Precuneus connectivity and symptom severity in chronic depression✰.

Although abnormal resting state connectivity within several brain networks has been repeatedly reported in depression, little is known about connectivity in patients with early onset chronic depression. We compared resting state connectivity in a homogenous sample of 32 unmedicated patients with early onset chronic depression and 40 healthy control participants in a seed-to-voxel-analysis. According to previous meta-analyses on resting state connectivity in depression, 12 regions implicated in default mode, limbic, frontoparietal and ventral attention networks were chosen as seeds. We also investigated associations between connectivity values and severity of depression. Patients with chronic depression exhibited stronger connectivity between precuneus and right pre-supplementary motor area than healthy control participants, possibly reflecting aberrant information processing and emotion regulation deficits in depression. Higher depression severity scores (Hamilton Rating Scale for Depression) were strongly and selectively associated with weaker connectivity between the precuneus and the subcallosal anterior cingulate. Our findings correspond to results obtained in studies including both episodic and chronic depression. This suggests that there may be no strong differences between subtypes of depression regarding the seeds analyzed here. To further clarify this issue, future studies should directly compare patients with different courses of depression.

Bulk-Sensitive Detection of the Total Ion Yield for X-ray Absorption Spectroscopy in Liquid Cells.

Detection of ionic current with two electrodes installed in a liquid cell has been established previously as an effective method, termed as total ion yield (TIY), to acquire X-ray absorption (XA) spectra of liquid solutions behind a membrane. In this study, the exact locations where TIY signals are generated are further investigated and unequivocally identified. The detected ionic current stems dominantly from the bulk solution species while only marginally from the species located at the membrane-solution interface. Such a two-electrode TIY detection in a liquid cell combines the advantages of bulk sensitivity of fluorescence yield and high signal strength (for light elements) of electron yield, exhibiting its novel and promising role in the XA spectroscopy measurements of liquid cells.

Introducing Ionic-Current Detection for X-ray Absorption Spectroscopy in Liquid Cells.

Photons and electrons are two common relaxation products upon X-ray absorption, enabling fluorescence yield and electron yield detections for X-ray absorption spectroscopy (XAS). The ions that are created during the electron yield process are relaxation products too, which are exploited in this study to produce ion yield for XA detection. The ionic currents measured in a liquid cell filled with water or iron(III) nitrate aqueous solutions exhibit characteristic O K-edge and Fe L-edge absorption profiles as a function of excitation energy. Application of two electrodes installed in the cell is crucial for obtaining the XA spectra of the liquids behind membranes. Using a single electrode can only probe the species adsorbed on the membrane surface. The ionic-current detection, termed as total ion yield (TIY) in this study, also produces an undistorted Fe L-edge XA spectrum, indicating its promising role as a novel detection method for XAS studies in liquid cells.

Analysis of the Electronic Structure of Aqueous Urea and Its Derivatives: A Systematic Soft X-Ray-TD-DFT Approach.

Soft X-ray emission (XE), absorption (XA), and resonant inelastic scattering (RIXS) experiments have been conducted at the nitrogen K-edge of urea and its derivatives in aqueous solution and were compared with density functional theory and time-dependent density functional theory calculations. This comprehensive study provides detailed information on the occupied and unoccupied molecular orbitals of urea, thiourea, acetamide, dimethylurea, and biuret at valence levels. By identifying the electronic transitions that contribute to the experimental spectral features, the energy gap between the highest occupied and the lowest unoccupied molecular orbital of each molecule is determined. Moreover, a theoretical approach is introduced to simulate resonant inelastic X-ray scattering spectra by adding an extra electron to the lowest unoccupied molecular orbital, thereby mimicking the real initial state of the core-electron absorption before the subsequent relaxation process.

[Hoarding as a Disorder of the Obsessive-Compulsive Spectrum]. / Pathologisches Horten und Sammeln als Erkrankung des Zwangsspektrums.

Hoarding often occurs without obsessive-compulsive disorder (OCD), it shows distinguishable neuropsychological and neurobiological correlates and a distinct comorbidity spectrum. Further, it occurs secondarily to other psychiatric and neurobiological disorders. Therefore hoarding disorder has been included as a distinct diagnosis in DSM-5.Neuroimaging studies point to functional and structural abnormalities of networks subserving decision making, attention, action planning and emotional regulation.The cognitive-behavioral model outlines the most important characteristics of pathological hoarding, comprising deficits of information processing, maladaptive beliefs about information processing deficits, maladaptive beliefs about posessions as well as emotional attachment to them accompanied with emotional distress and avoidance.Because of a low willingness for therapy plus a high rate of discontinuation of therapy, a manualized cognitive-behavioral therapy approach for pathological hoarding has been established. It builds on observational learning, cognitive strategies, graduated exposure, response prevention, training/coaching to sort out, and relapse prevention are key components of the treatment. Particularily in case of lacking motivation for any kind of behavioral therapy or other psychological treatments, a pharmacotherapy with SSRIs is recommended.

The "Pathological Gambling and Epidemiology" (PAGE) study program: design and fieldwork.

The German federal states initiated the "Pathological Gambling and Epidemiology" (PAGE) program to evaluate the public health relevance of pathological gambling. The aim of PAGE was to estimate the prevalence of pathological gambling and cover the heterogenic presentation in the population with respect to comorbid substance use and mental disorders, risk and protective factors, course aspects, treatment utilization, triggering and maintenance factors of remission, and biological markers. This paper describes the methodological details of the study and reports basic prevalence data. Two sampling frames (landline and mobile telephone numbers) were used to generate a random sample from the general population consisting of 15,023 individuals (ages 14 to 64) completing a telephone interview. Additionally, high-risk populations have been approached in gambling locations, via media announcements, outpatient addiction services, debt counselors, probation assistants, self-help groups and specialized inpatient treatment facilities. The assessment included two steps: (1) a diagnostic interview comprising the gambling section of the Composite International Diagnostic Interview (CIDI) for case finding; (2) an in-depth clinical interview with participants reporting gambling problems. The in-depth clinical interview was completed by 594 participants, who were recruited from the general or high-risk populations. The program provides a rich epidemiological database which is available as a scientific use file.

Viral hepatitis in alcohol-dependent inpatients: prevalence, risk factors, and treatment uptake.

OBJECTIVES: Most epidemiological literature on the prevalence of viral hepatitis in alcohol-dependent patients is based on older data. This study aimed to provide current estimates and an assessment of risk factors. We further investigated whether the initiation of antiviral hepatitis C virus (HCV) treatment is feasible after detoxification. METHODS: We assessed serological markers for hepatitis B virus (HBV) and HCV infection and liver enzyme levels (alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase) in a sample of 463 inpatients in a tertiary care hospital, fulfilling International Classification of Diseases, Tenth Revision criteria for alcohol dependence. A subsample of 141 patients was interviewed on addiction history and risk factors for HCV acquisition. All patients with an indication for antiviral treatment were followed up. RESULTS: Compared with that in the general population, we found an elevated anti-HCV prevalence in alcohol-dependent patients (5.2%; 95% confidence interval, 3.2%-7.2%), whereas anti-Hbc immunoglobulin G prevalence (8.3%; 95% confidence interval, 5.7%-10.8%) corresponded to normal rates. Liver enzyme levels significantly differed between patients with chronic, past/remitted, or no HCV infection. On an observational level, a history of injection drug use or nonprofessional tattooing emerged as potential risk factors. In 1 of 10 patients, antiviral therapy was initiated. This 1 patient achieved the end-of-treatment response after extended rapid virological response, despite continuous alcohol consumption. CONCLUSIONS: The elevated HCV infection rates in our sample and the higher levels of fibrosis biomarkers in those with positive polymerase chain reaction corroborate previous findings and emphasize the importance of HCV screening in this population, particularly if further risk factors like injection drug use are given. Factors influencing treatment reluctance and conditions that may enhance the feasibility of antiviral treatment in alcohol-dependent patients should be subject of further research.

Associations between the perception of dyspnea, pain, and negative affect.

The perception of dyspnea shares many characteristics with the perception of pain, and both sensations might be linked to affective states. Therefore, the present study investigated the associations between perceived dyspnea, pain, and negative affect during resistive load breathing, the cold-pressor test, and affective picture viewing in healthy volunteers. Physiological and psychological measures confirmed successful experimental manipulation. There was a positive correlation between perceived dyspnea and pain in the unpleasantness dimension, but not in the intensity dimension, and this was further related to negative affect. These associations might be explained by similarities in the cortical processing of dyspnea, pain, and negative affect. The present findings extend the knowledge on similarities between dyspnea and pain and provide support for theories focusing on the perception of physiologic sensations in the development of affective states.

Reduced perception of dyspnea and pain after right insular cortex lesions.

RATIONALE: The perception of dyspnea and pain show many similarities. Initial imaging studies suggested an important role of the insular cortex for the perception of both sensations. However, little is known about the cortical processing of dyspnea. OBJECTIVES: This study investigated the influence of lesions of the insular cortex on the perception of dyspnea and pain. METHODS: Dyspnea was induced by resistive loaded breathing in four patients with right-hemispheric insular cortex lesions, as assessed with computer tomography or magnetic resonance imaging, and four matched healthy control subjects. Pain was induced by a cold-pressor test. Perceived intensity and unpleasantness of both sensations were rated on visual analog scales. MEASUREMENTS AND MAIN RESULTS: In contrast to healthy control subjects, patients with lesions demonstrated reduced perceptual sensitivity for dyspnea, in particular for the unpleasantness of dyspnea (P < 0.05). This was paralleled by reduced sensitivity for pain in patients with lesions, as reflected by smaller ratings of intensity and unpleasantness, higher sensory pain-thresholds, and, in particular, higher affect-related pain tolerance times (P < 0.05). CONCLUSIONS: The results suggest that lesions of the right insular cortex are associated with reduced sensitivity for the perception of dyspnea and pain, in particular for their perceived unpleasantness. This underlines the importance of the insular cortex for the perception of both sensations.

Puberty in disorders of somatosexual differentiation.

Despite enormous advances in the understanding of the molecular mechanisms of sexual differentiation, the medical decisions made in patients with disorders of somatosexual differentiation are mostly lacking evidence-based principles. Recent critical discussions have focused on approaches to gender assignment in infants with ambiguous genitalia. These decisions must be based on the correct diagnosis to be able to predict the development during puberty and adulthood in the affected individual. Puberty in this process plays a pivotal role not only because of the physical changes induced by endogenous or supplementary sex steroids to enhance the sex of rearing, but it is also the time for sexual orientation and promotion of gender identity. In this review we focus not only on the molecular impact of sex steroid action, but also view current opinions and studies on the gender development of the intersex patient during puberty.