Computational Search for Hypotheses Concerning the Endocannabinoid Contribution to the Extinction of Fear Conditioning.

Computational search for hypotheses concerning the endocannabinoid contribution to the extinction of fear conditioning.

Front Comput Neurosci. 2013; 7: 74
Anastasio TJ

Fear conditioning, in which a cue is conditioned to elicit a fear response, and extinction, in which a previously conditioned cue no longer elicits a fear response, depend on neural plasticity occurring within the amygdala. Projection neurons in the basolateral amygdala (BLA) learn to respond to the cue during fear conditioning, and they mediate fear responding by transferring cue signals to the output stage of the amygdala. Some BLA projection neurons retain their cue responses after extinction. Recent work shows that activation of the endocannabinoid system is necessary for extinction, and it leads to long-term depression (LTD) of the GABAergic synapses that inhibitory interneurons make onto BLA projection neurons. Such GABAergic LTD would enhance the responses of the BLA projection neurons that mediate fear responding, so it would seem to oppose, rather than promote, extinction. To address this paradox, a computational analysis of two well-known conceptual models of amygdaloid plasticity was undertaken. The analysis employed exhaustive state-space search conducted within a declarative programming environment. The analysis reveals that GABAergic LTD actually increases the number of synaptic strength configurations that achieve extinction while preserving the cue responses of some BLA projection neurons in both models. The results suggest that GABAergic LTD helps the amygdala retain cue memory during extinction even as the amygdala learns to suppress the previously conditioned response. The analysis also reveals which features of both models are essential for their ability to achieve extinction with some cue memory preservation, and suggests experimental tests of those features. HubMed – depression


Health-related utility values of patients with primary Sjogren’s syndrome and its predictors.

Ann Rheum Dis. 2013 Jun 12;
Lendrem D, Mitchell S, McMeekin P, Bowman S, Price E, Pease CT, Emery P, Andrews J, Lanyon P, Hunter J, Gupta M, Bombardieri M, Sutcliffe N, Pitzalis C, McLaren J, Cooper A, Regan M, Giles I, Isenberg D, Vadivelu S, Coady D, Dasgupta B, McHugh N, Young-Min S, Moots R, Gendi N, Akil M, Griffiths B, Ng WF,

OBJECTIVES: EuroQoL-5 dimension (EQ-5D) is a standardised preference-based tool for measurement of health-related quality of life and EQ-5D utility values can be converted to quality-adjusted life years (QALYs) to aid cost-utility analysis. This study aimed to evaluate the EQ-5D utility values of 639 patients with primary Sjögren’s syndrome (PSS) in the UK. METHODS: Prospective data collected using a standardised pro forma were compared with UK normative data. Relationships between utility values and the clinical and laboratory features of PSS were explored. RESULTS: The proportion of patients with PSS reporting any problem in mobility, self-care, usual activities, pain/discomfort and anxiety/depression were 42.2%, 16.7%, 56.6%, 80.6% and 49.4%, respectively, compared with 5.4%, 1.6%, 7.9%, 30.2% and 15.7% for the UK general population. The median EQ-5D utility value was 0.691 (IQR 0.587-0.796, range -0.239 to 1.000) with a bimodal distribution. Bivariate correlation analysis revealed significant correlations between EQ-5D utility values and many clinical features of PSS, but most strongly with pain, depression and fatigue (R values>0.5). After adjusting for age and sex differences, multiple regression analysis identified pain and depression as the two most important predictors of EQ-5D utility values, accounting for 48% of the variability. Anxiety, fatigue and body mass index were other statistically significant predictors, but they accounted for <5% in variability. CONCLUSIONS: This is the first report on the EQ-5D utility values of patients with PSS. These patients have significantly impaired utility values compared with the UK general population. EQ-5D utility values are significantly related to pain and depression scores in PSS. HubMed – depression


Depression Among Last-Year High School Students in Vientiane, Capital City of Lao PDR.

Asia Pac J Public Health. 2013 Jun 11;
Phanthavong P, Naphayvong P, Reinharz D

In spite of being a major public health issue, no data on depression in young people exist in Laos. Decision makers are therefore poorly equipped to define the degree of prioritization of this pathology among their preoccupations. This study aimed at estimating the prevalence of depression among last-year high schools students and exploring some of its determinants with a qualitative approach. The quantitative component was based on a survey of a representative sample consisting of 210 students studying in 30 schools in the capital city, Vientiane, using the Beck Depression Inventory validated in the Lao language. The qualitative component was based on interviews with 5 nondepressive and 5 depressive students. Clinical depression prevalence was 24%. Depressed students were aware of the effectiveness of available medication and its importance in controlling the disease. The other students had little knowledge about the disease and how to handle it. HubMed – depression


What kind of diagnosis in a case of mobbing: post-traumatic stress disorder or adjustment disorder?

BMJ Case Rep. 2013; 2013:
Signorelli MS, Costanzo MC, Cinconze M, Concerto C

Over the last decade a consistent increase in stress-related psychological consequences at the workplace, usually called ‘mobbing’, has been seen. It claimed physical, psychical and social distress as its victims, leading to an increased incidence of many illnesses, such as psychosomatic disorders (ache, high blood pressure, chronic fatigue and insomnia) and psychiatric disturbances (high level of anxiety, depression and suicidal attempts). It was recently demonstrated that mobbing is significantly widespread among healthcare workers, especially among female nurses. In this report, we illustrate the case of a nurse who, after a brilliant career, underwent mobbing at the workplace, showing depression, anxiety and sleep disorders that required hospitalisation and a substantial intervention. HubMed – depression