Open Access Case Study

A Rare Case of Third Ventricular Epidermoid Cyst as Seen by Newer MRI Sequences

Ralph Xiu-Gee Man, Avinash Kumar Kanodia, Richard Stephen Nicholas, Gavin Main

International Neuropsychiatric Disease Journal, Page 68-77
DOI: 10.9734/INDJ/2014/7009

Aim: We describe a 52 year old gentleman who had a third ventricular lesion, presumed to be epidermoid cyst, which is very rare. We also describe the appearances of this rare condition on newer MRI sequences.

Presentation of Case: Third ventricle is a rare site of epidermoid cysts and difficult to visualise specially in routine MRI sequences. We used 3D FLAIR sequence as part of routine MRI protocol that was helpful in raising suspicion initially, aided by clinical presentation. Subsequent 3D T2 SPACE sequence confirmed the presence of abnormality.

Discussion: The case highlights the importance of high resolution 3D FLAIR sequence as part of initial MRI protocol that is devoid of CSF flow artefacts and therefore helpful for small intraventricular lesions. Importance of 3D T2 SPACE is also highlighted which is another new MRI sequence. It has excellent spatial resolution without artefacts that is helpful in clearly delineating the presence of small lesions such as epidermoid cyst and its relationship with surrounding structures and increasing diagnostic certainty.

Conclusion: We present a rare case of presumed third ventricular epidermoid cyst and potential role of newer MRI sequences in small intraventricular lesions.


Open Access Original Research Article

Possible Effect of COMTVal158Met Polymorphism on the Association between Childhood Maltreatment and Externalizing Behavior: A Preliminary Study

Valentina Bianchi, Rita Galluzzi, Angelo Massagli, Roberto Giorda, Massimo Molteni, Maria Nobile

International Neuropsychiatric Disease Journal, Page 54-67
DOI: 10.9734/INDJ/2014/7092

Aims: Over the course of the past decades, studies on child maltreatment have increasingly adopted multiple levels of analysis (particularly by the inclusion of genetics factors) on the basis of the variability in children’s responses to stressful life events. This is a preliminary study on the effects of child maltreatment in a sample of adolescents according to this perspective.

Study Design: Case-control study.

Methodology: We investigated the moderating effect of COMT Val158Met polymorphism onthe association of child maltreatment with a range of externalizing behavior - assessed by the Child Behavior Check List/6-18 scale - in a sample composed of 52 maltreated children and adolescents and 90 healthy controls aged 10-18. Maltreatment was recorded on the basis of the presence/absence of physical contact.

Results: COMT Val158Met polymorphism interacts with physical contact abuse to influence externalizing behavior (p=.04), with both genetic (p=.03) and environmental risk factor (p=.003) having a significant main effect. Similar results were found considering the rule-breaking component of externalizing behavior, and the main effect of maltreatment was highly significant in all analyses performed.

Conclusion: This preliminary study supports the hypothesis that the variability in children's responses to maltreatment might be partially explained by individual genetic differences. Considering the presence of physical contact as a risk factor we could explain inconsistence of findings in literature on GxE in maltreatment.


Open Access Original Research Article

Gender Differences in Young Adults with Social Phobia

Naumovska Andromahi, Bonevski Dimitar

International Neuropsychiatric Disease Journal, Page 78-84
DOI: 10.9734/INDJ/2014/6494

Aim: To examine the gender differences in young adults with clinical manifestation of social phobia.

Study Design: analytical, cross-sectional cohort study

Place and Duration of Study: Psychiatric Hospital- Skopje, Centre for Mental Health- Centre, between January 2012 and June 2013

Method: The severity of social phobia was measured with the Social Phobia Inventory (SPIN). The questionnaire was administered to 65 patients (age range 18 to 25, 53% female), diagnosed according to DSM-IV with social phobia, without co-morbidity of other mental disorders.

Results: Statistically significant differences between the examined groups (male and female) were found. These findings confirm that female young patients with social phobia are showing more severe fear and avoidant behaviour in speaking to anyone in authority, giving speeches, talking to people they don’t know, activities in which they are the centre of attention, while male young patients with social phobia are showing more severe fear and avoidant behaviour if they are criticized, with statistical significance p<0.01. 

Conclusion: Female young adults with social phobia are showing more severe fear and avoidant behaviour if they assume that other people are looking and monitoring them, while male young adults are showing more severe fear and avoidant behaviour if they are criticized.

Open Access Original Research Article

Comparison between the First and Sixth Year Medical Students in the Arabian Gulf University of Bahrain Regarding Anxiety and Depression

Hasfa M. Ali, Duaa M. Attar, Fatma Al-Abdulwahid, Fatema A. Juma, Hussah I. Al-Mezail, Jawaher A. Al-Jalahma, Raneem R. Al-Shaikh, Samar S. Hussain, Sara A. A. Al-Mail, Wafa A. T. Al-Omari, Amer Kamal

International Neuropsychiatric Disease Journal, Page 85-93
DOI: 10.9734/INDJ/2014/8048

A cross sectional study involving all year 1 and 6 medical student of Arabian Gulf University in Bahrain in the year 2011-2012 was performed by self reporting anxiety and depression using HADS forms. The results showed that 33.96 % of year 1 and 55.07% of year 6 students showed anxiety, while student of year 1 and 6 showed 18.87% and 31.88% depression state respectively. Statistically the anxiety and depression were significantly higher in year 6 compared to year 1 students (Analysis of Variance ANOVA, p< 0.05). Neither of these mental states were significantly different in males and females students. The averaged score of male medical student was 9.64±0.4 for anxiety and 8.01±0.4 for depression compared to 9.88±0.5 and 8.13±0.5 which were scored in females for anxiety and depression respectively (ANOVA p˃0.05). It is concluded that the stress associated with studying medicine is continuous and accumulative during the years of the study and that medical students confrontation with extra stressors related to their studies in addition to the normal daily stressors of life making them more vulnerable to anxiety and depression states.


Open Access Original Research Article

Normative Minor Childhood Stress and Risk of Later Adult Psychopathology in Saudi Arabia

Michael E. Hyland, Ahmed M. Alkhalaf, Ben Whalley

International Neuropsychiatric Disease Journal, Page 94-103
DOI: 10.9734/INDJ/2014/7997

Chronic minor childhood stress in the form of corporal punishment predicts adult psychopathology in the United States but has not been demonstrated in a country where corporal punishment is normative. We tested whether adult psychopathology was predicted by recalled frequency of childhood corporal punishment and recalled controllability of punishment in Saudi Arabia. Two hundred and fifty nine Saudi men with substance addictions (who for cultural reasons were at risk for depression) completed a survey measuring: demographic variables, frequency of beating and controllability of punishment as a child, depression and borderline personality disorder symptoms (BPD). Beating frequency and punishment control were uncorrelated and unrelated to patients’ or parents’ education. 92 men (36%) had major depression (PHQ-9 ≥15). Compared to those never beaten, those experiencing infrequent beating (once or twice a year) were significantly more likely to have major depression and higher BPD symptoms, after controlling for demographic variables. Those experiencing frequent beating (monthly or more frequent) were more likely to have major depression and higher BDP symptoms compared to those never beaten, but only when perceived control was low. Perceived punishment control was not significantly related to outcome for those who never had or had infrequent corporal punishment. These results provide evidence in a culture where corporal punishment is normative that corporal punishment, even when infrequent, predisposes to adult psychopathology and that uncontrollability increases the pathogenic effect of frequent corporal punishment. These results support the hypothesis that frequent minor stressors in childhood act as kindling factor for later depression.


Open Access Review Article

The Involvement of the Hypothalamic-pituitary-gonadal, Hypothalamic-pituitary-adrenal and Somatotrophic Axes in the Development and Treatment of Schizophrenia

T. Gleich, J. B. Deijen, M. L. Drent

International Neuropsychiatric Disease Journal, Page 34-53
DOI: 10.9734/INDJ/2014/6842

In the present review, organizational and activational hormonal effects are proposed to be dysfunctional in schizophrenia and psychosis. Specifically, organizational effects are held responsible for the long-lasting anatomical and functional changes in brain development associated with the disease. Later in life, activational effects may be superimposed and may interact with the earlier induced biological vulnerabilities, eventually triggering the first psychotic episode in schizophrenia. In parallel, it is known that schizophrenia follows a different course in male and female patients and that the first psychotic episode frequently occurs shortly before or during puberty. The different course of schizophrenia in male and female patients seems to be related to digressions in hormonal secretion between the genders. Further the excessive change of hormonal secretion during puberty suggests a relationship between hormonal secretion and the development of schizophrenia, possibly mediated by epigenetic regulation of neuroendocrine systems. We discuss the Hypothalamic-Pituitary-Gonadal (HPG), the Hypothalamic-Pituitary-Adrenal (HPA) and the Somatotropic axes and further present evidence for positive treatment effects in schizophrenia by hormonal agents. We conclude that organizational as well as activational effects of hormones may attribute to the development of schizophrenia. Research on hormonal factors in schizophrenia might therefore enhance the general understanding of the disease in regard to its neurobiology and treatment options.