The habenula is a small and bilateral nucleus above dorsal thalamus, which contains several different types of neurons. The habenula has extensive connections with the forebrain, septum and monoaminergic nuclei in the midbrain and brainstem. Habenula is known as an 'anti-reward' nucleus, which can be activated by aversive stimulus and negative reward prediction errors. Accumulating researchs have implicated that the habenula is involved in several behaviors crucial to survival. Meanwhile, the roles of the habenula in neuropsychiatric diseases have received increasing attention. This review summaries the studies regarding the roles of habenula and the related circuits in neuropathic pain, depression, drug addiction and schizophrenia, and discusses the possibility to use the habenula as a treatment target.
Depressive Disorder ; Habenula ; Humans ; Mental Disorders ; pathology ; Mesencephalon ; Neurons ; metabolism ; Reward

The concept of bipolar spectrum disorder (BSD) has developed to include affective temperaments such as cyclothymia and hyperthymia. This has greatly helped clinicians to differentiate depressed patients, who would potentially benefit from mood stabilizing treatment, from those with unipolar depression. Cyclothymia, however, has significant similarities with personality disorders, especially with borderline personality disorder (BPD). All the diagnostic items for BPD are frequently found in patients with BSD as well, which presents diagnostic challenges. There are no clear guidelines on how to differentiate BSD from BPD. Featuring borderline pathology for clinical purposes, it may be useful to rely on psychodynamic approaches to identify primitive defense mechanisms of splitting and projective identification suggesting borderline personality organization. Based on new findings on common features between BSD and BPD, some authors have proposed a renewal of the classification system of mental disorders. The dichotomy of bipolar and unipolar depression has gestated a new concept of BSD. Currently, the BSD concept forced us to formulate the border of BSD and personality disorders.
Bipolar Disorder* ; Borderline Personality Disorder ; Classification ; Defense Mechanisms ; Depressive Disorder ; Humans ; Mental Disorders ; Pathology ; Personality Disorders* ; Temperament

OBJECTIVES: The Personality Belief Questionnaire-Short Form (PBQ-SF) is a self-report instrument for assessment of dysfunctional beliefs based on Beck's cognitive formulations of personality disorders. The aims of this study was to examine the reliability and validity of the Korean version of PBQ-SF in clinical samples. METHODS: The Korean version of PBQ-SF was examined in 115 participants (50 patients with personality disorder and 65 patients without personality disorder). All participants were assessed for personality disorder using the semi-structured clinical interview of the Personality Assessment Schedule. The construction validity was examined by correlation with Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Neuroticism-Extraversion-Openness Five-Factor Inventory neuroticism scales. Twenty four randomly sampled patients were examined for the test-retest reliability. RESULTS: The Korean version of PBQ-SF showed good internal consistency [Cronbach's alpha=0.73 (schizoid)-0.92 (paranoid)] and test-retest reliability [r=0.74 (narcissistic)-0.92 (paranoid)]. The PBQ-SF was correlated with depression, anxiety, and neuroticism. The overall subscales of PBQ-SF were correlated with Diagnostic and Statistical Manual of Mental Disorders based diagnosis of personality disorders. CONCLUSION: Consistent with previous findings using the Korean full version of PBQ as well as the English version of PBQ-SF, our results support that the Korean version of PBQ-SF is a reliable and valid instrument for assessment of dysfunctional beliefs associated with personality pathology.
Anxiety ; Appointments and Schedules ; Depression ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Pathology ; Personality Assessment ; Personality Disorders ; Reproducibility of Results ; Weights and Measures

von Economo neuron (VEN) is a bipolar neuron characterized by a large spindle-shaped soma. VEN is generally distributed in the layer V of anterior insular lobe and anterior cingulate cortex. Fork neuron is another featured bipolar neuron. In recent years,many studies have illustrated that VEN and fork neurons are correlated with complicated cognition such as self-consciousness and social emotion. Studies in the development and morpholigies of these two neurons as well as their pathological changes in various neurological and psychiatric disorders have found that the abnormal number and functions of VEN can cause corresponding dysfunctions in social recognition and emotions both during the neuro-developmental stages of childhood and during the nerve degeneration in old age stage. Therefore, more attentions should be paid on the research of VEN and fork neurons in neuropsychiatric diseases.
Central Nervous System Diseases ; pathology ; Cerebral Cortex ; Humans ; Mental Disorders ; Neurons

ObjectiveTo investigate the clinical (including reproductive) manifestations and genetic characteristics of familial fragile X syndrome (FXS).

METHODSWe collected the clinical data about a case of familial FXS by inquiry, testicular ultrasonography, semen analysis, determination of sex hormone levels, and examinations of the peripheral blood karyotype and Y chromosome microdeletions. Using Southern blot hybridization, we measured the size of the CGG triple repeat sequence of the fragile X mental retardation-1 (FMR1) gene and determined its mutation type of the pedigree members with a genetic map of the FXS pedigree.

RESULTSAmong the 34 members of 4 generations in the pedigree, 3 males and 1 female (11.76%) carried full mutation and 9 females (26.47%) premutation of the FMR1 gene. Two of the males with full FMR1 mutation, including the proband showed a larger testis volume (>30 ml) and a higher sperm concentration (>250 ×10⁶/ml), with a mean sperm motility of 50.5%, a mean morphologically normal sperm rate of 17.5%, an average sperm nuclear DNA fragmentation index (DFI) of 18.5%, a low level of testosterone, normal karyotype in the peripheral blood, and integrity of the azoospermia factor (AZF) region in the Y chromosome. One of the second-generation females carrying FMR1 premutation was diagnosed with premature ovarian failure and another 3 with uterine myoma.

CONCLUSIONSSome of the FXS males in the pedigree may present macroorchidism and polyzoospermia but with normal semen parameters. In the intergenerational transmission, premutation might extend to full mutation, with even higher risks of transmission and extension of mutation in males, especially in those with >80 CGG triple repeat sequences. Therefore, it is recommended that the couples wishing for childbearing receive genetic testing, clinical guidance, and genetic counseling before pregnancy and, if necessary, prenatal diagnosis and preimplantation genetic diagnosis.

Chromosome Deletion ; Chromosomes, Human, Y ; genetics ; DNA Fragmentation ; Female ; Fragile X Mental Retardation Protein ; genetics ; Fragile X Syndrome ; genetics ; Genetic Testing ; Humans ; Infertility, Male ; genetics ; Karyotyping ; Male ; Mutation ; Organ Size ; Pedigree ; Pregnancy ; Preimplantation Diagnosis ; Risk ; Sex Chromosome Aberrations ; Sex Chromosome Disorders of Sex Development ; genetics ; Sperm Count ; Testis ; diagnostic imaging ; pathology

No abstract available.
Adult ; Brain/diagnostic imaging ; Bronchoscopy ; *Chromosomes, Human, Pair 9 ; Death, Sudden, Cardiac/*etiology ; Gene Duplication ; Humans ; Karyotyping ; Male ; Mental Disorders/*complications/genetics/pathology ; Tomography, X-Ray Computed ; Tracheomalacia/diagnostic imaging ; Ventricular Fibrillation/complications

OBJECTIVETo observe the clinical characteristics and regular patterns of subacute 1, 2-dichloroethane poisoning patients for providing evidences to it's diagnosis, treatment and prognosis.

METHODS51 cases of subacute 1, 2-dichloroethane poisoning analyzed. They were divided into 3 groups according to their main clinical manifestation: group A mainly with intracranial hypertension (n = 25), group B with limbs tremor (n = 18), group C with mental and behavior disorder (n = 8). All cases' clinical symptoms, cranial computer tomography, cerebrospinal pressure (Group A) were observed, the durations of the onset, deterioration, improvement, recovery and whole course of the disease were compared between groups and in each group.

RESULTSIn all of 51 cases, only the differences between the deterioration duration of cranial CT and symptom was significantly (t = 2.555, P<0.05), which indicate the deterioration of symptom was earlier than radiological change. The symptom deterioration of group C was the fastest than group A and group B (P<0.00). As to the change of symptom duration, group B's improvement, recovery and whole course was the longest comparing with group A and group C (P<0.05). As to the change of cranial CT duration, group B's recovery duration was the shortest and group A's recovery duration was the longest (P<0.01); group B's whole course was also the shortest and group A's whole course was the longest (P<0.05). The clinical course of symptoms, cranial computer tomography, cerebrospinal pressure (Group A) was compared in each group, in group A, the duration of improvement and whole course of the cranial CT and cerebrospinal pressure change was longer than that of the symptom change (P<0.01), this indicated that group A has longer asymptomatic intracranial hypertension and their cranial radiography recover slowly. In group B, their symptoms (3.94 ± 4.31 days) deteriorated is earlier than cranial CT changes (P<0.05), the recovery (92.39 ± 55.04 days) and whole course of symptom was longer than cranial CT change (all P<0.01). In group C, symptom deterioration was earlier than CT deterioration (P< 0.05).

CONCLUSIONThe clinical characteristic of subacute 1, 2- dichloroethane poisoning is central nervous system damage, it differs according to the different stage of course, the regions and severity of pathology lesions.

Cerebrospinal Fluid Pressure ; Disease Progression ; Ethylene Dichlorides ; poisoning ; Humans ; Intracranial Hypertension ; Mental Disorders ; Poisoning ; diagnosis ; pathology ; Prognosis ; Tomography, X-Ray Computed ; Tremor

PURPOSE: This study was done to develop and test a structural model for caregiving experience including caregiving satisfaction and caregiving strain in families providing care for family members with a mental disorder. METHODS: The Stress-appraisal-coping model was used as the conceptual framework and the structural equation model to confirm the path that explains what and how variables affect caregiving experience in these families. In this hypothesis model, exogenous variables were optimism, severity of illness and uncertainty. The endogenous variables were self efficacy, social support, caregiving satisfaction and caregiving strain. Data were collected using structured questionnaires. RESULTS: Optimism and caregiving self-efficacy had significant direct and indirect effects on caregiving satisfaction. Optimism, severity of illness and uncertainty had significant direct and indirect effects on caregiving strain. The modified path model explained effects of optimism on caregiving self-efficacy with social support in the path structure as a mediator. Also, there were direct and indirect effects of optimism and uncertainty on caregiving satisfaction with social support and caregiving self-efficacy in the path structure as a mediators. CONCLUSION: Results suggest the need to improve caregiving self-efficacy of these families, establish support systems such as a mental health professional support programs for caregiving self-efficacy. Optimism, severity of illness and uncertainty perceived by families need to be considered in the development of support programs in order to increase their effectiveness.
Adaptation, Psychological ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Caregivers/*psychology ; Family ; Female ; Humans ; Logistic Models ; Male ; Mental Disorders/*pathology ; Middle Aged ; Personal Satisfaction ; Self Efficacy ; Severity of Illness Index ; Social Support ; Surveys and Questionnaires ; Uncertainty ; Young Adult

Standards for the recognition of occupational diseases (ODs) in Korea were established in 1954 and have been amended several times. In 2013, there was a significant change in these standards. On the basis of scientific evidence and causality, the International Labour Organization list, European Commission schedule, and compensated cases in Korea were reviewed to revise the previous standards for the recognition of ODs in Korea. A disease-based approach using the International Classification of Diseases (10th version) was added on the previous standards, which were agent-specific approaches. The amended compensable occupational neurological disorders and occupational mental disorders (OMDs) in Korea are acute and chronic central nervous system (CNS) disorders, toxic neuropathy, peripheral neuropathy, manganese-related disorders, and post-traumatic stress disorder. Several agents including trichloroethylene (TCE), benzene, vinyl chloride, organotin, methyl bromide, and carbon monoxide (CO) were newly included as acute CNS disorders. TCE, lead, and mercury were newly included as chronic CNS disorders. Mercury, TCE, methyl n-butyl ketone, acrylamide, and arsenic were newly included in peripheral neuropathy. Post-traumatic stress disorders were newly included as the first OMD. This amendment makes the standard more comprehensive and practical. However, this amendment does not perfectly reflect the recent scientific progress and social concerns. Ongoing effort, research, and expert consensus are needed to improve the standard.
Female ; Humans ; Mental Disorders/chemically induced/*economics/pathology ; Nervous System Diseases/chemically induced/*economics/pathology ; Occupational Diseases/*economics ; Occupational Exposure ; Republic of Korea ; Stress Disorders, Post-Traumatic/diagnosis/*economics ; Workers' Compensation/*economics

OBJECTIVETo review the main neuropsychiatric disorders and cognitive deficits in patients with Cushing's disease (CD) and the associated pathophysiological mechanisms underlying CD. These mechanistic details may provide recommendations for preventing or treating the cognitive impairments and mood disorders in patients with CD.

DATA SOURCESData were obtained from papers on psychiatric and cognitive complications in CD published in English within the last 20 years. To perform the PubMed literature search, the following keywords were input: cushing's disease, cognitive, hippocampal, or glucocorticoids.

STUDY SELECTIONStudies were selected if they contained data relevant to the topic addressed in the particular section. Because of the limited length of this article, we have frequently referenced recent reviews that contain a comprehensive amalgamation of literature rather than the actual source papers.

RESULTSPatients with active CD not only suffer from many characteristic clinical features, but also show some neuropsychiatric disorders and cognitive impairments. Among the psychiatric manifestations, the common ones are emotional instability, depressive disorder, anxious symptoms, impulsivity, and cognitive impairment. Irreversible effects of previous glucocorticoid (GC) excess on the central nervous system, such as hippocampal and the basal ganglia, is the most reasonable reason. Excess secretion of cortisol brings much structural and functional changes in hippocampal, such as changes in neurogenesis and morphology, signaling pathway, gene expression, and glutamate accumulation. Hippocampal volume loss can be found in most patients with CD, and decreased glucose utilization caused by GCs may lead to brain atrophy, neurogenesis impairment, inhibition of long-term potentiation, and decreased neurotrophic factors; these may also explain the mechanisms of GC-induced brain atrophy and hippocampal changes.

CONCLUSIONSBrain atrophy and hippocampal changes caused by excess secretion of cortisol are thought to play a significant pathophysiological role in the etiology of changes in cognitive function and psychiatric disturbances. The exact mechanisms by which GCs induce hippocampal volume loss are not very clear till now. So, further investigations into the mechanisms by which GCs affect the brain and the effective coping strategy are essential.

Brain-Derived Neurotrophic Factor ; genetics ; Cognition Disorders ; etiology ; Glucocorticoids ; physiology ; Hippocampus ; pathology ; physiology ; Humans ; Mental Disorders ; etiology ; Neurogenesis ; Pituitary ACTH Hypersecretion ; complications ; pathology ; physiopathology ; Quality of Life ; Signal Transduction