Anxiety Disorders: Ebert D

Salvatore P, Bhuvaneswar C, Ebert D, Maggini C, Baldessarini RJ. · Department of Psychiatry, Harvard Medical School, Massachusetts, USA. · Harv Rev Psychiatry. · Pubmed #18569038 No free full text.

Abstract: Emil Kraepelin proposed to separate psychiatric disorders with psychotic features into two major categories, dementia praecox (later schizophrenia) and manic-depressive insanity (later bipolar disorder and major depression). Over the past century, there have been many efforts to categorize conditions that do not fit readily in either group. These conditions include many cases of acute psychotic illnesses of limited duration, with recovery between recurrences. For some of these conditions, Karl Kleist proposed the term cycloid psychosis: acute features were psychotic, as in schizophrenia, but the course was episodic, as in manic-depression. His concept was later elaborated by Karl Leonhard and Carlo Perris, and validated by modern studies. Leonhard described three overlapping cycloid subtypes (anxiety-beatific, excited-inhibited confusional, and hyperkinetic-akinetic motility dysfunction forms); Perris proposed a more unitary syndrome with operational diagnostic criteria; and recent investigators have considered relatively affective versus thought-disordered subtypes. The cycloid concept is not explicitly included in standard international diagnostic schemes, but both DSM-IV and ICD-10 have broad categories for acute, recurrent psychotic disorders, whose validity remains insecure. We present two cases of probable cycloid psychosis, review the history of the concept, and propose that it be reconsidered as a clinically useful category whose validity and utility for prognosis and treatment can be further tested.

Ruchsow M, Reuter K, Hermle L, Ebert D, Kiefer M, Falkenstein M. · Department of Psychiatry, Christophsbad, Göppingen, Germany. · J Neural Transm. · Pubmed #17610122 No free full text.

Abstract: Obsessive-compulsive disorder (OCD) has been related to a hyperactive cortico-striatal-pallidal-thalamic circuitry resulting clinically in an impaired inhibition of repetitive thoughts and behaviors. We examined thirteen patients with OCD and thirteen age-, sex-, and education matched healthy controls using event-related potentials (ERPs). Participants performed a hybrid flanker-Go/Nogo task while multichannel EEG was recorded. Our study focused on two ERP components: the Nogo-N2 and the Nogo-P3, which have been discussed in the context of response inhibition and response conflict. Artifact-free EEG-segments were used to compute ERPs on correct Go trials (button press) and correct Nogo trials (no button press), separately. Patients with OCD showed enhanced (more negative) Nogo-N2 amplitudes than controls, and a significant difference in amplitudes between Nogo-N2 and Go-N2 trials (more negative for Nogo trials) at central midline electrode positions. However, groups did not differ with regard to the Nogo-P3 and Go-P3. The present study replicates and extends previous findings of altered executive control processes in OCD patients.

Tebartz van Elst L, Ludaescher P, Thiel T, Büchert M, Hesslinger B, Bohus M, Rüsch N, Hennig J, Ebert D, Lieb K. · South German Brain Imaging Center, and Department of Psychiatry and Psychotherapy, Medical School, Albert-Ludwigs-University Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany. · Neurosci Lett. · Pubmed #17397999 No free full text.

Abstract: In order to detect possible links between structural and neurochemical brain abnormalities we applied high resolution morphometric imaging and short-echo time absolute-quantification magnetic resonance spectroscopy (MRS) at the left hand side to the amygdala in 12 patients with borderline personality disorder (BPD) and 10 group-matched healthy controls. Confirming earlier reports we found a significant 11-17% reduction of amygdalar volumes in patients with BPD. In addition there was a significant 17% increase of left amygdalar creatine concentrations in BPD patients. Left amygdalar creatine concentration correlated positively with measures of anxiety and negatively with amygdalar volume. This pilot study of simultaneous amygdalar morphometry and spectroscopy in BPD reveals a possible link between amygdalar volume loss, psychopathology and neurochemical abnormalities in terms of creatine signals.