Nociceptors for the 21st century

This review summarizes recent developments in the context of the neurochemical classification of nociceptors and explores the relationships between functionally and neurochemically defined subgroups. Although the complete picture is not yet available, several lines of intriguing evidence suggest that despite the complexity and diversity of nociceptor properties, a relatively "simple" neurochemical classification fits well with several recently identified molecular characteristics.     

Inpatient bed needs for psychiatric care

Along with other types of hospital inpatient care, acute psychiatric units are subject to state certificate-of-need review under Public Law 93-641. A study of 15 hospitals in Virginia suggests that prevailing techniques for determining inpatient bed needs are not appropriate for psychiatric beds, if indeed they are for other types of care. An alternative technique is offered, not as a substitute for judgment in such matters, but as assistance to it.Dr. MacStravic is an Associate Professor and Associate Director, Graduate Program in Health Services Administration and Planning, University of Washington, Seattle.     

Neo-psychoanalysis: a paradigm for the 21st century

Freud's metapsychological assumption, splitting mind from brain, created two major and unsolved problems: the relation of the mind with the brain and with outer reality. Recently neuroscientists have focused on the first problem, often basing their work on a category error (mereological fallacy). The second problem may be avoided by considering the coevolution of mind/brain, and by recognizing a non-dualistic symbiosis. Psychodynamic science, built largely on a century of psychoanalytic progress, is proposed as a coequal partner with traditional science in the effort to better understand the theory of knowledge, a central problem of both disciplines. Group selection and downward causation contribute to the recognition of neo-psychoanalysis, a new paradigm to complement the traditional viewpoint. The new view will permit a reunion between traditional and psychodynamic science. Recent fMRI and other data are presented in support of this view.     

Encephalitis in the 21 st century

As the 21st century begins, several outbreaks of encephalitis have been reported. An examination of these outbreaks brings into focus important epidemiological developments. Specifically, urbanization and encroachment on natural environments, the ease of world travel, and global trade can lead to spread of vectors and viruses from the developing world to the developed world. This review focuses on two recent epidemics of encephalitis: West Nile virus encephalitis in the eastern United States and Nipah virus encephalitis in Malaysia and Singapore. These examples demonstrate spread of a known viral agent from an endemic area to an area in which it had not previously been found and identification of a new viral agent. Infectious diseases in the developed world once considered "exotic" are now potential threats to all patients.     

Psychopathology in the 21st century

Abstract

Objectives. The present publication sets out to evaluate the position of psychopathology in the 21st century and should also serve as a basis for defining the framework for the future tasks of the WFSBP Task Force. Methods. Review of publications on the various approaches of psychopathology in general and of different tasks, theories and tools of psychopathology approaches in particular. Results. The main tasks of psychopathology are, to record and describe experiential and behavioral abnormalities in their intersubjective context, to explain their origin from an objective scientific perspective, and to attempt to understand them from the subjective perspective of the patient. In order to provide stable fundaments for the work in clinical and scientific psychiatry all three components are indispensable. Conclusions. The future of psychiatry hence lies in the hands of a type of psychopathology that we will call Integrative Psychopathology. The main tasks of psychopathology can only be pursued in close cooperation with other branches of science interested in studying psychiatric issues. Whereas contemporary psychopathology must lay the foundations for that cooperation, Integrative Psychopathology must be complemented by further advancements in Theoretical Psychopathology, so as to enable conceptual new developments, which can then be fruitful for cooperative research and psychiatric clinical practice.     

Mitochondrial disorders: a classification for the 21st century

Mitochondrial encephalomyopathies were described in the 60's when accumulation of mitochondria were observed in patients with exercise intolerance. The electronic transport chain is located in the mitochondria and forms the oxidative phosphorylation (OXPHOS) system that produces ATP in the cell. The electronic transport chain is coded by two different genomes, nuclear and mitochondrial, with different genetic characteristics. The main differences between nuclear and mitochondrial genetics are heteroplasmy and threshold effect, mitotic segregation and maternal inheritance. Mitochondrial diseases are due to defects in the genes encoding proteins involved in some mitochondrial pathways. Those genes may be ARNts, structural proteins of the electronic transport chain or associated proteins of the mitochondria (transporters or assembly proteins). Alterations in those genes may be point mutations, deletions or duplications in the mitochondrial DNA and alterations of the genomic signaling between nucleus and mitochondria.     

Psychiatric genetics: into the 21st century

Epidemiological studies have identified a positive family history of Alzheimer's disease (AD) as a major risk factor for the development of the disease. The results of recent family studies to determine the proportion of AD which is familial are reviewed and possible reasons for the discrepancies discussed. All these studies are consistent with a significant number of cases being caused by a dominantly inherited defect in an autosomal gene. The evidence for genetic linkage between AD and markers on the long arm of chromosome 21 in families multiply affected by disease is presented as well as discussion about the generality of this linkage and its relationship to sporadic AD.