Psychiatric diseases and their treatment in general practice in Germany. Results of a World Health Organization (WHO) study

As part of an international study initiated by the World Health Organization (WHO) about psychological disorders in primary health care, patients in the Federal Republic of Germany were compared with patients in other European centres. Patients from Germany do not differ from other European patients in respect to sociodemographic variables or psychiatric disorders. The most frequent CIDI-based diagnoses recorded in patients attending general practices are current depressive episodes (8.6%), generalized anxiety disorders (8.5%), neurasthenia (7.5%), and alcohol dependence (6.3%). In 20.9% of the patients at least one psychiatric diagnosis based on ICD-10 was recorded. In Germany significantly lower global ratings of health status are given than in other European centres although there is no difference in diagnostic prevalence rates. The recognition rate, i.e. the agreement between the CIDI-based ICD-10 diagnoses and the recognition as a case by the physician, is 56.2%-60.2%. On the other hand, the CIDI detects 90% of the patients described as psychologically ill by the physicians if subthreshold cases are also counted, or 46.4% if only defined diagnoses are taken into account. There is a significant correlation between severity of the psychiatric disorder and disability in social functioning. In Mainz and in the other European countries the disability rate of patients with a well-defined disorder is between 67.0% and 72.7%, whereas in Berlin this relation is not as clear, because especially in East Berlin there is a higher rate of unemployment in view of the political situation. Drug treatment is prescribed for 16.1% of the patients in primary care for psychiatric disorders. Half the patients recognized by physicians as cases receive medication. In the rest of Europe patients receive significantly more tranquillizers than in Germany, where the use of herbal drugs is more wide spread.     

Psychopathy and alexithymia in female offenders.

Determined the comorbidity of psychopathy and alexithymia in 37 female inmates of a medium-security prison. The authors also investigated the association between psychopathy and alexithymia with the use of affective language in response to questions about an emotional event, and with their propensity for violence. The extent of psychopathy and alexithymia were assessed with the Hare Psychopathy Checklist—Revised (PCL-R) and the Toronto Alexithymia Scale (TAS), respectively. Using standard cutoff scores, 30% were identified as psychopaths, and 32% as alexithymics. Three Ss were both psychopaths and alexithymics. The correlation between PCL-R and TAS total scores was not significant, but the socially deviant impulsive factor of the PCL-R significantly correlated with the TAS items that reflect inability to discriminate feelings and bodily sensations. Alexithymia, but not psychopathy, was negatively related to measures of affective speech content. Both psychopathy and alexithymia were associated with a history of violence. In spite of several manifest similarities, psychopathy and alexithymia appear to be different clinical constructs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visual, cognitive, and neurodevelopmental outcome at 51/2 years in children with perinatal haemorrhagic-ischaemic brain lesions

To determine predictive values of early visual and neurocognitive assessment in children with perinatally acquired haemorrhagic or ischaemic brain lesions selected on the basis of ultrasound, 63 children (37 boys, 26 girls), who had been followed and examined until the age of 18 months, were reexamined at 5 1/2 years. Good correlations between visual and neurodevelopmental assessments at 18 months and at 5 1/2 years were found. When ultrasound abnormalities were combined with early visual and neurocognitive assessment data, good predictive values, especially for the group of children who had grade 2 to 4 leukomalacia, were found for visual acuity and neurodevelopment.     

Synaptically evoked glutamate transport currents may be used to detect the expression of long-term potentiation in cerebellar culture

Cerebellar long-term potentiation (LTP) is a use-dependent increase in the strength of the granule cell-Purkinje neuron synapse that occurs after brief stimulation of granule cell axons at 2-8 Hz. Previous work has shown that cerebellar LTP also may be seen when synaptic currents are evoked in granule cell-glial cell pairs in culture. This finding suggests a model in which cerebellar LTP is expressed presynaptically and therefore may be detected by either neuronal or glial postsynaptic cells. However, synaptic currents evoked in both granule cell-glial cell pairs and granule cell-Purkinje neuron pairs in culture are mediated primarily by alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)/kainate receptors, raising the possibility that cerebellar LTP might be expressed postsynaptically in both glial cells and Purkinje neurons in a similar manner. To address this question, glutamate transport currents were recorded in granule cell-glial cell pairs in culture by pharmacological isolation. These currents were increased by substitution of internal Cl with NO3 and were blocked by -pyrrolidine-2,4-dicarboxylate, both characteristics of the major cloned Bergmann glial cell glutamate transporter, EAAT1. After acquisition of baseline responses, LTP of isolated transport current was evoked by stimulation at 4 Hz (100 pulses) and could be blocked by removal of external Ca during this stimulation. The expression of LTP was associated with a decrease in the rate of synaptic failures and a decrease in the degree of paired-pulse facilitation. These findings, when taken together with the previous observation that both Purkinje neuron and glial AMPA/kainate responses can be used to detect cerebellar LTP, strongly suggest that the expression of cerebellar LTP is, at least in part, presynaptic. This strategy should also be useful in illuminating the locus of expression of other model systems of information storage such as hippocampal LTP/long-term depression.     

A painful inflammation of the thyroid

Four women aged 30, 29, 52 and 43 years presented with what appeared to be subacute thyroiditis (De Quervain's thyroiditis). This disease is characterized by fatigue, a painful thyroid gland and thyrotoxic manifestations. The diagnosis is further based on a high erythrocyte sedimentation rate and low tracer uptake during thyroid scintigraphy. Only the first patient showed a typical course. In the second and third ones the painful thyroid was associated with nodular enlargement. Fine needle aspiration cytology was at first consistent with subacute thyroiditis but a repeated aspiration showed papillary carcinoma in the second and anaplastic carcinoma in the third patient. In the fourth one, subacute thyroiditis was accompanied by normochromic anaemia, a low serum albumin concentration and liver function disorders. She made a full recovery without treatment. Thyroid malignancies can mimic subacute thyroiditis. Persistent nodular enlargement of the thyroid is suspicious and requires careful investigation.     

Plasma-derived proteins in airway defence, disease and repair of epithelial injury

One significant characteristic of the airway mucosa in vivo, that cannot easily be mimicked in vitro, is its microcirculation, which generates a highly dynamic, biologically active milieu of plasma-derived molecules that may pass to the airway lumen in vivo. New data on the mechanisms of airway mucosal exudation indicate that the protein systems of circulating plasma may contribute significantly to the biology and immunology of the lamina propria, its surface epithelium and the luminal surface, not only in injured airways, but also in airways that are activated but display no sign of oedema, epithelial disruption, or increased absorption capacity. We suggest that present knowledge of the mechanisms of plasma exudation, together with rapidly emerging information (not detailed herein) on receptors, target cells and cellular responses to the plasma-derived molecules, must be considered in any realistic model that investigates "immuno-inflammatory" mechanisms of the airway mucosa.     

The Koala component model for consumer electronics software

Most consumer electronics today contain embedded software. In the early days, developing CE software presented relatively minor challenges, but in the past several years three significant problems have arisen: size and complexity of the software in individual products; the increasing diversity of products and their software; and the need for decreased development time. The question of handling diversity and complexity in embedded software at an increasing production speed becomes an urgent one. The authors present their belief that the answer lies not in hiring more software engineers. They are not readily available, and even if they were, experience shows that larger projects induce larger lead times and often result in greater complexity. Instead, they believe that the answer lies in the use and reuse of software components that work within an explicit software architecture. The Koala model, a component-oriented approach detailed in this article, is their way of handling the diversity of software in consumer electronics. Used for embedded software in TV sets, it allows late binding of reusable components with no additional overhead     

Influence of Emotion on Memory for Temporal Information.

Contextual information, such as color and spatial location, has been found to be better remembered for emotional than for neutral items. The current study examined whether the influence of emotion extends to memory for another fundamental feature of episodic memory: temporal information. Results from a list-discrimination paradigm showed that (a) item memory was enhanced for both negative and positive pictures compared with neutral ones and was better for negative than for positive pictures and (b) temporal information was better remembered for negative than for positive and neutral pictures, whereas positive and neutral pictures did not differ from each other. These findings are discussed in relation to the processes involved in memory for temporal information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The smile of Asia: Acculturation effects on symptom reporting.

Compared Canadian Asian with Caucasian university students (N?=?292) on symptom reporting and response styles and evaluated acculturation effects on symptom reporting and response styles among the Asian Ss. Asian Ss were subdivided into low, medium, or high levels of acculturation. Measures comprised psychological and somatic symptom report scales, behavioral affect expression, and scales tapping self-deception and impression management as response styles. Asian Ss reported more cognitive anxiety than Caucasian Ss, but did not differ in frequency of somatic symptom reports or in preferred response styles, although a linear acculturation effect was noted on behavioral affect expression. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)