Caregiver-mediated approaches to managing challenging behaviors in children with autism spectrum disorder.
Authors: Grofer Klinger L, Ence W, Meyer A Abstract A significant proportion of children with autism spectrum disorder (ASD) are referred to mental health centers due to the presence of challenging behaviors. Because challenging behaviors in children and adolescents with ASD often result from underlying social and communication difficulties and comorbid anxiety, traditional caregiver-mediated behavior intervention techniques developed for children with disruptive behavior disorders may need to be adapted for this population. Behavioral interventions that target communication skills, social skills, anxiety, and sens...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

BRAIN: innovative neurotechnologies for imaging and therapeutics.
Authors: Church GM Abstract Conceived with the aim of meeting the needs of the neurobiology and clinical communities, the Brain Research through Advancing Innovative Technologies (BRAIN) Initiative builds on the lessons learned from major projects in genetics, such as the Human Genome Project. It concentrates on the use of new imaging technologies in conjunction with genomics to inform therapeutic decisions. PMID: 24174897 [PubMed - indexed for MEDLINE] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Structure and function of complex brain networks.
Authors: Sporns O Abstract An increasing number of theoretical and empirical studies approach the function of the human brain from a network perspective. The analysis of brain networks is made feasible by the development of new imaging acquisition methods as well as new tools from graph theory and dynamical systems. This review surveys some of these methodological advances and summarizes recent findings on the architecture of structural and functional brain networks. Studies of the structural connectome reveal several modules or network communities that are interlinked by hub regions mediating communication process...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Animal models and high field imaging and spectroscopy.
Authors: Öz G, Tkáč I, Uğurbil K Abstract A plethora of magnetic resonance (MR) techniques developed in the last two decades provide unique and noninvasive measurement capabilities for studies of basic brain function and brain diseases in humans. Animal model experiments have been an indispensible part of this development. MR imaging and spectroscopy measurements have been employed in animal models, either by themselves or in combination with complementary and often invasive techniques, to enlighten us about the information content of such MR methods and/or verify observations made in the human brain....
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Functional neuroimaging and schizophrenia: a view towards effective connectivity modeling and polygenic risk.
Authors: Birnbaum R, Weinberger DR Abstract We review critical trends in imaging genetics as applied to schizophrenia research, and then discuss some future directions of the field. A plethora of imaging genetics studies have investigated the impact of genetic variation on brain function, since the paradigm of a neuroimaging intermediate phenotype for schizophrenia first emerged. It was initially posited that the effects of schizophrenia susceptibility genes would be more penetrant at the level of biologically based neuroimaging intermediate phenotypes than at the level of a complex and phenotypically heterogeneous...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Brain oscillations in neuropsychiatric disease.
Authors: Başar E Abstract The term "brain (or neural) oscillations" refers to the rhythmic and/or repetitive electrical activity generated spontaneously and in response to stimuli by neural tissue in the central nervous system. The importance of brain oscillations in sensory-cognitive processes has become increasingly evident. It has also become clear that event-related oscillations are modified in many types of neuropathology, in particular in cognitive impairment. This review discusses methods such as evoked/event-related oscillations and spectra, coherence analysis, and phase locking. It gives example...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

High-frequency oscillations and the neurobiology of schizophrenia.
Authors: Uhlhaas PJ, Singer W Abstract Neural oscillations at low- and high-frequency ranges are a fundamental feature of large-scale networks. Recent evidence has indicated that schizophrenia is associated with abnormal amplitude and synchrony of oscillatory activity, in particular, at high (beta/gamma) frequencies. These abnormalities are observed during task-related and spontaneous neuronal activity which may be important for understanding the pathophysiology of the syndrome. In this paper, we shall review the current evidence for impaired beta/gamma-band oscillations and their involvement in cognitive functions...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Molecular imaging as a guide for the treatment of central nervous system disorders.
Authors: Kim E, Howes OD, Kapur S Abstract Molecular imaging techniques have a number of advantages for research into the pathophysiology and treatment of central nervous system (CNS) disorders. Firstly, they provide a noninvasive means of characterizing physiological processes in the living brain, enabling molecular alterations to be linked to clinical changes. Secondly, the pathophysiological target in a given CNS disorder can be measured in animal models and in experimental human models in the same way, which enables translational research. Moreover, as molecular imaging facilitates the detection of functional c...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Use of proton magnetic resonance spectroscopy in the treatment of psychiatric disorders: a critical update.
Authors: Bustillo JR Abstract Because of the wide availability of hardware as well as of standardized analytic quantification tools, proton magnetic resonance spectroscopy ((1)H-MRS) has become widely used to study psychiatric disorders. (1)H-MRS allows measurement of brain concentrations of more traditional singlet neurometabolites like N-acetylaspartate, choline, and creatine. More recently, quantification of the more complex multiplet spectra for glutamate, glutamine, inositol, and γ-aminobutyric acid have also been implemented. Here we review applications of (1)H-MRS in terms of informing treatment option...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Schizophrenia and abnormal brain network hubs.
Authors: Rubinov M, Bullmore E Abstract Schizophrenia is a heterogeneous psychiatric disorder of unknown cause or characteristic pathology. Clinical neuroscientists increasingly postulate that schizophrenia is a disorder of brain network organization. In this article we discuss the conceptual framework of this dysconnection hypothesis, describe the predominant methodological paradigm for testing this hypothesis, and review recent evidence for disruption of central/hub brain regions, as a promising example of this hypothesis. We summarize studies of brain hubs in large-scale structural and functional brain networks ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The brain's default network: origins and implications for the study of psychosis.
Authors: Buckner RL Abstract The brain's default network is a set of regions that is spontaneously active during passive moments. The network is also active during directed tasks that require participants to remember past events or imagine upcoming events. One hypothesis is that the network facilitates construction of mental models (simulations) that can be used adaptively in many contexts. Extensive research has considered whether disruption of the default network may contribute to disease. While an intriguing possibility, a specific challenge to this notion is the fact that it is difficult to accurately measure t...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Typical and atypical brain development: a review of neuroimaging studies.
Authors: Dennis EL, Thompson PM Abstract In the course of development, the brain undergoes a remarkable process of restructuring as it adapts to the environment and becomes more efficient in processing information. A variety of brain imaging methods can be used to probe how anatomy, connectivity, and function change in the developing brain. Here we review recent discoveries regarding these brain changes in both typically developing individuals and individuals with neurodevelopmental disorders. We begin with typical development, summarizing research on changes in regional brain volume and tissue density, cortical th...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Simultaneous EEG and fMRI: towards the characterization of structure and dynamics of brain networks.
Authors: Mulert C Abstract Progress in the understanding of normal and disturbed brain function is critically dependent on the methodological approach that is applied. Both electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) are extremely efficient methods for the assessment of human brain function. The specific appeal of the combination is related to the fact that both methods are complementary in terms of basic aspects: EEG is a direct measurement of neural mass activity and provides high temporal resolution. FMRI is an indirect measurement of neural activity and based on hemodynamic cha...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Memory: from the laboratory to everyday life.
Authors: Schacter DL Abstract One of the key goals of memory research is to develop a basic understanding of the nature and characteristics of memory processes and systems. Another important goal is to develop useful applications of basic research to everyday life. This editorial considers two lines of work that illustrate some of the prospects for applying memory research to everyday life: interpolated quizzing to enhance learning in educational settings, and specificity training to enhance memory and associated functions in individuals who have difficulties remembering details of their past experiences. PMID...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Memory in health and in schizophrenia.
We present evidence in healthy populations for sex differences-females outperforming in verbal and face memory, and age effects-slowed memory processes with age. We then describe deficits associated with schizophrenia. Impairment in schizophrenia is more severe in patients with negative symptoms-especially flat affect-who also show deficits in measures of social cognition. This evidence implicates medial temporal and frontal regions in schizophrenia. PMID: 24459407 [PubMed - indexed for MEDLINE] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The "working" of working memory.
The "working" of working memory. Dialogues Clin Neurosci. 2013 Dec;15(4):411-8 Authors: Miller EK Abstract This review examines the evidence for a neurobiological explanation of executive functions of working memory. We suggest that executive control stems from information about task rules acquired by mixed selective, adaptive coding, multifunctional neurons in the prefrontal cortex. The output of these neurons dynamically links the cortex-wide networks needed to complete the task. The linking may occur via synchronizing of neural rhythms, which may explain why we have a limited capacity for ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A neurobiological approach to the cognitive deficits of psychiatric disorders.
Authors: Etkin A, Gyurak A, O'Hara R Abstract Deficits in brain networks that support cognitive regulatory functions are prevalent in many psychiatric disorders. Findings across neuropsychology and neuroimaging point to broad-based impairments that cross traditional diagnostic boundaries. These dysfunctions are largely separate from the classical symptoms of the disorders, and manifest in regulatory problems in both traditional cognitive and emotional domains. As such, they relate to the capacity of patients to engage effectively in their daily lives and activity, often persist even in the face of symptomatically e...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Cellular basis of memory for addiction.
Authors: Nestler EJ Abstract DESPITE THE IMPORTANCE OF NUMEROUS PSYCHOSOCIAL FACTORS, AT ITS CORE, DRUG ADDICTION INVOLVES A BIOLOGICAL PROCESS: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. Here, we review the types of molecular and cellular adaptations that occur in specific brain regions to mediate addiction-associated behavioral abnormalities. These include alterations in gene expression achieved in part via epigenetic mechanisms, plasticity in...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Memory loss in Alzheimer's disease.
Authors: Jahn H Abstract Loss of memory is among the first symptoms reported by patients suffering from Alzheimer's disease (AD) and by their caretakers. Working memory and long-term declarative memory are affected early during the course of the disease. The individual pattern of impaired memory functions correlates with parameters of structural or functional brain integrity. AD pathology interferes with the formation of memories from the molecular level to the framework of neural networks. The investigation of AD memory loss helps to identify the involved neural structures, such as the default mode network, the in...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Disorders of memory and plasticity in psychiatric disease.
Authors: Pittenger C Abstract Plasticity is found throughout the nervous system and is thought to underlie key aspects of development, learning and memory, and repair. Neuropiastic processes include synaptic plasticity, cellular growth and remodeling, and neurogenesis. Dysregulation of these processes can contribute to a variety of neuropsychiatric diseases. In this review we explore three different ways in which dysregulation of neuropiastic and mnemonic processes can contribute to psychiatric illness. First, impairment of the mechanisms of plasticity can lead to cognitive deficits; this is most obvious in dementi...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Non-Alzheimer's disease-related memory impairment and dementia.
Authors: Arlt S Abstract Although Alzheimer's disease (AD) is a common cause of memory impairment and dementia in the elderly disturbed memory function is a widespread subjective and/or objective symptom in a variety of medical conditions. The early detection and correct distinction of AD from non-AD memory impairment is critically important to detect possibly treatable and reversible underlying causes. In the context of clinical research, it is crucial to correctly distinguish between AD or non-AD memory impairment in order to build homogenous study populations for the assessment of new therapeutic possibilities. ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Memory as a new therapeutic target.
Authors: Nader K, Hardt O, Lanius R Abstract This review aims to demonstrate how an understanding of the brain mechanisms involved in memory provides a basis for; (i) reconceptualizing some mental disorders; (ii) refining existing therapeutic tools; and (iii) designing new ones for targeting processes that maintain these disorders. First, some of the stages which a memory undergoes are defined, and the clinical relevance of an understanding of memory processing by the brain is discussed. This is followed by a brief review of some of the clinical studies that have targeted memory processes. Finally, some new insight...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Imaging autobiographical memory.
Authors: Fossati P Abstract Autobiographical memory (AM) defines the memory systems that encode, consolidate, and retrieve personal events and facts, AM is strongly related to self-perception and self representation. We review here the neural correlates of AM retrieval. AM retrieval encompasses a large neural network including the prefrontal, temporal, and parietal cortex, and limbic structures. All these regions subserve the cognitive processes (episodic remembering, cognitive control, self-processing, and scene construction) at play during memory retrieval. We emphasize the specific role of medial prefrontal cort...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Redesigning antidepressant drug discovery.
Authors: Holsboer F Abstract Antidepressant drug discovery and development have been put on hold by many pharmaceutical companies. The main reason for this is the negative efficacy studies with novel specific drugs. Here I argue that the main obstacles are the absence of gene tests and biomarkers as an integral part of a diagnostic process. Further, too much emphasis has been put on validating drug candidates in animal models of psychiatric disorders. A more rapid transfer of drug candidates into human research is necessary to overcome current obstacles that prevent the discovery of next-generation antidepressants....
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Pathophysiology of depression and innovative treatments: remodeling glutamatergic synaptic connections.
Authors: Duman RS Abstract Despite the complexity and heterogeneity of mood disorders, basic and clinical research studies have begun to elucidate the pathophysiology of depression and to identify rapid, efficacious antidepressant agents. Stress and depression are associated with neuronal atrophy, characterized by loss of synaptic connections in key cortical and limbic brain regions implicated in depression. This is thought to occur in part via decreased expression and function of growth factors, such as brain-derived neurotrophic factor (BDNF), in the prefrontal cortex (PFC) and hippocampus. These structural alter...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Serotonin-related pathways and developmental plasticity: relevance for psychiatric disorders.
Authors: Dayer A Abstract Risk for adult psychiatric disorders is partially determined by early-life alterations occurring during neural circuit formation and maturation. In this perspective, recent data show that the serotonin system regulates key cellular processes involved in the construction of cortical circuits. Translational data for rodents indicate that early-life serotonin dysregulation leads to a wide range of behavioral alterations, ranging from stress-related phenotypes to social deficits. Studies in humans have revealed that serotonin-related genetic variants interact with early-life stress to regulate...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Emerging role of microRNAs in major depressive disorder: diagnosis and therapeutic implications.
Authors: Dwivedi Y Abstract Major depressive disorder (MDD) is a major public health concern. Despite tremendous advances, the pathogenic mechanisms associated with MDD are still unclear. Moreover, a significant number of MDD subjects do not respond to the currently available medication. MicroRNAs (miRNAs) are a class of small noncoding RNAs that control gene expression by modulating translation, messenger RNA (mRNA) degradation, or stability of mRNA targets. The role of miRNAs in disease pathophysiology is emerging rapidly. Recent studies demonstrating the involvement of miRNAs in several aspects of neural plastic...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Proteomics, metabolomics, and protein interactomics in the characterization of the molecular features of major depressive disorder.
Authors: Martins-de-Souza D Abstract Omics technologies emerged as complementary strategies to genomics in the attempt to understand human illnesses. In general, proteomics technologies emerged earlier than those of metabolomics for major depressive disorder (MDD) research, but both are driven by the identification of proteins and/or metabolites that can delineate a comprehensive characterization of MDD's molecular mechanisms, as well as lead to the identification of biomarker candidates of all types-prognosis, diagnosis, treatment, and patient stratification. Also, one can explore protein and metabolite interactom...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Functional neuroimaging studies of the effects of psychotherapy.
Authors: Beauregard M Abstract It has been long established that psychological interventions can markedly alter patients' thinking patterns, beliefs, attitudes, emotional states, and behaviors. Little was known about the neural mechanisms mediating such alterations before the advent of functional neuroimaging techniques. Since the turn of the new millenium, several functional neuroimaging studies have been conducted to tackle this important issue. Some of these studies have explored the neural impact of various forms of psychotherapy in individuals with major depressive disorder. Other neuroimaging studies have inv...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Deep brain stimulation in the treatment of depression.
Authors: Delaloye S, Holtzheimer PE Abstract Major depressive disorder is a worldwide disease with debilitating effects on a patient's life. Common treatments include pharmacotherapy, psychotherapy, and electroconvulsive therapy. Many patients do not respond to these treatments; this has led to the investigation of alternative therapeutic modalities. Deep brain stimulation (DBS) is one of these modalities. It was first used with success for treating movement disorders and has since been extended to the treatment of psychiatric disorders. Although DBS is still an emerging treatment, promising efficacy and safety hav...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Endogenous and exogenous electric fields as modifiers of brain activity: rational design of noninvasive brain stimulation with transcranial alternating current stimulation.
Authors: Fröhlich F Abstract Synchronized neuronal activity in the cortex generates weak electric fields that are routinely measured in humans and animal models by electroencephalography and local field potential recordings. Traditionally, these endogenous electric fields have been considered to be an epiphenomenon of brain activity. Recent work has demonstrated that active cortical networks are surprisingly susceptible to weak perturbations of the membrane voltage of a large number of neurons by electric fields. Simultaneously, noninvasive brain stimulation with weak, exogenous electric fields (transcranial c...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neurofeedback and networks of depression.
Authors: Linden DE Abstract Recent advances in imaging technology and in the understanding of neural circuits relevant to emotion, motivation, and depression have boosted interest and experimental work in neuromodulation for affective disorders. Real-time functional magnetic resonance imaging (fMRI) can be used to train patients in the self regulation of these circuits, and thus complement existing neurofeedback technologies based on electroencephalography (EEG). EEG neurofeedback for depression has mainly been based on models of altered hemispheric asymmetry. fMRI-based neurofeedback (fMRI-NF) can utilize function...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Henri Laborit and the inhibition of action.
Authors: Kunz E Abstract Henri Laborit was one of the founders of modern neuropsychopharmacology, having discovered, or participated in, the discovery of chlorpromazine, gamma-OH, clomethiazole, and minaprine. He also put forward a theory regarding the necessity of counteracting the negative consequences of defense mechanisms during anesthesia or behavioral inhibition. The scope of his work covers neurophysiology, pharmacology, psychiatry, and psychosomatics. His independence of spirit meant that most of his research was not done within university settings. PMID: 24733976 [PubMed - in process] (Source: Dialogu...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Patient-reported outcomes in psychiatry.
Authors: Sartorius N Abstract The recent trend for recognizing the need that patients actively participate in the assessment of the outcome of treatment is a welcome development, not only because it adds valuable data, but also because its recognition of the partnership role that the patients should have in research on outcome of mental illness. PMID: 25152651 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A history of health-related quality of life outcomes in psychiatry.
This article summarizes studies that highlight the development, validation, and application of HRQoL measures in psychiatry. Thoughtful application of these tools in psychiatric research can provide a much-needed patient perspective in the future of comparative effectiveness research, patient-centered outcomes research, and clinical care. PMID: 25152652 [PubMed - in process] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Quality of life as patient-reported outcomes: principles of assessment.
Authors: Bullinger M, Quitmann J Abstract Assessing quality of life (QoL) as a patient-reported outcome in adult psychiatry poses challenges in terms of concepts, methods, and applications in research and practice. This review will outline conceptually the construct of QoL, its dimensionality, and its representation across patient groups. Methodological challenges are examined, along with principles of QoL instrument development and testing, as well as across cultures. Application of instruments in epidemiological, clinical health economics, and health services research is reviewed based on pertinent literature. Va...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

How to assess quality of life in child and adolescent psychiatry.
This article provides an overview of the conceptual foundations of measuring health-related quality of life (HRQoL) in children and adolescents in child and adolescent psychiatry, and of the current state of research in this field. The available procedures for determining quality of life are presented according to their areas of use and their psychometric characteristics. The internationally available generic instruments for measuring HRQoL in children are identified and assessed in terms of their strengths and weaknesses with regard to selected criteria. As a result, seven generic HRQoL instruments and two utility procedu...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Challenges in measuring outcomes for caregivers of people with mental health problems.
Authors: Zendjidjian XY, Boyer L Abstract Patient-reported outcomes (PROs) are increasingly important in health care and mental health research. Furthermore, caregivers become partners in care for patients with mental disorders, and health workers are more attentive to the expectations and needs of caregivers. A number of outcomes for caregivers are measured and used in daily practice in order to promote actions to improve health care systems and progress in research on the impact of mental disorders on their caregivers. This paper proposes an inventory of the different outcomes and different measurement tools used...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Patient-reported outcomes before and after treatment of major depressive disorder.
Authors: IsHak WW, Mirocha J, Pi S, Tobia G, Becker B, Peselow ED, Cohen RM Abstract Patient reported outcomes (PROs) of quality of life (QoL), functioning, and depressive symptom severity are important in assessing the burden of illness of major depressive disorder (MDD) and to evaluate the impact of treatment. We sought to provide a detailed analysis of PROs before and after treatment of MDD from the large Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. This analysis examines PROs before and after treatment in the second level of STAR*D. The complete data on QoL, functioning, and depressive...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The assessment of quality of life in clinical practice in patients with schizophrenia.
Authors: Karow A, Wittmann L, Schöttle D, Schäfer I, Lambert M Abstract The aim of the present article is to review QoL scales used in studies investigating patients with schizophrenia over the past 5 years, and to summarize the results of QoL assessment in clinical practice in these patients. Literature available from January 2009 to December 2013 was identified in a PubMed search using the key words "quality of life" and "schizophrenia" and in a cross-reference search for articles that were particularly relevant. A total of n=432 studies used 35 different standardized generic and spe...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Assessment of patient-reported symptoms of anxiety.
Authors: Rose M, Devine J Abstract Patient self-reported symptoms are of crucial importance to identify anxiety disorders, as well as to monitor their treatment in clinical practice and research. Thus, for evidence-based medicine, a precise, reliable, and valid (ie, "objective") assessment of the patient's reported "subjective" symptoms is warranted. There is a plethora of instruments available, which can provide psychometrically sound assessments of anxiety, but there are several limitations of current tools that need to be carefully considered for their successful use. Nevertheless, the empiri...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Patient-reported outcomes in post-traumatic stress disorder. Part I: focus on psychological treatment.
Authors: d'Ardenne P, Heke S Abstract Since 2000, patient reports have contributed significantly to the widening diagnostic criteria for post-traumatic stress disorder, notably with the inclusion of complex, repeated, and indirect threat to people who develop symptoms. This paper describes and explains why patient reports matter, through worldwide mental health users' movements and the human rights movement. It looks at 46 recent patient-reported outcomes of preferred psychological treatments in clinical research and practice, and compares them with clinician-reported outcomes, using rating scales that diagnose and...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Patient-reported outcomes in post-traumatic stress disorder. Part II: focus on pharmacological treatment.
Authors: Kapfhammer HP Abstract Post-traumatic stress disorder (PTSD) may be associated with long-lasting psychological suffering, distressing psychosocial disability, markedly reduced health-related quality of life, and increased morbidity and mortality in a subgroup of individuals in the aftermath of serious traumatic events. Both etiopathogenesis and treatment modalities of PTSD are best conceptualized within a biopsychosotial model. Pharmacotherapy may lay claim to a major role in the multimodal treatment approaches. Here we outline two different pharmacotherapeutic trends that aim to modify the encoding, conso...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Patient-reported outcomes in obsessive-compulsive disorder.
Authors: Subramaniam M, Soh P, Ong C, Esmond Seow LS, Picco L, Vaingankar JA, Chong SA Abstract The purpose of the article was to provide an overview of patient-reported outcomes (PROs) and related measures that have been examined in the context of obsessive-compulsive disorder (OCD). The current review focused on patient-reported outcome measures (PROMs) that evaluated three broad outcome domains: functioning, health-related quality of life (HRQoL), and OCD-related symptoms. The present review ultimately included a total of 155 unique articles and 22 PROMs. An examination of the PROs revealed that OCD patients ten...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Patient-reported outcomes in borderline personality disorder.
Authors: Hasler G, Hopwood CJ, Jacob GA, Brändle LS, Schulte-Vels T Abstract Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable exper...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Epigenetic advances in clinical neuroscience.
Authors: Abel T, Poplawski S Abstract Epigenetics, broadly defined as the regulation of gene expression without alteration of the genome, has become a field of tremendous interest in neuroscience, neurology, and psychiatry. This research has rapidly changed the way researchers think about brain function. Exciting epigenetic discoveries have been found in addiction, early life stress, neurodegeneration, post-traumatic stress disorder, and depression. As researchers more precisely define the epigenetic landscape that regulates disease progression in each of these cases, therapeutics can be designed to specifically ta...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Epigenetic signaling in psychiatric disorders: stress and depression.
Authors: Bagot RC, Labonté B, Peña CJ, Nestler EJ Abstract Psychiatric disorders are complex multifactorial disorders involving chronic alterations in neural circuit structure and function. While genetic factors play a role in the etiology of disorders such as depression, addiction, and schizophrenia, relatively high rates of discordance among identical twins clearly point to the importance of additional factors. Environmental factors, such as stress, play a major role in the psychiatric disorders by inducing stable changes in gene expression, neural circuit function, and ultimately behavior. Insults ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Lifetime stress experience: transgenerational epigenetics and germ cell programming.
Authors: Bale TL Abstract The transgenerational epigenetic programming involved in the passage of environmental exposures to stressful periods from one generation to the next has been examined in human populations, and mechanistically in animal models. Epidemiological studies suggest that gestational exposures to environmental factors including stress are strongly associated with an increased risk of neurodevelopmental disorders, including attention deficit-hyperactivity disorder, schizophrenia, and autism spectrum disorders. Both maternal and paternal life experiences with stress can be passed on to offspring dire...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Developmental programming of brain and behavior by perinatal diet: focus on inflammatory mechanisms.
Authors: Bolton JL, Bilbo SD Abstract Obesity is now epidemic worldwide. Beyond associated diseases such as diabetes, obesity is linked to neuropsychiatric disorders such as depression. Alarmingly maternal obesity and high-fat diet consumption during gestation/lactation may "program" offspring longterm for increased obesity themselves, along with increased vulnerability to mood disorders. We review the evidence that programming of brain and behavior by perinatal diet is propagated by inflammatory mechanisms, as obesity and high-fat diets are independently associated with exaggerated systemic levels of inf...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function.
Authors: Anacker C, O'Donnell KJ, Meaney MJ Abstract We review studies with human and nonhuman species that examine the hypothesis that epigenetic mechanisms, particularly those affecting the expression of genes implicated in stress responses, mediate the association between early childhood adversity and later risk of depression. The resulting studies provide evidence consistent with the idea that social adversity, particularly that involving parent-offspring interactions, alters the epigenetic state and expression of a wide range of genes, the products of which regulate hypothalamic-pituitary-adrenal function. We ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research