Attentional bias in depressive patients and the moderating effect of concurrent anxiety

BACKGROUND: Most previous studies finding positive results in the emotional Stroop test did not control for concurrent anxiety symptoms. This study investigated depressive patients without comorbid anxiety disorders in order to clarify existing inconsistent findings. Furthermore, we examined the relationship between anxiety level and the emotional Stroop effect in patients and healthy subjects. SUBJECTS AND METHODS: Twenty-three depressive patients without comorbid anxiety disorder and 27 healthy subjects performed a mixed computerized version of the emotional Stroop test (attentional bias test). We assessed the state and trait anxiety and examined its correlation with the emotional Stroop effect. RESULTS: We failed to find evidence for attentional bias in the patients as measured by longer reaction times to the emotional stimuli. However, there was a positive correlation between state anxiety and attentional bias in depressed patients. On the other hand, in healthy subjects the trait anxiety correlated negatively with attentional bias. CONCLUSIONS: Attentional bias is not found in depressed patients if only patients without comorbid anxiety disorders are included. Furthermore, healthy subjects with high trait anxiety levels may be vulnerable to affective disorders because they use avoidance strategies when encountering negative information

Effectiveness of antiepileptic therapy in patients with PCDH19 mutations

Purpose PCDH19 mutations cause epilepsy and mental retardation limited to females (EFMR) or Dravet-like syndromes. Especially in the first years of life, epilepsy is known to be highly pharmacoresistant. The aim of our study was to evaluate the effectiveness of antiepileptic therapy in patients with PCDH19 mutations. Methods We report a retrospective multicenter study of antiepileptic therapy in 58 female patients with PCDH19 mutations and epilepsy aged 2-27 years (mean age 10.6 years). Results The most effective drugs after 3 months were clobazam and bromide, with a responder rate of 68% and 67%, respectively, where response was defined as seizure reduction of at least 50%. Defining long-term response as the proportion of responders after 12 months of treatment with a given drug in relation to the number of patients treated for at least 3 months, the most effective drugs after 12 months were again bromide and clobazam, with a long-term response of 50% and 43%, respectively. Seventy-four percent of the patients became seizure-free for at least 3 months, 47% for at least one year. Significance The most effective drugs in patients with PCDH19 mutations were bromide and clobazam. Although epilepsy in PCDH19 mutations is often pharmacoresistant, three quarters of the patients became seizure-free for at least for 3 months and half of them for at least one year. However, assessing the effectiveness of the drugs is difficult because a possible age-dependent spontaneous seizure remission must be considered