Dan J Stein

..This paper reports on the perceived effectiveness of trichotillomania (TTM) internet support groups for people suffering from hair-pulling...

..Functional magnetic resonance imaging (fMRI) studies of disgust-inducing visual stimuli in OCD have suggested disorder specific alterations in brain activation during these tasks...

..As further progress is made in understanding the cognitive-affective neuroscience of OCD and related conditions, constructs about obsessive-compulsive spectrum disorders will become increasingly sharp...

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..This analysis was conducted to specifically assess the efficacy of sertraline in the treatment of PTSD secondary to interpersonal trauma or childhood abuse...

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..An integrative framework is required in order to conceptualize this data and to apply it in the clinic...

..The clinical and genetic correlates of hoarding in OCD therefore deserve additional investigation...

..We aimed to determine whether this holds across a broader set of developed and developing countries, and whether subtyping according to number of performance versus interactional fears would be more useful...

..Comorbidity of the putative OCSDs in OCD has, however, not often been systematically investigated...

..There is increasing recognition that obsessive-compulsive disorder (OCD) is not a homogeneous entity. It has been suggested that gender may contribute to the clinical and biological heterogeneity of OCD...

..In a regression model, a lower level of education and male gender were predictive of HIV-D. These findings suggest that HAND are highly prevalent in primary care settings in South Africa where clade C HIV is predominant...

..It remains unclear, however, whether OCPD in OCD represents a distinct subtype of OCD or whether it is simply a marker of severity in OCD...

..These data support a role for the dopaminergic system, which may be relevant to the development of early-onset OCD...

..Despite high rates of mental disorders and associated disability in South Africa, they are less likely to be treated than physical disorders...

..Comorbidity of symptoms might support the idea that they are indicative of an underlying stereotypic disorder, and we therefore explored their frequency in people with hair-pulling...

..We raise the possibility that genetically-driven variation in COMT may interact with childhood trauma to contribute to the risk of developing schizotypal personality traits...

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..However, there was also a concern that individuals with TRC relevant experience would simply be re-traumatized by participation in the process. To date, there has been little empirical data for either hypothesis...

..In South Africa, given the high rates of violence and trauma, there is particular interest in traumatic exposures as potential risk factors for IED...

..Against the backdrop of stressful life events and childhood abuse and neglect, we investigated the cumulative effect of multiple trauma exposure on PTSD, anxiety, and depression in an adolescent sample...

..The current findings support the involvement of the COMT Val158Met polymorphism in mediating the relationship between trauma and psychopathology...

..There is increasing evidence that obsessive-compulsive disorder (OCD) is a heterogeneous disorder. Different clinical subtypes may be characterized by differing pathophysiological mechanisms and treatment outcomes...

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..g., lower age) and comorbidity profile (e.g., increased incidence of impulse dyscontrol disorders). Additional work is necessary before conclusions about the role of monoaminergic systems in mediating such dissociation can be drawn...

..This paper further examines the notion of overlap in the neurocircuitry of treatment and indeed treatment response across anxiety disorders with SSRI treatment...

..In this study, we used diffusion tensor imaging (DTI) to examine white matter integrity in specific regions of interest (ROIs) in patients with OCD...

..These preliminary findings require replication to determine their reliability, and extension to determine whether or not they are disorder specific...

..Nevertheless, there is evidence of important differences between these two disorders. Some authors have conceptualized the disorders as lying on an OCD spectrum of conditions...

..The response of OCD symptom dimensions to 12 weeks of treatment with escitalopram or placebo was investigated...

..Further effort is required to educate the public about the psychobiological underpinnings of psychiatric disorders and about the value of effective treatments...

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..Results of the study confirmed the hypothesis which anticipated changes associated with apathy in white matter tracts that relay through the medial prefrontal cortex...

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..We investigated the prevalence of self-reported early suicidality (suicidal ideation, planning and attempts) in a nationally representative sample of South Africans...

..To date, there have been no cohort studies of the impact of highly active anti-retroviral treatment (HAART) in South Africa where clade C HIV is predominant...

..This study provides evidence that white-matter integrity is compromised in individuals infected with clade C HIV...

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..A number of rigorous studies of mindfulness-based cognitive therapy for depression have been positive. However, much remains to be discovered about the underlying mechanisms of and clinical indications for mindfulness-based approaches...

..More generally, HIV care and treatment services represent an important venue to identify and manage individuals with common mental disorders in resource-limited settings...

..Here, two different but related statistical techniques (multiple regression and partial least squares), confirmed that physical neglect and the 5-HTT genotype jointly play a role in predicting dissociation in OCD...

..Nevertheless, the neurotrophin hypothesis has already given impetus to a range of valuable research...

..Variable performance in neuropsychological testing may account for false negative screens. The inclusion of brief tests of executive function in a screening battery should be considered...

..Quetiapine is generally well tolerated and previous open-label data has produced mixed results in OCD and additional controlled data is needed...

..The AVIDI demonstrated a good psychometric property and can therefore be used to screen for depression in settings with higher rates of illiteracy...

..Here, we characterize a unique sample of treatment-naïve adolescents without such comorbidity to help identify vulnerable youth who may benefit from early intervention...

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..There are a number of possible reasons for low reports of HIV-related stigma, including having access to treatment and not disclosing HIV status...

..However, the neural substrates of PTSD remain poorly understood and the effect of selective serotonin reuptake inhibition on regional cerebral activity is deserving of further investigation...

..If this change is made, the name of this category should be changed to reflect this proposed change...

..Recovery could potentially be defined as a lack of disability, with an associated reduction in symptom severity. Conversely, relapse could potentially be defined in terms of either increased disability or increased symptoms...

..Future work, incorporating further investigation of the role of gender and psychobiological and treatment outcomes, is needed before definitive conclusions about hair-pulling subtypes can be drawn...

..An affect regulation, behavioral addiction, and cognitive control (A-B-C) approach is outlined to conceptualizing and managing these conditions...

..Speculatively, disruptions in cognitive-affective processes relevant to judgements about physical beauty lead to BDD...

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..There is increasing evidence that the symptoms of obsessive-compulsive disorder lie on discrete dimensions. Relatively little work has, however, explored the relationship between such factors and response to pharmacotherapy...

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..This underlines the impact of HIV on the nervous system and the importance of screening for co morbid mental health conditions...

..to compare differences in temperament dimensions between carriers of different (dominant vs. recessive) alleles for selected polymorphisms in SAD patients...

..However, there are few prospective studies on the rates of psychiatric disorders in HIV/AIDS, particularly in the context of the developing world...

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..Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues...

..The extension of conventional analysis strategies, to include time as a significant dimension of behaviour on the EPM, identified behavioural nuances, which could reflect adaptive aspects of stress-driven behaviours in MS mice...

..Recommendations for mental health service provision in South Africa and for future research on the relative risk for PTSD are offered...

..Accurate assessment is challenging yet important. More reliable measures of anxiety disorders in patients with schizophrenia and other psychotic disorders are clearly needed to allow for timely identification and treatment...

..Compared with placebo, escitalopram was associated with lower symptom scores, increased response and remission rates, and improved functioning...

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..Our study does not provide convincing support for the inclusion of the current diagnostic criteria B and C for TTM in DSM-5...

..Alternative practitioners, including traditional healers and religious advisors, appear to play a notable role in the delivery of mental health care in South Africa...

..In this population, trauma and PTSD were highly prevalent and associated with significant unidentified morbidity and comorbidity. Patients remain untreated for years in the current system of primary care consultations...

..A better understanding of these disorders amongst the public would presumably lessen stigmatisation and encourage the use of currently available and effective interventions...

..Future work to assess the implications of overlap for clinical evaluation and intervention in the two conditions may be useful...

..These findings suggest that posttrauma factors may be as important as pretrauma and peritrauma variables in the development of PTSD...

..A cognitive-affective neuroscience approach provides a conceptual basis from which clinical research can further explore how best to assess and treat a wide range of disruptions to the self...

..Misdiagnosis and ineffective treatment of survivors of human rights abuses are likely to pose a significant drain on primary care resources. Accurate diagnosis and appropriate treatment are important challenges in primary care settings...

..Genetic and environmental contributors to panic disorder are beginning to be delineated. Effective pharmacotherapy and psychotherapy are able to normalize the relevant psychobiology...

..A six-factor model of social anxiety symptoms is supported by the distinctive association between these symptom dimensions and different areas of disability, but did not predict differential response to escitalopram...

..Although evidence suggests that resilience may moderate the relationship between some of these risk factors and PTSD symptoms, no studies to date have examined these risk factors collectively...

..Conversely, many antidepressants result in decreased levels of 5-HT2A receptor levels, and blockade of 5-HT2A receptors has proven useful in the treatment of a number of psychiatric disorders...

..The efficacy of selective serotonin reuptake inhibitors in the acute treatment of social anxiety disorder (social phobia) is well established...

..There is increasing recognition that obsessive-compulsive disorder (OCD) is not a homogeneous entity. It has been suggested that gender may contribute to the clinical and biological heterogeneity of OCD...

..These findings highlight the high rates of exposure to multiple, noncombat-related trauma in military personnel, the potentially high rates of PTSD, and the role of inflicted trauma as an additional risk factor for PTSD...

..Studies examining the long-term effects of HAART on HIV-associated neurocognitive disorders (HANDs) using uniform methods of data collection are needed, together with clear reporting of HAART regimens...

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..A list of the meta-analyses included in this review is available on an evidence-based website of anxiety and trauma-related disorders...

..Recommendations include the need for traditional healers to be trained to identify potential cases of mental illness in their communities and for dialogue between traditional and allopathic physicians in regard to mental health care...

..These findings suggest that the ε4 allelic variant in HIV-positive individuals is not associated with the development of HAD in Southern Africa...

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..The relationship between food insufficiency and mental disorders within a nationally representative sample of South African adults was examined...

..Interventions designed to increase mental health literacy and reduce the stigma associated with psychiatric disorders may increase the likelihood of PLWHA seeking treatment should they suffer from these conditions...

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..Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and The Cochrane Library should be consulted for the most recent version of the review...

..The early and persistent effect of venlafaxine ER over placebo on anger/irritability is noteworthy in view of the clinical significance of these symptoms in PTSD...

..A randomized, double-blind, placebo-controlled trial was designed to assess the efficacy of agomelatine in generalized anxiety disorder (GAD)...

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..The paper closes by considering limitations of the review and possible future research avenues...

..Advances in the cognitive-affective neuroscience of fear processing may ultimately lead to new approaches to the clinical management of phobias...

..Assessment of these meta-analyses and guidelines provides an opportunity to review the strengths and weaknesses of the evidence-base...

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