Clinical predictors of long-term outcome in obsessive-compulsive disorder

Background: The purpose of this study was to investigate demographic and clinical factors associated with the long-term outcome of obsessive-compulsive disorder (OCD). Methods: A hundred ninety-six previously untreated patients with DSM-IV criteria OCD completed a 12-week randomized open trial of group cognitive-behavioral therapy (GCBT) or fluoxetine, followed by 21 months of individualized, uncontrolled treatment, according to international guidelines for OCD treatment. OCD severity was assessed using the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) at different times over the follow-up period. Demographics and several clinical variables were assessed at baseline. Results: Fifty percent of subjects improved at least 35% from baseline, and 21.3% responded fully (final Y-BOCS score < or = 8). Worse prognosis was associated with earlier age at onset of OCD (P = 0.045), longer duration of illness (P = 0.001) presence of at least one comorbid psychiatric disorder (P = 0.001), comorbidity with a mood disorder (P = 0.002), higher baseline Beck-Depression scores (P = 0.011), positive family history of tics (P = 0.008), and positive family history of anxiety disorders (P = 0.008). Type of initial treatment was not associated with long-term outcome. After correction for multiple testing, the presence of at least one comorbid disorder, the presence of a depressive disorder, and duration of OCD remained significant. Conclusions: Patients under cognitive-behavioral or pharmacological treatment improved continuously in the long run, regardless of initial treatment modality or degree of early response, suggesting that OCD patients benefit from continuous treatment. Psychiatric comorbidity, especially depressive disorders, may impair the long-term outcome of OCD patients.

An ecological economic interpretation of the Jevons effect

This article develops an ecological economic interpretation of the Jevons effect. Moreover, it is argued that under the neoclassical paradigm there are no elements with which to foresee the long-term existence of this phenomenon. The objective of these arguments is to demonstrate that the Jevons effect can be used to compare the ability of neoclassical and ecological economics describing the social appropriation of nature. This is elaborated in two steps. First, we show the importance of the thesis that the economy cannot be cut off from the biophysical materiality of what is produced to give consistency to the so-called Khazzoom-Brookes postulate. It is made clear that this supposition is exogenous to the neoclassical paradigm. Second, the supposition of the biophysical materiality of what is produced is utilized to make an ecological economic interpretation of the Jevons effect. Afterwards, a comparison is made between the neoclassical and the ecological economic perspectives. This comparison leads to the following conclusions: (i) the persistent presence of the Jevons effect in the long run is an anomaly in the neoclassical paradigm; (ii) the observation of the non-existence of the Jevons effect is a refutation of the supposition that economic growth and biophysical materiality are not separable, a central thesis defended by ecological economists. This situation makes possible to use the Jevons effect as a 'laboratory test' to compare the ability of neoclassical and ecological economic paradigms to describe the social appropriation of nature. (C) 20111 Elsevier B.V. All rights reserved.

Transiting exoplanets from the CoRoT space mission XXIII. CoRoT-21b: a doomed large Jupiter around a faint subgiant star

CoRoT-21, a F8IV star of magnitude V = 16 mag, was observed by the space telescope CoRoT during the Long Run 01 ( LRa01) in the first winter field (constellation Monoceros) from October 2007 to March 2008. Transits were discovered during the light curve processing. Radial velocity follow-up observations, however, were performed mainly by the 10-m Keck telescope in January 2010. The companion CoRoT-21b is a Jupiter-like planet of 2.26 +/- 0.33 Jupiter masses and 1.30 +/- 0.14 Jupiter radii in an circular orbit of semi-major axis 0.0417 +/- 0.0011 AU and an orbital period of 2.72474 +/- 0.00014 days. The planetary bulk density is ( 1.36 +/- 0.48) x 10(3) kg m(-3), very similar to the bulk density of Jupiter, and follows an M-1/3 - R relation like Jupiter. The F8IV star is a sub-giant star of 1.29 +/- 0.09 solar masses and 1.95 +/- 0.2 solar radii. The star and the planet exchange extreme tidal forces that will lead to orbital decay and extreme spin-up of the stellar rotation within 800 Myr if the stellar dissipation is Q(*)/k2(*) <= 107.