Should antidepressants be used in minor depression?
Authors: Naber D, Bullinger M Abstract Minor/subthreshold depression is associated with functional impairment, reduced quality of life, and the risk of developing into major depression. Therefore, it should be treated. Watchful waiting should be an option only for patients who, despite adequate information, are not interested in any kind of treatment. Psychotherapy has been found to be effective, but due to methodological problems (control group, blinding), efficacy derived from randomized trials might be over-estimated. Studies on the efficacy of antidepressants in the treatment of minor depression have found clin...
Source: Dialogues in Clinical Neuroscience - December 26, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Dissociation debates: everything you know is wrong.
Authors: Loewenstein RJ Abstract Controversy about dissociation and the dissociative disorders (DD) has existed since the beginning of modern psychiatry and psychology. Even among professionals, beliefs about dissociation/DD often are not based on the scientific literature. Multiple lines of evidence support a powerful relationship between dissociation/DD and psychological trauma, especially cumulative and/or early life trauma. Skeptics counter that dissociation produces fantasies of trauma, and that DD are artefactual conditions produced by iatrogenesis and/or socio-cultural factors. Almost no research or clinical...
Source: Dialogues in Clinical Neuroscience - December 26, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

New ways of understanding brain neurocircuitry.
Authors: Thibaut F Abstract Inside the brain, neural regions dynamically interact at multiple spatial and temporal scales through a highly structured and adaptive neurocircuitry. Comprehensive maps of brain connectivity have led to the emerging field of connectomics. Graph theory methods are interesting tools to improve our understanding of the brain as a complex interconnected system. PMID: 30250385 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - September 27, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Data-driven approaches for identifying links between brain structure and function in health and disease.
Authors: Calhoun V Abstract Brain imaging technology provides a powerful tool to visualize the living human brain, provide insights into disease mechanisms, and potentially provide a tool to assist clinical decision-making. The brain has a very specific structural substrate providing a foundation for functional information; however, most studies ignore the very interesting and complex relationships between brain structure and brain function. While a variety of approaches have been used to study how brain structure informs function, the study of such relationships in living humans in most cases is limited to noninva...
Source: Dialogues in Clinical Neuroscience - September 27, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Connectome development and a novel extension to the neurodevelopmental model of schizophrenia.
Authors: Collin G, Keshavan MS Abstract The brain is the ultimate adaptive system, a complex network organized across multiple levels of spatial and temporal resolution that is sculpted over several decades via its interactions with the environment. This review sets out to examine how fundamental biological processes in early and late neurodevelopment, in interaction with environmental inputs, guide the formation of the brain's network and its ongoing reorganization throughout the course of development. Moreover, we explore how disruptions in these processes could lead to abnormal brain network architecture and org...
Source: Dialogues in Clinical Neuroscience - September 27, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Graph theory methods: applications in brain networks.
Authors: Sporns O Abstract Network neuroscience is a thriving and rapidly expanding field. Empirical data on brain networks, from molecular to behavioral scales, are ever increasing in size and complexity. These developments lead to a strong demand for appropriate tools and methods that model and analyze brain network data, such as those provided by graph theory. This brief review surveys some of the most commonly used and neurobiologically insightful graph measures and techniques. Among these, the detection of network communities or modules, and the identification of central network elements that facilitate commun...
Source: Dialogues in Clinical Neuroscience - September 27, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Rich-club neurocircuitry: function, evolution, and vulnerability.
Authors: Griffa A, Van den Heuvel MP Abstract Over the past decades, network neuroscience has played a fundamental role in the understanding of large-scale brain connectivity architecture. Brains, and more generally nervous systems, can be modeled as sets of elements (neurons, assemblies, or cortical chunks) that dynamically interact through a highly structured and adaptive neurocircuitry. An interesting property of neural networks is that elements rich in connections are central to the network organization and tend to interconnect strongly with each other, forming so-called rich clubs. The ubiquity of rich-club or...
Source: Dialogues in Clinical Neuroscience - September 27, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The frontoparietal network: function, electrophysiology, and importance of individual precision mapping.
Authors: Marek S, Dosenbach NUF Abstract The frontoparietal network is critical for our ability to coordinate behavior in a rapid, accurate, and flexible goal-driven manner. In this review, we outline support for the framing of the frontoparietal network as a distinct control network, in part functioning to flexibly interact with and alter other functional brain networks. This network coordination likely occurs in a 4 Hz to 73 Hz θ/α rhythm, both during resting state and task state. Precision mapping of individual human brains has revealed that the functional topography of the frontoparietal network is ...
Source: Dialogues in Clinical Neuroscience - September 27, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Evolving a new neuropsychiatry.
Authors: Fricchione GL Abstract Clinical neuroscience struggles with poor scientific validity of neuropsychiatric diagnosis and its negative impact on management. Sydenham's ancient conformity of type approach to nosology with its assumption that the symptom cluster and course of a disorder are due to a common etiology, has proven no match for the complicated comorbidities faced in neuropsychiatry. In the absence of accurate pathological biomarkers there is a challenge in finding a solid foundation for modern neuropsychiatry. We find standard psychiatric nosology to be of limited benefit at the general hospital bed...
Source: Dialogues in Clinical Neuroscience - September 27, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The mind-body Cartesian dualism and psychiatry.
Authors: Thibaut F Abstract The French philosopher René Descartes (1596-1650) argued that the natures of mind and body are completely different from one another and that each could exist by itself. How can these two structures with different natures causally interact in order to give rise to a human being with voluntary bodily motions and sensations? Even today, the problem of mind-body causal interaction remains a matter of debate. PMID: 29946205 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Historical epistemology of the body-mind interaction in psychiatry.
Authors: Berrios GE Abstract This paper deals with the history of the relationship between the mind-body dualism and the epistemology of madness. Earlier versions of such dualism posed little problem in regard to the manner of their communication. The Cartesian view that mind and body did, in fact, name different substances introduced a problem of incommunicability that is yet to be resolved. Earlier views that madness may be related to changes in the brain began gaining empirical support during the 17th century. Writers on madness chose to resolve the mind-body problem differently Some stated that such communicati...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Psycho-oncology.
Authors: Lang-Rollin I, Berberich G Abstract Medical progress, the improvement of general living conditions, and an increase in life expectancy have led to an increase in the general prevalence of oncologic disease. More importantly, more and more patients survive cancer or live with the disease for long periods of time. While the battle for survivorship is continuously being fought, improving patients' quality of life has come to the fore. Psychosocial issues may modulate the course of the disease, but mainly have a deep impact on patients' physical and mental wellbeing. Psycho-oncology has risen as a relatively n...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Management of somatic symptom disorder.
Authors: Henningsen P Abstract This review paper gives an overview of the management of somatic symptom disorder. It starts with a description of the clinical problem of patients with persistent bodily distress, discusses classificatory, epidemiological, and etiological issues and then describes the evidence and practical principles of dealing with these patients who are often seen as "difficult" to treat. It is concluded that the best-suited approach is stepped care with close cooperation of primary care, a somatic specialist, and mental health care professionals operating on the basis of a biopsychosoci...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The intriguing relationship between coronary heart disease and mental disorders.
Authors: De Hert M, Detraux J, Vancampfort D Abstract Coronary heart disease (CHD) and mental illness are among the leading causes of morbidity and mortality worldwide. Decades of research has revealed several, and sometimes surprising, links between CHD and mental illness, and has even suggested that both may actually cause one another. However, the precise nature of these links has not yet been clearly established. The goal of this paper, therefore, is to comprehensively review and discuss the state-of-the-art nature of the epidemiological and pathophysiological aspects of the bidirectional links between mental i...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The relationship between stress and infertility.
Authors: Rooney KL, Domar AD Abstract The relationship between stress and infertility has been debated for years. Women with infertility report elevated levels of anxiety and depression, so it is clear that infertility causes stress. What is less clear, however, is whether or not stress causes infertility. The impact of distress on treatment outcome is difficult to investigate for a number of factors, including inaccurate self-report measures and feelings of increased optimism at treatment onset. However, the most recent research has documented the efficacy of psychological interventions in lowering psychological d...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Depression and diabetes.
Authors: Sartorius N Abstract The comorbidity of mental and physical disorders is a major challenge for health care worldwide. Its prevalence is increasing and is likely to continue to grow due to the increase in life expectancy and a variety of other reasons. The comorbidity of depression and diabetes can be seen as a prototypical example of mental/physical comorbidity. The prevalence of both conditions is growing, and depression is twice as frequent in people with diabetes compared with those without diabetes. Health services are by and large inadequately prepared to deal with comorbid depression and diabetes, an...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Facts and myths pertaining to fibromyalgia.
Authors: Häuser W, Fitzcharles MA Abstract Fibromyalgia (FM) is characterized by chronic widespread pain, unrefreshing sleep, physical exhaustion, and cognitive difficulties. It occurs in all populations throughout the world, with prevalence between 2% and 4% in general populations. Definition, pathogenesis, diagnosis, and treatment of FM remain points of contention, with some even contesting its existence. The various classification systems according to pain medicine, psychiatry, and neurology (pain disease; persistent somatoform pain disorder; masked depression; somatic symptom disorder; small fiber neuropat...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Metabolic syndrome in psychiatric patients: overview, mechanisms, and implications.
Authors: Penninx BWJH, Lange SMM Abstract Psychiatric patients have a greater risk of premature mortality, predominantly due to cardiovascular diseases (CVDs). Convincing evidence shows that psychiatric conditions are characterized by an increased risk of metabolic syndrome (MetS), a clustering of cardiovascular risk factors including dyslipidemia, abdominal obesity, hypertension, and hyperglycemia. This increased risk is present for a range of psychiatric conditions, including major depressive disorder (MDD), bipolar disorder (BD), schizophrenia, anxiety disorder, attention-deficit/hyperactivity disorder (ADHD), a...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Psychiatric sequelae of cardiac arrest.
Authors: Naber D, Bullinger M Abstract This manuscript summarizes the literature on mental health outcomes after cardiac arrest. Survivors of cardiac arrest show high rates of mental illness with more than 40% suffering from anxiety, 30% from depression, and 25% from posttraumatic stress disorder (PTSD). Mental health outcomes may differ depending on the setting in which the cardiac arrest occurred. A major problem is reduced neuropsychological functioning. Between 30% and 50% of survivors of cardiac arrest suffer from cognitive deficits. Deficits of attention, declarative memory, executive function, visual-spatial...
Source: Dialogues in Clinical Neuroscience - June 28, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

New perspectives in autism spectrum disorders.
Authors: Thibaut F Abstract Autism spectrum disorder, a complex developmental disorder, has been found to be one of the most heritable neuropsychiatric disorders. The next step will be to translate these findings into successful treatments for this disorder. PMID: 29398927 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Brain and behavior development in autism from birth through infancy.
Authors: Shen MD, Piven J Abstract Autism spectrum disorder (ASD) is a heterogeneous condition that affects 1 in 68 children. Diagnosis is based on the presence of characteristic behavioral impairments that emerge in the second year of life and thus is not typically made until 3 to 4 years of age. Recent studies of early brain and behavior development have provided important new insights into the nature of this condition. Autism-specific brain imaging features have been identified as early as 6 months of age, and age-specific brain and behavior changes have been demonstrated across the first 2 years of life, highli...
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Translating genetic and preclinical findings into autism therapies.
Authors: Chahrour M, Kleiman RJ, Manzini MC Abstract Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by social deficits and repetitive/restrictive interests. ASD is associated with multiple comorbidities, including intellectual disability, anxiety, and epilepsy. Evidence that ASD is highly heritable has spurred major efforts to unravel its genetics, revealing possible contributions from hundreds of genes through rare and common variation and through copy-number changes. In this perspective, we provide an overview of the current state of ASD genetics and of how genetic research ...
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Autism and talent: the cognitive and neural basis of systemizing.
Authors: Baron-Cohen S, Lombardo MV Abstract In 2003, we proposed the hypersystemizing theory of autism. The theory proposes that the human mind possesses a systemizing mechanism (SM) that helps identify lawful regularities (often causal) that govern the input-operation-output workings of a system. The SM can be tuned to different levels, from low to high, with a normal distribution of individual differences in how strongly people search for such input-operation-out-put regularities in any data that is systemizable. Evidence suggests that people with autism are on average hypersystemizers, scoring higher than avera...
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Syndromic autism spectrum disorders: moving from a clinically defined to a molecularly defined approach.
Authors: Fernandez BA, Scherer SW Abstract Autism spectrum disorder (ASD) encompasses a group of neurodevelopmental conditions diagnosed solely on the basis of behavioral assessments that reveal social deficits. Progress has been made in understanding its genetic underpinnings, but most ASD-associated genetic variants, which include copy number variants (CNVs) and mutations in ASD-risk genes, account for no more than 1 % of ASD cases. This high level of genetic heterogeneity leads to challenges obtaining and interpreting genetic testing in clinical settings. The traditional definition of syndromic ASD is a disorder...
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neuropsychological assessment in autism spectrum disorder and related conditions.
This article presents an overview of five cognitive areas that are essential for neuropsychological evaluation (ie, intelligence, attention, executive function, social cognition, and praxis) and explores the underlying causes of behavioral problems in persons with ASD. Furthermore, it stresses the importance of meticulous neuropsychological testing with regard to cognitive remediation, a method that can help to enhance single cognitive processes in a targeted manner. Objective test results suggest it might be possible to promote an improved sense of coherence. In line with the salutogenic model, this may be fundamental for...
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder.
Authors: Schöttle D, Briken P, Tüscher O, Turner D Abstract Like nonaffected adults, individuals with autism spectrum disorders (ASDs) show the entire range of sexual behaviors. However, due to the core symptoms of the disorder spectrum, including deficits in social skills, sensory hypo- and hypersensitivities, and repetitive behaviors, some ASD individuals might develop quantitatively above-average or nonnormative sexual behaviors and interests. After reviewing the relevant literature on sexuality in high-functioning ASD individuals, we present novel findings on the frequency of normal sexual behaviors a...
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Pharmacotherapy of emotional and behavioral symptoms associated with autism spectrum disorder in children and adolescents.
Authors: Stepanova E, Dowling S, Phelps M, Findling RL Abstract Autism spectrum disorder (ASD) is characterized by impairment in social communication and restricted patterns of behavior. Although there is no pharmacological treatment approved by the US Food and Drug Administration (FDA) for the core symptoms of ASD, there is mounting support in the literature for the management of behavioral symptoms associated with this developmental disorder, in particular, irritability and hyperactivity. Aripiprazole and risperidone are currently approved by the FDA for the treatment of irritability in youth with ASD. Though not...
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Vaccination as a cause of autism-myths and controversies.
This article presents a narrative of the origin of the myths around autism. PMID: 29398935 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - February 7, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Addictive behaviors: where do we stand, and where are we going?
Authors: Thibaut F, Hoehe M Abstract Tobacco and alcohol use remain the most prevalent addictive behaviors reported and the leading risk factors for global burden of disease, injury, and death. Considering addiction as a chronically relapsing brain disorder has opened up the way for biomedical treatment approaches. PMID: 29302218 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Individual differences in the neuropsychopathology of addiction.
Authors: George O, Koob GF Abstract Drug addiction or substance-use disorder is a chronically relapsing disorder that progresses through binge/intoxication, withdrawal/negative affect and preoccupation/anticipation stages. These stages represent diverse neurobiological mechanisms that are differentially involved in the transition from recreational to compulsive drug use and from positive to negative reinforcement. The progression from recreational to compulsive substance use is associated with downregulation of the brain reward systems and upregulation of the brain stress systems. Individual differences in the neur...
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A brief review of the genetics and pharmacogenetics of opioid use disorders.
Authors: Berrettini W Abstract Increased physician prescribing of opioids to treat chronic nonprogressive pain has been accompanied by an increase in opioid addiction. Twin studies of opioid addiction are consistent with an inherited component of risk, approximately 50%. Several genome-wide association study (GWAS) reports indicate that genetic risk for opioid addiction is conveyed by many alleles of small effect (odds ratios
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Genetics of addictive behavior: the example of nicotine dependence.
Authors: Gorwood P, Le Strat Y, Ramoz N Abstract The majority of addictive disorders have a significant heritability-roughly around 50%. Surprisingly, the most convincing association (a nicotinic acetylcholine receptor CHRNA5-A3-B4 gene cluster in nicotine dependence), with a unique attributable risk of 14%, was detected through a genome-wide association study (GWAS) on lung cancer, although lung cancer has a low heritability. We propose some explanations of this finding, potentially helping to understand how a GWAS strategy can be successful. Many endophenotypes were also assessed as potentially modulating the eff...
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Animal models of addiction.
Authors: Spanagel R Abstract In recent years, animal models in psychiatric research have been criticized for their limited translational value to the clinical situation. Failures in clinical trials have thus often been attributed to the lack of predictive power of preclinical animal models. Here, I argue that animal models of voluntary drug intake-under nonoperant and operant conditions-and addiction models based on the Diagnostic and Statistical Manual of Mental Disorders are crucial and informative tools for the identification of pathological mechanisms, target identification, and drug development. These models p...
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The prescription opioid epidemic: a review of qualitative studies on the progression from initial use to abuse.
Authors: Cicero TJ, Ellis MS Abstract Most research designed to answer the "why" of the prescription opioid epidemic has relied on structured interviews, which rigidly attempt to capture the complex reasons people use opioids. In contrast this systematic literature review focuses on peer-reviewed studies that have used a qualitative approach to examine the development of an opioid-use disorder from the point of initial exposure. Rather than simply providing a "high," opioids reportedly relieve psychological/emotional problems or provide an escape from life stressors. As use continues, avoidance ...
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Tobacco use disorder and treatment: new challenges and opportunities.
Authors: Ziedonis D, Das S, Larkin C Abstract Tobacco use remains a global problem, and options for consumers have increased with the development and marketing of e-cigarettes and other new nicotine and tobacco products, such as "heat-not-burn" tobacco and dissolvable tobacco. The increased access to these new products is juxtaposed with expanding public health and clinical intervention options, including mobile technologies and social media. The persistent high rate of tobacco-use disorders among those with psychiatric disorders has gathered increased global attention, including successful approaches to ...
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Clinical neuropsychiatric considerations regarding nonsubstance or behavioral addictions.
Authors: Potenza MN Abstract Over the past several decades, non-substance-use behaviors like gambling, gaming, and sex have received greater consideration as possible foci of addictions. In this article, I will review the recent history and current status of non-substance or behavioral addictions. A main focus will involve gambling and gambling disorder, given that the latter is currently the sole non-substance addictive disorder described in the main text of the current (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Internet gaming disorder, currently in the DSM-5 section add...
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Minding the brain: the role of pharmacotherapy in substance-use disorder treatment.
Authors: Elias D, Kleber HD Abstract With its medicalization as a brain-based disease, addiction has come to be regarded as amenable to biomedical treatment approaches, most commonly pharmacotherapy. Various vulnerabilities are recognized to contribute to maladaptive substance use, and have been linked to diverse neurobiological alterations that may be targeted with pharmacotherapy: withdrawal, craving and cue reactivity, and aberrant reward processing are the most significant. Here, we summarize current thinking regarding pharmacotherapy for substance-use disorders, grouping medications by the type of vulnerabilit...
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Treatment of opioid dependence with buprenorphine: current update.
Authors: Soyka M Abstract Opioid maintenance treatment is the first-line approach in opioid dependence. Both the full opioid agonist methadone (MET) and the partial agonist buprenorphine (BUP) are licensed for the treatment of opioid dependence. BUP differs significantly from MET in its pharmacology, side effects, and safety issues. For example, the risk of respiratory depression is lower than with MET. The risk of diversion and injection of BUP have been reduced by also making it available as a tablet containing the opioid antagonist naloxone. This review summarizes the clinical effects of BUP and examines possibl...
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Cannabis, cannabinoids, and health.
The objective of this article is to summarize current developments concerning cannabis and the spread of SCs. Future studies must further explore the benefit-risk profile of medical cannabis use. PMID: 29302228 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - January 6, 2018 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Anxiety disorders: a review of current literature.
Authors: Thibaut F Abstract Anxiety disorders are the most prevalent psychiatric disorders. There is a high comorbidity between anxiety (especially generalized anxiety disorders or panic disorders) and depressive disorders or between anxiety disorders, which renders treatment more complex. Current guidelines do not recommend benzodiazepines as first-line treatments due to their potential side effects. Selective serotonin reuptake inhibitors and selective serotonin norepinephrine reuptake inhibitors are recommended as first-line treatments. Psychotherapy, in association with pharmacotherapy, is associated with bette...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Treatment of anxiety disorders.
Authors: Bandelow B, Michaelis S, Wedekind D Abstract Anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, social anxiety disorder, and others) are the most prevalent psychiatric disorders, and are associated with a high burden of illness. Anxiety disorders are often underrecognized and undertreated in primary care. Treatment is indicated when a patient shows marked distress or suffers from complications resulting from the disorder. The treatment recommendations given in this article are based on guidelines, meta-analyses, and systematic reviews of randomized controlled studies. Anxiety diso...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The history of generalized anxiety disorder as a diagnostic category.
Authors: Crocq MA Abstract From the 19th century into the 20th century, the terms used to diagnose generalized anxiety included "pantophobia" and "anxiety neurosis." Such terms designated paroxysmal manifestations (panic attacks) as well as interparoxysmal phenomenology (the apprehensive mental state). Also, generalized anxiety was considered one of numerous symptoms of neurasthenia, a vaguely defined illness. Generalized anxiety disorder (GAD) appeared as a diagnostic category in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980, when anxiety neuro...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Cultural aspects of anxiety disorders in India.
Authors: Khambaty M, Parikh RM Abstract Cultural factors have influenced the presentation, diagnoses, and treatment of anxiety disorders in India for several centuries. This review covers the antecedents, prevalence, phenomenology, and treatment modalities of anxiety disorders in the Indian cultural context. It covers the history of the depiction of anxiety in India and the concept of culture in the classification of anxiety disorders, and examines the cultural factors influencing anxiety disorders in India. We review the prevalence and phenomenology of various disorders, such as generalized anxiety disorder, panic...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Epidemiology of anxiety disorders: from surveys to nosology and back.
Authors: Stein DJ, Scott KM, de Jonge P, Kessler RC Abstract On the basis of epidemiological survey findings, anxiety disorders are the most prevalent mental disorders around the world and are associated with significant comorbidity and morbidity. Such surveys rely on advances in psychiatric nosology and may also contribute usefully to revisions of the nosology. There are a number of questions at the intersection of psychiatric epidemiology and nosology. This review addresses the following: What is the prevalence of anxiety disorders and how do we best explain cross-national differences in prevalence estimates? Wha...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Environmental transmission of generalized anxiety disorder from parents to children: worries, experiential avoidance, and intolerance of uncertainty.
Authors: Aktar E, Nikolić M, Bögels SM Abstract Generalized anxiety disorder (GAD) runs in families. Building on recent theoretical approaches, this review focuses on potential environmental pathways for parent-to-child transmission of GAD. First, we address child acquisition of a generalized pattern of fearful/anxious and avoidant responding to potential threat from parents via verbal information and via modeling. Next, we address how parenting behaviors may contribute to maintenance of fearful/anxious and avoidant reactions in children. Finally, we consider intergenerational transmission of worries as a way...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Biological markers of generalized anxiety disorder.
Authors: Maron E, Nutt D Abstract Generalized anxiety disorder (GAD) is a prevalent and highly disabling mental health condition; however, there is still much to learn with regard to pertinent biomarkers, as well as diagnosis, made more difficult by the marked and common overlap of GAD with affective and anxiety disorders. Recently, intensive research efforts have focused on GAD, applying neuroimaging, genetic, and blood-based approaches toward discovery of pathogenetic and treatment-related biomarkers. In this paper, we review the large amount of available data, and we focus in particular on evidence from neuroima...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Genetics of generalized anxiety disorder and related traits.
Authors: Gottschalk MG, Domschke K Abstract This review serves as a systematic guide to the genetics of generalized anxiety disorder (GAD) and further focuses on anxiety-relevant endophenotypes, such as pathological worry fear of uncertainty, and neuroticism. We inspect clinical genetic evidence for the familialityl heritability of GAD and cross-disorder phenotypes based on family and twin studies. Recent advances of linkage studies, genome-wide association studies, and candidate gene studies (eg, 5-HTT, 5-HT1A, MAOA, BDNF) are outlined. Functional and structural neuroimaging and neurophysiological readouts relatin...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Affective neuroimaging in generalized anxiety disorder: an integrated review.
Authors: Fonzo GA, Etkin A Abstract Affective neuroimaging has contributed to our knowledge of generalized anxiety disorder (GAD) through measurement of blood oxygenation level-dependent (BOLD) responses, which facilitate inference on neural responses to emotional stimuli during task-based functional magnetic resonance imaging (fMRI). In this article, the authors provide an integrated review of the task-based affective fMRI literature in GAD. Studies provide evidence for variable presence and directionality of BOLD abnormalities in limbic and prefrontal regions during reactivity to, regulation of, and learning from...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Behavioral methods to study anxiety in rodents.
Authors: Lezak KR, Missig G, Carlezon WA Abstract Stress is a precipitating factor for anxiety-related disorders, which are among the leading forms of psychiatric illness and impairment in the modern world. Rodent-based behavioral tests and models are widely used to understand the mechanisms by which stress triggers anxiety-related behaviors and to identify new treatments for anxiety-related disorders. Although substantial progress has been made and many of the key neural circuits and molecular pathways mediating stress responsiveness have been characterized, these advances have thus far failed to translate into fu...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Oxytocin and social functioning.
Authors: Jones C, Barrera I, Brothers S, Ring R, Wahlestedt C Abstract Social anxiety is a form of anxiety characterized by continuous fear of one or more social or performance situations. Although multiple treatment modalities (cognitive behavioral therapy, selective serotonin reuptake inhibitors/selective norepinephrine reuptake inhibitors, benzodiazepines) exist for social anxiety, they are effective for only 60% to 70% of patients. Thus, researchers have looked for other candidates for social anxiety treatment. Our review focuses on the peptide oxytocin as a potential therapeutic option for individuals with soc...
Source: Dialogues in Clinical Neuroscience - September 6, 2017 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research