Heavy alcohol consumption is associated with poorer cognitive function in older adults. Although understudied in middle-aged adults, the relationship between alcohol and cognition may also be influenced by genetics such as the apolipoprotein (ApoE) ε4 allele, a risk factor for Alzheimer’s disease. We examined the relationship between alcohol consumption, ApoE genotype, and cognition in middle-aged adults and hypothesized that light and/or moderate drinkers (≤2 drinks per day) would show better cognitive performance than heavy drinkers or non-drinkers. Additionally, we hypothesized that the association between alcohol use and cognitive function would differ by ApoE genotype (ε4+ vs. ε4−).

Participants were 1266 men from the Vietnam Era Twin Study of Aging (VETSA; M age = 56; range 51–60) who completed a neuropsychological battery assessing seven cognitive abilities: general cognitive ability (GCA), episodic memory, processing speed, executive function, abstract reasoning, verbal fluency, and visuospatial ability. Alcohol consumption was categorized into five groups: never, former, light, moderate, and heavy.

In fully adjusted models, there was no significant main effect of alcohol consumption on cognitive functions. However, there was a significant interaction between alcohol consumption and ApoE ε4 status for GCA and episodic memory, such that the relationship of alcohol consumption and cognition was stronger in ε4 carriers. The ε4+ heavy drinking subgroup had the poorest GCA and episodic memory.

Presence of the ε4 allele may increase vulnerability to the deleterious effects of heavy alcohol consumption. Beneficial effects of light or moderate alcohol consumption were not observed.

The presentation aims at summarizing current knowledge about sleep in children and adolescents and at describing possible factors influencing their sleep.

For preschoolers, there is evidence that objectively assessed (sleep-EEG, actigraphy) poor sleep is associated with increased endocrine activity; this is to say, with increased morning cortisol secretion, an associative pattern observed so far only in adults. Furthermore, poor sleep and increased cortisol secretion are associated with emotional and behavioral difficulties.

During life span, notable changes occur with respect to sleep quantity and quality. Compared to childhood, in adolescence, three prominent changes occur: First, sleep quantity declines from about 10 hours at 10 years of age to between 6.5 and 8.5 hours in older adolescents. Second, a marked shift towards a longer sleep duration and later bed time from school nights to weekend nights is observable. Third, daytime sleepiness (20%) and insomnia symptoms (25%) are common among adolescents.

Among a variety of factors affecting adolescents’ sleep, we could show that negative parenting styles unfavorably influenced adolescents’ sleep quality, suggesting that even 18 years old adolescents may be far away from been emotionally independent from their parents. Furthermore, the so-called weekend-shift was correlated with increased sleepiness during the week, suggesting that irregular sleep schedules may negatively influence sleep quality and daytime functioning.

Last, if compared to healthy controls, children and adolescents after cleft lip and palate (CLP) repair were not at risk reporting sleep difficulties; rather, irrespective of the presence of CLP, sleep was affected by psychological strain.

Sleep regulation is closely associated to HPA activity. Alterations in both systems may be precursors of psychiatric disorders like depression even at an early stage of development. So far the impact of microstructure in sleep regulation like sleep spindles is unknown. In recent studies, sleep spindles have been linked to efficient cortical-subcortical connectivity and cognitive abilities especially during neurodevelopment.

Sleep spindles in kindergarten children were analyzed and related to sleep regulation and HPA axis functioning.

Patients and Methods: Nine five-year old kindergarten children were enrolled in a cross-sectional examination of HPA system activity assessed by saliva cortisol measurements (morning cortisol after awakening) and sleep regulation investigated by sleep EEG-monitoring. Sleep EEG spindles were visually scored and were put into relation to macrostructural sleep and HPA activity parameters.

Sleep spindles were correlated to basal morning cortisol secretion (AUC basal) (curvilinear r = .83, p = .01), though were negatively correlated to cortisol increase (AUC netto) after awakening (r = -.77, p < .05). Though not statistically significant but by trend, spindle density (i.e. number of spindles per hour of stage 2 -sleep) is negatively correlated to REM density (r = - .57, p = .11), as increase of awakening cortisol was associated to REM density by trend (r = .63, p = .07).

Not only sleep continuation parameters as reported before but also sleep microstructure reflected by sleep spindles may be associated to sleep regulation and HPA system functioning.

Frowning expresses negative emotions like anger, fear, and sadness. According to the facial feedback hypothesis, suppression of frowning will also diminish the corresponding negative emotions. Hence, mood improvement has been observed in patients who underwent treatment of glabellar frown lines with botulinum neurotoxin. This observation suggests the possibility that the intervention may be employed for the management of psychiatric disorders associated with negative emotions. Preliminary data from an open case series indicate that the intervention might improve the symptoms of depression.

To test whether an onabotulinumtoxinA injection into the glabellar region is benefical as an adjunctive treatment of major depression within a clinical trial.

We used a randomized, double-blinded, placebo-controlled study design (n = 30; ClinicalTrials.gov, number, NCT00934687).

We show that a single onabotulinumtoxinA treatment shortly leads to a strong and sustained improvement in partly chronic major depression that did not respond sufficiently to previous treatment. As for the primary end-point, Hamilton Depression Rating Scale (HAM-D17) six weeks after treatment compared to baseline, scores of onabotulinumtoxinA recipients showed 37.9% (8.34 points) more improvement than those of placebo-treated participants (F = 12.30, p = 0.002, η2 = 0.31, d = 1.28).

Our findings support the concept that the facial musculature not only expresses, but also regulates, mood states. As it stands, treatment of glabellar frown lines with botulinum neurotoxin can be considered for depressed patients with the objective of inducing mood-lifting effects.

A dimensional approach in psychiatry strives to identify neurobiological signatures of core (dys)functions such as responses to emotional stimuli across nosological boundaries.

We compared responses to emotional stimuli between major psychiatric disorders and investigated whether there is a psychopathological correlate irrespective of diagnostic group.

We used functional magnetic resonance imaging (fMRI) to assess the functional correlates of responses to unexpected pleasant and aversive emotional pictures in n=175 subjects suffering from alcohol dependence (n=29), schizophrenia (n=37), major depressive disorder (MDD; n=25), bipolar disorder (acute manic episode; n=12), panic disorder (n=12) or attention deficit/hyperactivity disorder (ADHD; n=20) and in healthy controls (n=40). The level of anxiety was measured in all diagnostic groups with the State-Trait Anxiety Inventory, and severity of depressive mood was measured with Beck's depressions inventory in all diagnostic groups with the exception of bipolar patients.

Over all diagnostic groups, a significant activation of BA10 was observed during the presentation of unexpected pleasant pictures, whereas a significant activation of the left amygdala and left insula was found during the presentation of unexpected aversive pictures. We did not find significant effects of group, nor a correlation of neuronal activation with depressed mood or anxiety.

In spite of reported alterations in emotion processing in different psychiatric diseases, responses to emotional pictures did not differ across nosological boundaries in our study. However, a dimensional approach that targets e.g. personality traits or basic learning mechanisms and their neuropsychological correlates across traditional disease categories may be more promising.

Studies investigating indicators of recovery from schizophrenia yielded two concepts of recovery. The first is the reduction of psychiatric symptoms and functional disabilities (‘clinical recovery’), while the second describes the individual adaptation process to the threat posed to the individual sense of self by the disorder and its negative consequences (‘personal recovery’). Evidence suggests that both perceptions contribute substantially to the understanding of recovery and require specific assessment and therapy. While current reviews of measures of clinical recovery exist, measures of personal recovery have yet to be investigated. Considering the steadily growing literature on recovery, this article gives an update about existing measures assessing personal recovery.

A literature search for instruments was performed using Medline, Embase, PsycINFO&PSYNDEXPlus, ISI Web of Knowledge, and Cochrane Library. Inclusion criteria were: (1) quantitative self-report measures; (2) specifically developed for adults with schizophrenia or schizoaffective disorder or at least applied to individuals suffering from severe mental illness; (3) empirically tested psychometric properties and/or published in a peer-reviewed, English-language journal. Instruments were evaluated with regard to psychometric properties (validity and reliability) and issues of application (user and administrator friendliness, translations).

Thirteen instruments met the inclusion criteria. They were individually described and finally summarized in a table reflecting the pros and cons of each instrument. This may enable the reader to make an evidence-based choice for a questionnaire for a specific application.

The Recovery Assessment Scale is possibly the best currently available measure of personal recovery when all evaluation criteria are included. However, the ratings listed in the current paper depended on the availability of information and the quality of available reports of previous assessment of the measurement properties. Considering the significant amount of information lacking and inconsistent findings, further research on the reviewed measures is perhaps more important than the development of new measures of personal recovery.

Despite the large scientific debate concerning potentially stigmatizing effects of informing an individual about being in an at-risk mental state (ARMS) for psychosis, studies investigating this topic are rare and quantitative assessment of this kind of stigmatization does not exist so far.

This study presents first results regarding potentially helpful or stigmatizing effects of being informed about an ARMS assessed with a newly developed quantitative self-rating (FePsy-Stigma questionnaire).

Forty ARMS patients participating in the prospective Basel Early Detection of Psychosis (FePsy) study as well as patients clinically assessed in the early detection service of the Psychiatric Services of Solothurn, completed the FePsy-Stigma questionnaire during their follow-up assessments at least six months after they had been informed about their increased risk of developing psychosis. The questionnaire was constructed based on a previous qualitative study and on adapted versions of formerly used instruments for assessing stigma in mental health (Internalized Stigma of Mental Illness Scale, Personal Beliefs and Experiences Questionnaire).

Stigmatization appeared to be low overall except for social withdrawal due to suspected stigma. Stigma resistance, stereotype awareness and expected discrimination scored considerably higher than actually experienced discrimination, alienation and stereotype endorsement.

The results suggest that early detection services help individuals cope with symptoms and build certain resilience toward potential stigmatization, rather than enhancing or causing the latter. In line with previous studies, our results indicate that there is a considerable difference between expected and actually experienced discrimination as well as between stereotype awareness and stereotype endorsement.

The authors have not supplied their declaration of competing interest.

22q11.2 deletion syndrome (22q11DS) is a genetic disorder caused by a microdeletion on chromosome 22q11.2 and associated with an increased risk for psychosis. A dysfunctional motivational reward system is thought to be one of the salient features in psychosis caused by abnormal dopamine functioning. It is unknown whether patients with 22q11DS have a dysfunctional reward system.

This study aims to investigate reward learning in 22q11DS. The study included 10 adults with 22q11DS (age: 33.1 years, 60% female) and 10 age-gender-matched healthy controls (HC, age: 39.7 years, 60% female). A single infusion 18F-fallypride PET scan was acquired during which all subjects performed a version of the learning phase of the Probabilistic Stimulus Selection Task for reward learning (RL), modified to deliver social feedback.

IQ-scores were significantly lower in the 22q11DS group (P < .001) compared to HC. The 22q11DS group both earned significantly less money (P < .05) and performed worse during the RL-task (P < .05) than HC. However, the learning curve for the RL-task was the same for both groups. IQ-scores were a significant positive predictor for earnings (P < .05) and performance (P < .05), but not for the learning curve.

These preliminary results indicate that people with 22q11DS are capable of learning at the same speed as HC, however they are less susceptible for reward than HC because their overall performance during RL is worse than HC. This lower reward sensitivity could be a result of haplo-insufficiency of COMT in 22q11DS and consequently abnormal prefrontal dopamine functioning.

The authors have not supplied their declaration of competing interest.

Alcohol relapse is often occurring to regulate negative affect during withdrawal. On the neurobiological level, alcoholism is associated with gray matter (GM) abnormalities in regions that regulate emotional experience such as the orbitofrontal cortex (OFC). However, no study to our knowledge has investigated the neurobiological unpinning of affect in alcoholism at early withdrawal and the associations of OFC volume with long-term relapse risk.

One hundred and eighty-two participants were included, 95 recently detoxified alcohol dependent patients (ADP) and 87 healthy controls (HC). We measured affective states using the positive and negative affect schedule (PANAS). We collected T1-weighted brain structural images and performed Voxel-based morphometry (VBM).

Findings revealed GM volume decrease in alcoholics in the prefrontal cortex (including medial OFC), anterior cingulate gyrus, and insula. GM volume in the medial OFC was positively associated with NA in the ADP group. Cox regression analysis predicted that risk to heavy relapse at 6 months increases with decreased GM volume in the medial OFC.

Negative affect during alcohol withdrawal was positively associated with OFC volume. What is more, increased GM volume in the OFC also moderated risk to heavy relapse at 6 months. Reduced GM in the OFC poses as risk to recovery from alcohol dependence and provides valuable insights into transient negative affect states during withdrawal that can trigger relapse. Implications exist for therapeutic interventions signifying the OFC as a neurobiological marker to relapse and could explain the inability of ADP to regulate internal negative affective states.

The authors have not supplied their declaration of competing interest.

In the growing research field of early psychosis detection in patients with an at risk mental state (ARMS), most studies focus on the transition to frank psychosis. However, the majority of ARMS patients do not go on to develop frank psychosis and reported transition rates are declining. Little is known about the long-term outcome of these non-transitioned patients (ARMS-NT).

To investigate in preliminary analyses the long-term outcome of ARMS-NT patients with respect to persistence of ARMS signs and symptoms and the rates of late psychotic transition.

The ongoing study “FePsy-BHS-NT” follows up ARMS-NT without transition during at least the first two years for up to 15 years after their initial assessment. ARMS status is ascertained with the Basel Screening Instrument for Psychosis (BSIP). ARMS remission is defined as the absence of attenuated psychotic symptoms or brief limited intermittent psychotic symptoms for at least 12 consecutive months.

In this preliminary sample of 51 ARMS-NT, the majority of patients (70.6%) have remitted from their at risk mental state, 13.7% remain at risk and 15.7% have made a late psychotic transition during the course of long-term follow up (median = 5.75, range 4–11 years after initial assessment).

The considerable rates of ARMS persistence and late psychotic transition indicate that longer follow-up durations than commonly recommended should be contemplated in ARMS patients. Potential predictors of favorable long-term clinical outcome, as well as psychosocial, neurocognitive and other outcomes of ARMS-NT patients will be further evaluated in the present study.

The authors have not supplied their declaration of competing interest.