Motivational Impairment is Accompanied by Corticoaccumbal Dysfunction in the BACHD-Tg5 Rat Model of Huntington's Disease

Neuropsychiatric symptoms, such as avolition, apathy, and anhedonia, precede the onset of debilitating motor symptoms in Huntington's disease (HD), and their development may give insight into early disease progression and treatment. However, the neuronal and circuit mechanisms of premanifest HD pathophysiology are not well-understood. Here, using a transgenic rat model expressing the full-length human mutant HD gene, we find early and profound deficits in reward motivation in the absence of gross motor abnormalities. These deficits are accompanied by significant and progressive dysfunction in corticostriatal processing and communication among brain areas critical for reward-driven behavior. Together, our results define early corticostriatal dysfunction as a possible pathogenic contributor to psychiatric disturbances and may help identify potential pharmacotherapeutic targets for the treatment of HD.

How recent medical school graduates evaluate the clinical relevancy of their behavioral science curriculum

Recent graduates of the University of South Carolina School of Medicine (n=108) evaluated the clinical relevancy of their behavioral science curriculum. The results indicate that a body of behavioral science data are clinically relevant to physicians regardless of their specialty. Additional behavioral science content areas are clinically relevant for practitioners in particular medical specialties. Suggestions are made for the role of behavioral science material in continuing medical education.

Phencyclidine-induced psychosis: eight-year follow-up of ten cases

In 1978, we identified ten patients who were hospitalized for phencyclidine-induced psychosis. Over the next eight years, we used their medical records to document their subsequent hospitalizations and psychosocial functioning. The overall outcome for this group of patients was poor, with chronic unemployment, continuing use of illicit drugs, dependence on relatives for shelter and financial support, and repeated hospitalizations being the rule.

Financing of child psychiatry pediatric consultation-liaison programs

Child psychiatrists and pediatricians recognize the importance of providing psychosocial care for children and their families in medical settings. Consultation-liaison and behavioral pediatric programs provide most of the training in this area. Twenty-nine pediatric consultation-liaison program directors participated in an initial and follow-up telephone survey about their programs. In the 5 years between the surveys, there was a drastic reduction in federal funding for these programs. The findings include a change in the number and composition of both staff and trainees. There were major shifts in the financial support of the programs. The programs were involved in fewer activities and in more restricted settings at the time of the follow-up survey. Financing of pediatric consultation-liaison programs plays a major role in shaping the structure and function of the programs.

Long-term results of early surgical release in club feet

One-hundred and seventy patients with 252 club feet treated by early posterior release were reviewed after a follow-up averaging 15 years 10 months. The feet were assessed both functionally and clinically and the results related to any bony deformity found radiographically; a satisfactory result was obtained in 81%. Lateral tibial torsion was examined and found to be less than in a normal population. The relationship between primary bone deformity and eventual functional result was examined, and a classification of talar dome deformity introduced. The range of ankle movement was a major factor in determining the functional result, and this in turn was influenced by the degree of talar dome flattening. It is suggested that the primary bone deformity present at birth dictates the eventual result of treatment.

Inpatient vs outpatient treatment of alcohol and drug abusers

The literature on inpatient and outpatient treatment of alcohol and drug abusers is reviewed. In addition, attrition as a major factor in treatment is examined. While several hypothesized advantages for both inpatient and outpatient treatment are advanced, it is pointed out that, because of methodological and situational differences among the studies, comparisons are difficult and risky to make. After suggesting that there is little evidence to cause one to tout either inpatient or outpatient treatment based on relative effectiveness, it is proposed that a flexible treatment program utilizing both inpatient and outpatient treatment with a focus on reducing attrition is most likely to maximize effectiveness.

Alcohol and drug abuse treatment: perceived effectiveness of inpatient combined treatment programs

The present study did not address directly the comparative superiority of treatment approaches for combined versus separate treatment. It reflects, instead, the perceptions of staff and clients from the programs visited, the available literature, information gathered in the search for combined programs, and program processes and outcomes. The primary hypothesis generated by the study proposed that, given a receptive treatment staff, it is probable that combined treatment has the flexibility to provide treatment to both drug and alcohol abusers that is at least as effective and probably more efficient than separate treatment. Until empirical evidence that clearly delineates problems associated with combined treatment is obtaned, it was suggested that the selection of a combined or separate treatment paradigm is best determined by the needs of the community and the attitudes of the treatment staff.