Posttraumatic stress reactions after single and double trauma

This study evaluated the severity and symptom profile of posttraumatic stress reactions of 202 adults exposed in 1988 to political violence in Azerbaijan and/or the earthquake in Armenia. High rates of severe posttraumatic stress reactions were found among the most highly exposed individuals, irrespective of the type of trauma. There was no difference in symptom profile for subjects exposed to earthquake versus violence. These similarities in severity and symptom profile may be attributable to common features of the exposures, which included experiencing life-threat and witnessing injury, mutilation and death. Recent prior exposure to violence contributed to the severity of reaction to the earthquake. The high rates of chronic and severe posttraumatic stress reactions in Armenia constitute a major public mental health problem.     

肌电生物反馈疗法治疗不同类型神经症的报告

本文报告肌电生物反馈治疗60例不同类型神经症的疗效;其中神经衰弱14例,紧张性头痛19例、焦虑症14例、强迫症6例、癔症4例、恐怖症2例、疑病症1例。总有效率为86.7％。其中10例紧张性头痛和焦虑症患者配合心理治疗和语言暗示,其效果显著。     

强迫症的自尊和自我和谐研究

目的:对门诊强迫症患者的自尊和自我和谐状况进行研究.方法:对52例符合CCMD-3诊断标准的门诊强迫症患者进行一般资料,MAUDSLEY强迫问卷(MOCI),耶鲁布郎强迫量表(Y-BOCS),社会功能缺陷筛选量表(SDSS),主观幸福感阶梯量表(Subjective well-being,SWB),自尊量表(Self-esteem),自我和谐量表(Self consistency and congruence scale,SCCS)评定,并与正常人作对照.结果:(1)强迫症患者的不和谐性(51.40±9.02)、自尊水平(23.67±4.81)高于对照组(35.64±6.91,18.12±5.88)(t=10.008及5.728,P<0.01).(2)主观幸福感与自尊,不和谐性与自尊相关(r=0.580,0.387,P<0.01).结论:强迫症患者的自我和谐性差、自尊水平高可能是疾病的病理基础.     

磁源成像在母语为汉语正常人的语言功能定位中的应用

目的 采用脑磁图（magnetoencephalograph，MEG）的等价电流偶极子定位法（Equivalent current dipole，ECD）和合成孔径磁场定位法（SAMSynthetic、Aperture Magnetometry，SAM）定位母语为汉语的健康自愿者的语占中枢，探讨汉字的语言处理过程。方法 对10例母语为汉语的健康受试者给予默读真词、假词的语言任务刺激，记录刺激后产生的诱发磁场，将采集的数据与MRI叠加获得磁源性影像（MSI Magnetic source imaging）语占功能区定位川同样的方法对4例胶质瘤患者进行术前语言功能区定位，术中皮层电刺激所定位语言功能区，明确是否产生言语障碍。结果 所有受试者真词、假词均在双侧大脑半球诱发出明显的晚期磁反应波，左侧大脑半球磁反应波分化较右侧大脑半球好，Broea区俯于额下回后部，Wernicke区位于颞中同、颢上回、缘上回，Wernieke区先于Broca区出现。胶质瘤患者术巾电刺激所定位的Broca区、Wernicke区均产生言语障碍：结论母语为汉语的正常人的Broca区Wernieke区与经典的语言中枢糕本相符，MEG定位语言中枢的技术是可行的。     

Parvalbumin neurons in the entorhinal cortex of subjects diagnosed with bipolar disorder or schizophrenia.

BACKGROUND: Growing evidence indicates that the entorhinal cortex (ECx) might be affected in schizophrenia (SZ) and bipolar disorder (BD). To test whether distinct interneuronal subpopulations might be altered, numbers of parvalbumin-immunoreactive (PVB-IR) neurons were measured in the ECx of BD and SZ subjects. These neurons play a pivotal role within ECx intrinsic circuits. METHODS: Numbers, numerical density, and soma size of PVB-IR neurons were measured in the ECx of normal control (n = 16), BD (n = 10), and SZ (n = 10) subjects. The volume of the ECx was measured in Nissl-stained sections. RESULTS: In BD, decreases of total numbers (p = .02) and numerical densities (p = .01) of PVB-IR neurons were detected in the ECx. Within distinct subregions, reductions were detected in the superficial layers of the lateral (p = .02), intermediate (p = .04), and caudal (p = .01) ECx. In SZ, total numbers and numerical densities were not altered. A reduction of soma size was present in the intermediate ECx (p = .01). Volume was unaffected in either disorder. CONCLUSIONS: In BD, a decrease of PVB-IR neurons may alter intrinsic inhibitory networks within the superficial layers of the ECx. The likely consequence is a disruption of integration and transfer of information from the cerebral cortex to the hippocampus.     

Effects of metyrapone on hypothalamic-pituitary-adrenal axis and sleep in women with post-traumatic stress disorder.

BACKGROUND: Metyrapone blocks cortisol synthesis which results in removal of negative feedback, a stimulation of hypothalamic corticotropin releasing factor (CRF) and a reduction in delta sleep. We previously reported a diminished delta sleep and hypothalamic-pituitary-adrenal (HPA) response to metyrapone in men with post-traumatic stress disorder (PTSD). In this study, we aimed to extend these findings to women. METHODS: Three nights of polysomnography were obtained in 17 women with PTSD and 16 controls. On day 3, metyrapone was administered throughout the day up until bedtime. Plasma adrenocorticotropic hormone (ACTH), cortisol, and 11-deoxycortisol were obtained the morning following sleep recordings the day before and after metyrapone administration. RESULTS: There were no significant between-group differences in hormone concentration and delta sleep at baseline. Relative to controls, women with PTSD had decreased ACTH and delta sleep responses to metyrapone. Decline in delta sleep was associated with the magnitude of increase in ACTH across groups. CONCLUSIONS: Similar to our previous findings in men, the ACTH and sleep electroencephalogram response to metyrapone is attenuated in women with PTSD. These results are consistent with a model of downregulation of CRF receptors in an environment of chronically increased CRF activity or with enhanced negative feedback regulation in PTSD.     

One-year follow-up of the outcome of a randomized controlled trial of a home-based intervention programme for children with autism and developmental delay and their families

Introduction There is debate about the type and intensity of early childhood intervention that is most helpful for children with developmental problems. The aim of the study was to determine whether a home‐based programme provided over 12 months resulted in sustained improvement in development and behaviour 12 months after the intervention ceased. The characteristics of the children and families who benefited most from the intervention were also studied. Method Randomized controlled trial. Participants A total of 59 children, aged 3–5 years, attending two early childhood intervention centres in Melbourne, Australia. Intervention Half of the subjects received an additional home‐based programme consisting of 40 weekly visits. Main outcome measures Bayley Scales of Infant Development and Wechsler Preschool and Primary Scale of Intelligence Revised, Preschool Behaviour Checklist, Bayley Behaviour Rating Scale and Behaviour Screening Questionnaire. All tests administered pre‐intervention, following the intervention and 12 months later. Secondary outcome measures Family stress, support and empowerment. Results Fifty‐four children completed the assessments 12 months after conclusion of the intervention. Compared with the control group, improvement in aspects of cognitive development in the children who received the extra intervention was sustained 1 year later (P= 0.007) while significant behavioural differences post intervention were not. Analyses of the data by the Reliable Change Index indicated improvement of clinical significance occurred in non‐verbal areas. In contrast to the control group who deteriorated, language skills in the intervention group remained stable. Improvements were significantly associated with higher stress in the families. Conclusion Improvements following the provision of a home‐based programme to preschool children with developmental disabilities were sustained 1 year later. Children from highly stressed families appeared to benefit most, reinforcing the importance of involving families in early childhood intervention programmes.     

Attempted suicide in bipolar disorder pedigrees: evidence for linkage to 2p12.

BACKGROUND: We are interested in identifying susceptibility genes that predispose subjects to attempted suicide. METHODS: We conducted a secondary analysis of genome-wide linkage data from 162 bipolar pedigrees that incorporated attempted suicide as a clinical covariate. RESULTS: The strongest covariate-based linkage signal was seen on 2p12 at marker D2S1777. The logarithm of odds (LOD) score at marker D2S1777 rose from 1.56 to 3.82 after inclusion of the suicide covariate, resulting in significant chromosome-wide empirically derived p-values for the overall linkage finding (p = .01) and for the change in LOD score after the inclusion of the covariate (p = .02). CONCLUSIONS: The finding on chromosome 2 replicates results from two previous studies of attempted suicide in pedigrees with alcohol dependence and in pedigrees with recurrent early-onset depression. Combined, these three studies provide compelling evidence for a locus influencing attempted suicide on 2p12.     

社交焦虑障碍患者父母的人格特征和心理健康状况调查

目的探索社交焦虑障碍(SAD)患者父母的人格特征和心理健康状况。方法设研究组(SAD患者的父母)和对照组。入组时按要求进行艾森克人格问卷(EPQ)和症状自评量表(SCL-90)评定。结果SAD患者的父母在EPQ量表测验中的内外向因子标准分低于对照组;SAD患者的父母SCL-90各项因子除强迫和敌对因子,标准分低于对照组。结论SAD患者的父母的人格特征倾向内向,易安静、内省、离群、不喜欢接触人;SAD患者的父母更容易表现出躯体化症状、人际交往的困惑、抑郁、焦虑、恐怖和偏执。     

Sensorimotor gating deficits in adults with autism.

BACKGROUND: Prepulse inhibition (PPI) is an operational measure of sensorimotor gating and is impaired in a family of neuropsychiatric disorders characterized by abnormalities of inhibitory function. Adults with autistic disorder (AD) exhibit clinical features of inhibitory deficits, such as restrictive and repetitive behaviors, that may be explained by deficits in sensorimotor gating. METHODS: Acoustic startle reactivity, habituation, and PPI (30-, 60-, 120-msec interstimulus intervals) were assessed in 14 adult men diagnosed with AD and 16 typically developing normal comparison (NC) participants. All participants were administered measures of intelligence and frontal-executive functioning. RESULTS: Adults with AD exhibited significantly less PPI in the 60-msec condition than NC participants, which was correlated with increased ratings of restricted and repetitive behaviors. The groups did not differ on measures of startle amplitude or overall habituation. There was, however, a significant group-by-block habituation effect. Furthermore, PPI was not related to intelligence but was moderately associated with performance on a measure of frontal-executive functioning. CONCLUSIONS: Adults with AD have sensorimotor gating deficits similar to other neurodevelopmental disorders, implicating a failure of normal inhibitory regulation of sensory, motor, and attentional mechanisms. Thus, PPI deficits may be indirectly linked to one of the hallmark features of AD.