Evidence suggests that a hyperactive frontal-striatal-thalamic-frontal circuit is associated with the symptoms of obsessive-compulsive disorder (OCD), but there is little agreement about the function of the exaggerated activity. We report electrophysiological evidence suggesting that part of this system monitors events and generates error signals when the events conflict with an individual's internal standards or goals. Nine individuals with OCD and 9 age-, sex-, and education-matched control participants performed a speeded reaction time task. The error-related negativity, an event-related brain potential component that reflects action-monitoring processes, was enhanced in the individuals with OCD. The magnitude of this enhancement correlated with symptom severity. Dipole modeling suggested that the locus of the enhancement corresponded to medial frontal regions, possibly the anterior cingulate cortex.

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Background Patients with diabetes and depression often have self-management needs that require between-visit support. This study evaluated the impact of telephone-delivered cognitive behavioral therapy (CBT) targeting patients’ management of depressive symptoms, physical activity levels, and diabetes-related outcomes. Methods 291 patients with type 2 diabetes and significant depressive symptoms (Beck Depression Inventory scores ≥14)were recruited from a community-university-and VA healthcare system. A manualized telephone CBT program was delivered by nurses weekly for 12weeks, followed by nine monthly booster sessions. Sessions initially focused exclusively on patients’ depression management and then added a pedometer-based walking program. The primary outcome was hemoglobin A1cmeasured at 12-months. Blood pressure was a secondary outcome; levels of physical activity were determined by pedometer readings; depression, coping, and health related quality of life (HRQL) were measured using standardized scales. Results Baseline A1c levels were relatively good and there was no difference in A1c at follow-up. Intervention patients experienced a4.26 mmHg decrease in systolic blood pressure relative to controls (p=.05). Intervention patients had significantly greater increases in step-counts (mean difference 1,131 steps/day; p=.0002) and greater reductions in depressive symptoms (58%remitted at12 months versus 39%; p=.002). Intervention patients also experienced relative improvements in coping and HRQL. Conclusions This program of telephone delivered CBT combined with a pedometer-based walking program did not improve A1c values but significantly decreased patients’ blood pressure, increased physical activity, and decreased depressive symptoms. The intervention also improved patients’ functioning and quality of life.

The central aim of this study is to estimate prevalence, ages of onset, severity, and associated disability of anxiety disorders among African Americans, Caribbean Blacks, and non-Hispanic whites in the U.S. Results indicated that whites were at elevated risk for generalized anxiety disorder, panic disorder, and social anxiety compared to Caribbean Blacks and African Americans. Black respondents were more likely to meet criteria for PTSD. When African American and Caribbean Black respondents met criteria for an anxiety disorder, they experienced higher levels of overall mental illness severity and functional impairment compared to whites. White respondents were at greater risk to develop generalized anxiety, social anxiety, and panic disorders late in life. Risk of developing PTSD endured throughout the life course for blacks whereas whites rarely developed PTSD after young adulthood. These results can be used to inform targeted interventions to prevent or remediate anxiety disorders among these diverse groups.

The 3' region of SLC1A1 may contain a susceptibility allele for early-onset OCD, with differential effects in males and females. The results also provide further support for the involvement of a glutamatergic dysfunction in the pathogenesis of early-onset OCD.