Mood Spectrum Disorders Research Articles

Cognition and mood-related behaviors in L3mbtl1 null mutant mice.

Alterations in histone lysine methylation and epigenetic regulators of gene expression could play a role in the neurobiology and treatment of patients diagnosed with mood spectrum disorder, including depression and anxiety. Mutations and altered expression of various lysine methyltransferases (KMTs) and demethylases (KDMs) have been linked to changes in motivational and emotional behaviors in preclinical model systems. However, it is not known whether regulators operating downstream of histone lysine methylation could affect mood-related behavior. Malignant Brain Tumor (MBT) domain ‘chromatin reader’ proteins bind to methylated histone lysine residues and associate with chromatin remodeling complexes to facilitate or repress gene expression. MBT proteins, including the founding member, L3mbtl1, maintain high levels of expression in neurons of the mature brain. Here, we exposed L3mbtl1 null mutant mice to a wide range of tests exploring cognition and mood-relevant behaviors at baseline and in the context of social isolation, as a stressor to elicit depression-related behavior in susceptible mice. L3mbtl1 loss-of-function was associated with significant decreases in depression and and anxiety in some of the behavioral paradigms. This was not associated with a more generalized neurological dysfunction because cognition and memory remained unaltered in comparison to controls. These findings warrant further investigations on the role of MBT chromatin reader proteins in the context of emotional and affective behaviors.

Addiction: the Burden of Cyclothymic Temperament

Disorders of the bipolar spectrum (e.g. cyclothymic disorder) and subthreshold manifestations of mood disorders (such as temperamental traits) have been suggested to influence the course of psychiatric diseases. Cyclothymic temperament (as described by Kraepelin and as measured by Akiskal's temperament scale, the TEMPS) has been suggested to be the most morbid and prodromal element in the pathogenic chain of personal disposition to behavioural and emotional problems. We studied the effects of affective temperaments on psychoactive substance use, on alcohol dependence and opioid dependence. In particular, we wanted to test the hypothesis whether cyclothymic temperament mediates a deleterious effect. 1380 inhabitants of residential student homes in Austria, 116 alcohol dependent patients at the Medical University of Vienna and 101 opioid dependent patients at the Oum El Nour rehabilitation center in Lebanon were investigated. Temperament was assessed using the briefTEMPS-M auto-questionnaire. In opioid dependence, subtypes were assessed according to the LAT interview (www.lat-online.at). In the college student group, cyclothymic (and irritable) temperament serves as predictor of self-reported nicotine dependence, alcohol abuse and cannabis use. In alcohol dependent patients, cyclothymic temperament influenced the age of onset of alcohol abuse and the age of onset of alcohol dependence. In the opioid dependence group, patients exhibiting symptoms of severe negative childhood development according to the LAT interview (e.g. prenatal trauma, cerebral trauma before the age of 14) showed the highest percentage of cyclothymic temperament. Our data show that cyclothymic temperament as measured by the briefTEMPS-M is an important negative pathoplastic factor for substance-related addictive disorders.

Suicidality Among Various Diagnostic Groups

Introduction The presence of mental illness has been found to be one of the major predictors of suicidality. Further, a lifetime history of suicide attempts increase the risk of death by suicide. Objectives Suicidality differs among diagnostic groups, with the strongest association being with mood disorders, but also with schizophrenia and anxiety disorders. Accordingly, we explored the differences in suicidality among various diagnostic groups. Aims To identify a diagnostic group with the highest risk of suicidality. Methods The study sample consisted of 122 patients categorized into three diagnostic groups: those with schizophrenia spectrum disorders (n=56), those with mood disorders (n=40) and those with anxiety disorders (n=26), mean age of 37.38 years. Assessment instruments included the Beck Scale for Suicide Ideation and the semistructured questionnaire for suicidal behaviour (lifetime history and method of suicide attempts). Results The three groups statistically differed with regard to lifetime suicide attempts (p ?0.01). More patients with mood (42.5%) and schizophrenia spectrum disorders (35.7%) reported lifetime suicide attempts compared to patients with anxiety disorders (0%). In all groups, self-poisoning was the most common method for suicide attempts. There was a significant difference among the diagnostic groups in the intensity of suicidal motivation (p 0.05) and suicidal preparation (p> 0.05). Patients with mood disorders scored higher on the intensity of suicidal motivation compared to patients with schizophrenia spectrum. Conclusion The risk of lifetime suicide attempts was highest in patients with mood disorders, as well as intensity of suicidal motivation.

Separation anxiety disorder from the perspective of DSM-5: clinical investigation among subjects with panic disorder and associations with mood disorders spectrum.

High levels of comorbidity between separation anxiety disorder (SEPAD) and panic disorder (PD) have been found in clinical settings. In addition, there is some evidence for a relationship involving bipolar disorder (BD) and combined PD and SEPAD. We aim to investigate the prevalence and correlates of SEPAD among patients with PD and whether the presence of SEPAD is associated with frank diagnoses of mood disorders or with mood spectrum symptoms. Adult outpatients (235) with PD were assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Panic Disorder Severity Scale (PDSS), the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), and the Mood Spectrum Self-Report Instrument (MOODS-SR, lifetime version). Of ther 235 subjects, 125 (53.2%) were categorized as having SEPAD and 110 (46.8%) as not. Groups did not differ regarding onset of PD, lifetime prevalence of obsessive compulsive disorder (OCD), social phobia, simple phobia, BD I and II, or major depressive disorder (MDD). SEPAD subjects were more likely to be female and younger; they showed higher rates of childhood SEPAD, higher PDSS scores, and higher MOODS-SR total and manic component scores than subjects without SEPAD. Discussion SEPAD is highly prevalent among PD subjects. Patients with both PD and SEPAD show higher lifetime mood spectrum symptoms than patients with PD alone. Specifically, SEPAD is correlated with the manic/hypomanic spectrum component. Our data confirm the high prevalence of SEPAD in clinical settings. Moreover, our findings corroborate a relationship between mood disorders and SEPAD, highlighting a relationship between lifetime mood spectrum symptoms and SEPAD.

Using neuroimaging to evaluate and guide pharmacological and psychotherapeutic treatments for mood disorders in children.

Mood disorders are increasing in childhood, and often require multimodal and comprehensive treatment plans to address a complex array of symptoms and associated morbidities. Pharmacotherapy, in combination with psychotherapeutic interventions, is essential for treatment and stabilization. Current evidence supports the use of a number of interventions in children and adolescents diagnosed with DSM-5 mood spectrum disorders, which are associated with impairments in prefrontal-striatal-limbic networks, which are key for emotional functioning and regulation. Yet, little is known about the neurobiological effects of interventions on the developing brain. This chapter provides a synopsis of the literature demonstrating the neural effects of psychotropic medications and psychotherapy in youth with depressive or bipolar spectrum disorders. Additional longitudinal and biological studies are warranted to characterize the effects of these interventions on all phases and stages of mood illness development in children and adolescents.

Exploring the concept of eating dyscontrol in severely obese patients candidate to bariatric surgery.

Eating dyscontrol constitutes a potential negative predictor for the outcome of treatment strategies for obese patients. The aim of this study was to examine the qualitative characteristics of eating dyscontrol in obese patients who engage in binge eating (BE) compared with those who do not (NBE), and to analyse the relationship between eating dyscontrol and axis-I, axis-II, spectrum psychopathology using instruments that explore mood, panic-agoraphobic, social-phobic, obsessive-compulsive and eating disorders spectrum psychopathology (SCI-MOODS-SR, SCI-PAS-SR, SCI-SHY-SR, SCI-OBS-SR, SCI-ABS-SR). This was a cross-sectional study involving a clinical sample of adult obese patients with severe obesity (average body mass index = 45 ± 8 kg m(-2) ) and candidate to bariatric surgery who were recruited between November 2001 and November 2010 at the Obesity Center of the Endocrinology Unit, University Hospital of Pisa. All participants completed a face-to-face interview, including a diagnostic assessment of axes-I and II mental disorders (using the Structured Clinical Interview for Manual of Mental Disorders, fourth edition [SCID]-I and SCID-II) and filled out self-report spectrum instruments. Among obese patients not affected by BE, eating dyscontrol was highly represented. Indeed, 39.7% (N = 177) of subjects endorsed six or more items of the Anorexia-Bulimia Spectrum Self-Report, lifetime version domain exploring this behaviour. The cumulative probability of having axis-I, axis-II and a spectrum condition disorder increased significantly with the number of eating dyscontrol items endorsed. In both BE and NBE obese subjects, eating dyscontrol may represent an independent dimension strongly related to the spectrum psychopathology and axes I/II disorders. A systematic screening for eating dyscontrol symptoms by means of self-report spectrum instruments may be valuable to assign specific treatment strategies.

Measuring psychological mindedness: validity, reliability, and relationship with psychopathology of an Italian version of the Balanced Index of Psychological Mindedness

Psychological mindedness (PM) is an underinvestigated, but important construct in psychoanalytic psychotherapy research and practice. It refers to the interest in and ability for reflecting on one's thoughts and feelings, and it represents an important precondition for insight-oriented therapy to be successful. Notwithstanding, very few instruments are available to measure PM. The current investigation aimed at evaluating the validity and reliability of the Balanced Index of Psychological Mindedness (BIPM; NyklíČek & Denollet, 2009, Psychological Assessment, 21, 32–44), a brief measure of PM. In a first study, factor structure, internal consistency, and concurrent validity of the BIPM were tested, along with the relationship between the BIPM and a continuous measure of general distress, using a sample of 298 Italian students. In a second study, test-retest stability analyses were completed using a new, different, Italian student sample (N = 58). In a third study, the BIPM scores of a clinical sample with diagnosis of mood spectrum disorders (N = 30) were compared to those of an age-, gender-, and education-matched nonclinical sample. Overall, results indicate that the BIPM is a psychometrically sound instrument that can be used in clinical practice to obtain rapid information about the client's mentalization skills and assess PM.

Role of Early Childhood Traumatic Stress in the Development of PTSD in Adulthood: A Review

Traumatic stress has been known through ages and children make a significant group to face it. Vast research has been done in traumatic stress to show the cause effect relationship. Post-traumatic stress disorder (PTSD) has been recognized subsequent to trauma and has been invariably linked to it. Besides PTSD, there have been a multitude of psychopathologies attributed to childhood traumas. Short-term effects of childhood traumas are studied in depth but the long-term effects are subject to a variety of risk and protective factors. Childhood maltreatment and other cumulative traumas are shown to cause a spectrum of anxiety disorders and mood disorders besides others; in contrast to single traumas of childhood mainly presenting as PTSD as a pathology. Re-trauma in adulthood of these early traumatized children seems to be a risk factor for PTSD and other pathologies. Significant neurobiological changes (structural and genetic) have been shown to occur in adults with childhood traumatic experiences. Resilience has been significant and has been seen more developed in children with effective parenting, stable families, adequate social support, spirituality and humour. Positive self-esteem, ego flexibility, and ego over-control are protective. These protective practices need to be identified and promoted in children with special emphasis in those having experienced traumatic stress.

Second-Generation Antipsychotic Use in Children and Adolescents: A Six-Month Prospective Cohort Study in Drug-Naïve Patients

To assess weight and metabolic effects of 6 months of treatment with second-generation antipsychotics in naïve/quasi-naïve youths. This study looked at a nonrandomized, naturalistic, multicenter, inception cohort study of 279 patients aged 4 to 17 years (mean= 14.6 ± 2.9 years). Of those, 248 (88.8%) received a single antipsychotic (risperidone, olanzapine, or quetiapine) and completed 2 visits, and 178 (63.8%) completed the 6-month follow-up. Patients had schizophrenia-spectrum disorders (44.5%), mood-spectrum disorders (23.2%), disruptive behavioral disorders (17.3%), or other disorders (15.1%). Fifteen age- and gender-matched, healthy, nonmedicated individuals served as a comparison group. From baseline to 1 month, 3 months, and 6 months, all anthropometric measures increased significantly with each antipsychotic, that is, 6-month changes with risperidone (n= 157; 7.1 kg and 0.66 body mass index [BMI] z score), olanzapine (n= 44; 11.5 kg and 1.08 BMI z score), and quetiapine (n= 47; 6.3 kg and 0.54 BMI z score), but not in healthy control participants (-0.11 kg and 0.006 BMI z score). Fasting metabolic parameters increased significantly with risperidone (glucose [3.8] mg/dL, insulin [4.9] mU/L, homeostasis model assessment of insulin resistance [HOMA-IR: 1.2], triglycerides [15.6] mg/dL), and olanzapine (glucose [5.0] mg/dL, total cholesterol [21.2] mg/dL, and low-density lipoprotein cholesterol [44.6] mg/dL), but not with quetiapine or in healthy control participants. The percentage of research participants considered to be "at risk of adverse health outcome" increased during the 6 months from 8.9% to 29.2% for risperidone (p< .0001), 6.8% to 38.1% for olanzapine (p<.0001), and 6.3%to 4.0% for quetiapine (p= .91). Olanzapine, quetiapine, and risperidone increase body weight but have different cardiometabolic side effect profiles and different temporalside effect patterns.

The Bipolar Prodrome Symptom Interview and Scale-Prospective (BPSS-P): description and validation in a psychiatric sample and healthy controls.

The aim of the present study was to investigate the psychometric properties of the Bipolar Prodrome Symptom Interview and Scale-Prospective (BPSS-P), the first specific interview for emerging bipolar disorder (BD) symptoms. A total of 205 youth aged 12-23 years and/or their caregivers underwent BPSS-P interviews: 129 patients with mood spectrum disorders [depression spectrum disorder (n = 77), mood disorder not otherwise specified (NOS) (n = 27), BD-NOS (n = 14), bipolar I disorder (BD-I)/bipolar II disorder (BD-II)/cyclothymia (n = 11), 34 with non-mood spectrum disorders, and 42 healthy controls (HCs)]. We used Cronbach's α to assess internal consistency; intra-class correlation (ICC) for inter-rater reliability; Spearman's rho for convergent validity with the Young Mania Rating Scale (YMRS), General Behavior Inventory-10-item Mania Form (GBI-M-10), and Cyclothymic-Hypersensitive Temperament (CHT) scale; and analysis of variance for discriminatory power between diagnostic groups. Internal consistency was good to very good for the BPSS-P Mania (Cronbach's α = 0.87), Depression (Cronbach's α = 0.89), and General Symptom indices (Cronbach's α = 0.74). Inter-rater reliability was high for the BPSS-P Total score (ICC = 0.939), and BPSS-P Mania (ICC = 0.934), Depression (ICC = 0.985), and General (ICC = 0.981) indices. Convergent validity was large (ρ ≥ 0.50) between the BPSS-P Mania Index and YMRS, GBI-M-10, and CHT; BPSS-P Depression Index and Montgomery-Åsberg Depression Rating Scale (MADRS) and CHT; and BPSS-P General Index and GBI-M-10 and CHT. Expectedly, convergent validity was small (ρ = 0.10 to < 0.30) between the BPSS-P Mania Index and MADRS, and BPSS-P Depression Index and YMRS. Furthermore, the BPSS-P and its subscales discriminated each patient group from HCs and from non-mood spectrum patients (except for the BPSS-P General Index). Moreover, the BPSS-P Total score discriminated BD-I/BD-II/cyclothymia from depression spectrum patients, and the BPSS-Mania Index differentiated all three bipolar spectrum groups from depression spectrum patients. The BPSS-P has good to excellent psychometric properties. Its use across multiple settings and predictive validity requires further investigation.

The emerging role of Buddhism in clinical psychology: Toward effective integration.

Research into the clinical utility of Buddhist-derived interventions (BDIs) has increased greatly over the last decade. While clinical interest has predominantly focused on mindfulness meditation, there has also been an increase in the scientific investigation of interventions that integrate other Buddhist principles such as compassion, loving kindness, and ‘non-self’. However, due to the rapidity at which Buddhism has been assimilated into the mental health setting, issues relating to the misapplication of Buddhist terms and practices have sometimes arisen. Indeed, hitherto, there has been no unified system for the effective clinical operationalization of Buddhist principles. Therefore, this paper aims to establish robust foundations for the ongoing clinical implementation of Buddhist principles by providing: (i) succinct and accurate interpretations of Buddhist terms and principles that have become embedded into the clinical practice literature, (ii) an overview of current directions in the clinical operationalization of BDIs, and (iii) an assessment of BDI clinical integration issues. It is concluded that BDIs may be effective treatments for a variety of psychopathologies including mood-spectrum disorders, substance-use disorders, and schizophrenia. However, further research and clinical evaluation is required to strengthen the evidence-base for existent interventions and for establishing new treatment applications. More importantly, there is a need for greater dialogue between Buddhist teachers and mental health clinicians and researchers in order to safeguard the ethical values, efficacy, and credibility of BDIs.

Mixed state discrimination: A DSM problem that won׳t go away?

BackgroundDSM׳s replacement of ‘mixed episodes’ with ‘mixed features’ has ironically created a specifier, which potentially lacks specificity because it overlooks two key symptoms: psychomotor agitation and distractibility. Therefore, the present study examined the presence of psychomotor agitation and distractibility across the mood disorder spectrum. MethodsTwo hundred patients were diagnosed and assigned to one of three groups (depression, bipolar spectrum disorder (BDspectrum) and bipolar disorder) based on clinical evaluation by a psychiatrist. On the basis of MDQ scores, the depression group was then further subdivided into two groups: unipolar depression (UP) and mixed depression (UPmix). These four groups were then compared to examine the relative distribution of psychomotor agitation and distractibility. Participants underwent a clinical evaluation by a psychiatrist and completed a series of questionnaires. ResultsIncreased distraction, racing thoughts, and increased irritability were the most commonly reported manic symptoms amongst the unipolar depression group. Further, UPmix and BDspectrum had significantly higher psychomotor agitation and distractibility than the other two groups. LimitationsThe present study depended on self-report measures and did not include standardised measures of distractibility and psychomotor agitation. Future research needs to examine pure unipolar patients without any manic symptoms to clarify further how different this group would be from those with mixed features. ConclusionsThe present findings suggest that distractibility and psychomotor agitation may represent the core of mixed states, as they are more common in patients with mixed depression and bipolar spectrum disorder than patients diagnosed with unipolar depression and bipolar I disorder. Future research and clinical implications are discussed.

EPA-1058 – Mood disorder is associated with excess cardiometabolic health comorbidities and cardiovascular risk factors: cross-sectional study using data from the uk biobank dataset

Introduction Individuals with serious mental illnesses experience poor physical health, particularly increased rates of cardiometabolic disorders. There are corresponding increases in premature mortality. Objectives/aims To assess the nature and extent of cardiometabolic risk factors and comorbidities in bipolar disorder and depression compared to controls. Methods Cross-sectional analysis of records for 502,602 participants within the UK Biobank database. Mood disorder was identified using an internally developed algorithm. Presence of cardiometabolic conditions and risk factors was examined. Multinomial logistic regression analyses were applied. Results Compared to controls, individuals with bipolar and depression were significantly more likely to smoke. Rates of smoking were particularly elevated in the bipolar group, with a RRR of 3.18 (95% CI 2.790–3.632) compared to controls. Individuals with bipolar disorder or severe recurrent depression were significantly more likely to be underweight, and have classes I, II and III obesity. All mood disorders were significantly associated with Class II and Class III obesity. Bipolar disorder was significantly associated with increased rates of hypertension, diabetes, MI, angina and stroke. Severe depression was also associated with an increased risk of hypertension, diabetes, angina and stroke and individuals with moderate depressive disorder showed increased rates of MI, angina and stroke. Rates of ‘no cardiovascular illness’ were significantly reduced across the mood disorder spectrum. Conclusions Individuals with mood disorder have significantly increased rates of both cardiovascular risk factors and cardiometabolic illness. These findings using a large and extensive national dataset highlight a significant health inequality.

Specificity of psychosis, mania and major depression in a contemporary family study

There has been increasing attention to the subgroups of mood disorders and their boundaries with other mental disorders, particularly psychoses. The goals of the present paper were (1) to assess the familial aggregation and co-aggregation patterns of the full spectrum of mood disorders (that is, bipolar, schizoaffective (SAF), major depression) based on contemporary diagnostic criteria; and (2) to evaluate the familial specificity of the major subgroups of mood disorders, including psychotic, manic and major depressive episodes (MDEs). The sample included 293 patients with a lifetime diagnosis of SAF disorder, bipolar disorder and major depressive disorder (MDD), 110 orthopedic controls, and 1734 adult first-degree relatives. The diagnostic assignment was based on all available information, including direct diagnostic interviews, family history reports and medical records. Our findings revealed specificity of the familial aggregation of psychosis (odds ratio (OR)=2.9, confidence interval (CI): 1.1-7.7), mania (OR=6.4, CI: 2.2-18.7) and MDEs (OR=2.0, CI: 1.5-2.7) but not hypomania (OR=1.3, CI: 0.5-3.6). There was no evidence for cross-transmission of mania and MDEs (OR=.7, CI:.5-1.1), psychosis and mania (OR=1.0, CI:.4-2.7) or psychosis and MDEs (OR=1.0, CI:.7-1.4). The strong familial specificity of psychotic, manic and MDEs in this largest controlled contemporary family study challenges the growing assertion that the major types of mood disorders are manifestations of a common underlying diathesis.

Physical Comorbidity and Psychiatric Diagnosis in a Neuropsychiatric Clinic in Sindhuli District, Rural Nepal

Background: Presence of physical illness with mental health problems is very common occurrence. Contraindication of certain psychotropics with certain physical problem and some beneficial effects of other drugs in comorbid conditions is one of important aspect of studying comorbidity. Comorbidity identification and intervention helps to cure and contain mental problems in most effective way. Materials and methods: Descriptive study with convenient sampling in all the patients who consented and attended monthly neuropsychiatric satellite health camp in Sindhuli district of Nepal from the month of Shrawan to Poush 2069 (6 months) organized by Tranquility Hospital and Research Centre, Khumaltar, Kathamndu. Results: Out of the 172 subjects studied, the most common age group was 20-39 years (47.7 %) followed by 40-59 years (27.9 %). The most common neuropsychiatric diagnosis was mood spectrum disorder followed by neurotic (neurotic, stress-related and somatoform) disorders. Psychosis spectrum (schizophrenia, schizotypal and delusional disorders) was the least common. The most common physical comorbid diagnosis was migraine followed by hypertension and diabetes mellitus. Conclusions: Migraine, hypertension and diabetes mellitus are the most common comorbid physical problems in psychiatric population found in our study. DOI: http://dx.doi.org/10.3126/jpan.v2i1.8571 J Psychiatrists’ Association of Nepal Vol .2, No.1, 2013 26-29

Perinatal Episodes Across the Mood Disorder Spectrum

CONTEXT Affective disorders are common in women, with many episodes having an onset in pregnancy or during the postpartum period. OBJECTIVE To investigate the occurrence and timing of perinatal mood episodes in women with bipolar I disorder, bipolar II disorder, and recurrent major depression (RMD). SETTING AND PATIENTS Women were recruited in our ongoing research on the genetic and nongenetic determinants of major affective disorders. Participants were interviewed and case notes were reviewed. Best-estimate diagnoses were made according to DSM-IV criteria. The 1785 parous women identified included 1212 women with bipolar disorder (980 with type I and 232 with type II) and 573 with RMD. Data were available on 3017 live births. MAIN OUTCOME MEASURES We report the lifetime occurrence of perinatal mood episodes, the rates of perinatal episodes per pregnancy/postpartum period, and the timing of the onset of episodes in relation to delivery. RESULTS More than two-thirds of all diagnostic groups reported at least 1 lifetime episode of illness during pregnancy or the postpartum period. Women with bipolar I disorder reported an approximately 50% risk of a perinatal major affective episode per pregnancy/postpartum period. Risks were lower in women with RMD or bipolar II disorder, at approximately 40% per pregnancy/postpartum period. Mood episodes were significantly more common in the postpartum period in bipolar I disorder and RMD. Most perinatal episodes occurred within the first postpartum month, with mania or psychosis having an earlier onset than depression. CONCLUSIONS Although episodes of postpartum mood disorder are more common in bipolar I disorder and manic and psychotic presentations occur earlier in the postpartum period, perinatal episodes are highly prevalent across the mood disorder spectrum.

Temperament and the spectrum of mood disorders

Temperament and the spectrum of mood disorders

Parametric Modulation of Neural Activity by Emotion in Youth With Bipolar Disorder, Youth With Severe Mood Dysregulation, and Healthy Volunteers

CONTEXT Youth with bipolar disorder (BD) and those with severe, nonepisodic irritability (severe mood dysregulation [SMD]) exhibit amygdala dysfunction during facial emotion processing. However, studies have not compared such patients with each other and with comparison individuals in neural responsiveness to subtle changes in facial emotion; the ability to process such changes is important for social cognition. To evaluate this, we used a novel, parametrically designed faces paradigm. OBJECTIVE To compare activation in the amygdala and across the brain in BD patients, SMD patients, and healthy volunteers (HVs). DESIGN Case-control study. SETTING Government research institute. PARTICIPANTS Fifty-seven youths (19 BD, 15 SMD, and 23 HVs). MAIN OUTCOME MEASURE Blood oxygenation level-dependent data. Neutral faces were morphed with angry and happy faces in 25% intervals; static facial stimuli appeared for 3000 milliseconds. Participants performed hostility or nonemotional facial feature (ie, nose width) ratings. The slope of blood oxygenation level-dependent activity was calculated across neutral-to-angry and neutral-to-happy facial stimuli. RESULTS In HVs, but not BD or SMD participants, there was a positive association between left amygdala activity and anger on the face. In the neutral-to-happy whole-brain analysis, BD and SMD participants modulated parietal, temporal, and medial-frontal areas differently from each other and from that in HVs; with increasing facial happiness, SMD patients demonstrated increased, and BD patients decreased, activity in the parietal, temporal, and frontal regions. CONCLUSIONS Youth with BD or SMD differ from HVs in modulation of amygdala activity in response to small changes in facial anger displays. In contrast, individuals with BD or SMD show distinct perturbations in regions mediating attention and face processing in association with changes in the emotional intensity of facial happiness displays. These findings demonstrate similarities and differences in the neural correlates of facial emotion processing in BD and SMD, suggesting that these distinct clinical presentations may reflect differing dysfunctions along a mood disorders spectrum.

Differential effects of fluoxetine and venlafaxine on memory recognition: Possible mechanisms of action

Serotonin-specific reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI) are antidepressant drugs commonly used to treat a wide spectrum of mood disorders (Wong and Licinio, 2001). Although they have been clinically used for more than 50 years, the molecular and cellular basis for the action of SSRIs and SNRIs is not clear. Considering that the changes in gene expression involved in the action of antidepressant drugs on memory have not been identified, in this study we investigated the impact of chronic treatment with a SSRI (fluoxetine) and a SNRI (venlafaxine) on the mRNA expression of genes related to memory cascade in the mouse hippocampus, namely, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), nitric oxide synthase 1 (NOS1), neurotrophic tyrosine kinase receptor type 2 (TrKB), mitogen-activated protein kinases (MAPK/ERK) and serotonin transporter (SERT). Animals treated with fluoxetine 10 mg/Kg/day for 28 days showed a significant decrease in the percentage of time spent in the novel object recognition test (p≤0.005) and induced MAPK1/ERK2 down-regulation (p=0.005). Our results suggest that the effect on cognition could probably be explained by fluoxetine interference in the MAPK/ERK memory pathway. In contrast, chronic treatment with venlafaxine did not reduce MAPK1/ERK2 expression, suggesting that MAPK1/ERK2 down-regulation is not a common effect of all antidepressant drugs. Further studies are needed to examine the effect of chronic fluoxetine treatment on the ERK-CREB system, and to determine whether there is a causal relationship between the disruption of the ERK-CREB system and the effect of this antidepressant on memory performance.

P01-475 - Psychiatry without borders

The socio-economic changes of recent decades with the massive migration flows from third world countries and Eastern Europe to the more industrialized nations, including Italy, has led to a need for a meeting point between different cultures and has placed psychiatrists and health services in the position of having to revise their organizational models.With this study we intend to analyze the mental health needs of non-CEE citizens in the context of a general hospital situation, and assess the impact of current laws.A revision, made in the period 2006/2010 in SPDC in Campi Salentina, of the admissions and consultancy carried in the Emergency Unit for non-patients was carried out. Patients were divided by geographical area of origin, date of immigration, personal data and clinical diagnoses. The data show an increase of users patients coming from European countries, non-CEE geopolitical areas and North Africa in the first three years.In the second two years, a reduction of admissions resulted because of a change in legislation. The clinical diagnosis showed a prevalence of clinical features of neurotic and adaptation of substance use for immigrants from Eastern Europe and pathology of the spectrum of mood disorders in patients from other continents. It is essential that the nature of the patient and their disease is considered in the context of socio-cultural dynamics to provide new knowledge, taking into account the size of collective psychopathology using a methodology that integrates the general cultural suffering from whatever country they come from.