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Objective: To identify neurocognitive and sociodemographic variables that could be associated with clinical response to three modalities of treatment for depression, as well as variables that predicted superior response to one treatment over the others. Method: The present study derives from a research project in which depressed patients (n=272) received one of three treatments - long-term psychodynamic psychotherapy (n=90), fluoxetine therapy (n=91), or a combination thereof (n=91) - over a 24-month period. Results: Sociodemographic variables were not found to be predictive. Six predictive neurocognitive variables were identified: three prognostic variables related to working memory and abstract reasoning; one prescriptive variable related to working memory; and two variables found to be moderators. Conclusions: The results of this study indicate subgroups of patients who might benefit from specific therapeutic strategies and subgroups that seem to respond well to long-term psychodynamic psychotherapy and combined therapy. The moderators found suggest that abstract reasoning and processing speed may influence the magnitude and/or direction of clinical improvement. [ABSTRACT FROM AUTHOR]

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Background: Light severely affects the occurrence of seasonal affective disorder (SAD).Aims: To compare the prevalence of SAD in persons with severe visual impairment and persons with full sight, and in persons with severe visual impairment with or without light perception.Method: This cross-sectional study assessed the Global Seasonality Score (GSS) and the prevalence of SAD among 2781 persons with visual impairment and 4099 persons with full sight using the Seasonal Pattern Assessment Questionnaire (SPAQ).Results: Respondents with visual impairment had significantly higher GSS and prevalence of SAD compared with full sight controls, P<0.001. Light perception respondents were more vulnerable to seasonal change than both full sight and no light perception respondents.Conclusions: The study showed a highly significant association between visual impairment and SPAQ-defined SAD parameters, supporting the hypothesis that decreased retinal light input plays a role in the pathogenesis of SAD. [ABSTRACT FROM AUTHOR]

Providing heroin to people with heroin addiction taking part in medical trials assessing the effectiveness of the drug as a treatment alternative breaches ethical research standards, some ethicists maintain. Heroin addicts, they say, are unable to consent voluntarily to taking part in these trials. Other ethicists disagree. In our view, both sides of the debate have an inadequate understanding of 'voluntariness'. In this article we therefore offer a fuller definition of the concept, one which allows for a more flexible, case-to-case approach in which some heroin addicts are considered capable of consenting voluntarily, others not. An advantage of this approach, it is argued, is that it provides a safety net to minimise the risk of inflicting harm on trial participants. [ABSTRACT FROM AUTHOR]

Major depression is a complex and severe psychiatric disorder whose symptomatology encompasses a critical shift in awareness, especially in the balance from external to internal mental focus. This is reflected by unspecific somatic symptoms and the predominance of the own cognitions manifested in increased self-focus and rumination. We posit here that sufficient empirical data has accumulated to build a coherent biologic model that links these psychologic concepts and symptom dimensions to observed biochemical, cellular, regional and neural network deficits. Specifically, deficits in inhibitory γ-aminobutyric acid regulating excitatory cell input/output and local cell circuit processing of information in key brain regions may underlie the shift that is observed in depressed subjects in resting-state activities between the perigenual anterior cingulate cortex and the dorsolateral prefrontal cortex. This regional dysbalance translates at the network level in a dysbalance between default-mode and executive networks, which psychopathologically surfaces as a shift in focus from external to internal mental content and associated symptoms. We focus here on primary evidence at each of those levels and on putative mechanistic links between those levels. Apart from its implications for neuropsychiatric disorders, our model provides for the first time a set of hypotheses for cross-level mechanisms of how internal and external mental contents may be constituted and balanced in healthy subjects, and thus also contributes to the neuroscientific debate on the neural correlates of consciousness. [ABSTRACT FROM AUTHOR]

Treatment-resistant major depressive disorder remains inadequately treated with currently available antidepressants. Opioid receptors (ORs) are involved in the pathophysiology of depression yet remain an untapped therapeutic intervention. The μ-δ OR heteromer represents a unique signaling complex with distinct properties compared with μ- and δ-OR homomers; however, its role in depression has not been characterized. As there are no ligands exclusively targeting the μ-δ heteromer, we devised a strategy to selectively antagonize the function of the μ-δOR complex using a specific interfering peptide derived from the δOR distal carboxyl tail, a sequence implicated in μ-δOR heteromerization. In vitro studies using a minigene expressing this peptide demonstrated a loss of the unique pharmacological and trafficking properties of δ-agonists at the μ-δ heteromer, with no effect on μ- or δ-OR homomers, and a dissociation of the μ-δOR complex. Intra-accumbens administration of the TAT-conjugated interfering peptide abolished the antidepressant-like and anxiolytic-like actions of the δ-agonist UFP-512 (H-Dmt-Tic-NH-CH(CH2-COOH)-Bid) measured in the forced swim test, novelty-induced hypophagia and elevated plus maze paradigms in rats. UFP-512's antidepressant-like and anxiolytic-like actions were abolished by pretreatment with either μOR or δOR antagonists. Overall, these findings demonstrate that the μ-δ heteromer may be a potential suitable therapeutic target for treatment-resistant depression and anxiety disorders. [ABSTRACT FROM AUTHOR]

Aims: Bipolar disorder (BD) shows some differences across genders. Pregnancy, delivery, and lactation periods of women with BD may sometimes interfere with their treatment. In terms of social and reproductive lives, the characteristics of women with bipolar disorder living in our country have not been thoroughly studied yet. The aims of this study were to investigate the characteristics of marital life, fertility, and social life of the women with BD. Methods: The study was conducted in 5 different centers from 3 parts of the Turkey between January–June 2011. A total of 231 women with the diagnosis of BD have been included in the study. The diagnosis was confirmed by using Structured Clinical Interview for the DSM-IV Axis-I Disorders (SCID-I). Sociodemographical and clinical features of the patients were recorded by using a semistructured form prepared by the authors. Results: The mean age of the patients was 39.19±11.2 years ranging from 18 to 73. Mean age at onset of BD was 24.22±7.5 years of age. The type of diagnosis was BD Type-I in 220 (95.2%) patients, whereas, BD Type-II in 11 (4.8%) patients. Mean numbers of depressive, manic, and hypomanic episodes were 3.36±3.4, 3.75±3.6, and 1.68±2.0, respectively. Mean number of hospitalizations was 3.43±3.8 where 92.3% (n=213) of the participants were hospitalized at least once. History of at least one suicide attempt was proclaimed by 32.5% (n=75) of the patients. Fourty-two (18.2%) patients reported at least one mood episode during their pregnancy. Additionally, a puerperal episode was defined by 20.77% (n=48) of the patients. Almost one fifth of the patients (18.6%) had to suspend their education due to their disorder, whereas 12.1% were not able to pursue it anymore. Frequency of the patients who worked in a regular job was 19.1%. Marital status of the patients were as follows; unmarried 23.3%, married 51.1%, living with a partner 2.2%, divorced 20.3%, and widowed 2.6%. Among the participants 11.3% reported that they could not marry due to stigma of their disorder, whereas, 16% reported a divorce history due to BD. Mean numbers of pregnancy and children were 3.02±2.0 and 2.18±1.4, respectively. Menstrual abnormalities were reported by 51.5% of the patients. Amenorrhea and galactorrhea secondary to the medications were identified in 13.9% and 22.5% of the patients at sometime during their disease course, respectively. Only 28.6% of the participants acknowledged that their psychiatrists have provided information about contraception. Conclusions: When its effects on social life and reproductive life were taken into account, BD harbors many specific conditions for female patients that should be investigated further and kept in mind. This study cross-sectionally investigated characteristics of social and reproductive lives of the patients with BD who were living in Turkey. Its results are important given the fact that it is the first large-scale study conducted in our country on this topic. [ABSTRACT FROM AUTHOR]

A study of patients with anxiety sensitivity with and without accompanying mood or anxiety disorders showed that while anxiety sensitivity was a predictor of substance abuse, there was no sign that patients with mood disorders where any more likely to abuse addictive substances.

The need to belong, a fundamental concept in psychology, organizes a wide range of findings in the study of interpersonal relationships. We suggest that human belongingness needs can be illuminated by examining when they go awry. We review research on social anhedonia, a trait that involves a marked disinterest in interpersonal contact. Social anhedonia has a long history in clinical psychology, particularly in the study of schizotypy and schizophrenia-spectrum disorders, but it is just starting to get attention from social and personality psychologists. Three lines of research-cross-sectional studies of individual differences, longitudinal studies of risk for psychopathology, and experience-sampling studies of interpersonal behavior-suggest that (1) social anhedonia represents genuine social disinterest, not merely shyness, introversion, or social anxiety, and (2) people high in social anhedonia have consistently poorer functioning, including a higher risk for developing schizophrenia-spectrum disorders. Just as satisfied relatedness needs promote flourishing, dysfunctional social needs promote psychopathology. [ABSTRACT FROM AUTHOR]

Ahmed AO, Green BA, Clark CB, Stahl KC, McFarland ME. Latent structure of unipolar and bipolar mood symptoms. Bipolar Disord 2011: 13: 522-536. © 2011 The Authors. Journal compilation © 2011 John Wiley & Sons A/S. Objectives: The taxonic versus dimensional status of mood symptoms has been the subject of debate among mental health professionals. Conventional diagnostic models suggest that mood disorders are categorical; however, the inability of categorical models to adequately account for subthreshold unipolar and bipolar presentations and the heterotypic continuity of symptoms in unipolar and bipolar cases has resulted in growing support for dimensional views. The current study sought to evaluate the relative viabilities of categorical and dimensional models of mood symptoms within a taxometric framework. Methods: We examined the latent structure of mood symptoms in an epidemiological sample drawn from the Collaborative Psychiatric Epidemiological Surveys. Using three taxometric procedures (MAMBAC, MAXEIG, and L-Mode), we analyzed indicators of mania and depression created from the mood symptoms section of the survey. Results: The taxometric analyses supported a taxonic rather than dimensional structure for mania and depression. Membership in the mania and depressive taxa was associated with meeting criteria for DSM-IV lifetime manic episode and major depressive disorder, respectively. We identified a subset of 700 individuals falling into both taxa; membership in this subset was associated with lifetime bipolar disorder status. Group membership predicted designated external variables including help-seeking, family history, and duration of impairment. Within taxon and/or complement groups, severity scores still appeared to predict external variables. Conclusion: Our findings suggest that although taxonic, mood disorders possess meaningful dimensional variation. [ABSTRACT FROM AUTHOR]

Current models divide social phobia into specific (SSP) and generalized (GSP) subtypes and suggest strong overlap between GSP and avoidant personality disorder (APD). Meanwhile, other research suggests reclassifying anxiety and mood disorders as fear and distress disorders. To unify these separate lines of research, this study was designed to test the hypothesis that SSP is more related to fear disorders (e.g., panic and phobias), whereas GSP and APD are more related to distress disorders (e.g., depression and generalized anxiety). Confirmatory factor analysis suggested the best-fitting model had symptoms of GSP, APD, and depression loading on one factor, and symptoms of SSP, panic, and specific phobias loading on a second factor. Key components of this model were (a) the inclusion of GAD symptoms reduced model fit and (b) GSP and APD symptoms significantly predicted SSP symptoms; this is consistent with conceptualizations of individuals with both GSP and SSP reporting performance anxiety. [ABSTRACT FROM AUTHOR]

Many factors may play role in the emergence of suicidal behavior. Familial tendency including some features of personality structure, hopelessness, affective disorder, and suicide behavior have attracted close attention recently. Personality disorders seem to be prevalent in individuals who attempt suicide. Besides it has been reported that personality disorders and other psychiatric disorder comorbidity may increase the risk of suicide. To present the relationship between suicide and personality is quite important for developing strategies in order to prevent suicide attempt. In this field, the data show variability based on scales used for the evaluation of personality, its definition and classification in the research. For example, while some authors used DSM criteria or ICD criteria, others preferred to focus on the temperament and character dimensions of personality. In studies based on diagnostic criteria; B group personality disorders, such as antisocial and borderline personality disorders were found to be most common comorbid personality disorder diagnosis. In studies aiming to investigate the relationship among suicide attempt, temperamenta and character features, the suicide attempters were found to have lower levels of self directedness, cooperativeness, and higher scores for self transcendence. Suicidal patients were inclined to have higher scores in several temperament groups like harm avoidance, novelty seeking, and reward dependence. Tendency to impulsive behavior is reported as a common denominator for suicidal patients. Individuals, who have familial or acquired tendency of impulsivity, could react more dramatically and present with depressive and pessimistic mood when they have difficulties and encounter stress factors in their daily routine and could easily develop depressive disorders. These factors as a whole could lead to self destructive actions like suicide. Individual or familial history of suicide attempts or completed suicide are important clues as to presence of suicidality. Several studies have been conducted on the relationship between suicide attempts and personality features. However, there is not sufficient number of studies conducted on the completed suicide victims. The only methodology that could be used among this group of patients is psychological autopsy which is quite hard to implement because of inherent methodological problems. These factors prevent accumulation of sufficient data on the relationships between completed suicide and personality. However, we should evaluate suicidal behavior comprehensively in order to treat and to prevent its occurrence. Personality features are important in choosing the method of treatment, for social arrangements, and predicting possible new attempts. Our knowledge, about relationship between personality and suicide, will reach a better level by accelerating studies on completed suicide, and investigating suicide, personality, temperament, character relationship more thoroughly. [ABSTRACT FROM AUTHOR]

Objective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability. Mental disorders were assessed with Composite International Diagnostic Interview (CIDI) 3.0. Chronic conditions were ascertained by self-report. Household-residing adults (80 737) participated in 17 population surveys in 16 countries. Results: Perceived stigma was present in 13.5% (22.1% in developing and 11.7% in developed countries). Suffering from a depressive or an anxiety disorder (vs. no mental disorder) was associated with about a twofold increase in the likelihood of stigma, while comorbid depression and anxiety was even more strongly associated (OR 3.4, 95%CI 2.7–4.2). Chronic physical conditions showed a much lower association. Conclusion: Perceived stigma is frequent and strongly associated with mental disorders worldwide. Efforts to alleviate stigma among individuals with comorbid depression and anxiety are needed. [ABSTRACT FROM AUTHOR]

In a randomized, controlled trial, the authors studied an adjunctive, individual psychotherapy, interpersonal and social rhythm therapy (IPSRT) for bipolar disorder. After stabilizing participants with episode appropriate pharmacotherapy and either IPSRT or intensive clinical management (CM), participants were reassigned to IPSRT or CM in conjunction with pharmacotherapy for 2 years of preventative treatment. Early results (n = 82) suggest that altering participants' treatment assignment at entry to the preventative phase is related to risk of recurrence. Participants remaining in the same treatment for both acute and preventative phases had lower rates of recurrence (40%) and levels of symptomatology over the subsequent 52 weeks than those reassigned to the alternate modality. This finding, consistent with the authors' philosophy that bipolar patients benefit from stable routines, suggests that disruptions in the psychosocial treatment plan contribute to worse outcomes.

The current study prospectively examined the impact of social support on symptom severity and recovery from episodes in bipolar disorder, both as a direct influence and as a buffer of life events. Fifty-nine individuals with Bipolar I disorder were followed longitudinally with monthly symptom severity interviews. Social support was measured by the Interpersonal Support Evaluation List and the Interview Schedule for Social Interaction, and life events were assessed using the Life Events and Difficulties Schedule. Individuals with low social support took longer to recover from episodes and were more symptomatic across a 6-month follow-up. Results suggest a polarity-specific effect, in that social support influences depression but not mania. Discussion focuses on theoretical implications of a series of polarity-specific findings within the field.

Childhood onset mood disorders can lead to stress and parenting burden as well as problems within family, peer, and school settings. We highlight the research related to caretaker burden among parents of children with mood disorders, then describe a multifamily psychoeducation group (MFPG) intervention designed to alleviate some of the problems that contribute to caretaker burden. Parental reports of intervention impact are described and differences between immediate and intermediate outcomes are discussed.

Researchers examined the range and frequency of sleep problems in a group of children with affectively ill mothers. Children in this group had more sleep problems than those in a control group, according to maternal ratings. A number of factors could cause this effect including maternal behaviour or a genetic vulnerability to psychiatric problems. An affective illness in the father, as well as in the mother, did not affect the incidence of sleep problems. The research also revealed a high level of co-occurring sleep problems amongst siblings.

Maternal affective style was found to be a stronger predictor of the child's coping style than was the diagnostic status of either mother or child. Sixty-four mother-child pairs participated in the study, grouped by mothers with affective disorders, chronic medical illness or normal. Data was drawn from psychiatric diagnosis of the child, completion of a conflict resolution task and assessment of maternal affective style and of child coping style. Results showed an association between mother and child interactional problems and between critical coping style and affective symptomology of the child.

Attributing negative outcomes to prejudice and discrimination may protect the mood and self-esteem of some stigmatized groups. Thus, the overweight may be low in self-esteem because they blame their weight, but not the attitudes of others, for negative outcomes based on their weight. In an experiment, 27 overweight and 31 normal weight college women received either positive or negative social feedback from a male evaluator. Relative to other groups, overweight women who received negative feedback attributed the feedback to their weight but did not blame the evaluator for his reaction. This attributional pattern resulted in more negative mood for these overweight women in comparison with other groups. Dimensions of stigma that may account for differences in the tendency to attribute negative outcomes to prejudice, and implications of these findings for weight loss programs and psychotherapy for the overweight, are discussed.

Research has consistently reported a female excess of minor physical morbidity and affective disorders compared to men. Using data from a national cross sectional survey of British women and men aged 18-59, this paper explores three prominent explanations for these patterns: that the female excess is due to problems associated with menstruation and the menopause; that it is 'caused' by the social positions which women occupy in contemporary western societies; and that the excess of affective disorders is 'caused' by women's social positions but that their higher rate of physical illness is psychosomatic in origin. The analysis presented here suggests that problems with menstruation and the menopause cannot explain gender inequalities in minor illness. Similarly the argument that the female excess of minor physical illness is psychosomatic is not supported, indeed, there is evidence that women's experience of minor physical illness may 'cause' their higher rates of affective disorders. Finally, with a few exceptions, the relationship between minor illness and four dimensions of social positions - marital status, employment status, social class and income - were broadly the same for women and men but in each social position category, women report higher rates of both types of ill health than men. It is concluded that present measures of these social positions do not capture the differing experiences of women and men and that more gender sensitive measures are needed if gender inequalities in minor illness are to be understood.

Examines the characteristics of a group of patients with major affective disorder. Demographic characteristics; Family history and developmental characteristics; Premorbid adjustment; Characteristics of episodes; Comparisons of type of affective illness and outcome status.

Points out the necessity of treatment for mental depression. Non-availing of appropriate treatment by sufferers; Social perception of the disease; Stigma attached to mental disorders; Difficulty in diagnosis; Limited employer benefit plans; Obstacles to the treatment of depression.

Agranulocytosis is defined as an absolute neutrophil count less than 100/mm3 in association with infectious disease. The risk of agranulocytosis is 0.38% of all clozapine treated cases and there is a relatively lesser incidence in Indian population. The risk of clozapine-induced agranulocytosis and neutropenia is highest in the first 6 months and higher in the initial 18 months after the onset of treatment. There have been very few reports of neutropenia and agranulocytosis after this period. There have so far been no reports of late onset clozapine induced agranulocytosis has been reported from India. A case of late onset clozapine induced agranulocytosis with possible mechanism of the same is reported. [ABSTRACT FROM AUTHOR]

The differential effects of inner-and outer-directed negative emotions on withdrawing behavior and the conditioning effects of social support on the understudied, deviant coping behavior of African Americans are examined. Data from a national survey of African American provide empirical evidence that depression and anxiety have larger effect on withdrawing behavior than anger and that social support tends to weaken or buffer the effects of nonangry emotions on withdrawing behavior.

Background: Mania is an important psychological problem. This disorder can be detected anywhere in the world. This psychological disorder becomes an important concern in modern psychological medicine. Aims: There are some researches on the pathogenesis of this disease; however, there is no clear-cut on its etiopathogenesis. The big query is on the genetic underlying of the mania. Materials and Methods: Here, the author uses the physiological genomics study to better understand the pathogenesis of mania. Results: According to this work, the physiogenomics relationship on chromosomes could not be identified. Conclusion: The result from this study shows that mania might not have a genetic, but epigenic origin, which is different from the well-known disorder in psychological medicine, Alzheimer's disease. [ABSTRACT FROM AUTHOR]

A study of a local chapter of the National Alliance for the Mentally Ill (NAMI) suggests that parents think about the causes of their offsprings' psychiatric disabilities in terms of psychogenic, organic and moral attributions. Comparisons of retrospective and current self-reports suggest that parents' attributional processes were influenced by their organizational participation. Comparatively stronger endorsement of the organic attribution (that biochemical illness is a primary causal factor) and comparatively weaker endorsement of the psychogenic attribution (that deficits in parenting are a primary causal factor) were associated with participation. Increased comfort in parent-child relationships was also associated with participation. It was speculated that these cognitive and behavioral changes were mediated by learning a comprehensive schema of information about schizophrenia that included information about causes, symptoms and methods of treatment.

The article presents several biographies of medical personnel at Tufts Medical Center. It says that S. Nassir Ghaemi is the Director of Mood Disorders Program at Tufts Medical Center in Boston, Massachusetts. It tells that doctor Paul Vohringer has received Chilean state scholarship for a fellowship in mood disorders at Tufts Medical Center. It mentions Elizabeth A. Whitman who is affiliated with the Mood Disorders Program at the said medical center.

The article discusses an issue regarding mobile phone addiction to be given a diagnostic criteria. It explains that inappropriate and uncontrolled use of the mobile phone can cause behavioral, affective and social problems. It mentions the development of a diagnostic tool of cellular phone dependence that is derived using the Diagnostic and Statistical Manual of Mental Disorders IV Text Revision (DSM-IV TR) that contains three factors which includes Abstinence, Lack of control and problems derived from the use and Tolerance and interference with other activities.

Enquiries into patients' perception of psychosocial support from families should help objectively to identify the strengths and needs of families with sick members, in order to enhance management. The aim of this study was to identify the categories of relatives in the extended family whom a sample of Nigerian psychiatric patients perceived as having provided material, social and emotional support, and the factors associated with these perceptions. 123 schizophrenics and 31 patients with major affective disorders attending out-patient clinics were interviewed. Using operational definitions of family member (i.e. tendency to confide in and expect support from a relative), it appears that the size of extended family network that was mostly relied upon for support was five, including parents, full siblings, uncles/aunts, first cousins and in-laws. There were no significant differences in summary scores of family size and social support between the two illness groups. Age and duration of illness were significantly negatively correlated with perception of supports. The size of family network with whom patients interacted was predicted by tendency to confide in members, and emotional support. The findings indicate that the presumed support of the extended family should not negate the need to strengthen the resources of the nuclear family, in order to provide a focus for attraction and deployment of materials needed for the effective care of patients. Key words - psychosocial support, family networks, psychiatric patients, Nigeria