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Seasonal panic disorder: a possible variant of seasonal affective disorder.

The present communication concerns a 30 year-old female patient with panic disorder in whom panic attacks appeared to be seasonally-related. Characteristically, attacks were more frequent and severe during the months of October to May with spontaneous remissions during the months of June to September. Since 70% of patients with seasonal affective disorder (SAD), a variant of affective illness characterized by recurrent winter depressions with remissions in summer, suffer from anxiety disorders, we propose that seasonal panic disorder may be a variant of SAD. Since SAD is associated with phase delay of circadian rhythms, some forms of panic disorder may be related to phase instability of circadian rhythms. Moreover, since administration of artificial bright light therapy is currently the most effective treatment for SAD, it is suggested that patients with panic disorder should be questioned as to whether their symptoms are seasonally related. If a positive association is established, these patients should be offered treatment with light therapy prior to or coincident with the institution of pharmacotherapy.

Adult↗

Accessibility of spoken, written, and sign language in Landau-Kleffner syndrome: a linguistic and functional MRI study.

Landau-Kleffner syndrome (LKS) is an acquired aphasia which begins in childhood and is thought to arise from an epileptic disorder within the auditory speech cortex. Although the epilepsy usually subsides at puberty, a severe communication impairment often persists. Here we report on a detailed study of a 26-year old, left-handed male, with onset of LKS at age 5 years, who is aphasic for English but who learned British Sign Language (BSL) at age 13. We have investigated his skills in different language modalities, recorded EEGs during wakefulness, sleep, and under conditions of auditory stimulation, measured brain stem auditory-evoked potentials (BAEP), and performed functional MRI (fMRI) during a range of linguistic tasks. Our investigation demonstrated severe restrictions in comprehension and production of spoken English as well as lip-reading, while reading was comparatively less impaired. BSL was by far the most efficient mode of communication. All EEG recordings were normal, while BAEP showed minor abnormalities. fMRI revealed: 1) powerful and extensive bilateral (R > L) activation of auditory cortices in response to heard speech, much stronger than when listening to music; 2) very little response to silent lip-reading; 3) strong activation in the temporo-parieto-occipital association cortex, exclusively in the right hemisphere (RH), when viewing BSL signs. Analysis of these findings provides novel insights into the disturbance of the auditory speech cortex which underlies LKS and its diagnostic evaluation by fMRI, and underpins a strategy of restoring communication abilities in LKS through a natural sign language of the deaf (with Video)

Adult↗

Autism spectrum disorder in Fragile X syndrome: differential contribution of adaptive socialization and social withdrawal.

The present study extends our previous work on characterizing the profile of social behavior abnormalities in boys with Fragile X (FraX) and autism spectrum disorder (ASD) using clinically oriented behavioral rating scales and standardized instruments. The goal was to further distinguish behavioral parameters contributing to the diagnostic classification of FraX + ASD. The study design included two cohorts of boys with FraX (3-8 years), a larger main cohort for cross-sectional analyses (n = 56, 24 with ASD), and a longitudinal subset (n = 30, 11 with ASD) of the main cohort with up to 3 yearly observations. The focus was on the relative contribution of delayed adaptive socialization and social withdrawal, including item components of their corresponding rating instruments, to the diagnosis of ASD in boys with FraX. Using a combination of regression analyses, we demonstrated that: (1) as delayed socialization, social withdrawal is also a correlate of FraX + ASD; (2) items of social withdrawal scales representing avoidance were the main predictors of ASD status, particularly in older boys; (3) adaptive socialization skills reflecting rules of social behavior and recognition and labeling of emotions, linked to verbal reasoning abilities, were selectively associated with FraX + ASD; (4) adaptive socialization is the primary determinant over time of ASD status in boys with FraX; and (5) integrated adaptive socialization-social withdrawal models allow the identification of distinctive FraX + ASD subgroups. Altogether, our findings suggest that two distinct but interrelated social behavior abnormalities, one linked to impaired cognitive processes (delayed socialization) and the second one to disturbance in limbic circuits (avoidance), play a role in the development of ASD in boys with FraX.

Adaptation, Psychological↗

[Complications and sequelae of the purulent, bacterial meningoencephalitis in the material from the 1st Clinic of Infectious Diseases of Silesian Medical Academy in Bytom in the years 1991-1997].

From 1991 to 1997 at the I Clinic of Infectious Diseases of Silesian Medical Academy in Bytom 123 patients with purulent, bacterial meningoencephalitis were treated. Mortality in the analysed group was 28.5% (35 cases). In the course of disease various complications were observed: seizures (43.1% cases), ischaemic stroke (2.4% cases), brain abscess (4.1%). Permanent consequences subsequent to the disease were found in 16.3% cases: deafness and partial deafness, psychic disorders, paresis and paralysis, epilepsy and cranial nerves paralysis. Bacterial infections of the central nervous system are still danger diseases producing high lethality, complications and subsequent neurological sequelae.

Abscess↗

Involuntary commitment and the treatment process: a clinical perspective.

The serious question of involuntary hospitalization at this point in history is properly referred to due process in court. While numerous studies have addressed the decisions, statistics and outcomes in this area, insufficient attention has been paid to how the clinician may productively incorporate the clinical experience mobilized by the procedure into the therapeutic work. The authors suggest that the issues raised include maintenance of the alliance, responsibility, dependence, limit-setting, the subjective experience of the process, and the problem of counter-transference. They indicate how the various aspects of commitment may be explored aso as to yield maximal therapeutic benefit, and maintain the alliance during the conflicts of an adversary procedure.

Adult↗

Signal crimes and signal disorders: notes on deviance as communicative action.

In this paper a 'signal crimes' perspective is outlined in an effort to unpack the relationships between experiences of crime and disorder, and perceptions of criminogenic risk. Grounded in symbolic interactionist sociology, and developing a social semiotic understanding of risk perception, it is a perspective that focuses upon processes of social reaction and the ways in which people interpret and define threats to their security. It is proposed that people interpret the occurrence of certain incidents as 'warning signals' about the levels of risk to which they are either actually or potentially exposed. These signals tend to take the form of signal crimes and/or signal disorders and are important in terms of how social space is symbolically constructed.

Crime↗

[The auditory late potentials (P300, MMN) in central speech disorders in children].

The aim of this paper was introduction of preliminary study of late auditory evoked potentials P300 and MMN insome central communication process disorders. The investigations were performed in the group of three children with development dysphasia and pseudobulbar dyzarthria. The registration of endogenic late cognitive potentials was performed using the alternate application of stimulus of pure tones 1 and 2 kHz, and logatoms (da)-(ga). In all patients the normal hearing threshold and the unilateral disturbances in registration of P300 and mismatch negativity (MMN) were found.

Audiometry, Pure-Tone↗