Conversion Hallucinations in a Patient with Pseudohypoparathyroidism

There are few case reports in the literature which discuss psychiatric disturbances in patients with pseudohypoparathyroidism (PH P) (1,2). PHP is a disease characterized by an inadequate response to parathyroid hormone . Often these patients are obese with a short, stocky build and moon-shaped face. Mental retardation is present in as many as 10% of these patients; a reversible dementialike syndrome can also occur (2,3). In addition, Capgras\u27 syndrome has been observed in pseudohypoparathyroid patients (1,2). In these last two reports the authors concluded that the psychosis was probably organically-based. Hay et al (I) noted in their case report that psychotic symptoms were correlated with EEG abnormalities; furthermore, remission of these symptoms was correlated with normalization of the EEG tracing

Using latent class growth modeling to examine cognitive predictors of suicidal ideation in the elderly

Late life suicide is a serious public health concern. Suicide rates peak in individuals aged 65 or older. Because individuals 65 or older will comprise 20% of the population by 2039, late life suicide is expected to be a growing public health problem. Recent cross sectional studies suggest that deficits in frontal executive functioning, memory and attention are associated with suicidal ideation in the elderly. Our current study is a secondary analysis of data from a clinical trial entitled “Incomplete Response in Late Life Depression: Getting to Remission”. Individuals with major depression received venlafaxine XR monotherapy for depression and were followed repeatedly for up to 16 weeks. We used latent class growth modeling to classify groups of individuals aged > 60 based on trajectories of suicidal ideation. We controlled for time dependent variables (depression and antidepressant doses) and baseline demographics. The optimal model classified individuals into three groups with linear or quadratic trajectories of suicidal ideation. We also ran various analyses using different link functions to find the link that was most appropriate for our data (logistic, censored normal or zero inflated Poisson). After trajectory group membership was determined, we examined whether cognitive dysfunction predicted suicidal ideation trajectory membership using multinomial logistic regression. Using the zero inflated Poisson link latent trajectory model, we determined that having a better score on the Trails B frontal lobe measure was statistically significantly associated with individuals having higher levels of suicidal ideation; however, this association was no longer significant when a multivariable model was used. No statistically significant associations were observed with the other frontal lobe measures, i.e., Trails B/A, Stroop 3 and Stroop 4. In addition, neither individual subscale scores nor total scores from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were associated with individuals with having higher trajectories of suicidal ideation. The present study is the first to our knowledge that examines how cognitive status is associated with long-term trajectories of suicidal symptoms in depressed elderly adults

Regulation of Corticotropin-Releasing Factor-Binding Protein Expression in Amygdalar Neuronal Cultures

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73102/1/j.1365-2826.1999.00413.x.pd

The association between race and gender, treatment attitudes, and antidepressant treatment adherence

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102669/1/gps3984.pd

Hypothalamic-Pituitary-Adrenal Axis Abnormalities in Response to Deletion of 11β-HSD1 is Strain-Dependent

Inter-individual differences in hypothalamic-pituitary-adrenal (HPA) axis activity underlie differential vulnerability to neuropsychiatric and metabolic disorders, although the basis of this variation is poorly understood. 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) has previously been shown to influence HPA axis activity. 129/MF1 mice null for 11β-HSD1 (129/MF1 HSD1−/−) have greatly increased adrenal gland size and altered HPA activity, consistent with reduced glucocorticoid negative feedback. On this background, concentrations of plasma corticosterone and adrenocorticotrophic hormone (ACTH) were elevated in unstressed mice, and showed a delayed return to baseline after stress in HSD1-null mice with reduced sensitivity to exogenous glucocorticoid feedback compared to same-background genetic controls. In the present study, we report that the genetic background can dramatically alter this pattern. By contrast to HSD1−/− mice on a 129/MF1 background, HSD1−/− mice congenic on a C57Bl/6J background have normal basal plasma corticosterone and ACTH concentrations and exhibit normal return to baseline of plasma corticosterone and ACTH concentrations after stress. Furthermore, in contrast to 129/MF1 HSD1−/− mice, C57Bl/6J HSD1−/− mice have increased glucocorticoid receptor expression in areas of the brain involved in glucocorticoid negative feedback (hippocampus and paraventricular nucleus), suggesting this may be a compensatory response to normalise feedback control of the HPA axis. In support of this hypothesis, C57Bl/6J HSD1−/− mice show increased sensitivity to dexamethasone-mediated suppression of peak corticosterone. Thus, although 11β-HSD1 appears to contribute to regulation of the HPA axis, the genetic background is crucial in governing the response to (and hence the consequences of) its loss. Similar variations in plasticity may underpin inter-individual differences in vulnerability to disorders associated with HPA axis dysregulation. They also indicate that 11β-HSD1 inhibition does not inevitably activate the HPA axis

Qualité de vie, schizophrénie et avancée en âge

International audienceAu-delà de 65 ans, la prévalence de la schizophrénie est estimée entre 0,1 % et 0,5 %. La majorité des sujets âgés avec une schizophrénie ont développé la maladie avant l'âge de 45 ans et 85 % d'entre eux vivent dans la communauté. Alors que près d'une personne sur sept atteint de schizophrénie est âgée de 65 ans ou plus et que le nombre de sujets âgés avec une schizophrénie va croître considérablement dans les prochaines années, 1 % seulement de la littérature s'intéressant à la schizophrénie est dédiée aux questions en lien avec l'avancée en âge. La schizophrénie, véritable handicap psychique, a un retentissement important sur le fonctionnement global de la personne et en particulier sur sa qualité de vie (QDV). La QDV des sujets avec une schizophrénie est déterminée par de nombreux facteurs, et ne se limite pas seulement à la symptomatologie présentée par le patient

Depressive symptoms and suicide in 56,000 older Chinese: a Hong Kong cohort study

Objective: To examine dose-response associations between depressive symptoms and suicide and modification effects of sex, age and health status in older Chinese. Methods: We used the Chinese version of the 15-item Geriatric Depression Scale (GDS) to measure depressive symptoms (GDS score ≥ 8) and Cox regression to examine association with suicide mortality in a population-based cohort of 55,946 individuals, aged 65 years or above, enrolled from July 1998 to December 2000 at one of 18 Elderly Health Centres of Hong Kong Department of Health. The cohort was followed up for suicide mortality till 31 March 2009 (mean follow-up 8.7 years). Results: Depressive symptoms were associated with suicide in men [hazard ratio (HR) 2.03, 95% confidence interval (CI) 0.96-4.29] and women (HR = 2.36, 95% CI 1.31-4.24) after adjusting for age, education, monthly expenditure, smoking, alcohol drinking, physical activity, body mass index, health status, and self-rated health. There was no threshold for GDS score and suicide in either sex. Age, sex and health status did not modify the association. Conclusions: Depressive symptoms predict higher suicide risk in older Chinese in a dose-response pattern. These associations were not attenuated by adjustment for health status, suggesting that depressive symptoms in older people are likely to be an independent causal factor for suicide. The GDS score showed no threshold in predicting suicide risk, suggesting that older people with low GDS scores deserve further attention and those with very high scores need urgent intervention. © 2011 The Author(s).published_or_final_versionSpringer Open Choice, 21 Feb 201