=0,057, Wilcoxon signed Rank test).
Subthalamic nucleus and accumbens nucleus targets seem to be comparable in alleviating several subtypes of compulsions (checking, cleaning, counting) as well as obsessions. Further investigations are required to assess the role of limbic globus pallidus in improving pharmacoresitant OCD. Implanted system was well accepted without triggering new obsessions.