Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique that have increasingly being used for the non-invasive evaluation of brain white matter (WM) abnormalities.Several studies suggest that the normal integration of cerebral function may be compromised in schizophrenia. Abnormalities in WM tracts may be directly relevant for the neuropathology of schizophrenia

The purpose of this review was to discuss recent DTI findings in schizophrenia and a methodologic analysis.

The literature search was performed with the search engine PubMed of the U.S. National Library of Medicine.Search strategy used was based on the Cochrane review technique, limited to the period between 1998 (first report on DTI and schizophrenia) and October 2011. And limited to ‘Title/Abstract’..The reference lists of these studies were used to identify additional studies.

There is a striking amount of heterogeneity in findings, probably by methodologic problems.Brain regions such as the cingulate bundle,corpus callosum, and regions within frontal and temporal WM have a proportionally larger number of positive findings across the studies.In addition,WM tracts as The superior longitudinal fasciculus, fronto-occipital longitudinal fasciculi, uncinate fasciculi,frontal longitudinal fasciculus and the arcuate fasciculus have also positive findings in patients with schizophrenia. Other brain structures as the cerebellar peduncles,the fornix,the hippocampus and parahippocampal gyrus, the thalamic and optic radiations have been evaluated and shown positive findings. However, these findings are not present in all studies.DTI abnormalities in first-episode patients are less robust than in chronic patients.

Recent DTI findings seem to support the hypothesis of structural dysconnectivity in schizophrenia.

Contemporary cognitive models emphasize the importance of certain dysfunctional beliefs in the development and maintenance of Obsessive-Compulsive Disorder (OCD): overimportance of thoughts, need to control thoughts, perfectionism, intolerance of uncertainty, inflated responsibility, and overestimation of threat. Although a recent twin study suggests that these dysfunctional beliefs are significantly heritable, there have been no previous attempts to analyze candidate genes associated with them.

Our study aimed to investigate the possible association between OC-related dysfunctional beliefs and variants of two functional polymorphisms of the COMT (Val158Met) and BDNF (Val66Met) genes in 141 OCD patients.

The non-synonymous mutation Val158Met (rs4680) in the COMT gene and the Val66Met functional variant (rs6265) in the BDNF gene were genotyped with the KASPar assay system. The validated Spanish short version of the Obsessive Beliefs Questionnaire, (OBQ-44), was used to assess dysfunctional beliefs. Multivariate analysis of covariance (MANCOVA) and a post hoc one-way analysis of covariance (ANCOVA) were perfomed.

Variability in dysfunctional beliefs was not affected by the COMT or BDNF genotype when examining the two genes in isolation, but we detected a significant COMT x BDNF interaction effect on responsibility and overestimation of threat scores. These cognitive distortions were significantly higher among OCD subjects with the BDNF Met-present genotype who were also carriers of the COMT Val/Met and Met/Met genotypes.

Our data suggest that an interaction between dopaminergic and neurotrophic functional gene variants influences some of the dysfunctional belief domains hypothesized to contribute to the etiology of OCD.

Primary focal dystonia (PFD) is an idiopathic movement disorder that manifests as involuntary, sustained muscle contractions, leading to abnormal postures. Its pathophysiology probably involves a functional disorder of the basal ganglia and their frontal cortical connections. The hypothetical association with obsessive-compulsive disorder (OCD) has raised particular interest, as both disorders seem to involve frontal cortical-basal dysfunction. Anyway, evidence supporting this association is scarce and contradictory.

To address the next two questions: (1) Do primary dystonia patients have high obsessive-compulsive symptom scores? (2) Are these symptoms more severe in dystonia than in controls with equivalent peripheral neurological disorders?

We’ve conducted a cross-sectional, descriptive, controlled study comprising 45 consecutive patients with PFD (i.e., blepharospasm, spasmodic torticollis, or writer's cramp), 46 consecutive patients with hemifacial spasm, cervical spondylarthropathy, or carpal tunnel syndrome, and 30 healthy volunteers. Assessment included the DSM-IV based psychiatric interview, Symptom Check- list 90R, Yale-Brown Obsessive-Compulsive Scale and Checklist, and the Unified Dystonia Rating Scale.

Dystonia patients had higher Yale-Brown scores than both control groups. Major depression and generalized anxiety disorder were the most frequent psychiatric diagnoses in PFD. Obsessive-compulsive disorder frequency was 6.7%. PFD patients have higher obsessive-compulsive symptom scores than individuals with similar functional disabilities resulting from other neurological disorders, suggesting that obsessive-compulsive symptoms in dystonia are not reactive to chronic disability.

Dystonic muscle contractions and obsessive-compulsive symptoms may share a common neurobiological basis related to cortical-basal dysfunction. Psychopathology, especially obsessive-compulsive symptoms, should be actively explored and treated in primary focal dystonia.

The duration of untreated illness (DUI), defined as the interval between the onset of a disorder and the first adequate treatment, has been increasingly investigated as a predictor of outcome in psychotic disorders. However, few data are available on the impact of DUI on the outcome of the obsessive-compulsive disorder.

This study aimed at investigating: 1) patients'socio-demographic and clinical characteristics which influence duration of untreated illness in OCD; 2) the effect of duration of untreated illness on outcome.

Eighty-three outpatients fulfilling DSM-IV criteria for OCD were recruited and prospectively followed up for 3 years. Baseline information, demographic and clinical characteristics, were collected by standardized instruments. Obsessive-compulsive symptoms were assessed using Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Fifty-nine patients completed the follow-up.

Recruited patients were predominantly male (52%), with a mean age of 31.5 (SD = 10.2) years, 11.2 (SD = 3.9) years spent in general education. Fifty-two per cent of them were married and 50.6% were employed. The mean DUI was 7.3 (SD = 5.8) years. Patients with a DUI > 2 years had a later onset of OCD, a familiarity for affective disorders, and showed an higher frequency of aggressive obsessions. At completion of the follow-up, these patients showed a worse clinical outcome and more frequently did not achieve remission.

DUI has a considerable impact on outcome of obsessive-compulsive disorder. Being DUI a modifiable prognostic factor, programs aimed to early detection and treatment of OCD could substantially reduce personal, social and economical burden related to this disorder.

In OCD serotonin is considered as key neurotransmitter. However role of dopamine is not well understood. Dopamine antagonists are used as adjunct medicine in resistant type of OCD. Serotonin dampens feelings of over self consciousness in OCD. In diseases with high dopamine levels patients jettison self consciousness to enter into state of ecstasy. Enhanced dopaminergic activity can possibly alleviate painful feelings of over self consciousness in OCD.

An electronic search was made to find out role of dopamine in OCD at various database website including medscape, and psychiatrist, com.

Search only revealed results of use of antidopaminergic drugs in OCD. Dopamine agonists have not been tried in treatment of OCD.

Increased dopamine levels tend to abate rigid conscious control of behavior. There are reports of increased incidences of impulse disorder in PD patients, using dopamine agonist. In BAD dopamine over activity make actions too spontaneous. In addiction dopamine action in NA produces euphoric feelings during which conscious control is minimized. Orgasm is highly euphoric phenomenon during which one feels like melting and loosing self-consciousness is mediated by dopamine. Thus pharmacological effects of dopamine inhere property of diminishing over self consciousness a hallmark of OCD. Low doses of antipsychotic have rather facilitatory effect on neurotransmission. Hence adding dopamine agonist to SSRI resistant OCD patient can have favorable effect. Drugs like bromocriptine or lasuride may be used in such patients.

Adjunct use of dopaminergic drug can be beneficial in treatment of OCD.

Cognitive and Behavioral Therapy (CBT) is recognized as a valid tool to improve Obsessive Compulsive Disorder (OCD) symptoms. The orbitofrontal cortex (OFC)-striatal circuit appears to play an important role in the pathophysiology of OCD. Neuroimaging studies suggest that CBT might change its abnormal activity in OCD patients.

The aim of this study is to use longitudinal functional Magnetic Resonance Imaging (fMRI) to assess the neural correlates of clinical improvement in OCD patients undergoing CBT.

Thirty-five OCD patients with checking compulsions undergoing 15 individual weekly CBT sessions were assessed on symptom severity with the Y-BOCS [1] at four stages of the therapies: before, during, at the end of therapy and six months later. On each assessment, patients also performed a symptom-provocation task in fMRI during which they reported their anxiety level upon watching neutral photographs, generic (validated in a population of OCD checkers) vs individualized (patient's photographs of personal objects) checking-provoking photographs.

Clinically, CBT resulted in a significant improvement (Y-BOCS scores: 24.8; 18,3; 13,7; 13.9). Behaviorally, the symptom-provocation task elicited anxiety that decreased through therapy (p < 0.05), even more so for individualized vs generic pictures (interaction p < 0.05). At the brain level, individualized pictures elicited activation in a distributed network specifically in right and left OFC, where neural response decreased during and after CBT, underlining the interest of tailoring individualized symptom-provoking items on the path to neuromarkers of response to psychotherapy.

The Maudsley Obsessional-Compulsive Inventory (MOCI; Hodgson & Rachman, 1977) continues to be a widely used self-report measure of obsessive-compulsive symptoms. It has been translated into at least seven languages and the respective validations have resulted in good psychometric characteristics. It has not been validated to the Portuguese population yet.

To investigate the psychometric properties and factorial structure of the MOCI Portuguese version.

The process of translation/re-translation followed the required steps. The MOCI was administered to a community sample of 217 first year university students (178 girls; 82.0%). The mean age was 18.50 (± 2.345: range: 17–35). To study the temporal stability 166 (135 girls; 81.3%) respondents answered the questionnaires again after approximately six weeks.

The MOCI Cronbach's a was good (.79). The test-retest coefficient for the total score was high (.79; p < .001). An inspection of the Cattel's Scree plot and also of the item's content led us to select a three factors structure, which explained variance was of 29.17%: Factor (F) 1 “Doubting and Rumination” (VE = 15.43%; a = .72); F2 “Checking” (VE = 7.65%; a = .66) and F3 “Cleaning” (VE = 6.08%; a = .63). Temporal stability of F1, F2 and F3 were high: .67, .65 and .73 (all p < .001), respectively. Pearson correlations between factors were moderate and significant (≥.30).

The MOCI Portuguese version has good psychometric properties and its factorial structure is in accordance with those reported by other groups. It could be very useful to clinical and epidemiological purposes, as well as to transcultural studies.

To assess the prevalence of obsessive compulsive symptoms OCS among adolescents, the prevalence of OCD among adolescents and as a secondary aim to assess perception of parents' rearing style among adolescents with OCS and OCD.

Consent from the Directory of Ministry of Education and another consent from the General authority of Population for the questionnaire and procedures were taken. The study is a cross sectional carried on 1299 secondary school students, the sample size was chosen based on an estimated OCD prevalence of 2% in literature. Equal samples were recruited from the 3 educative zones in Alexandria Governorate. Obsessive compulsive symptoms were assessed by the Arabic version of Lyeton obsessive inventory child version LOI-CV. Students scoring above 35 were subjected to the Mini International Neuropsychiatric Interview for children MINI-KID Arabic version to assess psychiatric comorbidities. OCD patient students detected by MINI-KID were assessed by psychiatric interview to confirm fulfilling criteria of OCD according to DSM IV -TR criteria.Perception of parents’rearing style was assessed using the Egna Minnen Uppfostren (EMBU) Arabic version.

The prevalence of obsessive compulsive symptoms was 15.5%, while that of obsessive compulsive disorder was 2.2%.As for EMBU scale, score of warmth, rejection and control subscales were 16.03 ± 4.72, 23.1 ± 5.39 and 10.31 ± 1.69 for OCD group compared to 19 ± 2.44, 23.07 ± 4.68 and 9.9 ± 1.35 for OCS group respectively. Only difference for warmth subscale was significant p < 0.002.

To assess the prevalence of obsessive compulsive symptoms OCS among adolescents, the prevalence of OCD among adolescents and as a secondary aim to assess perception of social support components among adolescents with OCS and OCD.

Consent from the Directory of Ministry of Education and another consent from the General authority of Population for the questionnaire and procedures were taken. The study is a cross sectional carried on 1299 secondary school students, the sample size was chosen based on an estimated OCD prevalence of 2% in literature. Equal samples were recruited from the 3 educative zones in Alexandria Governorate. Obsessive compulsive symptoms were assessed by the Arabic version of Lyeton obsessive inventory child version LOI-CV. Students scoring above 35 were subjected to the Mini International Neuropsychiatric Interview for children MINI-KID Arabic version to assess psychiatric comorbidities. OCD patient students detected by MINI-KID were assessed by psychiatric interview to confirm fulfilling criteria of OCD according to DSM IV -TR criteria.Perception of social support was assessed using the the Provision and Social Relation PSR scale Arabic version.

The prevalence of obsessive compulsive symptoms was 15.5%, while that of obsessive compulsive disorder was 2.2%. As for PSR scale, score of friends and family subscales were 10.72 ± 3.53 and 16.83 ± 3.5 for OCD group compared to 12.87 ± 3.04 and 18.62 ± 3.1 for OCS group respectively. Difference for both subscales were significant at p < 0.001 for friends subscale and at p < 0.002 for family subscale

To assess the prevalence of obsessive compulsive symptoms OCS among adolescents, the prevalence of OCD among adolescents and as a secondary aim to assess recurrent tonsillitis among adolescents with OCS and OCD.

Consent from the Directory of Ministry of Education and another consent from the General authority of Population for the questionnaire and procedures were taken. The study is a cross sectional carried on 1299 secondary school students, the sample size was chosen based on an estimated OCD prevalence of 2% in literature. Equal samples were recruited from the 3 educative zones in Alexandria Governorate. Obsessive compulsive symptoms were assessed by the Arabic version of Lyeton obsessive inventory child version LOI-CV. Students scoring above 35 were subjected to the Mini International Neuropsychiatric Interview for children MINI-KID Arabic version to assess psychiatric comorbidities. OCD patient students detected by MINI-KID were assessed by psychiatric interview to confirm fulfilling criteria of OCD according to DSM IV -TR criteria.Recurrent tonsillitis was assessed by a standardized questionnaire for parents to assess if no recurrent tonsillitis or if there's recurrent tonsillitis including those who had tonsillectomy or receiving long acting penicillin injection.

The prevalence of obsessive compulsive symptoms was 15.5%, while that of obsessive compulsive disorder was 2.2%. As for history of recurrent tonsillitis, no difference could be found between those having OCD and the other group non-OCD with ob sessive compulsive symptoms (X2 = 0.87; p > 0.05).

Obsessive-compulsive symptoms are common phenomena in society and they have negative effects on individual's function. The aim of the present study was to investigate the predictive power of some potential predictors of obsessive-compulsive symptoms subtypes. In this study, the correlations of meta cognitive beliefs, maladaptive schemas and worry with obsessive-compulsive symptoms subtypes were examined.

eighty students of Tehran University of Medical Sciences were selected based on cluster sampling. The students completed Obsessive-Compulsive Inventory-Revised(OCI-R), Meta Cognition Questionnaire(MCQ), Young Schema Questionnaire-Short Form(YSQ-SF) and Penn State Worry Questionnaire(PSWQ). Correlation and regression analyses were used to analyze the data.

All predictive variables significantly correlated with obsessive- compulsive symptoms. Results from stepwise regression showed that meta cognitive beliefs entered in regressional models more than other variables. Worry had the lowest weight in prediction of the dependent variables. Predictors had different weights in predicting of subtypes. Predictive formulate were reported for each of subtypes and the total score of obsessive-compulsive symptoms.

Results from this study about correlations of meta cognitive beliefs, maladaptive schemas and worry with obsessive-compulsive symptoms were consistent with cognitive theories in this field. The roles of each predictor and its clinical applications are discussed.

Although antipsychotics are commonly employed in treatment augmentation strategies for severe obsessive-compulsive disorder (OCD) among adolescents, the role of atypical neuroleptics is still unclear (1.2.). Since our clinical practice suggest that in some cases small amount of olanzapine was helpful for patient with resistance to SSRI mono therapy (specially added to fluvoxamine mono therapy) we tested the hypothesis that olanzapine augmentation would be beneficial in treatment-unresponsive OCD.

8-week trial, we recruited 11 adolescents (mean age 14,7) with OCD (DSM-IV criteria), unresponsive to Fluvoxamine (≥100 mg/day) for ≥ 10 weeks, which was continued throughout the trial. Subjects had OCD for ≥ 2 year, a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score typically was of ≥ 18, and no other primary Axis I disorder is exist. After 10 week Fluvoxamine therapy Olanzapine was added in minimal therapeutic amount of 2,5 mg daily. After 6 week combination therapy the symptoms was evaluated by Y-BOCS.

Preliminary analyses of data of these patients demonstrate a statistically and clinically significant improvement in OCD symptoms (50%–60% mean improvement in general, Y-BOCS scores dropped 68%, 30%, and 30%,). Combo treatment for adolescents was well tolerated and safety.

To study in depth the neurotoxic effects of chemotherapy on the cognitive functions. Also, to explore relationships between NP function and metabolite ratios of specific brain regions using magnetic resonance spectroscopy (MRS).

Observational analytical case control study which includes thirty patients with diagnosis of leukemia receiving chemotherapy “Cases” & another group of thirty patients with diagnosis of leukemia not receiving chemotherapy at all as “Controls”. All participants were subjected to Semi structured interview, Wechsler Intelligence Scale for Children (WISC) and Magnetic Resonance Spectroscopy (MRS).

The means of Wechsler Intelligence Scale for Children (WISC) Total, Performance and verbal among the patient group were lower than the control group (P < 0.001). There was statistical significant difference between the two groups regarding Magnetic Resonance Spectroscopy (MRS) in different brain areas. The means of Frontal Cho/NAA, Frontal Cho/Cr, Temporal Cho/NAA, Temporal Cho/Cr, Parieto-Occipital Cho/NAA, Parieto-Occipital Cho/Cr, Basal ganglia Cho/NAA and Basal ganglia Cho/Cr among the patient group were higher than the control group and the means of Temporal NAA/Cr and Parieto-Occipital NAA/Cr among the patient group were lower than the control group.

MR spectroscopy is more sensitive method demonstrating metabolite changes in the brain after chemotherapy treatment of leukemic children in the absence of structural white matter abnormalities at MR imaging. A significant cognitive function difference was detected in leukemic treated cases compared to controls and correlated to the metabolic brain changes detected by MRS.

Depression is common in cancer patients. However, only limited evidence is available in Asian populations. The authors proposed to examine the prevalence of depression in Thai patients with cancer. In addition, factors associated with depression were also determined.

This cross-sectional study conducted in cancer patients admitted in a university hospital during December 2006 - December 2007. Patient Health Questionnaire (PHQ-9) was used to assess all cancer patients. Suicidal risk was assessed by using the Mini-International Neuropsychiatric Interview (M.I.N.I.) in the module of suicidal risk assessment.

Of 108 cancer patients, 29.6 % was diagnosed with depressive disorder (mild: 14.8 %, moderate: 5.6 %, severe: 9.3 %). However, only 25.0 % of all depressed patients were recognized as depressive disorder by primary physician. According to M.I.N.I., 28.1 % of these depressed cancer patients had moderate to severe level of suicidal risk. In addition, the findings suggest that increased risk of depression is significantly associated with increased pain score, less number of cancer treatments (< 2 methods), increased educational duration (>13 years), increased age (> 50 years old) and female group.

Prevalence of depression is high in cancer patients. However, depressive disorder in those patients is frequently misdiagnosed. They are also associated with several factors including pain, a number of cancer treatments, education duration, age and sex. To improve quality of life, increase compliance of treatments and prevent of suicide, screening for depressive disorder in those patients should be strongly recommended.

Although there is a growing impact of psychiatric disorders and depressive disorders in cancer patients, there is scarce literature on the idiosyncrasies of antidepressants (ADs) used in those conditions and their interactions with antineoplastic agents (ANs). Sharing the same biotransformation roots enhances the risk of drug interaction between ADs e ANs, which specific pharmacokinetic properties are determinant to their nature as inducer, inhibitor or substrate of cytochromes P450 (CYP450). In cancer patient, such drug interactions (DIs) may result in less efficacy of the drug and/or increase their side effects. Therefore, the choice of AD should be cautious (safe and effective) and well supported. The main purpose of this paper is to analyse the individual pharmacokinetic properties of the most used ADs and ANs, in order to summarize the risk of possible DIs between them, anticipating the consequences of their co-administration.

The authors reviewed books, articles and PubMed on line articles, published in the last 6 years.

Most of ANs suffer transformation in CYP450 3A4 and that co-administration of ADs with inhibiting properties of this CYP isoform as fluoxetine, sertraline, paroxetine and fluvoxamine may result in loss of efficacy or higher toxicity and should be used cautiously.

Among the ADs, escitalopran, citalopram, venlafaxine, mirtazapine and milnacipran stood out regarding their weak CYP450 inhibitory potential and safety profile in those patients.