Reduced white matter integrity in attention-deficit hyperactivity disorder.

We used diffusion tensor imaging to investigate fractional anisotropy (FA), a measure of fiber tract integrity, in attention-deficit hyperactivity disorder (ADHD). Using a tract-based atlasing approach on six-direction diffusion tensor imaging data, we examined FA within the cingulum, corpus callosum, corticospinal tract, fornix, optic radiations, superior longitudinal fasciculus, uncinate fasciculus, and the superior and inferior occipitofrontal fasciculi in an all-male sample of 17 children and adolescents with ADHD and 16 age-matched controls. ADHD patients had significantly lower FA in the corticospinal tract (P=0.

Peripheral biomarker composite associated with smaller hippocampal volume.

Animal and human studies demonstrate an association between smaller hippocampal volume and stress. A composite index of peripheral biomarkers used to objectively quantify human psychosocial stress has demonstrated utility, but has not yet been linked to hippocampal volume in putative 'high stress' groups. Structural magnetic resonance imaging exams and a composite of biomarkers representing cardiovascular, atherosclerosis, hypothylamic-pituitary-adrenal axis, glucose metabolism, and sympathetic nervous system activity were assessed in 30 healthy women with histories of stress precipitated by their child's diagnosis of a life-threatening illness.

Types of psychotherapy for pathological gamblers.

Several types of psychotherapy are currently used to treat pathological gamblers. These include Gambler's Anonymous, cognitive behavioral therapy, behavioral therapy, psychodynamic therapy, and family therapy. Research into which types of psychotherapy are the most effective for pathological gambling is limited but is a growing area of study.

The vulnerable faces of pathological gambling.

Pathological gambling is an emerging psychiatric disorder that has medical, psychiatric, and social consequences. Recently, research has been focusing on identifying which portions of the population are most vulnerable to developing problems related to ongoing gambling. Specific populations of interest have included adolescents, elderly, minorities, those with comorbid psychiatric or substance use disorders, and gender differences.

Extensions of errorless learning for social problem-solving deficits in schizophrenia.

Objective: There is a clear need to develop psychosocial rehabilitation methods that compensate for neurocognitive deficits common to persons with severe and persistent mental illness. Errorless learning, a compensatory training intervention, has been successful in teaching entry-level job tasks. However, errorless learning's applicability to broader, more complex functions is unknown.

Spanish translation and reliability testing of the Child Depression Inventory.

The goal of this study was to test the internal reliability of a Spanish translation of the CDI, (i.e., CDI-LA), a potentially useful screening instrument for Hispanic youngsters in their native language at a primary-care level.

The impact of depression and fluoxetine treatment on obstetrical outcome.

Introduction: This study prospectively followed women over the course of pregnancy to assess the impact of depression and/or antidepressant treatment on obstetrical outcome.

Method: Sixty-four outpatient women with an Axis I diagnosis of major depressive disorder or no psychiatric history were followed in each trimester of pregnancy with administration of the CES-D. A subset of the women with depression received treatment with fluoxetine during pregnancy.

An Update on Mood and Anxiety Disorders During Pregnancy and the Postpartum Period.

Because women in the childbearing years are vulnerable to mood and anxiety disorders, physicians in all patient care specialties need to be familiar with the prevalence and course of these disorders, particularly during pregnancy and the postpartum period. Systematic prospective data are limited on the onset of mood and anxiety disorders during pregnancy and the postpartum period as well as on the risk of relapse during these time periods in women with prior histories of the disorders. The literature on mood and anxiety disorders during pregnancy is frequently complicated by the use of various methodologies, procedures, and study populations, and inconsistencies in the postpartum time frame (up to 6 months after delivery) make the literature on epidemiology of postpartum disorders difficult to interpret.

Special considerations in treating bipolar disorder in women.

There are obvious gaps in research surrounding issues specific to women who suffer from bipolar disorder, including gender differences and their implications for management, the impact of the reproductive cycle, and evidence based treatment guidelines for pregnancy and the postpartum period. Gender differences have not been reported for the prevalence of bipolar disorder; however, women are more likely to experience rapid cycling, mixed mania, and antidepressant-induced manias. This may affect response to treatment, which has been found, in some cases, to differ in men and women.

Portable computing in psychiatry.

Personal digital assistants (PDAs) or handheld computers have become more popular in the practice of medicine. These devices have implications for psychiatric practice, and this paper reviews various published articles describing their use. The literature demonstrates their use in document editing, patient tracking, accessing medical information and drug reference guides, prescription writing, and medical education.

Placental passage of antidepressant medications.

Objective: This study determined the placental transfer of antidepressants and their metabolites.

Method: A total of 38 pregnant women taking citalopram, fluoxetine, paroxetine, or sertraline participated. Maternal and umbilical cord blood samples were obtained to determine antidepressant and metabolite concentrations.

Weight gain in breastfed infants of mothers taking antidepressant medications.

Background: Little is known about the physical development of infants who are exposed to antidepressant medications through breast milk.

Method: Seventy-eight breastfeeding women taking antidepressant medications were included in the study. Maternal mood was prospectively evaluated at 6, 12, and 18 months postpartum.

Birth outcomes after prenatal exposure to antidepressant medication.

Objective: The purpose of this study was to examine prospectively the incidence of congenital anomalies and neonatal complications after prenatal exposure to antidepressant medication.

Study Design: Birth outcomes were obtained from a review of obstetric and neonatal records of 138 women who were treated with selective serotonin reuptake inhibitor antidepressant medications (SSRIs) during pregnancy.

Results: The incidence of congenital anomalies in this study was 1.

Estimates of nursing infant daily dose of fluoxetine through breast milk.

Background: This study compared three methods of estimating the daily dose of fluoxetine to nursing infants and the relationship between these estimates and infant serum concentrations.

Methods: Breast milk and infant serum concentrations of fluoxetine and norfluoxetine were obtained from 10 nursing mother-infant pairs. Quantification of daily infant dose was determined by three methods: 1) collection of the total volume of breast milk over 24 hours and determination of the average breast milk concentration (Baby's Total Daily Dose); 2) determination of the maximum and minimum breast milk concentrations during 24 hours and an estimated milk consumption of 150 mL/kg/day (Atkinson Model); and 3) determination of the gradient of excretion of medication into breast milk at a specified time after the maternal dose, applying this gradient to each nursing collection and summing the values for 24 hours (Mathematical Model).

Fluoxetine and norfluoxetine concentrations in nursing infants and breast milk.

Background: This study's goal was to characterize nursing infants' exposure to fluoxetine through breast milk and to identify variables for minimizing such exposure.

Methods: Nursing women on stable daily doses of fluoxetine were recruited into the study. Breast milk, maternal and infant serum concentrations of fluoxetine and norfluoxetine were determined with high-performance liquid chromatography.

Base rate of a WMS-R malingering index in a sample of non-compensation-seeking men infected with HIV-1.

HIV-1 infected persons who are pursuing disability benefits are increasingly seeking neuropsychological assessment for purposes of corroborating functional impairment. Thus, research on the utility of measures of symptom validity among these patients is needed. Recently, Mittenberg, Azrin, Millsaps, and Heilbronner (1993) proposed a malingering index score for the WechslerMemoryScale-Revised that is derived by subtracting the Attention/Concentration Index (ACI) score from the General Memory Index Score (GMI).

Use of sertraline, paroxetine and fluvoxamine by nursing women.

Background: The pharmacological treatment of depression in nursing women requires information on the magnitude of medication exposure to the infant that may occur through breast milk.

Aims: To examine serum concentrations of antidepressants in infants exposed to these medications through breast-feeding.

Method: Maternal and infant serum concentrations of sertraline, paroxetine and fluvoxamine were determined with high-performance liquid chromatography (limit of detection=1 ng/ml).

The use of psychotropic medications during breast-feeding.

Objective: The authors reviewed the risks and benefits regarding the use of psychiatric medications during breast-feeding as they relate to the health and well-being of mothers and their infants. Strategies are discussed to limit infant exposure to a medication while effectively treating the nursing mother.

Method: A MEDLINE search of the literature since 1955 was conducted to determine the use of psychotropic medications in breast-feeding women.