DSM-5: a collection of psychiatrist views on the changes, controversies, and future directions

The recent release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association has led to much debate. For this forum article, we asked BMC Medicine Editorial Board members who are experts in the field of psychiatry to discuss their personal views on how the changes in DSM-5 might affect clinical practice in their specific areas of psychiatric medicine. This article discusses the influence the DSM-5 may have on the diagnosis and treatment of autism, trauma-related and stressor-related disorders, obsessive-compulsive and related disorders, mood disorders (including major depression and bipolar disorders), and schizophrenia spectrum disorders

Disproportionate Alterations in the Anterior and Posterior Insular Cortices in Obsessive–Compulsive Disorder

Recent studies have reported that the insular cortex is involved in the pathophysiology of obsessive–compulsive disorder (OCD). However, specific morphometric abnormalities of the insular subregions remain unclear. In this study, we examined insular cortical volume to determine whether the volume of the anterior and posterior insular cortices of unmedicated OCD patients differed according to different symptom dimensions.Using magnetic resonance imaging, we measured the gray matter volumes of the insular cortex and its subregions (anterior and posterior divisions) in 41 patients with OCD (31 drug-naïve and 10 non-medicated) and 53 healthy controls. Volumetric measures of the insular cortex were compared according to different OC symptoms. Enlarged anterior and reduced posterior insular cortices were observed in OCD patients. The insular volumetric alterations were more significant in OCD patients with predominant checking rather than cleaning symptoms when compared with healthy controls.Our results suggest the presence of unbalanced anterior and posterior insular volumetric abnormalities in unmedicated OCD patients and emphasize the distinct role of the insular cortex in different OC symptoms. We propose that the insular morphometric alterations may influence the modulation of interoceptive processing, the insular functional role, in OCD patients with different symptoms

Studying type II supernovae as cosmological standard candles using the Dark Energy Survey

Despite vast improvements in the measurement of the cosmological parameters, the nature of dark energy and an accurate value of the Hubble constant (H$_0$) in the Hubble-Lema\^itre law remain unknown. To break the current impasse, it is necessary to develop as many independent techniques as possible, such as the use of Type II supernovae (SNe II). The goal of this paper is to demonstrate the utility of SNe II for deriving accurate extragalactic distances, which will be an asset for the next generation of telescopes where more-distant SNe II will be discovered. More specifically, we present a sample from the Dark Energy Survey Supernova Program (DES-SN) consisting of 15 SNe II with photometric and spectroscopic information spanning a redshift range up to 0.35. Combining our DES SNe with publicly available samples, and using the standard candle method (SCM), we construct the largest available Hubble diagram with SNe II in the Hubble flow (70 SNe II) and find an observed dispersion of 0.27 mag. We demonstrate that adding a colour term to the SN II standardisation does not reduce the scatter in the Hubble diagram. Although SNe II are viable as distance indicators, this work points out important issues for improving their utility as independent extragalactic beacons: find new correlations, define a more standard subclass of SNe II, construct new SN II templates, and dedicate more observing time to high-redshift SNe II. Finally, for the first time, we perform simulations to estimate the redshift-dependent distance-modulus bias due to selection effects.Comment: 39 pages, 22 figures, 10 tables, Accepted for publication in MNRA

Spoiling for a Fight: B Lymphocytes As Initiator and Effector Populations within Tertiary Lymphoid Organs in Autoimmunity and Transplantation.

Tertiary lymphoid organs (TLOs) develop at ectopic sites within chronically inflamed tissues, such as in autoimmunity and rejecting organ allografts. TLOs differ structurally from canonical secondary lymphoid organs (SLOs), in that they lack a mantle zone and are not encapsulated, suggesting that they may provide unique immune function. A notable feature of TLOs is the frequent presence of structures typical of germinal centers (GCs). However, little is known about the role of such GCs, and in particular, it is not clear if the B cell response within is autonomous, or whether it synergizes with concurrent responses in SLOs. This review will discuss ectopic lymphoneogenesis and the role of the B cell in TLO formation and subsequent effector output in the context of autoimmunity and transplantation, with particular focus on the contribution of ectopic GCs to affinity maturation in humoral immune responses and to the potential breakdown of self-tolerance and development of humoral autoimmunity

Locus of control and its intergenerational implications forearly childhood skill formation

This paper builds upon Cunha’s (2015) subjective rationality model in which parents have a subjective belief about the impact of their investment on the early skill formation of their children. We propose that this subjective belief is determined in part by locus of control (LOC), i.e., the extent to which individuals believe that their actions can influence future outcomes. Consistent with the theory, we show that maternal LOC measured at the 12th week of gestation strongly predicts maternal attitudes towards parenting style, maternal time investments, as well as early and late cognitive outcomes. We also utilize the variation in inputs and outputs by maternal LOC to help improve the specification typically used in the estimation of skill production function parameters

Epidemiologic and clinical updates on impulse control disorders: a critical review

The article reviews the current knowledge about the impulse control disorders (ICDs) with specific emphasis on epidemiological and pharmacological advances. In addition to the traditional ICDs present in the DSM-IV—pathological gambling, trichotillomania, kleptomania, pyromania and intermittent explosive disorder—a brief description of the new proposed ICDs—compulsive–impulsive (C–I) Internet usage disorder, C–I sexual behaviors, C–I skin picking and C–I shopping—is provided. Specifically, the article summarizes the phenomenology, epidemiology and comorbidity of the ICDs. Particular attention is paid to the relationship between ICDs and obsessive–compulsive disorder (OCD). Finally, current pharmacological options for treating ICDs are presented and discussed

Gender and release from imprisonment: Convict licensing systems in mid to late 19th century England

This paper draws on the research undertaken into the lives and prison experiences of around 650 male and female convicts who were released on licence (an early form of parole) from sentences of long term imprisonment (three years to life) in England in the mid- to late-nineteenth century. Our project confirmed the patterns of offending seen in other studies of female and male offending, namely, that women were committed to periods of long-term imprisonment overwhelmingly for crimes of larceny and sometimes low-level violence (or their criminal backgrounds indicated this type of low-level disorderly behaviour) and only in the minority for crimes of serious interpersonal violence. Similarly, the majority of men were also committed to the convict system for larceny. Yet how male and female offenders were treated by the prison licensing system did differ significantly. The vast majority of all prisoners, male and female, were released early on licence from their prison terms, even those who had committed very serious offences. All licences had several conditions in them and licence-holders were free so long as they met these conditions. Any breach of the above conditions meant that the individual would be returned to prison to serve out the remainder of their sentence.However, a proportion of female offenders were released slightly earlier than their male counterparts, though not directly into the community but on a conditional licence to Female Refuges. Out of the 288 women researched in our project, 200 of them were released in this manner; under further confinement in a refuge. Women stayed in such refuges for on average between six and nine months, before their final release was then approved by the Directors of the Convict Prisons

"Monstrous and indefensible"? Newspaper accounts of sexual assaults on children in nineteenth-century England and Wales

This material has been published in Women's Criminality in Europe, 1600–1914 edited by Edited by Manon van der Heijden, Marion Pluskota, Sanne Muurling, https://doi.org/10.1017/9781108774543. This version is free to view and download for private research and study only. Not for re-distribution or re-use. © 2020 Cambridge University Press.Popular crime reportage of sexual violence has a long history in England. Despite the fact that from the 1830s onwards newspapers and periodicals – and sometimes even law reports – were increasingly liable to skim over the reporting of sexual offences as ‘unfit for publication’, this does not mean that such reportage vanished entirely. Instead, certain linguistic codes and euphemisms were invoked to maintain a respectable discourse. Given the serious problems with gaps in the surviving archival record for modern criminal justice, newspapers remain an essential tool for understanding the history of sexual violence in nineteenth century England and Wales. Using keyword searches in digitized newspaper databases such as the British Newspaper Archive and Welsh Newspapers Database, this chapter examines the continuities and changes in the reporting of sexual violence against children between 1800 and 1900, and explores what these euphemisms and elisions reveal about attitudes to gender and crime in nineteenth-century England and Wales.Peer reviewe