Human beings evolved in “natural” environments. Many intervention studies have shown that exposure to natural environments (compared to built/urban environments) reduces stress and increases cognitive functioning. We set out to test differences in fMRI functional connectivity while showing participants photographs from natural versus built environments (matched in terms of scenicness ratings). No differences in self-reported perceived stress, rumination, valence, arousal or dominance were observed. However, functional connectivity was significantly higher when participants saw natural rather than built environmental photographs in circuits consisting of dorsal attention network (DAN) and ventral attention network (VAN), DAN and default mode network (DMN) and DMN and Somatomotor connections. In addition, we observed lower functional connectivity during the natural environment condition correlated with more years that individuals spent in major cities during upbringing. Future studies, linking changes in cognitive functioning due to nature exposure and alterations in functional connectivity, are warranted.

Background: The approach-avoidance training program (AATP) has shown preliminary promise as an add-on to standard treatment for alcohol dependence. However, knowledge is lacking as to whether the effectiveness of AATP can be enhanced further when performed in a typical drinking situation. The main aim of this study is to investigate whether approach-avoidance training implemented in a virtual reality bar environment is superior to the classical joystick PC-version of the AATP. Methods: The study will be implemented as a randomized controlled trial. A total of 204consecutively enrolled alcohol use disorder (AUD) patients, recruited from alcohol inpatient clinics in Germany, Poland and Denmark, will be randomized into one of three groups at the start of standard alcohol treatment: group A) stimuli-relevant AATP + treatment as usual (TAU); group B) stimuli-relevant AATP in virtual reality + TAU, and group C) TAU only (control group). Treatment outcomes will be assessed at pre-treatment, post-treatment and 3-month follow-up. Repeatedmeasures ANOVA will be applied to compare the trajectories of the groups over time on drinking, craving and impulsiveness outcomes. It is hypothesized that the two experimental groups will achieve better treatment outcomes compared to group C and that group B will achieve better outcomes than group A.

A multicentre study compared the antidepressant efficacy and the tolerance of two selective serotonin reuptake inhibitors, paroxetine (20–30 mg/d) and fluvoxamine (50–200 mg/d) in two parallel groups of respectively 56 and 64 patients with major depression, as defined by DSM‐III‐R criteria. The duration of the study was six weeks, with assessments at baseline and at the end of weeks 1, 2, 4, and 6. For efficacy the Hamilton depression, the Hamilton anxiety scales and the clinical global impressions were used; adverse events were assessed by means of a non‐leading question. Results showed a similar improvement in both groups on all rating instruments. The total number of patients reporting adverse events did not significantly differ between paroxetine (52 per cent) and fluvoxamine (64 per cent); severe adverse events were however significantly less frequently reported with paroxetine than with fluvoxamine (13 per cent versus 28 per cent), and resulted less frequently in the discontinuation of treatment (5 per cent versus 17 per cent).

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