Insular dysfunction within the salience network is associated with severity of symptoms and aberrant inter-network connectivity in major depressive disorder

Major depressive disorder (MDD) is characterized by altered intrinsic functional connectivity within (intra-iFC) intrinsic connectivity networks (ICNs),such as the Default Mode- (DMN),Salience- (SN) and Central Executive Network (CEN). It has been proposed that aberrant switching between DMN-mediated self-referential and CEN-mediated goal-directed cognitive processes might contribute to MDD, possibly explaining patients' difficulties to disengage the processing of self-focused, often negatively biased thoughts. Recently, it has been shown that the right anterior insula (rAl) within the SN is modulating DMN/CEN interactions. Since structural and functional alterations within the Al have been frequently reported in MDD, we hypothesized that aberrant intra-iFC in the SN's rAl is associated with both aberrant iFC between DMN and CEN (inter-iFC) and severity of symptoms in MDD. Twenty-five patients with MDD and 25 healthy controls were assessed using resting-state fMRI (rs-fMRI) and psychometric examination. High-model-order independent component analysis (ICA) of rs-fMRI data was performed to identify ICNs including DMN, SN, and CEN. Intra-iFC within and inter-iFC between distinct subsystems of the DMN, SN, and CEN were calculated, compared between groups and correlated with the severity of symptoms. Patients with MDD showed (1) decreased intra-iFC within the SN's rAl,(2) decreased inter-iFC between the DMN and CEN, and (3) increased inter-iFC between the SN and DMN. Moreover, decreased intra-iFC in the SN's rAl was associated with severity of symptoms and aberrant DMN/CEN interactions, with the latter losing significance after correction for multiple comparisons. Our results provide evidence for a relationship between aberrant intra-iFC in the salience network's rAl, aberrant DMN/CEN interactions and severity of symptoms, suggesting a link between aberrant salience mapping, abnormal coordination of DMN/CEN based cognitive processes and psychopathology in MDD

Insular dysfunction reflects altered between-network connectivity and severity of negative symptoms in schizophrenia during psychotic remission

Schizophrenia is characterized by aberrant intrinsic functional connectivity (iFC) within and between intrinsic connectivity networks (ICNs), including the Default Mode- (DMN), Salience- (SN), and Central Executive Network (CEN). The anterior insula (AI) of the SN has been demonstrated to modulate DMN/CEN interactions. Recently, we found that the dependence of DMN/CEN interactions on SN's right AI activity is altered in patients with schizophrenia in acute psychosis and related to psychotic symptoms, indicating a link between aberrant AI, DMN, CEN, and psychosis. However, since structural alterations of the insula are also present during psychotic remission and associated with negative symptoms, impaired AI interaction might be relevant even for psychotic remission and corresponding symptoms. Twelve patients with schizophrenia during psychotic remission (SR) and 12 healthy controls were assessed using resting-state fMRI and psychometric examination. High-model-order independent component analysis of fMRI data revealed ICNs including DMN, SN, and CEN. Scores of iFC within (intra-iFC) and between (inter-iFC) distinct subsystems of the DMN, SN, and CEN were calculated, compared between groups and correlated with the severity of symptoms. Intra-iFC was altered in patients SN, DMN, and CEN, including decreased intra-iFC in the left AI within the SN. Patients' inter-iFC between SN and CEN was increased and correlated with the severity of negative symptoms. Furthermore, decreased intra-iFC of the left AI correlated with both severity of negative symptoms and increased inter-iFC between SN and CEN. Our result provides first evidence for a relationship between AI dysfunction and altered between-network interactions in schizophrenia during psychotic remission, which is related to the severity of negative symptoms. Together with our previous results, data suggest specific SN/DMN/CEN reorganization in schizophrenia with distinct insular pathways for distinct symptom dimensions

Dr. Marvin Monroe and Dr. Zweig: The Therapists of “The Simpsonsâ€

 Einleitung: Es scheint zu einer vermehrten Darstellung von psychischen Erkrankungen, Psychiatern und Psychotherapeuten in Fern-sehserien zu kommen. Dies wird vermutlich auch vermehrt die öffentliche Wahrnehmung dieser Erkrankungen und dieser Berufsgruppe beeinflussen. Methode: Es wurden die Psychotherapeuten und psychotherapeutischen Methoden in der Zeichentrickserie „Die Simpsons“ dargestellt und miteinander verglichen. Mit Hilfe von Da-tenbanken und ergänzenden Suchmethoden wurden die Episoden, in denen Psychothera-peuten vorkommen identifiziert und anschlie-ßend unter psychiatrischen und psychothera-peutischen Aspekten betrachtet. Schlussfolgerung: Es zeigt sich, dass die Darstellung der Therapeuten in dieser Serie von Überzeichnung, Satire und Fiktion geprägt ist. Dabei überwiegt die negative Darstellung von Psychotherapeuten und psychotherapeuti-schen Interventionen.Objective: The psychotherapists and therapeutical methods in the cartoon serial „The Simpsons“ are shown and compaired to each other. Methods: Productions were identified by film databases and altenative search. Each episode was evaluated along psychotherapeutic und psychiatric lines. Results: Therapeuts are shown here in an exaggerated, satirical and fictional way. There are more negative than positive portrayals of psychotherapeuts and psychotherapeutical interventions in the serial. Conclusions: There is growing appearance of psychical illness, psychiatrics an psychotherapists in TV-serials. This will shape the public immage of these disorders and therapists