Pain tolerance selectively increased by a sweet-smelling odor

Posted on May 3, 2007 by Maurice Preter MD
Psychol Sci. 2007 Apr;18(4):308-11. Related Articles
Pain tolerance selectively increased by a sweet-smelling odor.

Prescott J, Wilkie J.

James Cook University, Cairns, Queensland, Australia.

The mechanism underlying reported analgesic effects of odors in humans is unclear, although odor hedonics has been implicated. We tested whether odors that are sweet smelling through prior association with tasted sweetness might influence pain by activating the same analgesic mechanisms as sweet tastes. Inhalation of a sweet-smelling odor during a cold-pressor test increased tolerance for pain compared with inhalation of pleasant and unpleasant low-sweetness odors and no odor. There were no significant differences in pain ratings among the odor conditions. These results suggest that smelled sweetness can produce a naturally occurring conditioned increase in pain tolerance.

PMID: 17470253 [PubMed – in process]

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Economic costs of full-blown and subthreshold panic disorder

Posted on May 2, 2007 by Maurice Preter MD
J Affect Disord. 2007 Apr 25; [Epub ahead of print] Related Articles
Economic costs of full-blown and subthreshold panic disorder.

Batelaan N, Smit F, Graaf RD, Balkom AV, Vollebergh W, Beekman A.

Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Department of Psychiatry and Institute for Research in Extramural Medicine, VU-University Medical Centre, Amsterdam, The Netherlands.

BACKGROUND: Data on the societal costs of mental disorders are necessary to inform health policies. METHODS: This study assessed the costs of panic disorder and subthreshold panic disorder, compared these with costs of other mental disorders, and assessed the effects of (psychiatric and somatic) comorbidity and agoraphobia on the costs of panic. Using a large, population-based study in The Netherlands (n=5504), both medical and production costs were estimated from a societal perspective within a one-year timeframe. RESULTS: Annual per capita costs of panic disorder were euro10,269, while subthreshold panic disorder generated euro6384. These costs were higher than those of the other mental disorders studied. About one quarter of the costs could be attributed to comorbidity. Agoraphobia was associated with higher costs. LIMITATIONS: Methodological choices influence cost estimates. In the present study most of these will result in conservative cost estimates. CONCLUSIONS: Panic thus causes substantial societal costs. Given the availability of effective treatment, treatment may not only benefit individual patients, but also have economic returns for society.

PMID: 17466380 [PubMed – as supplied by publisher]

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The revolution in psychiatric diagnosis: problems at the foundations

Posted on May 2, 2007 by Maurice Preter MD
Perspect Biol Med. 2007 Spring;50(2):161-80. Related Articles
The revolution in psychiatric diagnosis: problems at the foundations.

Galatzer-Levy IR, Galatzer-Levy RM.

Department of Clinical Psychology, Teachers College, Columbia University, New York, USA. galatzerlevy@sbcglobal.net

The third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-III; 1974) not only revolutionized psychiatric diagnosis, it transformed and dominated American psychiatry. The nosology of psychiatry had been conceptually confusing, difficult to apply, and bound to widely questioned theories. Psychiatry and clinical psychology had been struggling with their scientific status. DSM attempted to solve psychiatry’s problems by making psychiatry more like its authors’ perception of general medicine. It tried to avoid theory, especially psychoanalytic theories, by discussing only observable manifestations of disorders. But DSM is actually highly theory-bound. It implicitly and powerfully includes an exclusively “medical” model of psychological disturbance, while excluding other psychiatric ideas. Its authors tried to meet what they saw as “scientific standards.” To a surprising extent, DSM reflects its creators’ personal distaste for psychoanalysis. The result is that DSM rests on a narrow philosophical perspective. The consequences of its adoption are widespread: it has profoundly affected drug development and other therapeutic studies, psychiatric education, attitudes toward patients, the public perception of psychiatry, and administrative and legal decisions. This article explores how DSM’s most problematic features arise from its history in psychiatric controversies of the 1960s and its underlying positivistic philosophy.

PMID: 17468537 [PubMed – in process]

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Morphine self-administration into the lateral septum depends on dopaminergic mechanisms: Evidence from pharmacology and Fos neuroimaging

Posted on May 2, 2007 by Maurice Preter MD
Behav Brain Res. 2007 Mar 16; [Epub ahead of print] Related Articles
Morphine self-administration into the lateral septum depends on dopaminergic mechanisms: Evidence from pharmacology and Fos neuroimaging.

Le Merrer J, Gavello-Baudy S, Galey D, Cazala P.

Centre de Neurosciences Integratives et Cognitives, Universites Bordeaux 1 et 2, UMR CNRS 5228, Avenue des Facultes, 33405 Talence, France.

Mice self-administer morphine into the lateral septum (LS), but the neuronal connections underlying this behaviour remain unknown. The present study tested whether the acquisition of intra-LS morphine self-administration depends on dopaminergic mechanisms. Mice were allowed to self-inject morphine (5 or 20ng/50nl) or vehicle directly into the LS using a spatial discrimination Y-maze task. Fos imaging was used to evaluate neuronal activation in cerebral structures directly connected to the LS or belonging to the dopaminergic system. The involvement of dopaminergic and opioidergic mechanisms was assessed by pre-treating naive mice peripherally with the D1 antagonist SCH23390, the D2/D3 antagonist sulpiride or the opiate antagonist naloxone before daily self-administration sessions. Mice acquired self-administration behaviour for intra-LS morphine that was associated with increased Fos expression in the ventral tegmental area (VTA), dorsal and ventral striatum and prefrontal cortex. Pre-treating animals with naloxone, SCH23390 or sulpiride completely prevented them from acquiring intra-LS morphine self-administration. All three antagonists consistently blocked Fos expression in the prefrontal cortex, but not in the VTA and striatum. Taken together, our results show that morphine self-administration into the LS depends on dopaminergic (D1 and D2/D3) and opioidergic mechanisms. Furthermore, they suggest that opioid peptides released in the LS could participate in regulating the activity of mesotegmental dopaminergic neurons.

PMID: 17467070 [PubMed – as supplied by publisher]

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Psychiatric comorbidity and suicide risk in adolescents with chronic daily headache

Posted on April 30, 2007 by Maurice Preter MD
 
Worried and unwell: Panic and migraine are highly comorbid, in Taiwan too.
 
 
 NEUROLOGY 2007;68:1468-1473
© 2007 American Academy of Neurology

Psychiatric comorbidity and suicide risk in adolescents with chronic daily headache

Shuu-Jiun Wang, MD, Kai-Dih Juang, MD, Jong-Ling Fuh, MD and Shiang-Ru Lu, MD

From the Departments of Neurology (S.-J.W., J.-L.F.) and Psychiatry (K.-D.J.), National Yang-Ming University School of Medicine, Taipei; Neurological Institute (S.-J.W., J.-L.F.), Taipei Veterans General Hospital; and the Department of Neurology (S.-R.L.), Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.

Address correspondence and reprint requests to Dr. Shuu-Jiun Wang, The Neurological Institute, Taipei Veterans General Hospital, Taipei, 112, Taiwan sjwang@vghtpe.gov.tw

Objectives: To investigate the prevalence and correlates of comorbid psychiatric disorders and suicidal risk in community-based adolescents with chronic daily headache (CDH).

Methods: We identified and recruited 122 adolescents with CDH from a non-referral student sample (n = 7,900). CDH subtypes were classified according to the most updated criteria of the International Classification of Headache Disorders, 2nd edition (ICHD-2). An in-person psychiatric interview was performed with each subject with CDH to assess depressive and anxiety disorders and suicidal risk based on the Mini-International Neuropsychiatric Interview–Kid (MINI-Kid). Clinical correlates and impacts were investigated.

Results: A total of 121 subjects (31 male/90 female, mean age 13.8 years) finished the psychiatric interview. Fifty-seven subjects (47%) had ≥1 assessed psychiatric comorbidity with major depression (21%) and panic disorder (19%) as the two most common diagnoses. Current suicidal risk was assessed as high (score ≥ 10) in 20% of subjects. Female gender and older age were associated with depressive disorders. Presence of migraine was associated with psychiatric comorbidities (OR = 3.5, p = 0.002). The associations with psychiatric disorders were stronger for migraine with aura than for migraine without aura. Migraine with aura also independently predicted a high suicidal risk (score ≥ 10) (adjusted OR = 6.0, p = 0.028). In contrast, CDH subtypes, headache frequencies, or medication overuse were not correlated. Comorbid psychiatric disorders were not related to physician consultations or more days of sick leave.

Conclusions: This community-based study showed high comorbidity of psychiatric disorders and suicidal risk in adolescents with chronic daily headache. The presence of migraine attacks, especially migraine with aura, was the major predictor for these associations.

Received October 17, 2006. Accepted in final form December 31,

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