Secondary social anxiety in hyperkinesias.

This is a comparison study that is aimed to investigate and compare the frequency and severity of secondary social anxiety disorder (SAD) in patients with hyperkinesias, which is associated with a significant sense of disfigurement and compromised social interaction. Patients with hemifacial spasm (n = 20), cervical dystonia (n = 20), and essential tremor (n = 20) were evaluated by SCID-I, Liebowitz Social Anxiety Scale, Hamilton Anxiety and Depression Rating Scales, and Sheehan Disability Scale. The DSM-IV H criterion excluding social anxiety related to a medical condition was disregarded for the diagnosis of secondary SAD. The control group (n = 60) consisted of matched healthy subjects. The frequency of the diagnosis and severity of symptoms were compared and associations with sociodemographic and clinical factors were explored. There was no difference between three patient groups in terms of the frequency or the severity of secondary SAD. Younger age and depressive symptoms were associated with the severity of secondary SAD, while severity or duration of the movement disorder or social disability was not. This study revealed a high frequency of secondary SAD in hyperkinesias, emphasizing the need for psychiatric assessment, especially for younger and depressed patients, who seem to be at greater risk.

Neural Mechanisms Underlying Time Perception and Reward Anticipation.

Findings suggest that the physiological mechanisms involved in the reward anticipation and time perception partially overlap. But the systematic investigation of a potential interaction between time and reward systems using neuroimaging is lacking. Eighteen healthy volunteers (all right-handed) participated in an event-related functional magnetic resonance imaging (fMRI) experiment that employs a visual paradigm that consists monetary reward to assess whether the functional neural representations of time perception and reward prospection are shared or distinct. Subjects performed a time perception task in which observers had to extrapolate the velocity of an occluded moving object in "reward" vs. "no-reward" sessions during fMRI scanning. There were also "control condition" trials in which participants judged about the color tone change of the stimuli. Time perception showed a fronto-parietal (more extensive in the right) cingulate and peristriate cortical as well as cerebellar activity. On the other hand, reward anticipation activated anterior insular cortex, nucleus accumbens, caudate nucleus, thalamus, cerebellum, postcentral gyrus, and peristriate cortex. Interaction between the time perception and the reward prospect showed dorsolateral, orbitofrontal, medial prefrontal and caudate nucleus activity. Our findings suggest that a prefrontal-striatal circuit might integrate reward and timing systems of the brain.

Relative sparing of executive functions in the early phase of schizophrenia.

Findings about the impairment of executive functions in schizophrenia are not conclusive. The authors hypothesized that the severity of the impairments in the abilities that comprise EF might be different. Forty patients were assessed with a comprehensive battery that included four measures of executive functions and were compared with 60 healthy subjects. Set shifting and response inhibition showed no significant between-group differences. Mental flexibility and concept formation were significantly worse in patients, but the effect sizes were small. Some executive functions might be relatively spared, at least in the early phase of schizophrenia. Studies on individual executive functions may yield more replicable findings.

Dissociation between inattentiveness during mental status testing and social inattentiveness in the Scale for the Assessment of Negative Symptoms attention subscale.

The Scale for the Assessment of Negative Symptoms (SANS) attention subscale has been found valid and reliable by some studies; however, there is some evidence to the contrary. We hypothesized that social inattentiveness (SANS 22) and inattentiveness during mental status testing (SANS 23) might be describing discrete constructs, and this dissociation might be a source of controversy. Thirty-five patients with DSM-IV schizophrenia were assessed by the Scale for the Assessment of Positive Symptoms (SAPS), SANS and a neuropsychological battery. The 2 attention items were not significantly interrelated. SANS 22 was correlated with bizarre behavior and alogia, and none of the neuropsychological test scores, whereas SANS 23 showed strong correlations with the Wechsler Memory Scale mental control subscore, total errors on the Benton Revised Visual Retention Test, and the information, similarities and the general verbal subscores on the Wechsler Adult Intelligence Scale. Regression analyses showed that SANS 23 could be a good estimate of general verbal abilities. These findings point to a dissociation between the 2 SANS attention items. Similar analyses should be repeated in larger and heterogeneous samples and include a factor analysis of the individual items rather than the global ratings.