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Compared to nonanxious depressed patients, anxious depressed patients respond less to pharmacotherapy, prompting consideration of alternate treatments. Based on the transdiagnostic principles of cognitive therapy (CT), a group of investigators predicted that anxious depressed patients would respond as well to CT as nonanxious depressed patients. Adults (n = 523) with recurrent major depressive disorder received 12–14 weeks of CT as part of the Continuation Phase Cognitive Therapy Relapse Prevention Trial. Anxious depressed patients (n=264; 50.4%) were compared to nonanxious depressed patients (n = 259; 49.6%) on demographic variables, initial severity, attrition, and rates and patterns of response and remission.

Anxious depressed patients presented with greater illness severity and had significantly lower response (55.3 vs. 68.3%) and remission rates (26.9 vs. 40.2%) based on clinician-administered measures. By contrast, smaller between-group differences for attrition, and for response (59.1 vs. 64.9%) and remission (41.7 vs. 48.7%) rates on self-report measures were not significant. Further, anxious depressed patients had greater speed of improvement on self-reported anxiety symptom severity and clinician-rated depressive and anxiety symptom severity measures. Consistent with prior reports, anxious depressed patients presented with greater severity and, following CT, had lower response and remission rates on clinician-administered scales. However, anxious depressed patients improved more rapidly and response and remission rates on self-report measures were not significantly different from nonanxious depressed patients. These findings suggest that anxious depressed patients may simply need additional time or more CT sessions to reach outcomes fully comparable to those of less anxious patients.

ᔥPsychotherapy and Psychosomatics

Full bibliographic information
Smits, J.A.J. ; Minhajuddin, A. ; Thase, M.E. ; Jarrett, R.B. Outcomes of Acute Phase Cognitive Therapy in Outpatients with Anxious versus Nonanxious Depression. Psychother Psychosom 2012;81:153-160

EEG signals may reflect underlying brain connectivity patterns in autism. This brain has less dense local clusters linked by long-range connections, which may represent a normal pattern. Image::Boston Childrens Hospital

At present autism, is currently diagnosed purely on the basis of behavior and assessing  clinical  history.

Widely available EEG testing can distinguish children with autism from neurotypical children as early as age 2, finds a study from Boston Children’s Hospital. The study is the largest, most rigorous study to date to investigate EEGs as a potential diagnostic tool for autism, and offers hope for an earlier, more definitive test.

Researchers Frank H. Duffy, MD, of the Department of Neurology, and Heidelise Als, PhD, of the Department of Psychiatry at Boston Children’s Hospital, compared raw EEG data from 430 children with autism and 554 control subjects, ages 2 to 12, and found that those with autism had consistent EEG patterns indicating altered connectivity between brain regions – generally, reduced connectivity as compared with controls.

While altered connectivity occurred throughout the brain in the children with autism, the left-hemisphere language areas stood out, showing reduced connectivity as compared with neurotypical children, consistent with neuroimaging research. Findings were published June 26 in the online open-access journal BMC Medicine.
Duffy and Als focused on children with “classic” autism who had been referred for EEGs by neurologists, psychiatrists or developmental pediatricians to rule out seizure disorders. Those with diagnosed seizure disorders were excluded, as were children with Asperger’s syndrome and “high functioning” autism, who tend to dominate (and skew) the existing literature because they are relatively easy to study. The researchers also excluded children with genetic syndromes linked to autism (such as Fragile X or Rett syndrome), children being treated for other major illnesses, those with sensory disorders like blindness and deafness and those taking medications. [continue reading…]

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“A half hour each day may not seem like much, but add that up over a week, then a month, and then a year and you have a big impact,” says lead author David Schary. “One child may be getting up to four hours more active play every week, and this sets the stage for the rest of their life.”

Some might wonder whether parents who were less participatory during the week days made up for it during the weekends. Actually, just the opposite happened. Sedentary time increased nearly one hour each weekend day.

Bradley Cardinal, who co-authored both papers with Schary and Paul Loprinzi, says sedentary behaviour goes against the natural tendencies of most preschool-age children.

“Toddlers and preschool-age children are spontaneous movers, so it is natural for them to have bursts of activity many minutes per hour,” he said. “We find that when kids enter school, their levels of physical activity decrease and overall, it continues to decline throughout their life. Early life involvement is imperative for establishing healthy, active lifestyles, self-awareness, social acceptance, and even brain and cognitive development.”

In their second study, it was also found that parents who actively played with their kids had the most impact, but that any level of encouragement, even just watching their child play, made a difference.

“When children are very young, playing is the main thing they do during waking hours, so parental support and encouragement is crucial,” Schary said. “So when we see preschool children not going outside much and sitting while playing… we need to help parents counteract that behaviour.”

Both these studies were published in Early Child Development and Care 182:8 (2012), and are now available to read online:

Parenting style associated with sedentary behaviour in preschool children

David P. Schary, Bradley J. Cardinal & Paul D. Loprinzi

Parental support exceeds parenting style for promoting active play in preschool children

David P. Schary, Bradley J. Cardinal & Paul D. Loprinzi
The entire special issue contents can be found at http://www.tandfonline.com/toc/gecd20/182/8.

ᔥTaylor and Francis