Anxiety Disorders: Lee M

Lee M, Shafran R. · Department of Psychiatry, Warneford Hospital, Oxford University, Oxford, OX3 7JX, UK. · Clin Psychol Rev. · Pubmed #15081517 No free full text.

Abstract: Research has supported a link between emotional disorders (such as depression and anxiety) and information processing biases of attention and memory. This article reviews the extension of this approach to such biases in eating disorders. Two paradigms are considered in detail: the modified Stroop task and the dot probe task. In addition, the relative merits and problems associated with both approaches are considered. The limitations of the current research for clinical practice are discussed and suggestions are made for ways in which the research may be made more ecologically valid.

Praschak-Rieder N, Hussey D, Wilson AA, Carella A, Lee M, Dunn E, Willeit M, Bagby RM, Houle S, Meyer JH. · Vivian M. Rakoff PET Imaging Centre and the Mood and Anxiety Disorders Division, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. · Biol Psychiatry. · Pubmed #15476688 No free full text.

Abstract: BACKGROUND: Recurrence of depressive symptoms after tryptophan depletion (TD) in selective serotonin reuptake inhibitor (SSRI)-treated depression is an important, unexplained phenomenon. With [(18)F] MPPF positron emission tomography (PET), serotonin (5-hydroxytryptamine, 5-HT) 1A receptor binding potential (5-HT(1A)BP) was measured after TD in various brain regions in citalopram-treated depression. This 5-HT(1A)BP measurement is sensitive to changes in extracellular 5-HT in animal models. METHODS: Eight remitted patients with major depressive disorder received [(18)F] MPPF PET scans twice: once after TD and once after sham depletion. Behavioral measures were evaluated with the Hamilton Depression Rating Scale and visual analog scales. RESULTS: No effect on regional 5-HT(1A)BP was observed after TD, despite an 86% decrease in total plasma tryptophan and transient depressive relapse in six of eight patients. CONCLUSIONS: Large-magnitude changes in extracellular 5-HT are not crucial for the mood effects observed in SSRI-treated subjects after TD. Therefore, greater consideration must be given to other mechanisms that involve vulnerability to small perturbations in extracellular 5-HT, such as impairment of signal transduction.

Suzuki G, Harper KM, Hiramoto T, Sawamura T, Lee M, Kang G, Tanigaki K, Buell M, Geyer MA, Trimble WS, Agatsuma S, Hiroi N. · Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY 10461, USA. · Hum Mol Genet. · Pubmed #19240081 No free full text.

Abstract: Deletion or duplication of the human chromosome 22q11.2 is associated with many behavioral traits and neuropsychiatric disorders, including autism spectrum disorders and schizophrenia. However, why phenotypes vary widely among individuals with identical deletions or duplications of 22q11.2 and which specific 22q11.2 genes contribute to these phenotypes are still poorly understood. Previous studies have identified a approximately 200 kb 22q11.2 region that contributes to behavioral phenotypes in mice. We tested the role of Septin 5 (Sept5), a gene encoded in the approximately 200 kb region, in affective behaviors, cognitive capacities and motor activity. To evaluate the impact of genetic backgrounds on behavioral phenotypes of Sept5 deficiency, we used mice on two genetic backgrounds. Our data show that Sept5 deficiency decreased affiliative active social interaction, but this phenotypic expression was influenced by genetic backgrounds. In contrast, Sept5 deficiency decreased anxiety-related behavior, increased prepulse inhibition and delayed acquisition of rewarded goal approach, independent of genetic background. These data suggest that Sept5 deficiency exerts pleiotropic effects on a select set of affective behaviors and cognitive processes and that genetic backgrounds could provide an epistatic influence on phenotypic expression.

Lee M, Shafran R. · Department of Psychiatry, University of Oxford, Oxford, United Kingdom. · Int J Eat Disord. · Pubmed #18213690 No free full text.

Abstract: OBJECTIVE: Previous research has indicated that temporal factors [specifically, the duration of interstimulus intervals (ISI) during a threat processing task] may influence the nature of processing biases exhibited in nonclinical populations with some degree of eating disorder psychopathology (Meyer et al., Int J Eat Disord, 27, 405-410, 2000). The current study aimed to test this hypothesis by investigating attentional biases for eating-disorder-relevant images and irrelevant visual images (animals) in patients with eating disorders (n = 23) and psychiatric (n = 19) and nonpsychiatric (n = 65) controls. METHOD: A dot probe task was modified from previous research (Shafran et al., Int J Eat Disord, 40, 369-380, 2007), whereby an original ISI of 500 ms was increased to 2,000 ms. RESULTS: Patients with an eating disorder continued to display a bias in the processing of weight stimuli. However, biases noted in previous research for shape and weight stimuli disappeared when the ISI duration was increased in this way. CONCLUSION: These findings highlight the importance of temporal factors in whether processing biases are displayed and may point to ways in which biases actually work in this population. However, further research is warranted.

Shafran R, Lee M, Cooper Z, Palmer RL, Fairburn CG. · Department of Psychiatry, Oxford University, Oxford, United Kingdom. · Int J Eat Disord. · Pubmed #18213684 No free full text.

Abstract: OBJECTIVE: The aims of these studies were (a) to investigate the relationship between attentional bias and eating disorders and (b) examine the impact of psychological treatment on attentional bias. METHOD: The first study compared performance on a pictorial dot probe of 82 female patients with clinical eating disorders and 44 healthy female controls. The second study compared the performance of 31 patients with eating disorder on the same task before and after receiving 20 weeks of standardized cognitive behavior therapy. Twenty-four patients with eating disorder served as wait-list controls RESULTS: With the exception of neutral shape stimuli, attentional biases for eating, shape, and weight stimuli were greater in the patient sample than the healthy controls. The second study found that attentional biases significantly reduced after active treatment only. CONCLUSION: Attentional biases may be an expression of the eating disorder. The question of whether such biases warrant specific intervention requires further investigation.

Nezu AM, Nezu CM, Jain D, Xanthopoulos MS, Cos TA, Friedman J, Lee M. · Department of Psychology, MS 515, Drexel University, 245 N. 15 Street, Philadelphia, PA 19102-1192, USA. · Psychosom Med. · Pubmed #17991820 No free full text.

Abstract: OBJECTIVE: To investigate differences in social problem solving (SPS) between individuals with noncardiac chest pain (NCCP) and persons with chest pain who tested positive for underlying cardiac disease. METHODS: The major design involved a matched case-control methodology and compared a group of patients with NCCP (n = 53) with a group of patients with cardiac disease-related chest pain (n = 53) with regard to a battery of psychological distress, stress, and pain measures as well as a multidimensional measure of SPS. RESULTS: Initial analyses found no differences between the groups regarding reported levels of chest pain intensity or frequency. However, patients with NCCP, as compared with their matched counterparts, reported significantly higher levels of depression, anxiety, perceived stress, and anger. In the analysis that addressed SPS differences between groups, general negative affectivity and prior history of cardiac disease served as covariates and revealed that individuals with NCCP were characterized by less effective problem solving on three of five dimensions assessed as compared with their matched counterparts. Moreover, the relationship between SPS and pain among patients with NCCP was found to be above and beyond that related to general negative affectivity. CONCLUSIONS: These findings both support and add to the literature regarding psychosocial correlates of NCCP and identify SPS as a potentially important factor in its pathogenesis.

Shafran R, Lee M, Cooper Z, Palmer RL, Fairburn CG. · Department of Psychiatry, Oxford University, Oxford, England, UK. · Int J Eat Disord. · Pubmed #17330290 No free full text.

Abstract: OBJECTIVE: To examine the relationship between eating disorders and attentional biases. METHOD: The first study comprised 23 female patients with clinical eating disorders, women with high levels of anxiety (n = 19), and three female normal control groups comprising low (n = 31), moderate (n = 21), or high levels of shape concern (n = 23). The second study comprised 82 women with clinical eating disorders and 44 healthy controls. All participants completed measures of eating disorder psychopathology and completed a modified pictorial dot-probe task. RESULTS: In the first study, biases were found for negative eating and neutral weight pictures, and for positive eating pictures in women with eating disorders; these biases were greater than those found in anxious and normal controls. The second study replicated these findings and biases were also found for negative and neutral shape stimuli. CONCLUSION: It is concluded that future research should establish whether such biases warrant specific therapeutic interventions.

Byun H, Yang J, Lee M, Jang W, Yang JW, Kim JH, Hong SD, Joung YS. · Division of Child and Adolescent Psychiatry, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, 135-710, Korea. · Yonsei Med J. · Pubmed #16502492 links to  free full text

Abstract: It is well-known that more than 50% of attention-deficit hyperactivity disorder (ADHD) cases also have comorbid psychiatric disorders. We evaluated the comorbid psychopathology of Korean children and adolescents with ADHD using a standardized diagnostic instrument. The Korean Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL-K) was administered and completed in 105 patients who had been referred to the outpatient and inpatient clinics at the Samsung Medical Center from March 2004 to May 2005. All of the cases were diagnosed as ADHD according to DSM-IV criteria. We analyzed their clinical characteristics and psychiatric comorbidities, and assessed the correlation of any comorbidity with gender, age and ADHD subtype. Among our 105 participants, 70 (66.7%) subjects were diagnosed with combined-type ADHD, 22 (21.0%) were the predominantly inattentive type, only 1 (1.0%) was determined to have the predominantly hyperactive-impulsive type of ADHD, and 12 (11.4%) were classified as not otherwise specified (NOS) ADHD. Eighty (76.2%) subjects had at least one comorbid disorder such as oppositional defiant disorder (n = 53, 50.5%), anxiety disorders (n = 35, 33.3%) and affective disorders (n = 15, 14.3%). Our patients ranged in age from five to 16 years. Among the factors including gender, age, and ADHD subtype, ADHD subtype was the only one significant to comorbidity in our study. The results of this study suggest that psychiatric comorbidity in Korean children with ADHD is similar to the results of previous studies in western countries. Out of all the ADHD subtypes, the combined-type group had a significantly higher ratio of comorbid disorders and psychopathologies.