Baseline neuroendocrine function and diagnostic stability among patients with a nonmanic psychosis

Summary Psychotic patients underwent a dexamethasone suppression test (DST), careful diagnostic assessments at baseline and diagnostic reevaluations after 1 year. The predicted associations between baseline DST results and diagnosis were much clearer after prospective observation.     

Placebo response in panic disorder

Of 43 patients with panic disorder or agoraphobia with panic attacks who took placebo for 8 weeks in two double-blind studies, one in four markedly improved. Those with consistently normal dexamethasone suppression test results were significantly more likely to show a placebo response as were those with lower anxiety ratings at the outset of treatment.     

Prognostic validity of the familial subtypes of depression

Summary We examined the prognostic validity of Winokur's familial subtypes of depression in 184 in-patients with primary unipolar major depression. Patients with familial pure depressive disease had a more favorable hospital course and reported less symptoms during a 6-month follow-up evaluation than patients with depressive spectrum disease or sporadic depressive disease. Consistent with previous studies of the validity of the familial subtypes, the use of stringent thresholds to diagnose the patient's relatives increased the validity of classification.     

Rapidly cycling affective disorder. Demographics, diagnosis, family history, and course.

Of 919 patients with major affective disorders who completed at least 1 year of a 5-year, semiannual follow-up, 45 developed a rapidly cycling bipolar course during the first year, but only one developed a rapidly cycling unipolar course. In comparison with patients who showed a non-rapidly cycling bipolar course, those who became rapid cyclers were more likely to be female and to have exhibited depression, hypomania, or cycling between depression and hypomania within the index episode. Family study data revealed no evidence that high cycle frequencies breed true. Rapid cycling was associated with a significantly lower likelihood of recovery in the second year of follow-up but not in the third, fourth, or fifth. These data suggest that rapid cycling is, in the large majority of cases, a transient, nonfamilial manifestation of bipolar affective disorder.     

The heritability of schizophrenia and schizoaffective disorder. A family study

Ninety-one consecutively admitted patients with schizophrenia (n = 21), schizoaffective depression (n = 43), or psychotic depression (n = 27) entered a blind family study along with 36 never-ill controls. Though schizophrenia spectrum disorders clustered within families, they were not significantly more prevalent in the families of schizophrenic probands. In contrast, morbid risks for affective disorder clearly separated the families of psychotically depressed probands from the families of both schizophrenics and controls. Family study data for schizoaffective probands indicated links to both affective disorder and schizophrenia and suggested, as well, that a small number of patients with schizoaffective disorder may carry a genetic liability to both conditions.     

The origin of left hand preference: Pathological and non-pathological influences

Models of the origin of left hand preference were tested with prospective data. Infants with and without a history of perinatal complications, matched for age, sex and parental handedness, were filmed at 6 weeks of age. Children with a history of perinatal complications lacked the rightward headturning bias of those children without a history of perinatal trauma. Children with a history of perinatal complications were also deviant with reference to the duration of a postural reflex and its degree of lateralization. Perinatal complications may delay the establishment of volitional hand use as well as increase the probability of left-handedness. The data were interpreted as supporting SATZ's (Cortex 8, 121–135, 1972) rather than Bakan et al.'s (Neuropsychologia 11, 363–366, 1973) model of “pathological” left-handedness.     

Influence of age on the cortisol response to dexamethasone

Controversy exists regarding the association of age with postdexamethasone serum cortisol levels. We evaluated this relationship in 95 patients with major depressive disorder and 49 healthy controls. Age and 8 a.m. postdexamethasone cortisol levels were not correlated among the healthy controls, but were positively associated among the depressives. There was also a trend for age and 4 p.m. postdexamethasone cortisol levels to be positively associated in depressives. Multiple linear regression analyses revealed that these associations could not be explained by other variables such as sex, psychotic features, or familial subtype of depression. Several hypotheses that might account for these associations are examined.     

Overexpression of acid-sensing ion channel 1a in transgenic mice increases acquired fear-related behavior

The acid-sensing ion channel 1a (ASIC1a) is abundantly expressed in the amygdala complex and other brain regions associated with fear. Studies of mice with a disrupted ASIC1 gene suggested that ASIC1a may contribute to learned fear. To test this hypothesis, we generated mice overexpressing human ASIC1a by using the pan-neuronal synapsin 1 promoter. Transgenic ASIC1a interacted with endogenous mouse ASIC1a and was distributed to the synaptosomal fraction of brain. Transgenic expression of ASIC1a also doubled neuronal acid-evoked cation currents. The amygdala showed prominent expression, and overexpressing ASIC1a enhanced fear conditioning, an animal model of acquired anxiety. These data raise the possibility that ASIC1a and H(+)-gated currents may contribute to the development of abnormal fear and to anxiety disorders in humans.