Neuropsychological and Socio-Occupational Functioning in Young Psychiatric Outpatients: A Longitudinal Investigation.

Neuropsychological and socio-occupational functioning in young psychiatric outpatients: a longitudinal investigation.

PLoS One. 2013; 8(3): e58176
Lee RS, Hermens DF, Redoblado-Hodge MA, Naismith SL, Porter MA, Kaur M, White D, Scott EM, Hickie IB

Clinical symptoms and neuropsychological deficits are longitudinally associated with functional outcome in chronic psychiatric cohorts. The current study extended these findings to young and early-course psychiatric outpatients, with the aim of identifying cognitive markers that predict later socio-occupational functioning.At baseline, 183 young psychiatric outpatients were assessed. Ninety-three returned for follow-up (M?=?21.6 years old; SD?=?4.5) with an average re-assessment interval of 21.6 months (SD?=?7.0), and primary diagnoses of major depressive disorder (?=?34), bipolar disorder (?=?29), or psychosis (?=?30). The primary outcome measure was cross-validated with various other functional measures and structural equation modelling was used to map out the interrelationships between predictors and later functional outcome.Good socio-occupational functioning at follow-up was associated with better quality of life, less disability, current employment and being in a romantic relationship. The final structural equation model explained 47.5% of the variability in functional outcome at follow-up, with baseline neuropsychological functioning (a composite of memory, working memory and attentional switching) the best independent predictor of later functional outcome. Notably, depressive and negative symptoms were only associated with functioning cross-sectionally. Diagnosis at follow-up was not associated with functional outcome.Neuropsychological functioning was the single best predictor of later socio-occupational outcome among young psychiatric outpatients. Therefore, framing psychiatric disorders along a neuropsychological continuum is likely to be more useful in predicting functional trajectory than traditional symptom-based classification systems. The current findings also have implications for early intervention utilising cognitive remediation approaches. HubMed – depression


Childhood Trauma and PTSD Symptoms Increase the Risk of Cognitive Impairment in a Sample of Former Indentured Child Laborers in Old Age.

PLoS One. 2013; 8(2): e57826
Burri A, Maercker A, Krammer S, Simmen-Janevska K

A growing body of evidence suggests a link between early childhood trauma, post-traumatic stress disorder (PTSD) and higher risk for dementia in old age. The aim of the present study was to investigate the association between childhood trauma exposure, PTSD and neurocognitive function in a unique cohort of former indentured Swiss child laborers in their late adulthood. To the best of our knowledge this is the first study ever conducted on former indentured child laborers and the first to investigate the relationship between childhood versus adulthood trauma and cognitive function. According to PTSD symptoms and whether they experienced childhood trauma (CT) or adulthood trauma (AT), participants (n?=?96) were categorized as belonging to one of four groups: CT/PTSD+, CT/PTSD-, AT/PTSD+, AT/PTSD-. Information on cognitive function was assessed using the Structured Interview for Diagnosis of Dementia of Alzheimer Type, Multi-infarct Dementia and Dementia of other Etiology according to ICD-10 and DSM-III-R, the Mini-Mental State Examination, and a vocabulary test. Depressive symptoms were investigated as a potential mediator for neurocognitive functioning. Individuals screening positively for PTSD symptoms performed worse on all cognitive tasks compared to healthy individuals, independent of whether they reported childhood or adulthood adversity. When controlling for depressive symptoms, the relationship between PTSD symptoms and poor cognitive function became stronger. Overall, results tentatively indicate that PTSD is accompanied by cognitive deficits which appear to be independent of earlier childhood adversity. Our findings suggest that cognitive deficits in old age may be partly a consequence of PTSD or at least be aggravated by it. However, several study limitations need to considered. Consideration of cognitive deficits when treating PTSD patients and victims of lifespan trauma (even without a diagnosis of a psychiatric condition) is crucial. Furthermore, early intervention may prevent long-term deficits in memory function and development of dementia in adulthood. HubMed – depression


A Neuropeptide Y Variant (rs16139) Associated with Major Depressive Disorder in Replicate Samples from Chinese Han Population.

PLoS One. 2013; 8(2): e57042
Wang Y, Yang Y, Hui L, Tie C, Li F, Xu ZQ, Wang C

This study aimed to investigate the single nucleotide polymorphisms (SNPs) of neuropeptide Y (NPY) and major depressive disorder (MDD) in Chinese Han population.Prospective and randomized studies were carried out.A total of 700 patients (324 male and 376 female; mean age?=?40±14.9 years) with depression who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and 673 healthy controls (313 male and 360 female; mean age?=?41.9±17.2 years) were used to investigate the relationship between SNPs of NPY and the pathogenesis of MDD. A total of 417 patients (195 male and 202 female; mean age?=?36±14.2 years) diagnosed with MDD and 314 healthy controls (153 male and 161 female; mean age?=?37.9±14.2 years) from Chinese Han population were used to verify the relationship between SNPs of NPY and the pathogenesis of MDD.Ligase detection reactions were performed to detect the SNP sites of NPY. A series of statistical methods was carried out to investigate the correlation between the NPY gene SNP and MDD.Statistical analysis showed a significant correlation between the SNP sites rs16139 in NPY and the morbidity of depression. Patients with MDD have a lower frequency of A-allele in rs16139 in replicate samples from Chinese Han population. However, the frequency varied between male and female patients.The gene polymorphism loci rs16139 was closely related to MDD in Chinese Han population. HubMed – depression


Operant Conditioning to Increase Ankle Control or Decrease Reflex Excitability Improves Reflex Modulation and Walking Function in Chronic Spinal Cord Injury.

J Neurophysiol. 2013 Mar 6;
Manella KJ, Roach KE, Field-Fote EE

Ankle clonus is common after spinal cord injury (SCI) and is attributed to loss of supra-spinally mediated inhibition of soleus stretch reflexes and maladaptive reorganization of spinal reflex pathways. The maladaptive reorganization underlying ankle clonus is associated with other abnormalities such as coactivation and reciprocal facilitation of tibialis anterior (TA) and soleus (SOL), which contribute to impaired walking ability in individuals with motor-incomplete SCI. Operant conditioning can increase muscle activation and decrease stretch reflexes in individuals with SCI. We compared two operant conditioning-based interventions in individuals with ankle clonus and impaired walking ability due to SCI. Training included either TA EMG activation (TA?) to enhance supraspinal drive or SOL H-reflex suppression (SOL?) to modulate reflex pathways at the spinal cord level. We measured clonus duration, plantar flexor (PF) reflex threshold angle, timed toe tapping, dorsiflexion (DF) active range of motion (ROM), lower extremity motor scores (LEMS), walking foot clearance, speed and distance, SOL H-reflex amplitude modulation as an index of reciprocal inhibition, presynaptic inhibition, and low-frequency depression, and SOL/TA clonus coactivation. TA? decreased PF reflex threshold angle (-4.33°) and DF active ROM angle (-4.32°), and increased LEMS of DF (+0.8 points), training leg (+2.2 points), and non-training leg (+0.8 points), and increased walking foot clearance (+ 4.8 mm) and distance (+12.09 m). SOL? decreased SOL/TA coactivation ratio (-0.21) and increased non-training leg LEMS (+1.8 points), walking speed (+0.02 m/s) and distance (+6.25 m). We found increased voluntary control associated with TA? outcomes and decreased reflex excitability associated with SOL? outcomes. HubMed – depression