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ABSTRACT: Enhanced understanding of cognitive deficits, and the neurobiological abnormalities that mediate them, can be achieved through translational research that employs comparable experimental approaches across species. This study employed a multiple-systems framework derived from the rodent literature to investigate visual-spatial memory abilities associated with schizophrenia.
Using the bin task, a human analog of rodent maze tasks, everyday objects were hidden in visually identical bins. Following a 1-min filled delay, participants with schizophrenia-spectrum disorders (n = 30) and healthy community controls (n = 30) were asked to identify both the object hidden and bin used on the basis of its spatial location. Three dimensions of visual-spatial memory were contrasted: (a) memory for spatial locations versus memory for objects, (b) allocentric (viewpoint independent) versus egocentric (body-centered) spatial representations, and (c) event (working) memory versus reference memory.
Most pronounced was a differential deficit in memory for spatial locations under allocentric (p = .005, d = -0.77) but not egocentric viewing conditions (p = .298, d = -0.28) in the schizophrenia group relative to healthy controls. Similarly, schizophrenia-related spatial memory deficits were pronounced under demands for event memory (p = .004, d = -0.77) but not reference memory (p = .171, d = -0.33).
These results support a heuristic of preferential deficits in hippocampal-mediated forms of memory in schizophrenia. Moreover, the task provides a useful paradigm for translational research and the pattern of deficits suggests that persons with schizophrenia may benefit from mnemonic approaches favoring egocentric representations and consistency when interacting with our visual-spatial world.
Neuropsychology 05/2010; 24(3):368-78. · 3.82 Impact Factor
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ABSTRACT: Sexual dysfunction is a common symptom of depression. Although decreased libido is most often reported, difficulties with arousal, resulting in vaginal dryness in women and erectile dysfunction in men, and absent or delayed orgasm are also prevalent. Sexual dysfunction is also a frequent adverse effect of treatment with most antidepressants and is one of the predominant reasons for premature drug discontinuation. Selective serotonin reuptake inhibitors are the most widely prescribed antidepressants and have significant effects on arousal and orgasm compared with antidepressants that target norepinephrine, dopamine, and melatonin systems. The availability of an antidepressant that does not cause or exacerbate sexual dysfunction represents an advance in pharmacotherapy for mood disorders and should reduce treatment noncompliance and decrease the need for switching antidepressants or adding antidotes. The purpose of this review was to provide an update on the prevalence, psychobiology, and relative adverse effect burden of sexual dysfunction associated with different antidepressants.
Journal of clinical psychopharmacology 05/2009; 29(2):157-64. · 5.09 Impact Factor
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ABSTRACT: Impaired sexual function is associated with major depressive disorder in the untreated state and is often more prevalent during antidepressant therapy, which frequently results in poor treatment compliance. In this double-blind, multicenter study, the effects of agomelatine (an MT1 and MT2 agonist and 5HT-2C antagonist) and venlafaxine XR on sexual function were compared using the Sex Effects Scale in depressed patients. A total of 276 male and female patients received either agomelatine (50 mg) or venlafaxine XR (titrated to a target dose of 150 mg/d) for 12 weeks. Those who were sexually active at baseline (n = 193) and those who, in addition, achieved remission (n = 111) were defined a priori for analyses of change in sexual function. Treatment-emergent sexual dysfunction was significantly less prevalent among patients who received agomelatine, and venlafaxine XR was associated with significantly greater deterioration on the Sex Effects Scale domains of desire and orgasm. Both treatments resulted in equivalently high rates of remission (agomelatine, 73%; venlafaxine XR, 66.9%), although fewer patients in the agomelatine group discontinued treatment because of adverse events (agomelatine, 2.2%, vs venlafaxine XR, 8.6%). Agomelatine seems to be an efficacious antidepressant with a superior sexual side effect profile compared with venlafaxine XR, although superiority to placebo was not evaluated in this trial.
Journal of Clinical Psychopharmacology 07/2008; 28(3):329-33. · 4.10 Impact Factor
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ABSTRACT: The obstacle facing pharmacotherapy for bipolar disorder is that almost half of the patients do not achieve recovery over the duration of treatment. Although the reason for this disappointing clinical outcome remains unclear, structured psychotherapy has helped to fill these gaps in the treatment of bipolar disorder. Psychoeducation, family-focused therapy, interpersonal and social rhythm therapy, and cognitive behavior therapy have all received attention in the research literature. In this review, by assessing the outcomes from randomized control trials across the phases of bipolar disorder, we demonstrate that psychotherapy is an effective adjunctive treatment. We also show that the use of psychotherapy for bipolar disorder has differential results depending on when and under what conditions it is administered.
Journal of Clinical Psychology 06/2007; 63(5):491-506. · 2.12 Impact Factor
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ABSTRACT: Although medication is the mainstay of treatment for bipolar disorder, several adjunctive psychosocial interventions have been manualized over the last decade. This paper's objective is to empirically evaluate the different treatment approaches.
We conducted a systematic review of the recent literature pertaining to psychosocial interventions in bipolar, using MEDLINE and PsycINFO. Bibliographies of papers were scrutinized for further relevant references. Articles published from 1999 up to and including 2006 were reviewed. Randomized controlled trials were emphasized.
Although psychological models of bipolar disorder fail to inform the psychotherapy treatment to the same extent as in unipolar depression, manualized adjunctive, short-term psychotherapies have been shown to offer fairly consistent benefits to bipolar disorder patients. Cognitive-behavioural therapy, family-focused therapy, and psychoeducation offer the most robust efficacy in regard to relapse prevention, while interpersonal therapy and cognitive-behavioural therapy may offer more benefit in treating residual depressive symptoms.
Canadian journal of psychiatry. Revue canadienne de psychiatrie 02/2007; 52(1):14-21. · 2.42 Impact Factor
