Karin Gutierrez-Lobos

[ 123 I]- β -CIT SPECT Imaging Shows Reduced Thalamus–Hypothalamus Serotonin Transporter Availability in 24 Drug-Free Obsessive-Compulsive Checkers

Numerous findings indicate alterations in brain serotonin systems in obsessive-compulsive disorder (OCD). We investigated the in vivo availability of thalamus–hypothalamus serotonin transporters (SERT) in patients with DSM-IV OCD who displayed prominent behavioral checking compulsions (OC-checkers). Four hours after injection of [123I]-2β-carbomethoxy-3β-(4-iodophenyl)tropane ([123I]-β-CIT), single photon emission computed tomography (SPECT) scans were performed in 24 medication-free non-depressed OC-checkers and 24 age- and gender-matched healthy controls. For quantification of brain serotonin transporter availability, a ratio of specific to non-displaceable [123I]-β-CIT brain binding was used (V″3=(thalamus and hypothalamus−cerebellum)/cerebellum). Drug-free non-depressed OC-checkers showed an 18% reduced brain serotonin transporter availability in the thalamus and hypothalamus, as compared with healthy control subjects (1.38±0.19 vs 1.69±0.21; p<0.001). There was a strong negative correlation between severity of OC symptomatology (Y-BOCS scores) and SERT availability (r=−0.80; p<0.001). Moreover, we found a significant positive correlation between illness duration and serotonin transporter availability (r=0.43; p<0.05). This first report of significantly reduced [123I]-β-CIT binding in the thalamus–hypothalamus region in OC-checkers suggests reduced brain serotonin transporter availability, which is more pronounced with increased severity of OC symptomatology and short duration of illness. The results provide direct evidence for an involvement of the serotonergic system in the pathophysiology of OCD.

Violent Sex Offenders Lack Male Social Support

Social networks and social support generally exert an important impact on the management of crisis and may thus influence prevention and rehabilitation strategies. The authors therefore investigated the social network and support in a group of 62 incarcerated sexual offenders. Irrespective of the underlying diagnosis, offenders were divided into a high-violent group and a low-violent group. A factor analysis resulted in five factors describing specific dimensions of social support. A significantly lower perceived social support was found in the high-violent group as compared with the low-violent offenders concerning the factors “talking about problems and feelings to someone” and “rely on someone.” This low support exclusively referred to men outside the family. Neither the number of previous convictions nor length of prior imprisonment predicted the amount of displayed violence. The authors’ results are compared with those in the pertinent literature and are discussed in light of relevant therapeutic strategies in prevention and rehabilitation.

Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

BackgroundWomen’s participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité – Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom).CaseThe percentage of female medical students and doctors in all four countries is now well within the 40–60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the ‘glass ceiling’ effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications.ConclusionSetting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises and newly created management structures. Developing comprehensive gender-sensitive health workforce monitoring systems and comparing progress across academic health centres in Europe could help to identify the gender leadership gap and utilise health human resources more effectively.

Reaction to pain stimulus before and during hypnosis measured by pupillary reaction

Abstract The aim of this study was to investigate the analgesic effects of hypnotic pain control on experimental pain by measuring pupil reactions as an objective psycho-physiologic parameter. Twenty-two healthy volunteers (11 female and 11 male) aged between 22 and 35 years participated in the study. Pupil diameter was measured as baseline measurement (i.e., static measurement) in the non-hypnotic and in the hypnotic state. Pupil diameter changes to a standardized pain stimulus were measured in the non-hypnotic and hypnotic state and compared. Additionally, a Fourier analysis of pupil oscillations reflecting central nervous activation during the static measurement (25.6 sec) was calculated. During the hypnotic state the pain related pupil dilation was significantly smaller than during the non-hypnotic state. Pupil oscillations were significantly reduced during hypnosis.

Discriminating among incarcerated sexual offenders by their perception of interpersonal problems and experience-related anxiety

Fifty-seven (57) incarcerated sex offenders were assessed for their capacity to perceive interpersonal difficulties and experience related anxiety. The findings suggest that the men who have sexually transgressed against minors view themselves as easily exploitable and nurturant, and those who have sexually aggressed against adult females demonstrated minimal regard for external negative views of them. These two groups did not differ significantly from each other along social avoidance and non assertiveness dimensions. Assertiveness was found to decrease as a consequence of multiple incarcerations in both groups. Furthermore, perception of interpersonal difficulties and experience related anxiety in our study correctly classified 72% of high and low violent sexual offenders.