Post-traumatic stress disorder (PTSD) is a mental health disorder precipitated by a stressful event that produces fear or terror in the individual. Post-traumatic stress disorder studies, particularly in early sexual abuse, have been associated with neuroendocrine dysfunction, most notably the hypothalamic-pituitary-adrenal (HPA) axis. Since the literature on PTSD and neuroendocrine factors in young subjects has been sparse, the present studies were designed to look at the basal functioning of the HPA axis in response to early sexual abuse in girls aged 5 to 7 years. Morning salivary samples were collected for cortisol determination from subjects and controls who were scheduled for a physical exam by their pediatrician. The present study shows that subjects who had been abused within the last couple of months had significantly lower cortisol in comparison to control subjects (age, social economic status and race matched). The data suggest that children may have an impaired HPA axis after early trauma.

The MASS Interview, a semi-structured interview containing behavioural descriptions of DSM-IV symptom criteria, shows promise as a potentially helpful tool in the psychiatric diagnostic evaluation of persons with ID and limited expressive language skills, in the detection of mood and anxiety disorders. The tool also yields a wide breadth of clinical information and is easy for mental health clinicians to use.

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Acta Neuropsychiatrica 287set of subcortical and limbic regions in which opposite changes are found. Conclusions: The pathophysiology of major depressive disorder involves a complicated series of networks of frontal, temporal-parietal cortical and limbic brain regions and the cerebellum. Questions remain as to whether one or other of these networks play a primary role in the etiology of the disorder. Objective:The study aimed to explore the effects of high-frequency, left-sided repetitive transcranial magnetic stimulation (rTMS) (HFL-TMS) and low-frequency stimulation to the right prefrontal cortex (LFR-TMS of HFL-TMS) using functional magnetic resonance imaging (fMRI) before and after a course of rTMS in patients with treatment-resistant depression (TRD). Methods: The study was a randomized parallel before and after trial using fMRI to study the effects of 3 weeks of daily HFL-TMS and LFR-TMS treatment. Twenty-six patients with TRD underwent rTMS treatment and were scanned with fMRI during a planning task pretreatment and after 3 weeks. Results: There was a signifi cant reduction in depression severity for patients in both treatment groups [F(1, 24) = 17.5, P = 0.05). Responders to HFL-TMS showed an increase in task-related activation in prefrontal regions bilaterally. In contrast, responders to LFR-TMS showed a decrease in bilateral prefrontal activity. There were also differences in pretreatment scans between responders and nonresponders. Conclusions: Changes in task-related brain activation produced by HFL-TMS and LFR-TMS occur bilaterally in frontal brain regions but are opposite in direction, with high-frequency stimulation increasing and lowfrequency stimulation decreasing task-related activation.