Huntington disease: a single-gene degenerative disorder of the striatum.
Authors: Nopoulos PC Abstract Huntington disease (HD) is an autosomal dominant, neurodegenerative disorder with a primary etiology of striatal pathology. The Huntingtin gene (HTT) has a unique feature of a DNA trinucleotide (triplet) repeat, with repeat length ranging from 10 to 35 in the normal population. Repeat lengths between 36 and 39 cause HD at reduced penetrance (some will get the disease, others won't) and when expanded to 40 or more repeats (mHTT), causes HD at full penetrance (every person with this length or beyond will definitely develop the disease). The symptoms of HD may be motor, cognitive, and psy...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Optogenetic approaches to evaluate striatal function in animal models of Parkinson disease.
Authors: Parker KL, Kim Y, Alberico SL, Emmons EB, Narayanan NS Abstract Optogenetics refers to the ability to control cells that have been genetically modified to express light-sensitive ion channels. The introduction of optogenetic approaches has facilitated the dissection of neural circuits. Optogenetics allows for the precise stimulation and inhibition of specific sets of neurons and their projections with fine temporal specificity. These techniques are ideally suited to investigating neural circuitry underlying motor and cognitive dysfunction in animal models of human disease. Here, we focus on how optogenetic...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Inhibition of the reward system by antipsychotic treatment.
Authors: Juckel G Abstract The mesolimbic dopaminergic reward system is responsible for the negative affective symptomatology of schizophrenia, which may be related to a low dopamine tonus within the ventral striatum. The monetary incentive delay (MID) task can be used to study the response of the ventral striatum to incentive stimuli. We show that activation of the ventral striatum is low in patients with schizophrenia, and that this low activation is related to primary and secondary negative symptoms induced by neuroleptics, also known as antipsychotics. Switching from first-(typical) to second-generation (atypic...
Source: Dialogues in Clinical Neuroscience - April 15, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Emotional processing needs further study in major psychiatric diseases.
Authors: Thibaut F Abstract Emotions are largely affected in many psychiatric diseases. A better understanding of the neural networks involved in emotion processing is an important way to be able to improve dysfunctions in emotion recognition, as well as expression, associated with major psychiatric disorders. PMID: 26869837 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Affective preclinical modeling of psychiatric disorders: taking imbalanced primal emotional feelings of animals seriously in our search for novel antidepressants.
Authors: Panksepp J Abstract Preclinical animal models of psychiatric disorders are of critical importance for advances in development of new psychiatric medicine. Regrettably, behavior-only models have yielded no novel targeted treatments during the past half-century of vigorous deployment. This may reflect the general neglect of experiential aspects of animal emotions, since affective mental states of animals supposedly cannot be empirically monitored. This supposition is wrong-to the extent that the rewarding and punishing aspects of emotion circuit arousals reflect positive and negative affective states. During...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Affiliative and prosocial motives and emotions in mental health.
Authors: Gilbert P Abstract This paper argues that studies of mental health and wellbeing can be contextualized within an evolutionary approach that highlights the coregulating processes of emotions and motives. In particular, it suggests that, although many mental health symptoms are commonly linked to threat processing, attention also needs to be directed to the major regulators of threat processing, ie, prosocial and affiliative interactions with self and others. Given that human sociality has been a central driver for a whole range of human adaptations, a better understanding of the effects of prosocial interac...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Emotor control: computations underlying bodily resource allocation, emotions, and confidence.
Authors: Kepecs A, Mensh BD Abstract Emotional processes are central to behavior, yet their deeply subjective nature has been a challenge for neuroscientific study as well as for psychiatric diagnosis. Here we explore the relationships between subjective feelings and their underlying brain circuits from a computational perspective. We apply recent insights from systems neuroscience-approaching subjective behavior as the result of mental computations instantiated in the brain-to the study of emotions. We develop the hypothesis that emotions are the product of neural computations whose motor role is to reallocate bod...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence.
Authors: McLaughlin KA, Garrad MC, Somerville LH Abstract Adolescence is a phase of the lifespan associated with widespread changes in emotional behavior thought to reflect both changing environments and stressors, and psychological and neurobiological development. However, emotions themselves are complex phenomena that are composed of multiple subprocesses. In this paper, we argue that examining emotional development from a process-level perspective facilitates important insights into the mechanisms that underlie adolescents' shifting emotions and intensified risk for psychopathology. Contrasting the developmental...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The rise of moral emotions in neuropsychiatry.
Authors: Fontenelle LF, de Oliveira-Souza R, Moll J Abstract Clinical psychopathology has largely ignored the developments in the field of social neuroscience. The so-called moral emotions are a group of affective experiences thought to promote cooperation, group cohesion, and reorganization. In this review, we: (i) briefly describe a provisional taxonomy of a limited set of moral emotions and their neural underpinnings; and (ii) discuss how disgust, guilt, anger/indignation, and shame/embarrassment can be conceptualized as key affective experiences in different neuropsychiatric disorders. Based on a concise review...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Emotional and cognitive dysregulation in schizophrenia and depression: understanding common and distinct behavioral and neural mechanisms.
Authors: Anticevic A, Schleifer C, Youngsun TC Abstract Emerging behavioral and neuroimaging studies in schizophrenia (SCZ) and major depressive disorder (MD) are mapping mechanisms of co-occurring and distinct affective disturbances across these disorders. This constitutes a critical goal towards developing rationally guided therapies for upstream neural pathways that contribute to comorbid symptoms across disorders. We highlight the current state of the art in our understanding of emotional dysregulation in SCZ versus MD by focusing on broad domains of behavioral function that can map onto underlying neural syste...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Emotional responses to interpersonal rejection.
This article examines seven emotions that often arise when people perceive that their relational value to other people is low or in potential jeopardy, including hurt feelings, jealousy, loneliness, shame, guilt, social anxiety, and embarrassment. Other emotions, such as sadness and anger, may occur during rejection episodes, but are reactions to features of the situation other than low relational value. The article discusses the evolutionary functions of rejection-related emotions, neuroscience evidence regarding the brain regions that mediate reactions to rejection, and behavioral research from social, developmental, and...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Compound facial expressions of emotion: from basic research to clinical applications.
Authors: Du S, Martinez AM Abstract Emotions are sometimes revealed through facial expressions. When these natural facial articulations involve the contraction of the same muscle groups in people of distinct cultural upbringings, this is taken as evidence of a biological origin of these emotions. While past research had identified facial expressions associated with a single internally felt category (eg, the facial expression of happiness when we feel joyful), we have recently studied facial expressions observed when people experience compound emotions (eg, the facial expression of happy surprise when we feel joyful...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Measuring facial expression of emotion.
Authors: Wolf K Abstract Research into emotions has increased in recent decades, especially on the subject of recognition of emotions. However, studies of the facial expressions of emotion were compromised by technical problems with visible video analysis and electromyography in experimental settings. These have only recently been overcome. There have been new developments in the field of automated computerized facial recognition; allowing real-time identification of facial expression in social environments. This review addresses three approaches to measuring facial expression of emotion and describes their specifi...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Oxytocin in the socioemotional brain: implications for psychiatric disorders.
Authors: Kirsch P Abstract The neuropeptide oxytocin (OXT), highly conserved during evolution, is an important modulator of social and emotional processes across many species. During the last decade, a large body of literature has revealed its effects on different aspects of social behavior, including social stress and anxiety, social memory, affiliation and bonding, emotion recognition, mentalizing, empathy, and interpersonal trust. In addition, as impairments in these social domains can be observed in a number of neuropsychiatric disorders, such as autism, social anxiety disorder, depression, schizophrenia, and b...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The effects of drugs on human models of emotional processing: an account of antidepressant drug treatment.
Authors: Pringle A, Harmer CJ Abstract Human models of emotional processing suggest that the direct effect of successful antidepressant drug treatment may be to modify biases in the processing of emotional information. Negative biases in emotional processing are documented in depression, and single or short-term dosing with conventional antidepressant drugs reverses these biases in depressed patients prior to any subjective change in mood. Antidepressant drug treatments also modulate emotional processing in healthy volunteers, which allows the consideration of the psychological effects of these drugs without the co...
Source: Dialogues in Clinical Neuroscience - February 13, 2016 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Anxiety and DSM-5.
Authors: Kupfer DJ Abstract The DSM-5 process, and the publication of DSM-5 in 2013, have had a considerable impact on the classification of anxiety disorders. Major changes included the reorganization of the chapter structure, individual groupings of disorders within each chapter from a life span viewpoint, and the use of specifiers. The DSM-5 chapter on anxiety disorders does not include obsessive-compulsive disorder or post-traumatic stress disorder. The chapter itself now reflects a developmental approach. The text of each disorder has been enhanced with short sections on development and course, risk and progno...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The overlap between anxiety, depression, and obsessive-compulsive disorder.
Authors: Goodwin GM Abstract The anxiety disorders include generalized anxiety disorder, specific phobia, social phobia, agoraphobia, and panic disorder. In addition to the specific symptoms of these disorders, there may be a common experience of anxiety and even dysphoria across the conditions, and of course recourse to the same drug or choice of drugs for treatment. This overlap probably occurs because of universal dimensions of distress or negative affectivity, a shared genetic predisposition, and a common neurobiology Evidence of shared genes is still based mainly on twin studies, but the shared neurobiology ca...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A systematic review of the neural bases of psychotherapy for anxiety and related disorders.
Authors: Brooks SJ, Stein DJ Abstract Brain imaging studies over two decades have delineated the neural circuitry of anxiety and related disorders, particularly regions involved in fear processing and in obsessive-compulsive symptoms. The neural circuitry of fear processing involves the amygdala, anterior cingulate, and insular cortex, while cortico-striatal-thalamic circuitry plays a key role in obsessive-compulsive disorder. More recently, neuroimaging studies have examined how psychotherapy for anxiety and related disorders impacts on these neural circuits. Here we conduct a systematic review of the findings of ...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Separation anxiety: at the neurobiological crossroads of adaptation and illness.
Authors: Battaglia M Abstract Physiological and adaptive separation anxiety (SA) is intimately connected with the evolutionary emergence of new brain structures specific of paleomammalians, the growth of neomammalian-and later hominid-brain and skull size, and the appearance of bipedalism. All these evolutionary milestones have contributed to expanding the behavioral repertoire and plasticity of prehuman and human beings, at the cost of more prolonged dependency of the infant and of the child on parental care. Separation anxiety disorder (SAD) can be seen as an exaggerated/inappropriate manifestation of SA that con...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neuroendocrine models of social anxiety disorder.
Authors: van Honk J, Bos PA, Terburg D, Heany S, Stein DJ Abstract Social anxiety disorder (SAD) is a highly prevalent and disabling disorder with key behavioral traits of social fearfulness, social avoidance, and submissiveness. Here we argue that hormonal systems play a key role in mediating social anxiety, and so may be important in SAD. Hormonal alterations, often established early in development through the interaction between biological and psychological factors (eg, genetic predisposition x early trauma), predispose to socially fearful, avoidant, and submissive behavior. However, whereas gene variants and hi...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Animal models for screening anxiolytic-like drugs: a perspective.
Authors: Bourin M Abstract Contemporary biological psychiatry uses experimental animal models to increase our understanding of affective disorder pathogenesis. Modern anxiolytic drug discovery mainly targets specific pathways and molecular determinants within a single phenotypic domain. However, greater understanding of the mechanisms of action is possible through animal models. Primarily developed with rats, animal models in anxiety have been adapted with mixed success for mice, easy-to-use mammals with better genetic possibilities than rats. In this review, we focus on the three most common animal models of anxie...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Biological predictors of pharmacological therapy in anxiety disorders.
Authors: Maron E, Nutt D Abstract At least one third of patients with anxiety disorders do not adequately respond to available pharmacological treatment. The reason that some patients with anxiety disorders respond well, but others not, to the same classes of medication is not yet fully understood. It is suggested that several biological factors may influence treatment mechanisms in anxiety and therefore could be identified as possible biomarkers predicting treatment response. In this review, we look at current evidence exploring different types of treatment predictors, including neuroimaging, genetic factors, and ...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A history of anxiety: from Hippocrates to DSM.
This article describes the history of the nosology of anxiety disorders. Greek and Latin physicians and philosophers distinguished anxiety from other types of negative affect, and identified it as a medical disorder. Ancient Epicurean and Stoic philosophers suggested techniques to reach an anxiety-free state of mind that are reminiscent of modern cognitive psychology. Between classical antiquity and the late 19(th) century there was a long interval during which anxiety was not classified as a separate illness. However, typical cases of anxiety disorders kept being reported, even if under different names. In the 17(th) cent...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Epidemiology of anxiety disorders in the 21st century.
Authors: Bandelow B, Michaelis S Abstract Anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder, social anxiety disorder, specific phobias, and separation anxiety disorder, are the most prevalent mental disorders and are associated with immense health care costs and a high burden of disease. According to large population-based surveys, up to 33.7% of the population are affected by an anxiety disorder during their lifetime. Substantial underrecognition and undertreatment of these disorders have been demonstrated. There is no evidence that the prevalence rates of anxiet...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.
Authors: Kaczkurkin AN, Foa EB Abstract A large amount of research has accumulated on the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders including posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, and specific phobia. The purpose of the current article is to provide an overview of two of the most commonly used CBT methods used to treat anxiety disorders (exposure and cognitive therapy) and to summarize and discuss the current empirical research regarding the usefulness of these techniques for e...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Cognitive behavioral group therapy for anxiety: recent developments.
This article is an overview of the recent studies concerning group cognitive-behavioral interventions for anxiety disorders. In the last few years, anxiety disorder prevention for children and adolescents has become an important focus of research work. Group prevention programs are based on standard cognitive behavioral therapy (CBT) strategies and are aimed at preventing anxiety disorders as early as possible. Numerous cognitive behavioral group therapies for children as well as adults have been well studied. There are many CBT protocols that have been developed for treating specific anxiety disorders. Now, specialized CB...
Source: Dialogues in Clinical Neuroscience - October 23, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Heading off depressive illness evolution and progression to treatment resistance.
Authors: Post RM Abstract Viewing recurrent depression as a potentially progressive illness may help transform treatment toward earlier, more consistent intervention and prevention. Evidence indicates that recurrent stressors, episodes of depression, and bouts of substance abuse can each show sensitization (increased reactivity upon repetition) and cross-sensitization to the others, and drive illness progression and treatment resistance. These long-lasting increases in pathological responsivity appear to be mediated by epigenetic mechanisms involving alterations in chemical marks placed on DNA and histories. These ...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Pharmacological approaches to the challenge of treatment-resistant depression.
Authors: Ionescu DF, Rosenbaum JF, Alpert JE Abstract Although monoaminergic antidepressants revolutionized the treatment of Major Depressive Disorder (MDD) over a half-century ago, approximately one third of depressed patients experience treatment-resistant depression (TRD). Such patients account for a disproportionately large burden of disease, as evidenced by increased disability, cost, human suffering, and suicide. This review addresses the definition, causes, evaluation, and treatment of unipolar TRD, as well as the major treatment strategies, including optimization, augmentation, combination, and switch thera...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Treatment of affective disorders in cardiac disease.
Authors: Mavrides N, Nemeroff CB Abstract Patients with cardiovascular disease (CVD) commonly have syndromal major depression, and depression has been associated with an increased risk of morbidity and mortality. Prevalence of depression is between 17% and 47% in CVD patients. Pharmacologic and psychotherapeutic interventions have long been studied, and in general are safe and somewhat efficacious in decreasing depressive symptoms in patients with CVD. The impact on cardiac outcomes remains unclear. The evidence from randomized controlled clinical trials indicates that antidepressants, especially selective serotoni...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations.
Authors: Flory JD, Yehuda R Abstract Approximately half of people with post-traumatic stress disorder (PTSD) also suffer from Major Depressive Disorder (MDD). The current paper examines evidence for two explanations of this comorbidity. First, that the comorbidity reflects overlapping symptoms in the two disorders. Second, that the co-occurrence of PTSD and MDD is not an artifact, but represents a trauma-related phenotype, possibly a subtype of PTSD. Support for the latter explanation is inferred from literature that examines risk and biological correlates of PTSD and MDD, including molecular processes. Treatment i...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Applications of magnetic resonance imaging for treatment-resistant late-life depression.
Authors: Agudelo C, Aizenstein HJ, Karp JF, Reynolds Iii CF Abstract Late-life depression (LLD) is a growing public and global health concern with diverse clinical manifestations and etiology. This literature review summarizes neuroimaging findings associated with depression in older adults and treatment-response variability. LLD has been associated with cerebral atrophy, diminished myelin integrity, and cerebral lesions in frontostriatal-limbic regions. These associations help explain the depression-executive dysfunction syndrome observed in LLD, and support cerebrovascular burden as a pathogenic mechanism. Furthe...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Depression in adolescents and young adults with cancer.
Authors: Park EM, Rosenstein DL Abstract Adolescents and young adults (AYAs) with cancer are at risk for depression due to disruptions in their developmental trajectory, greater physical symptom burden, and increased likelihood of developing aggressive disease. Rates of depression and other psychological disorders are substantially higher in AYAs with cancer when compared with older adults. Psychiatrists caring for these patients must consider the age-appropriate developmental context of these patients along with familial and medical factors that may influence the presentation and treatment of depression. Previous ...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Assessment and treatment of mood disorders in the context of substance abuse.
Authors: Tolliver BK, Anton RF Abstract Recognition and management of mood symptoms in individuals using alcohol and/or other drugs represent a daily challenge for clinicians in both inpatient and outpatient treatment settings. Diagnosis of underlying mood disorders in the context of ongoing substance abuse requires careful collection of psychiatric history, and is often critical for optimal treatment planning and outcomes. Failure to recognize major depression or bipolar disorders in these patients can result in increased relapse rates, recurrence of mood episodes, and elevated risk of completed suicide. Over the ...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Treatment-refractory anxiety; definition, risk factors, and treatment challenges.
Authors: Roy-Byrne P Abstract A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to "pseudo-resistance" (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true "treatment resistance." Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nonadherence to a course of treatment. True treatment resistance can be due to ...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Optimizing the treatment of mood disorders in the perinatal period.
Authors: Meltzer-Brody S, Jones I Abstract The perinatal period is a time of high risk for women with unipolar and bipolar mood disorders. We discuss treatment considerations for perinatal mood disorders, including unipolar and bipolar depression as well as postpartum psychosis. We further explore the unique issues faced by women and their families across the full trajectory of the perinatal period from preconception planning through pregnancy and following childbirth. Treatment of perinatal mood disorders requires a collaborative care approach between obstetrics practitioners and mental health providers, to ensure...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Challenges in the diagnosis and treatment of depression in autism spectrum disorders across the lifespan.
Authors: Chandrasekhar T, Sikich L Abstract Diagnosis and treatment of comorbid neuropsychiatric illness is often a secondary focus of treatment in individuals with autism spectrum disorder (ASD), given that substantial impairment may be caused by core symptoms of ASD itself. However, psychiatric comorbidities, including depressive disorders, are common and frequently result in additional functional impairment, treatment costs, and burden on caregivers. Clinicians may struggle to appropriately diagnose depression in ASD due to communication deficits, atypical presentation of depression in ASD, and lack of standardi...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neurobiologically informed treatment for adults with anorexia nervosa: a novel approach to a chronic disorder.
Authors: Knatz S, Wierenga CE, Murray SB, Hill L, Kaye WH Abstract Anorexia nervosa (AN) is a severe and debilitating disorder with significant medical and psychological sequelae. To date, there are no effective treatments for adults, resulting in high rates of chronicity, morbidity, and mortality. Recent advances in brain imaging research have led to an improved understanding of etiology and specific neurobiological mechanisms underlying symptoms. Despite this, there are no treatments focused on targeting symptoms using this empirically supported mechanistic understanding of the illness. Updated treatment approach...
Source: Dialogues in Clinical Neuroscience - August 9, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Why do we need a diagnosis? Maybe a syndrome is enough?
Authors: Sartorius N Abstract The recent publication of the Diagnostic and Statistical Manual of Mental Disorders 5.1 by the American Psychiatric Association, and the continuing work of the World Health Organization on the 11th revision of the International Classification of Diseases raises once more the question of the need for, the use, and the usefulness of diagnosis in psychiatry The fact that, despite significant advances of science, we are still uncertain about the causes and pathogenesis of mental disorders seems to support the notion that it would be better to use syndromes instead of diagnoses, or go even ...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Focus on psychosis.
Authors: Gaebel W, Zielasek J Abstract The concept of psychosis has been shaped by traditions in the concepts of mental disorders during the last 170 years. The term "psychosis" still lacks a unified definition, but denotes a clinical construct composed of several symptoms. Delusions, hallucinations, and thought disorders are the core clinical features. The search for a common denominator of psychotic symptoms points toward combinations of neuropsychological mechanisms resulting in reality distortion. To advance the elucidation of the causes and the pathophysiology of the symptoms of psychosis, a deconstr...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Descriptive psychopathology, phenomenology, and the legacy of Karl Jaspers.
Authors: Häfner H Abstract With his early publications (1910-1913), Karl Jaspers created a comprehensive methodological arsenal for psychiatry, thus laying the foundation for descriptive psychopathology. Following Edmund Husserl, the founder of philosophical phenomenology, Jaspers introduced phenomenology into psychopathology as "static understanding," ie, the unprejudiced intuitive reproduction (Vergegenwärtigung) and description of conscious phenomena. In a longitudinal perspective, "genetic understanding" based on empathy reveals how mental phenomena arise from mental phenomena. Sev...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The Kraepelinian tradition.
Authors: Hoff P Abstract Emil Kraepelin (1856-1926) was an influential figure in the history of psychiatry as a clinical science. This paper, after briefly presenting his biography, discusses the conceptual foundations of his concept of mental illness and follows this line of thought through to late 20th-century "Neo-Kraepelinianism," including recent criticism, particularly of the nosological dichotomy of endogenous psychoses. Throughout his professional life, Kraepelin put emphasis on establishing psychiatry as a clinical science with a strong empirical background. He preferred pragmatic attitudes and a...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Eugen Bleuler's schizophrenia-a modern perspective.
Authors: Maatz A, Hoff P, Angst J Abstract The introduction of the term and concept schizophrenia earned its inventor, Swiss psychiatrist Eugen Bleuler, worldwide fame. Prompted by the rejection of the main principle of Kraepelinian nosology, namely prognosis, Bleuler's belief in the clinical unity of what Kraepelin had described as dementia praecox required him to search for alternative characterizing features that would allow scientific description and classification. This led him to consider psychological, and to a lesser degree, social factors alongside an assumed underlying neurobiological disease process as c...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

French perspectives on psychiatric classification.
This article reviews the role of the French schools in the development of psychiatric nosology. Boissier de Sauvages published the first French treatise on medical nosology in 1763. Until the 1880s, French schools held a pre-eminent position in the development of psychiatric concepts. From the 1880s until World War I, German-speaking schools exerted the most influence, featuring the work of major figures such as Emil Kraepelin and Eugen Bleuler. French schools were probably hampered by excessive administrative and cultural centralization. Between the 1880s and the 1930s, French schools developed diagnostic categories that ...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders.
Authors: Shorter E Abstract The current Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 arose from a tradition filled with haphazard science and politically driven choices. The nosology of modern psychiatry began with the German classifiers of the late 19th century, especially Emil Kraepelin. Psychoanalysis then blotted out the classificatory vision for the next half-century, and most of this European psychopathological science failed to cross the Atlantic. The DSM series was a homegrown American product, beginning with Medical 203 in 1945, then guided by psychoanalytic insights through DSM-I in 1952 ...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Genetic and genomic analyses as a basis for new diagnostic nosologies.
Authors: Gershon ES, Grennan KS Abstract For schizophrenia, bipolar disorder, and autism, clinical descriptions are precise and reliable, but there is great overlap among diagnoses in associated genetic polymorphisms and rare variants, treatment response, and other phenomenological findings such as brain imaging. It is widely hoped that new diagnostic categories can be developed which are more precise and predictive of important features of illness, particularly response to pharmacological agents. It is the intent of this paper to describe the diagnostic implications of some current genetic findings, and to describ...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A knowledge network for a dynamic taxonomy of psychiatric disease.
Authors: Krishnan RR Abstract Current taxonomic approaches in medicine and psychiatry are limited in validity and utility. They do serve simple communication purposes for medical coding, teaching, and reimbursement, but they are not suited for the modern era with its rapid explosion of knowledge from the "omics" revolution. The National Academy of Sciences published a report entitled Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. The authors advocate a new taxonomy that would integrate molecular data, clinical data, and health outcomes in a d...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Research Domain Criteria: toward future psychiatric nosologies.
Authors: Cuthbert BN Abstract The Research Domain Criteria (RDoC) project was initiated by the National Institute of Mental Health (NIMH) in early 2009 as the implementation of Goal 1.4 of its just-issued strategic plan. In keeping with the NIMH mission, to "transform the understanding and treatment of mental illnesses through basic and clinical research," RDoC was explicitly conceived as a research-related initiative. The statement of the relevant goal in the strategic plan reads: "Develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and...
Source: Dialogues in Clinical Neuroscience - May 21, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Pursuit of the "truth" about mental illness: the significance of findings in neuropsychiatric research, and lessons from the past.
Pursuit of the "truth" about mental illness: the significance of findings in neuropsychiatric research, and lessons from the past. Dialogues Clin Neurosci. 2014 Dec;16(4):447-50 Authors: DeLisi LE Abstract Technology in genetics and brain imaging has advanced so rapidly that it is difficult to be knowledgeable about all the new tools being used in the pursuit of progress toward understanding and treating mental illness. While findings from new studies remain promising, caution is needed with regard to their current applicability to clinical use, both to predict who is likely to become ill and...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Prediction of treatment outcomes in psychiatry-where do we stand ?
Authors: McMahon FJ Abstract Psychiatric treatment relies on a solid armamentarium of pharmacologic and nonpharmacologic treatment modalities that perform reasonably well for many patients but leave others in a state of chronic disability or troubled by problematic side effects. Treatment planning in psychiatry remains an art that depends on considerable trial and error. Thus, there is an urgent need for better tools that will provide a means for matching individual patients with the most effective treatments while minimizing the risk of adverse events. This review will consider the current state of the science in ...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Computational modeling of drug response with applications to neuroscience.
Authors: Herwig R Abstract The development of novel high-throughput technologies has opened up the opportunity to deeply characterize patient tissues at various molecular levels and has given rise to a paradigm shift in medicine towards personalized therapies. Computational analysis plays a pivotal role in integrating the various genome data and understanding the cellular response to a drug. Based on that data, molecular models can be constructed that incorporate the known downstream effects of drug-targeted receptor molecules and that predict optimal therapy decisions. In this article, we describe the different st...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research