'Actual neurosis' and psychosomatic medicine: THE VICISSITUDES OFAN ENIGMATIC CONCEPT

Out of the concept of neurasthenia, the main non-psychotic diagnosis of nineteenth-century psychiatry besides hysteria, and on the basis of psychophysiological problems of his own, self-diagnosed as neurasthenia, Freud developed the notion of 'actual neurosis', a 'contentless psychic state' manifested by various somatic symptoms and a depressive mood, which he attributed to a chemical factor associated with aberrant sexual practices and in particular masturbation. Rejected by post-Freudian analysts as such along with the diagnosis of neurasthenia, the concept of 'actual neurosis' has survived under various theoretical schemes that seek to explain psychosomatic illness and somatisation, in general, with its concomitant poverty of affects and dearth of fantasy life. In more recent years, the concept of 'actual neurosis' has resurfaced under the label of chronic fatigue syndrome, a medical entity thought to be an immunological deficiency, while in psychoanalysis Freud's idea of a contentless mental state has been replaced by that of unconscious fantasy and symbolisation at a pre-genital or pre-verbal level.     

Longitudinal Changes in Intellectual Development in Children with Fragile X Syndrome

Structural equation modeling (SEM) was used to examine the development of intellectual functioning in 145 school-age pairs of siblings. Each pair included one child with Fragile X syndrome (FXS) and one unaffected sibling. All pairs of children were evaluated on the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) at time 1 and 80 pairs of children received a second evaluation at time 2 approximately 4 years later. Compared to their unaffected siblings, children with FXS obtained significantly lower percentage correct scores on all subtests of the WISC at both time points. During the time between the first and second assessments, the annual rate of intellectual development was approximately 2.2 times faster in the unaffected children compared to the children with FXS. Levels of the fragile X mental retardation protein (FMRP) were highly associated with intellectual ability scores of the children with FXS at both time points (r=0.55 and 0.64 respectively). However, when gender, age, and the time between assessments were included as covariates in the structural equation model, FMRP accounted for only 5% of the variance in intellectual ability scores at time 1 and 13% of the variance at time 2. The results of this study suggest that slower learning contributes to the low and declining standardized IQ scores observed in children with FXS.     

Patterns of maternal responding in postpartum mothers with schizophrenia

Little is known about how schizophrenia might affect how a mother responds to her infant, such as whether responding is reduced or impaired. The aim was to identify, from brief videotaped interactions, whether the responses of mothers with schizophrenia were fewer, less positive, more negative, and more ‘abnormal’ than mothers with affective disorder, and whether their infants (mean age: 15 weeks) lacked activity or initiation to which mothers could respond. Mothers with schizophrenia (N = 14) were as responsive as mothers with affective disorder (N = 31), but they showed markedly low positive responsiveness. Only the schizophrenia group exhibited non-responses as a result of being psychologically withdrawn from the interaction, and abnormal behaviors. Inconsistent to our hypothesis, infants in both groups showed similar levels of activity, initiative and negativity. The findings highlight the need for further research to examine the contribution of maternal response impairments to the developmental vulnerability of this genetically high-risk group.     

Counselling Australian baby boomers: examining the loss and grief issues facing aging distance-separated sibling dyads

It has long been recognised that mature-aged sibling dyads provide each other with emotional support. What has yet to be determined is whether this support function is maintained within the baby boomer generational cohort of sibling dyads who through economic relocation/migration have become separated by distance. As such, this paper highlights the need for research to be conducted into the experiences of baby boomers dealing with sibling loss and grief-related issues without the support of their nuclear and extended family members.     

从中西医结合角度探讨代谢综合征

代谢综合征的发生、发展、变化错综复杂,中医的病因病机学说有很多包括脾胃功能失常、肝失疏泄、痰浊瘀血阻滞等。由于老年人抗病能力和修复能力低下,往往同时合并多种其他病变。所以,在辨证研究上需要一个标准化的、符合实际情况的、临床可行的分型。由于目前的中医临床研究的深度和广度还不足以产生一个辨证分型的方案,所以可分期对待,在分期的基础上进一步辨证论治。治疗的重点在于纠正代谢紊乱,改善和延缓合并症的发生及发展。中医学整体调整的理念和中药中的多种成分的多重作用,有利于多因素多系统病变的防治。中药可通过不同途径和环节改善胰岛素敏感性,在防治代谢综合征方面可能有着广阔的前景。     

Affect, Social Behavior, and the Brain in Williams Syndrome

ABSTRACT— Williams syndrome (WS) is a rare genetic disorder characterized by intellectual impairment and a distinctive physical and neuropsychological profile. Relative to their level of intellectual functioning, individuals with WS exhibit strengths in language and face recognition, with deficits in visual-spatial cognition. A heightened appetitive drive toward social interaction is a strong behavioral feature. Relative to other neurodevelopmental disorders, WS has a clearly defined genetic basis, together with a consistent neurocognitive profile of strengths and deficits. Thus, this disorder offers unique opportunities for elucidating gene–brain–behavior relationships. We focus on manifestations of the unusual social profile in WS, by examining data within and across levels of cognition, brain, and molecular genetics.     

神经内分泌系统与多囊卵巢综合征

精神、心理因素会引起神经递质的改变,神经递质的变化又能引起促性腺激素的分泌异常,以神经递质作为桥梁,研究精神、心理因素与多囊卵巢综合征(PCOS)的关系。精神、心理因素使体内多巴胺、去甲肾上腺素、β-内啡肽及5-羟色胺的含量变化,从而影响促性腺激素释放激素及黄体生成素的水平。因此,精神、心理因素是PCOS的重要诱因,而PCOS又加重心理障碍。     

恶性肿瘤皮肤表现

恶性肿瘤皮肤表现可分为肿瘤直接效应与间接效应。直接效应是指恶性肿瘤或其转移灶生长影响周围器官或组织正常功能;间接效应是指恶性肿瘤或其转移灶经复杂生物学效应影响远处器官或组织正常功能,也称为副肿瘤性皮肤病。恶性肿瘤皮肤表现发病率根据原发肿瘤而束同,可能是患者潜在肿瘤首发临床表现,并且与肿瘤复发转移相关。     

Intonation and Emotion in Autistic Spectrum Disorders

The classic picture of an autistic individual includes an impoverished ability to interpret or express emotion. The prosody of spoken language in autistic children is thought to lack emotional content. In this study, the verbal intonation of children with autism was examined and compared to that of children with Asperger Syndrome (AS) and normal controls (ctrl). Utterances elicited by repetition and by spontaneous story completion were analyzed by quantifying phonetic features (pitch, amplitude, and length) and comparing them to subjective ratings of produced emotion (happy, sad or angry). Since the most consistent phonetic correlate of these emotional targets has been demonstrated to be pitch range, speakers with autistic spectrum disorders were expected to have decreased pitch range; however in the repetition task, autistic subjects actually had a larger pitch range than the other groups. Other measures of intonation including amplitude, duration, and location of pitch peak revealed defects that are more complex than predicted. In spontaneous speech, autistic subjects performed more poorly on both phonetic targets and subjective ratings than ctrls, and AS subjects fell between autistics and normals.     

An experimental approach to detecting dementia in Down syndrome: a paradigm for Alzheimer's disease

Measures developed from animal models of aging may detect dementia of the Alzheimer's type in a population at-risk for Alzheimer's disease (AD). Although, by middle age, individuals with Down syndrome (DS) show an extraordinarily high prevalence of AD-type pathology, their severe idiopathic cognitive deficits tend to confound the clinical diagnosis of AD. The current study was designed to improve detection of AD in DS by using measures of learning and memory derived from animal models of aging. Adults with DS (N=34) were assessed and reassessed (n=19) approximately one year later using stimulus-response (S-R) test methods derived from experimental literature, as well as standardized informant-based tests. Results demonstrated high validity and reliability of select tests. The implication of early symptom detection in a population at-risk for AD-type dementia was discussed in terms of potential brain regions of interest.