OBJECTIVE: We examined the effect of risk alleles of polymorphisms of three schizophrenia risk genes that mediate monoamine signalling in the brain on regional brain volumes of schizophrenia and healthy control subjects. The risk alleles and the gene polymorphisms studied were: Val allele of catechol o-methyltransferase (COMT) rs4680 polymorphism; short allele of 5-hydroxy tryptamine transporter linked polymorphic region (5HTTLPR) polymorphism; and T allele of 5-hydroxy tryptamine 2A (5HT2A) rs6314 polymorphism. METHODS: The study was carried out on patients with recent onset schizophrenia (n=41) recruited from the outpatient department of National Institute of Mental Health and Neurosciences, Bangalore, India and healthy control subjects (n=39), belonging to South Indian Dravidian ethnicity. Individual and additive effects of risk alleles of the above gene polymorphisms on brain morphometry were explored using voxel-based morphometry. RESULTS: Irrespective of phenotypes, individuals with the risk allele T of the rs6314 polymorphism of 5HT2A gene showed greater (at cluster-extent equivalent to family wise error-correction [FWEc] p<0.05) regional brain volumes in the left inferior temporal and left inferior occipital gyri. Those with the risk alleles of the other two polymorphisms showed a trend (at p<0.001, uncorrected) towards lower regional brain volumes. A trend (at p<0.001, uncorrected) towards additive effects of the above 3 risk alleles (subjects with 2 or 3 risk alleles vs. those with 1 or no risk alleles) on brain morphology was also noted. CONCLUSION: The findings of the present study have implications in understanding the role of individual and additive effects of genetic variants in mediating regional brain morphometry in health and disease.
Alleles ; Brain* ; Catechol O-Methyltransferase ; Humans ; India ; Magnetic Resonance Imaging ; National Institute of Mental Health (U.S.) ; Negotiating* ; Neurosciences ; Outpatients ; Phenotype ; Schizophrenia*

Cognitive deficit is frequently observed in patients with schizophrenia. It is significantly associated with functional outcome. In the past 20 years, due to significant advances on the concept of schizophrenia, cognitive deficit has been accepted as a core feature. In the DSM-5, cognitive deficit does not introduce diagnostic criteria of schizophrenia, but did one dimension of diagnosis of psychosis. Existing schizophrenia drugs are effective in treatment of positive symptoms of schizophrenia, but lack of effectiveness on improving cognitive function. Led by NIMH (National Institute of Mental Health), the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) meeting was conducted in order to achieve consensus on measuring tools and neuropharmacological targets for clinical trials for development of new drugs for improvement of cognitive function in schizophrenia. At the MATRICS consensus meeting, glutamatergic modulators and nicotinic and muscarinic agonists are expected to be promising, but should be proven by a double-blind placebo-controlled multicenter study for patients.
Cognition ; Consensus ; Diagnosis ; Drug Therapy ; Humans ; Muscarinic Agonists ; National Institute of Mental Health (U.S.) ; Psychotic Disorders ; Schizophrenia*

The new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is published by the American Psychiatric Association. The diagnostic systems for mental disorders have come under criticism for relying on presenting signs and symptoms with the result that they do not adequately reflect relevant neurobiological and behavioral systems. Finally, the National Institute of Mental Health (NIMH) in the United States has suggested the Research Domain Criteria (RDoC) to develop a research classification system based upon dimensions of neurobiology and behavioral aspect. The present review introduces the RDoC as a new reaseach framework.
Classification ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Mental Disorders ; National Institute of Mental Health (U.S.) ; Neurobiology ; United States

PURPOSE: To evaluate the impact of intravitreal bevacizumab injection on visual function and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) using the Korean version of the National Eye Institute Visual Function Questionnaire 25 (K-NEI-VFQ-25). METHODS: This study included 32 normal control subjects and 32 patients with BRVO. The Korean version of NEI-VFQ-25 was answered by the patients with BRVO before and 3 months after intravitreal bevacizumab injection, as well as by normal control subjects. Clinical data were collected, including central macular thickness (CMT), total macular volume (TMV) (using time-domain optical coherence tomography [OCT]), and best corrected visual acuity (BCVA). RESULTS: Visual acuity, CMT, and TMV significantly improved 3 months after intravitreal bevacizumab injections. No bevacizumab-related systemic or ocular adverse effects following intravitreal drug injections were observed. Significant improvement in the VFQ-25 composite score was observed in patients with BRVO. Subscale scores, including general vision, near activities, distance activities, social functioning, mental health, role difficulties, dependency, and peripheral vision, improved after injection. However, subscale scores regarding general health, ocular pain, driving, and color vision did not improve significantly. CONCLUSIONS: Intravitreal bevacizumab injection appears to be an effective treatment for visual function, as well as VR-QOL in macular edema secondary to BRVO. However, improvement of driving function and color vision appears to require a longer recovery time than visual function.
Antibodies, Monoclonal, Humanized ; Color Vision ; Dependency (Psychology) ; Humans ; Macular Edema ; Mental Health ; National Eye Institute (U.S.) ; Quality of Life ; Surveys and Questionnaires ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Bevacizumab

BACKGROUND: Alcohol Use Disorders Identification Test (AUDIT) is effective in identifying problem drinking. This study purposed to evaluate the usefulness of AUDIT in identifying problem drinking among Korean university students whose drinking characteristic is different from adults. METHODS: The subjects were 235 students who had visited the Health Service Center of Chungnam National University. All subjects had a diagnostic interview for the presence of at-risk drinking and alcohol use disorder. At-risk drinking was defined according to the criteria of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed by the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV TR). At-risk drinking or alcohol use disorder was classified into problem drinking. At the same time, a survey was conducted using three screening tools: AUDIT, cut down, annoyed, guilty feelings, eye opener (CAGE), and cut down, under influence, guilty feelings, eye opener (CUGE). Area under receiver operating characteristic curve (AUROC) of the questionnaires to the results of interviews were compared. RESULTS: Seventy one students were at-risk drinkers and 46 had alcohol use disorder, and 75 were classified into problem drinkers. For identification of problem drinking, AUROC of AUDIT was 0.970 in men and 0.989 in women. For CAGE, it was 0.650 in men and 0.747 in women. For CUGE, it was 0.689 in men and 0.745 in women. CONCLUSION: Above results suggest that AUDIT is most effective in identifying university students' problem drinking.
Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Eye ; Female ; Health Services ; Humans ; Male ; Mass Screening ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; ROC Curve

OBJECTIVES: The current review aimed to describe the major findings of the NIMH Collaborative Multisite Multimodal Treatment Study of Children with Attention-Deficit Hyperactivity Disorder (MTA) with regard to the treatment of children with attention-deficit hyperactivity disorder (ADHD). METHODS: We performed a general review of the literature regarding the efficacy of the MTA's proposed treatments. RESULTS: There is a large and still increasing body of evidence regarding the MTA's treatment outcomes. We present and discuss details of the findings at each follow-up point. CONCLUSION: Currently, findings regarding the MTA's treatments suggest children with combined-type ADHD exhibit significant impairment in adolescence, despite their initial symptom improvement. Further studies, using innovative treatment approaches and targeting specific areas of adolescent impairment, are needed in order to enhance ADHD treatment outcomes.
Adolescent ; Child ; Combined Modality Therapy ; Follow-Up Studies ; Glutamates ; Guanine ; Humans ; National Institute of Mental Health (U.S.) ; Pemetrexed

Attention Deficit Disorder with Hyperactivity ; psychology ; therapy ; Behavior Therapy ; methods ; Central Nervous System Stimulants ; therapeutic use ; Child ; Combined Modality Therapy ; Humans ; National Institute of Mental Health (U.S.) ; Social Adjustment ; Treatment Outcome ; United States

Antipsychotic drugs have focused on treatment of positive and negative symptoms of schizophrenia. While these drugs resulted in improvements of these symptoms, they did not yield the expected recovery to pre-morbid level of functioning. Recently, a growing number of publications have shown that the cognitive deficits are a core feature of schizophrenia and they are critical determinants of poor functional outcome. Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) is a NIMH initiative that is designed to stimulate development of drugs to improve cognition in schizophrenia. MATRICS has four main goals: 1) to promote development of novel compounds to enhance cognition in schizophrenia, 2) to increase acceptance of cognition in schizophrenia as a valid target for drug approval from the US Food and Drug Administration, 3) to help focus the economic research power of industry on this important, but neglected, clinical target, and 4) to identify promising compounds and support proof of concept trials for cognition-enhancers in schizophrenia. In this article, we reviewed the contents of MATRICS and its progress.
Antipsychotic Agents ; Cognition* ; Drug Approval ; National Institute of Mental Health (U.S.) ; Psychopharmacology ; Schizophrenia* ; United States Food and Drug Administration

It is sufficient to justify distinguishing age-appropriate and age-inappropriate forms of age-related memory decline. The former, of which AAMI is an example, represents a normal age-related phenomenon, whereas the latter, the true descendent of benign senescent forgetfulness, is by definition abnormal and possibly, pathological. Whether age-inappropriate forgetfulness is progressive, whether it can be distinguished from other concepts of mild cognitive decline by virtue of being specific to memory, and whether it is qualitatively different from normal memory or merely worse is not yet certain. The prevalence of age-inappropriate forgetfulness is undetermined, but it is certainly less common than AAMI. The construct of AAMI was introduced by an NIMH work group. It was the group's declared intention to facilitate communication and stimulate research into late-life memory loss, particularly its treatment. Completely satisfactory diagnostic criteria do not yet exist for AAMI. Improved criteria would take an individual's overall level of intellectual functioning or educational background into account when setting the standard against which to rate memory, distinguish age-appropriate from age-inappropriate decline. AAMI differs from BSF in several points. First, the AAMI criteria define impairment with respect to healthy young adult levels, not to those of the older individual's age peers as was implied in the description of BSF. Second, the term AAMI is non-specific with regard to etiology and does not necessarily imply that the disorder is non-progressive. Thus, patients whose memory impairment is subsequently shown to be the earliest stage of a dementing illness are not necessarily excluded from the category of AAMI, and it is sensible to ask how often AAMI is, in fact, a dementia prodrome.
Aging ; Dementia ; Humans ; Intention ; Memory Disorders ; Memory* ; National Institute of Mental Health (U.S.) ; Prevalence ; Virtues ; Young Adult

OBJECTIVES: The pharmacologic treatment of obsessive-compulsive disorder(OCD) with serotonergic antidepressant agents is well established in clinical psychiatry on the basis of serotonin hypothesis. Studies on predictive factors of treatment response to OCD are relatively scarce. The author compared the demographic factors, age of onset, length of illness, family history of mental illness, previous drug history for OCD, severity and type of symptoms between the drug responders and non-responders to find out the predicitive factors that may be related to treatment response. METHODS: The subjects were 31, both inpatients and outpatients who met the diagnostic criteria for OCD by DSM-IV and scored 20 or higher on the Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) completed 12-week trial of sertraline. Y-BOCS, National Institute of Mental Health Obsessive-Compulsive Scale(NIMHOCS), Clinical Global Impression Scale(CGI) were scored to measure the changes of obsessive-compulsive symptoms, and Hamilton Anxiety Scale(HAM-A) was measured at each visit. RESULTS: 1) The responders, defined as achieving at least a 40% decrease in the Y-BOCS total score and more than a 2 point decrease in CGI score, were 17(54.8%), and non-responders were 14(45.2%). Responders tended to show later onset(p<0.1), and shorter duration of illness(p<0.05), and less previous drug therapy for OCD(p<0.05) than non-responders. There were no significant differences in family history of mental illness between the two groups. 2) The baseline Y-BOCS compulsive score was significantly lower in responders(p<0.05), although there was no significant difference in the baseline severity of other measures. 3) The obsession of contamination and washing behaviors were more frequent, but compulsive counting was not shown, in responders(p<0.05). The pathological doubt tended to be more common in nonresponders(p<0.1). CONCLUSIONS: In summary, the patients with shorter duration of illness, less prior drug therapy for OCD, and less severe compulsive behaviors, and the obsession of contamination and washing behaviors are expected to be better outcome with sertraline, whereas compulsive counting are the predictor of poor response.
Age of Onset ; Anxiety ; Compulsive Behavior ; Demography ; Diagnostic and Statistical Manual of Mental Disorders ; Drug Therapy ; Humans ; Inpatients ; National Institute of Mental Health (U.S.) ; Obsessive Behavior ; Obsessive-Compulsive Disorder* ; Outpatients ; Serotonin ; Sertraline*