All Articles

Wolfgang Wölwer^1*, Gerhard Buchkremer², Heinz Häfner³, Joachim Klosterkötter⁴, Wolfgang Maier⁵, Hans-Jürgen Möller⁶, Wolfgang Gaebel¹

¹Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, LVR Klinikum Düsseldorf, Germany

²Department of Psychiatry and Psychotherapy, University Tübingen, Germany

³Research Group Schizophrenia Research, Central Institute of Mental Health Mannheim, Germany

⁴Department of Psychiatry and Psychotherapy, University Cologne, Germany

⁵Department of Psychiatry and Psychotherapy, University Bonn, Germany

⁶Department of Psychiatry and Psychotherapy, University Munich, Germany

Background: The German Research Network on Schizophrenia (GRNS) was funded by the Federal Ministry of Education and Research (BMBF) from 1999 to 2011. The aim was to obtain a better horizontal and vertical networking of German research and care facilities on schizophrenia, in order to investigate open research questions, to transfer the results into clinical practice and after all to improve care and quality of life in patients with schizophrenia.

Objectives / Methods: This paper describes the concept and functioning of the GRNS as well as its results on the basis of selected research projects.

Results: The GRNS comprised about 25 clinical trials of high practical relevance, which were closely interrelated regarding content, methodology and organization. The trials primarily served the development and evaluation of new and established diagnostic and therapeutic approaches, the assessment of the status quo of clinical care as well as its improvement, together with the investigation of basic scientific questions. Many substantial results to highly relevant issues could be obtained, which led or will lead to an improvement in mental health care.

Conclusions: Quantitative and qualitative evaluation parameters such as scientific publications and raising of additional grants, as well as promotion of young scientists, public relations activities, congress activities and foundation of the European Scientific Association on Schizophrenia and other Psychoses (ESAS) prove the successful work of the network. The successful grant raising will allow continuing cooperative schizophrenia research in Germany as initiated by the GRNS.

Laleh Jamshidi^1*, Lies Declercq¹, John M. Ferron², Mariola Moeyaert³, S. Natasha Beretvas⁴, and Wim Van den Noortgate¹

¹Faculty of Psychology and Educational Sciences & imec-Itec, KU Leuven (University of Leuven), Belgium

²University of South Florida, Tampa, Florida, USA

³University at Albany – State University of New York, New York, USA

⁴University of Texas at Austin, Texas, USA

Single-case experimental design (SCED) studies are becoming more prevalent in a variety of different fields and are increasingly included in meta-analyses (MAs) and systematic reviews (SRs). As MA/SR’s conclusions are used as an evidence base for making decisions in practice and policy, the methodological quality and reporting standards of SRs/MAs are of uttermost importance. One way to improve the reliability and validity of SCED MAs and therefore to provide more confidence in MA/SR findings to practitioners and clinicians to decide on a particular intervention is the use of high-quality standards when conducting and reporting MAs/SRs. In the current study, some existing tools for assessing the quality of SRs/MAs that might also be helpful for SCED MAs will be reviewed briefly. These tools and guidelines can help meta-analysts, reviewers, and users to organize and evaluate the quality and reliability of the findings.

Verletta Saxon^1*, Dhrubodhi Mukherjee², Deborah Thomas³

¹Department of Children and Family Services, State of Illinois, Chicago, IL, United States

²Associate Professor, Department of Social Work, University of North Texas, Denton, TX, United States

³Crisis Manager, Centerstone of Illinois, Carterville, IL, United States

Shifting resources and funding from institutionalized care for those with mental illness to community-based care has shown promise for behavioral health parity in health crisis circumstances and yet, it has been underfunded. One of the unfortunate trends of deinstitutionalization of behavioral health services in general has been a persistent gap in emergency crisis services. This gap in services leaves those in a behavioral health crisis to receive treatment in the Hospital Emergency Departments culminating in an astounding increase in overall healthcare expenditures. Providing behavioral health crisis assessment and treatment in busy emergency departments that produce long waits for care can be a challenging environment for those in need of immediate treatment for psychological needs. Crisis Stabilization Centers are effective at providing suicide prevention services, addressing behavioral health treatment, diverting individuals from entering a higher level of care and addressing the distress experienced by individuals in a behavioral health crisis. Studies also show that the cost of Crisis Stabilization Centers is significantly less than psychiatric inpatient units and satisfaction among clients is greater. Expanding the options for Behavioral Health Crisis Care from community-based behavioral health out-patient care and inpatient care to various community alternatives, benefits individuals in crisis as well as the community. This article provides an overview of community alternatives to psychiatric hospitalization, financial barriers to care and future research.

Rüdiger Hardeland*

University of Goettingen, Johann Friedrich Blumenbach Institute of Zoology and Anthropology, Goettingen, Germany

In the traditional view of mood disorders, the circadian system has been insufficiently considered. However, polymorphisms of circadian oscillator genes in bipolar disorder, seasonal affective disorder, and subforms of major depressive disorder as well as demonstrable deviations in overt circadian rhythms indicate a role of the circadian system in these pathologies. Circadian malfunction affects sleep, and sleep deprivation can initiate proinflammatory responses. Being parts of the circadian system, melatonin and sirtuin 1 deserve particular attention. Either of them displays neuroprotective, anti-inflammatory, and circadian amplitude-enhancing properties, which are of relevance to neurodegeneration that is observed in a number of depressive patients. Notably, both circulating melatonin levels as well as sirtuin 1 expression decline by age. In the gerontological context, melatonin upregulates sirtuin 1, which mediates some of melatonin’s actions. Correction of a deviating circadian system seems to be of value regarding causes that contribute to depressive symptoms.

Gadi Lissak*

Meuhedet Health Services, Jerusalem, Israel

Moira J van Staaden^1,2*, F Scott Hall^1,3 and Robert Huber^1,2

¹Juvatech creative behavioral designs, Maumee, OH 43537, USA

²JP Scott Center for Neuroscience, Mind & Behavior, Department of Biological Sciences, Bowling Green State University, Bowling Green, OH 43403, USA

³Department of Pharmacology and Experimental Therapeutics, University of Toledo, Toledo, OH 43606, USA

Addiction is now recognized as a phenomenon with exceedingly deep evolutionary roots. Addictive plant alkaloids, as secondary metabolites, evolved primarily to counter insect herbivory. Although some views regard addiction as a human/mammal specific, cognitive phenomenon, we suggest that its roots are found in much more fundamental biological mechanisms for learning and motivation, mechanisms which are shared by taxa since the early evolution of bilateral metazoans. According to this view, addiction is fundamentally an invertebrate phenomenon and humans can be viewed as collateral damage in this coevolutionary arms race. Results from a variety of invertebrate preparations demonstrate behavioral and neural consequences of drug exposure, ranging from psychostimulant properties and sensitization, to conditioned cue learning and operant self-administration. This mini review focuses attention on our recent work in crayfish, but there is certainly evidence for the presence of addictionlike phenomena in more ancient invertebrate taxa.

L. Hertzberg^1,2*, E. Domany¹

¹Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot, Israel

²The Emotion-Cognition Research Center, Shalvata Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

The number of Genome Wide Association Studies (GWAS) of schizophrenia, as well as that of subjects studied have increased dramatically over the last years. Nevertheless, biologically meaningful interpretation of GWAS results remains very difficult due to the complexity and heterogeneity of both clinical and genetic aspects of schizophrenia, and the small contribution of each single gene to the disease. Our study presented a methodology that integrated GWAS results with gene expression data, and applied it to schizophrenia. Integration of two types of information, of both DNA-level and of messenger RNA (mRNA) level, increases the validity and reliability of the results and improves our understanding of the biological meaning of the GWAS results. We comment here on the methodology used and the main result of our study.

Qianlan Yin^#, Zhuoer Sun^#, Weizhi Liu*

Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China

“Shidu Parents” (SDP) means parents whose only child has passed away or is disabled to perform the basic social function and daily living activities due to an accident or other events. These parents cannot conceive or adopt another child. Bereavement is a great grief and threat to mental and physical states evidenced by many studies, but SDP are a new and increasing subgroup emerging in this field, especially in China. The goal of this paper is to review the research literature regarding mental and physical health consequences of SDP and the intertwined influence, thus to add to the corresponding assistance from the government.

Deborah R. Gordon^1*, Patricia Benner¹, Jodi Halpern², Catherine Long Popell³, and Patricia W. Kelley⁴

¹University of California, San Francisco, CA, USA

²University of California, Berkeley, CA, USA

³Services for Brain Injury, San Jose, CA, USA

⁴Duquesne University, Pittsburgh, PA, USA

Hermeneutic phenomenology provides an alternative to objectifying approaches to understanding Post-Traumatic Stress Disorder (PTSD). PTSD is the one major psychiatric diagnosis where social causation is established, yet PTSD is predominantly viewed in terms of the usual neuro-physiological causal models, with traumatic social events viewed as pathogens with dose-related effects. However, framing PTSD as an objective disease state separates it from the narrative historical details of the trauma. Personal stories and cultural meanings of the traumatic events are seen as epiphenomenal, unrelated to the understanding of, and ultimately, the therapeutic treatment of PTSD. Sixty-seven US service members injured in the Iraq and Afghanistan wars who were in the rehabilitation phase of their recovery, and 401 nurses who provided care for service members, were interviewed. Most wounded service members described classic symptoms of PTSD: flashbacks, insomnia, hyperarousal, etc. All experienced disturbance in their sense of place and time: distortions and ruptures between “here” and “there,” “then” and “now.” Effective nursing care required being attuned to where a patient is “at” phenomenologically. Rather than see the occurrence of these symptoms as decontextualized mechanistic reverberations of war, we consider how these symptoms meaningfully reflect actual war experiences and the sense of displacement experienced by service members.

Merlin G. Butler*

Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA

Judith Edwards*

*Tavistock Clinic NHS Trust, London, United Kingdom

Lucas Fortaleza de Aquino Ferreira

Hospital de Saúde Mental Professor Frota Pinto, Fortaleza, Brazil

Gareth Nortje ^1* , Absol Uteshit ²

^*1 University of South Dakota, Nelspruit, South Africa

² University of the Sciences, Phalaborwa, South Africa

Many statisticians would agree that, had it not been for hierarchical cognitive therapies in conversational dynamics, the emulation of cognitive reflection might never have occurred. After years of important research into virtual conversations, we verify the study of mood-state-dependent verbal influences, which embodies the theoretical principles of cognitive analytic psychotherapy. In order to answer this riddle, we confirm that even though randomized conversational smalltalk can be made perfect, embedded, and replicated, the effective on mood is no longer questionable¹.

Won-Gyo Shin¹, Tae Young Lee^2*, Jun Soo Kwon^1,2

¹ Department of Brain & Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea

^*2 Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea

Rogers Kasirye^1*, Rogers Mutaawe^2*

¹Executive Director, Uganda Youth Development Link, Kampala Uganda

²Senior Programme Manager, Uganda Youth Development Link, Kampala Uganda

The goal of this descriptive study was to examine the relationship between sexual risky behaviors and substance abuse among street and slum youth of Kampala. The study was conducted among youths seeking services for the first time from Drop In center facilities run by Uganda Youth Development Link, located in Kampala City. While several studies have examined risks for substance abuse and sexual risky behaviors among children and adolescents in Uganda, none have identified protective factors among this sub population including street children in Kampala. This study conducted baseline interviews of street children enrolling in a youth intervention program in Kampala City, Uganda. A total of 203 youth between the ages of 14 and 24 were interviewed about their consumption of alcohol, tobacco and other forms of drug use; and sexual risky behaviors. The study results Preliminary results reveal high prevalence of alcohol and other substance use coupled with early sexual risk involvement (e.g. sex without condoms).

M. Kathryn Jedrziewski^1,2,3*, Dara Meekins¹, Samuel A. Gorka¹, Mariegold E. Wollam⁵, Mihloti Williams^4,5, George A. Grove⁵, Charles Lwanga^4,5, Chelsea M. Stillman^4,6, and Kirk I. Erickson^4,5

¹The Institute on Aging, Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania

²Alzheimer’s Disease Core Center, Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania

³Department of Pathology, Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania

⁴Center for the Neural Basis of Cognition, School of Medicine, University of Pittsburgh

⁵Department of Psychology, School of Medicine, University of Pittsburgh

⁶Department of Psychiatry, School of Medicine, University of Pittsburgh

Vicente Mustieles¹, Carmen Messerlian², Iris Reina¹, Andrea Rodríguez-Carrillo¹, Nicolás Olea¹, and Mariana F. Fernández¹*

^*1University of Granada, Center for Biomedical Research (CIBM); Biosanitary Research Institute of Granada (ibs.GRANADA), Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Spain.

²Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

In 2015 we reviewed the state of knowledge regarding the potential impact of bisphenol A (BPA) exposure on child neurobehavior. At that time, we expressed concern about the effects of BPA on children’s behavior, especially when exposure takes place in utero. Since then, the number of human studies addressing the BPA-neurobehavior hypothesis has doubled, most of them reinforcing previous prenatal associations and frequently showing differences between boys and girls. An increasing number of studies have also shown an association between postnatal BPA exposure and diverse neurobehavioral impairments, including attention-deficit and hyperactivity disorder (ADHD). It may never be possible to establish a causal link between this specific endocrine disruptor and a particular neurobehavioral endpoint; however, research data on the relationship between human BPA exposure and children’s behavior has revealed a relatively consistent pattern that cannot be ignored. The mounting experimental and epidemiologic evidence on neurobehavioral effects support more than ever the need to apply the precautionary principle during development, especially in relation to pregnant women and children. It seems that the time to act has arrived.

Nuwan Dissanayaka¹*

^*1Leeds and York Partnership NHS Foundations Trust, Leeds LS15 8ZB, UK.

Leo Wolmer^1,2*, Daniel Hamiel^1,3, Lee Pardo-Aviv¹, and Nathaniel Laor^1,4,5

¹ Donald J. Cohen & Irving B. Harris Resilience Center, Association for Children at Risk, Israel

² Baruch Ivcher School of Psychology, Herzlyia Interdisciplinary Center, Israel

³ Tel-Aviv-Brüll Community Mental Health Center, Clalit Health Services

⁴ Departments of Psychiatry and Medical Education, Sackler Faculty of Medicine, Tel-Aviv University, Israel

⁵ Child Study Center, Yale University, New Haven, CT

Preschool children are exposed to an increasingly wide variety of disasters and terrorist incidents that may have severe effects on their mental health and development. The goal of this paper is to review the research literature regarding the needs of preschoolers in the context of disasters and terrorism with the aim of understanding: a) the consequences of such events for young children and the main moderating variables influencing the event-consequence association. b) the existing methods for assessment, prevention and intervention to provide recommendations and point out required research and development. We differentiate between screening tools that provide initial evaluation and assessment tools for diagnosing preschooler children's’ pathology and review possible interventions that address the preschool child's needs before, during and after the incident itself. We discuss the challenges in performing research following disaster and terrorism and the lack of dissemination and research of prevention programs and mass interventions for preschoolers. Finally, we emphasize the need for research and intervention programs aimed at dealing with the impact of terrorism and armed conflict on children's worldview.

Keron D Fletcher*

Shrewsbury, Shropshire SY2 5EE, UK

Karen L. Houseknecht^1,2*, C.C. Bouchard¹, C.A Black²

¹College of Osteopathic Medicine, University of New England, 11 Hills Beach Road, Biddeford, ME 04005, USA
²College of Pharmacy, University of New England, 716 Stevens Avenue, Portland, Maine 04013, USA

Mood spectrum disorders and medications used to treat these disorders, such as atypical antipsychotic drugs (AA), are associated with metabolic and endocrine side effects including obesity, dyslipidemia, hyperglycemia and increased risk of fractures. Antidepressant medications, including selective serotonin reuptake inhibitors (SSRI), have also been reported to increase fracture risk in some patients. The pharmacology underlying the increased risk of fractures is currently unknown. Possible mechanisms include alternations in dopaminergic and/or serotonergic signaling pathways. As these medications distribute to the bone marrow as well as to the brain, it is possible that drug-induced fractures are due to both centrally mediated effects as well as direct effects on bone turnover. Given the growing patient population that is prescribed these medications for both on- and off-label indications, understanding the level of risk and the mechanisms underlying drug-induced fractures is important for informing both prescribing and patient monitoring practices.

Pamela Rosenthal Rollins*

University of Texas at Dallas, Callier Center for Communication Disorders, 1966 Inwood Road, Dallas, USA

Early identification and intervention that focus on the core social deficits of children with autism spectrum disorder (ASD) are imperative for these children to be able to reach their optimal potential. This report examines the Pathways Early Autism Intervention (Pathways), a translational parent-mediated, naturalistic developmental behavioral intervention (NDBI) for toddlers with ASD. Pathways fits the service delivery model and principles of Texas’ state-funded Early Childhood Intervention (ECI) programs. Pathways was found to be more effective than traditional ECI programs in improving early foundational social communication skills and in reducing parental stress in culturally and economically diverse toddlers with ASD. Pathways shows promise as an effective ASD specific intervention with the potential of being implemented within publicly funded ECI programs.

Maria Pia Bucci^1*, Nathalie Goulème^1,2, Coline Stordeur³, Eric Acquaviva³, Mathilde Septier³, Aline Lefebvre³, Hugo Peyre^3,4,5, Richard Delorme^3,4,5

¹UMR 1141 Inserm - Paris Diderot University. Robert Debré Hospital, Paris, France
²Lyon Neuroscience Research Center (Inserm U1028 CNRS UMR5292), Lyon, France & Department of Audiology and Otoneurological Evaluation, Civil Hospitals of Lyon, Lyon, France
³Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
⁴Paris Diderot University, Paris 7, France
⁵High Functioning Autism Expert Centre, Fondamental Foundation, Paris, France

We summarize postural instabilities in children with autistic spectrum disorder (ASD) and in children with attention deficit hyperactivity disorder (ADHD), and we reported behavioral results suggesting poor cerebellar integration. We conclude that postural measures could be a promising method with which to indirectly observe cerebellar performance in children developmental disabilities such as ASD and/or ADHD.

Peter A. Lichtenberg

Institute of Gerontology & Merrill Palmer Skillman Institute, Wayne State University, USA