Michael J. Schrift

Brief pulse ECT in melancholia: EEG and clinical effects

In a visual analysis of electroencephalograms (EEGs) obtained in 33 melancholic men before and after six brief pulse right unilateral, left unilateral, or bilateral electroconvulsive therapy (ECT) treatments, the authors were unable to detect the relation between therapeutic outcome and differential hemispheric lateralization of ECT-induced EEG slowing that had been reported previously for sine wave ECT at the same clinical site. These results may be related to differences in neurophysiologic effects between sine wave and brief pulse ECT, and do not support the hypothesis that lateralization of ECT-induced EEG slowing is central to the antidepressant effects of ECT.

Interhemispheric Transfer in Major Psychoses

The authors studied 25 schizophrenics and 21 affectively ill, pure right-handed, male patients by using the Tactual Performance Test (TPT), a stereognosis block identification task, and an anomia task to evaluate their interhemispheric information transfer. Although both groups generally had difficulty performing the TPT, the pattern of performance deficit was not different between diagnostic groups and was not consistent with a clear-cut interhemispheric transfer problem. Schizophrenics made more naming errors and TPT preferred-hand errors than did affectively ill patients, whereas affectively ill patients were able to identify more blocks with their preferred hand than could the schizophrenics. Patient index age, illness onset age, handedness, medications received at time of testing, personal and family history of alcoholism, and family history of major mental illness did not relate to cognitive performance. It is concluded that these data are not consistent with an interhemisphere transfer deficit that is specific for schizophrenia, but they are consistent with either a nonspecific interhemisphere transfer deficit in psychoses or with a left or bilateral hemisphere impairment in schizophrenia.

Forensic Neuropsychological Evaluations in an Academic Medical Center

Within the expanding field of clinical neuropsychology, the subspecialty of forensic neuropsychology has developed. Currently, there is considerable diversity within the discipline as to how practitioners approach test selection, reports, and number of hours billed. How individuals handle these issues is subject to debate, but what is clear is that there are no specific guidelines as to how to conduct these evaluations. The current study provides an introduction to the issues faced by clinical neuropsychologists completing forensic evaluations. In addition, the authors present how the relevant issues are addressed in one neuropsychology service housed within a university-affiliated academic medical center.

Behavioral abnormalities are common and severe in patients with distal 22q11.2 microdeletions and microduplications

We describe six individuals with microdeletions and microduplications in the distal 22q11.2 region detected by microarray. Five of the abnormalities have breakpoints in the low‐copy repeats (LCR) in this region and one patient has an atypical rearrangement. Two of the six patients with abnormalities in the region between LCR22 D–E have hearing loss, which has previously been reported only once in association with these abnormalities. We especially note the behavioral/neuropsychiatric problems, including the severity and early onset, in patients with distal 22q11.2 rearrangements. Our patients add to the genotype–phenotype correlations which are still being generated for these chromosomal anomalies.