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Recent explorations into the gut microbiome of humans and animals reveal implications in chronic physical and mental health disorders. Relatively little is known regarding the relationship of gut microbiome and depression. In the current review, we reviewed existing scientific data related to the gut microbiome and healthy patients versus patients with depression. Additionally, scientific literature containing the utility of microbiome interventions to improve depression symptoms was reviewed.A PubMed and Clinical Key literature search combined the key terms 'gut,' 'microbiome,' 'bacteria,' and 'depression' to identify studies investigating these relationships.76 relevant articles were identified. Human and animal studies reviewed examined marked alterations in the dominant bacterial phyla in the gut of individuals with depression, the connection between leaky gut and neuroinflammation in depression, brain regulatory centers impacted by changes in the gut microbiome, and the benefits of the addition of a probiotic/prebiotic for gut and mental health.The current review confirmed the suspected direct communication between the gut microbiome, brain functioning, and depression. Additionally, studies suggest antibiotics disrupt the gut microbiome. There are important implications for psychiatrists in providing opportunities for intervention and enhancement of current treatments for individuals with depression.

The Independent Living Scales Health and Safety (ILS HS) scale is commonly used by neuropsychologists when evaluating older adults' instrumental activities of daily living (IADLs). However, there is a minimal amount of research on its use in dementia populations and, specifically, its relationship to other neuropsychological measures. The present study investigated relationships between the ILS HS scale and measures of cognition and depression. The study utilized archival data from a sample (

As the population is aging, there is increasing need for clinicians with expertise in the evaluation and management of cognitive and emotional disorders in older adults. Neuropsychological evaluations are a critical tool in the assessment of these conditions, providing information as to cognitive strengths and weaknesses. Pertinent emotional and behavioral symptoms are also assessed. This article provides an introduction to what these assessments entail (i.e., length of assessment, insurance coverage) and the domains that are typically covered (i.e., attention, language, memory, psychiatric symptoms). Examples are provided as to the types of referral questions that can be addressed. We also discuss how information gleaned from these evaluations can aid in differential diagnosis. Specifically, pattern of test performance may be suggestive of a particular disorder. Assessment results can also aid in the treatment, management, and dispositional planning for aging patients. Case examples, relevant to geriatric psychiatry, are used to illustrate these points.

Previous research has yielded minimal empirical support for the theoretically formulated five-factor structure of the RBANS, a brief, yet comprehensive standardized neuropsychological test battery used to assess cognitive impairment. The present study tested the theoretically formulated five-factor structure, as well as three alternative factor solutions, using a combination of exploratory and confirmatory factor analytic approaches. The present study utilized archival data from a clinical sample of 150 older adults who were evaluated at an outpatient neuropsychological service. A total of four RBANS models were specified using confirmatory factor analysis. Results of the five-factor model demonstrated good to excellent fit following modifications to the model. Results of chi-square difference tests demonstrated that the five-factor model was statistically superior to the two- and three-factor models (p

Moyamoya disease (MMD) is a rare cerebral vasculopathy with limited information on the associated cognitive and emotional sequelae, particularly presenting in a psychiatric setting. We present the case of a 25-year-old female with a history of MMD and depressive disorder. She underwent revascularization surgery following an ischemic stroke at age 15 years. Magnetic resonance imaging at the time of the current assessment revealed markedly abnormal appearance in the anterior cerebral circulation with extensive periventricular collateral vasculature involvement. Neuropsychological assessment data revealed deficits in inhibition and problem-solving, consistent with frontal lobe dysfunction. We discuss the importance of further research on the neuropsychological sequelae of MMD.

We wanted to determine the neurocognitive profile of adult patients with moyamoya disease prior to neurosurgical intervention. The experience of three United States medical centers, Columbia University, University of Illinois at Chicago, and the University of Texas Southwestern Medical Center at Dallas, were combined. Clinical data from adult patients (N = 29) referred for neuropsychological evaluation from 1996 to 2008 were reviewed. Neurocognitive functioning was assessed using standardized neuropsychological tests and all data were converted to z-scores. Memory, attention, processing speed, verbal memory, visuo-spatial, language, and executive functions were examined. Cognitive dysfunction was defined as performance in two or more cognitive domains 1.5 standard deviations below age-corrected normative means OR one or more cognitive domains two standard deviations below age-corrected normative means. Manual strength and dexterity, as well as depressive symptoms, were also assessed. Two-thirds of patients demonstrated neurocognitive dysfunction. A large proportion of patients were found to have pronounced cognitive dysfunction (>2 SD below the mean) on tests of processing speed (29%), verbal memory (31%), verbal fluency (26%) and executive function (25%). Manual strength and dexterity were also affected in many patients, with impairment found in 36-58% of patients. Twenty-eight percent of patients reported moderate to severe depression, but depressive symptoms did not correlate with neurocognitive findings. A large proportion of adults with moyamoya disease demonstrate disruption of neurocognition in a broad range of functions, particularly those mediated by subcortical and frontal regions. The pattern of deficits suggests a mechanism of diffuse small vessel disease possibly caused by chronic hypoperfusion.

Within the expanding field of clinical neuropsychology, the subspecialty of forensic neuropsychology has developed. Currently, there is considerable diversity within the discipline as to how practitioners approach test selection, reports, and number of hours billed. How individuals handle these issues is subject to debate, but what is clear is that there are no specific guidelines as to how to conduct these evaluations. The current study provides an introduction to the issues faced by clinical neuropsychologists completing forensic evaluations. In addition, the authors present how the relevant issues are addressed in one neuropsychology service housed within a university-affiliated academic medical center.

When examining visual memory test results one must be aware of other variables that impact performance, particularly in individuals with traumatic brain injury who have broad cognitive deficits. The present investigation sought to determine the extent to which executive functioning, as operationally defined as perceptual organization, planning, and mental flexibility, impacted Rey Complex Figure Test (RCFT) performance. Results indicated that executive functioning measures accounted for between 11% and 16% of the variance in RCFT scores. ANCOVAs revealed that the relationship between degree of executive impairment and RCFT memory trials were non-significant when performance on the copy trial was controlled for. Furthermore, speed of processing and word reading were significantly related to RCFT performance. The predicted relationship with fine motor functioning was not supported. Implications and future research directions are discussed.

The WAIS-III Digit Span and Vocabulary subtests were investigated as indicators of feigned cognitive impairment. Participants included 64 undergraduates randomly assigned to control, symptom-coached, or test-coached groups. Six previously researched validity indicators were examined. We hypothesized that symptom-coached participants would perform worse relative to test-coached simulators. Analyses determined both simulator groups performed lower than controls on all indicators except Vocabulary. Symptom-coached participants, however, did not differ from test-coached participants on any indicator. Classification accuracies for these six indicators ranged from 42 to 78%. While the WAIS-III validity indicators hold some promise, they should not be employed as independent measures.