Anxiety psychopathology predictive of outcome in patients with panic disorder and depression treated with imipramine, alprazolam and placebo

This study examines clinical predictors of outcome for patients with panic disorder and depression in a 16 week, placebo-controlled trial of alprazolam and imipramine (n = 126). Baseline global severity of illness and phobic avoidance were differentially predictive of acute response to treatment. Patients in the mild to moderate range of global distress experienced smaller degrees of improvement on alprazolam than on imipramine at week 4. At endpoint, the relative effectiveness of the active medication versus placebo was diminished in patients with higher levels of phobic avoidance. This relationship was not evident for completers, suggesting that the adverse effects of avoidance on outcome after sustained treatment was reduced.     

Identification of a frequent variant in ALG6, the cause of Congenital Disorder of Glycosylation-Ic

Congenital Disorder of Glycosylation (CDG) type Ic is caused by mutations in ALG6. This gene encodes an alpha1,3 glucosyltransferase used for synthesis of the lipid linked oligosaccharide (LLO) precursor of the protein N-glycosylation pathway. CDG-Ic patients have moderate to severe psychomotor retardation, seizures, hypotonia, strabismus, and feeding difficulties. We previously identified a typical patient with a heterozygous point mutation, c.391T>C (p.Tyr131His) in ALG6. Using complementation analysis of ALG6-deficient yeast, we show that this alteration is as severe as the most common disease-causing mutation, c998C>T (p. Ala333Val), which occurs in over half of all known CDG-Ic patients. The frequency of c.391T>C (p.Tyr131His) in the US population, is 0.0214, suggesting that homozygotes would occur at a rate of& tilde;1:2,200. We identified one patient with typical CDG-Ic symptoms and a homozygous p.Tyr131His alteration in ALG6. However, in contrast to most CDG patients, her LLO and plasma transferrin glycosylation appeared normal. Thus, it is unclear whether c.391T>C causes CDG-Ic or contributes to the symptoms. Genotyping additional patients with CDG-like symptoms will be required to resolve this issue.     

Hidden posttraumatic stress disorder in the mother of a boy with traumatic limb amputation

Posttraumatic stress disorder (PTSD) is usually diagnosed in the primary victim of a psychologically distressing event who demonstrates the criteria symptomatology. Presented here is a case study of PTSD symptoms in a mother whose 4-year-old boy underwent bilateral arm amputation. Discussed is how the mother became the primary PTSD victim and why the particular injury (electrical shock) can be explained as readily giving rise to her problems. Consultants to pediatric and trauma services are reminded that the primary patient's medical care may suffer if disorders such as PTSD are not recognized in those responsible for making treatment decisions for the young victim.     

Psychophysiological Predictors of Attentional Dysfunction in Children with Congenital Heart Defects

Cardiac responses to non-signal stimuli and to signal stimuli in a vigilance task were examined in children born with congenital heart defects (CHD), and in normal and attention deficit disordered (ADD) subjects. Overall task performance was lower in subjects with heart defects and in the ADD group. Cardiac measures revealed that normal children displayed significantly larger heart rate deceleration to the target stimuli than did either of the clinical groups. Moreover, although no group differences were observed in the cardiac response to non-signal auditory stimuli, exaggerated heart rate deceleration was observed to vibrotactile stimuli in both the clinical groups. Regression analyses revealed that the magnitude of the cardiac response to somatosensory stimuli was predictive of task performance (both within and between subject groups), with larger responses associated with higher error rates and lower perceptual sensitivity. Results were suggestive of a predictive relationship between somatosensory reactivity and neuropsychological maturation.     

No evidence for allelic association between bipolar disorder and monoamine oxidase a gene polymorphisms

We have tested the hypothesis that DNA markers in the MAOA gene show allelic association with bipolar affective disorder. Eighty-four unrelated Caucasian patients with DSM III-R bipolar disorder and 84 Caucasian controls were typed for three markers in MAOA: a dinucleotide repeat in intron 2, a VNTR in intron 1, and an Fnu4HI RFLP in exon 8. No evidence for allelic association was observed between any of the markers and bipolar disorder. © 1995 Wiley-Liss, Inc.     

Are Compulsive Checkers Impaired in Memory? A Meta‐Analytic Review

Researchers have hypothesized that compulsive checkers suffer from impairment in explicit memory (e.g., Sher, Frost, & Otto, 1983 ), low confidence in explicit memory (e.g., McNally & Kohlbeck, 1993 ), or both. However, empirical findings have been equivocal, possibly due to variability in effect sizes produced by small samples. Combining data across studies may yield more meaningful conclusions than can be surmised from a narrative review. Following a brief review of the literature on checking and memory, we present meta-analytic results suggesting that checkers are impaired on many types of memory tasks (e.g., verbal free recall, verbal cued recall, and recall of actions) and are less confident in recognition than noncheckers. We discuss implications of these findings, suggestions for future research, and limitations of this analysis.     

Perceived parental rearing behaviour in unipolar and bipolar depressed patients. A verification study in an Italian sample

Two groups of former depressed Italian patients comprising 54 bipolars and 52 unipolars completed the Italian version of the EMBU, a Swedish instrument aimed at assessing the experience of parental rearing behaviour. As in a previous study of Swedish depressives, three factors, "rejection", "emotional warmth", and "over-protection", have been taken into account. The results obtained in the patient group have been compared with those obtained in Italian healthy controls. Depressed patients rated both parents significantly lower than the controls on the factor "emotional warmth". The present results cross-validate those obtained previously in the Swedish depressives and strengthen, together with other findings in the literature, the assumption that the lack of emotional warmth in the parents' rearing practices might be a crucial variable in the pathogenesis of depressive illnesses.     

Psychogenic pain: a study of marital adjustment

The marital adjustment of patients with psychogenic pain disorder was evaluated and compared with a matched group of patients with other neurotic disorders. Pain patients spouses were found to have better marital adjustment and less psychiatric morbidity than the spouses of neurotic patients. These findings are discussed in terms of the concepts of "sick role homeostasis" and "tertiary gain".     

Depressive disorders in Ethiopia. A standardized assessment using the SADD schedule

Fifty-two depressed patients were selected from out-patients at the psychiatric department of St. Paul's Hospital in Addis Ababa. A clinical assessment on each patient was carried out using a slightly revised SADD schedule. The findings were very similar to those from previous SADD studies in different cultures. The same "core" of depressive symptomatology could be detected in Ethiopian depressed patients. Most patients presented with somatic complaints. An interesting finding was that more women than men admitted aggressive feelings or acts. Remarkably few "culture-specific" data were found, which probably is not surprising when using a diagnostic tool with a cultural bias. Suggestions are put forward to explain the difference in frequency of some symptoms in Ethiopian patients compared with patients from other countries.     

Social Distancing in Chronic Migraine during the COVID-19 Outbreak: Results from a Multicenter Observational Study

Background: The restrictions taken to control the rapid spread of COVID-19 resulted in a sudden, unprecedented change in people’s lifestyle, leading to negative consequences on general health. This study aimed to estimate the impact of such changes on migraine severity during 2020 March–May lockdown. Methods: Patients affected by migraine with or without aura, diagnosed by expert physicians, completed a detailed interview comprehensive of: assessment of migraine characteristics; measure of physical activity (PA) levels; measure of the intake frequency of main Italian foods; the Insomnia Severity Index (ISI) questionnaire investigating sleep disorders. Results: We included 261 patients with a mean age of 44.5 ± 12.3 years. During social distancing, 72 patients (28%) reported a headache worsening, 86 (33%) an improvement, and 103 (39%) a stable headache frequency. A significant decrease of the PA levels during COVID-19 quarantine in the whole study sample was observed (median total metabolic equivalent task (METs) decreased from 1170 to 510; p < 0.001). Additionally, a significant difference was reported on median ISI scores (from 7 to 8; p < 0.001), which were increased in patients who presented a stable or worsening headache. Conclusions: Our study confirmed that the restrictions taken during the pandemic have affected the practice of PA levels and sleep quality in migraine. Hence, PA and sleep quality should be assessed to find strategies for an improvement in quality of life.