Obsessive-compulsive disorder: Influence of age at onset on comorbidity patterns

Purpose. - This study investigates the influence of age at onset of OCS on psychiatric comorbidities, and tries to establish a cut-off point for age at onset. Methods. - Three hundred and thirty OCD patients were consecutively recruited and interviewed using the following structured interviews: Yale-Brown Obsessive Compulsive Scale; Yale Global Tic Severity Scale and the Structured Clinical Interview for DSM-IV. Data were analyzed with regression and cluster analysis. Results. - Lower age at onset was associated with a higher probability of having comorbidity with tic, anxiety, somatoform, eating and impulse-control disorders. Longer illness duration was associated with lower chance of having tics. Female gender was associated with anxiety, eating and impulse-control disorders. Tic disorders were associated with anxiety disorders and attention-deficit/hyperactivity disorder. No cutoff age at onset was found to clearly divide the sample in homogeneous subgroups. However, cluster analyses revealed that differences started to emerge at the age of 10 and were more pronounced at the age of 17, suggesting that these were the best cut-off points on this sample. Conclusions. - Age at onset is associated with specific comorbidity patterns in OCD patients. More prominent differences are obtained when analyzing age at onset as an absolute value. (C) 2008 Elsevier Masson SAS. All rights reserved.

Early Onset Obsessive-Compulsive Disorder With and Without Tics

Introduction: Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations. Objective: The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated. Methods: Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the ""early onset"" group (EOG): before 11 years of age, 75 patients had an ""intermediate onset"" (IOG), and 95 patients were from the ""late onset"" group (LOG): after 18 years of age. From the 160 EOG, 60 had comorbidity with tic disorders. The diagnostic instruments used were: the Yale-Brown Obsessive Compulsive Scale and the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS), Yale Global Tics Severity Scale; and Structured Clinical Interview for DSM-IV Axis I Disorders-patient edition. Statistical tests used were: Mann-Whitney, full Bayesian significance test, and logistic regression. Results: The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the ""aggression/violence"" and ""miscellaneous"" dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the ""contamination/cleaning"" dimension. Conclusion: The current results disentangle some of the clinical overlap between early onset OCD with and without tics. CNS Spectr. 2009; 14(7):362-370

Post-polio syndrome: epidemiologic and prognostic aspects in Brazil

Objectives - To describe the clinical and epidemiological aspects of post-polio syndrome (PPS) and identify predictors of its severity. Materials and methods - 132 patients with PPS were selected at the Neuromuscular Disease Outpatient Clinic of the Federal University of Sao Paulo. Descriptive analysis was carried out and predictors of PPS severe forms were investigated using an unconditional logistic regression. Results - The average age at onset was 39.4 years. The most common symptoms were fatigue (87.1%), muscle pain (82.4%) and joint pain (72.0%); 50.4% of the cases were severe. The following were associated with PPS severity: a < 4-year period of neurological recovery (OR 2.8), permanent damage in two limbs (OR 3.6) and residence at the time of acute polio in a city with more advanced medical assistance (OR 2.5). Conclusions - Health professionals should carefully evaluate polio survivors for PPS and be aware of the implications of muscle overuse in the neurological recovery period.

The onset of flood basalt volcanism, Northern Parana Basin, Brazil: A precise U-Pb baddeleyite/zircon age for a Chapeco-type dacite

We report the first U-Pb baddeleyite/zircon date for a felsic volcanic rock from the Parana Large Igneous Province in south Brazil. The new date of 134.3 +/- 0.8 Ma for a hypocrystalline Chapeco-type dacite from Ourinhos (northern Parana basin) is an important regional time marker for the onset of flood basalt volcanism in the northern and western portion of the province. The dated dacite was erupted onto basement rocks and is overlain by a high-Ti basalt sequence, interpreted to be correlative with Pitanga basalts elsewhere. This new U-Pb date for the Ourinhos dacite is consistent with the local stratigraphy being slightly older than the few reliable step-heating (40)Ar/(39)Ar dates currently available for overlying high-Ti basalts (133.6-131.5 Ma). This indicates an similar to 3 Ma time span for the building of the voluminous high-Ti lava sequence of the Parana basin. On the other hand, it overlaps the (40)Ar/(39)Ar dates (134.8-134.1 Ma) available for the stratigraphically older low-Ti basalt (Gramado + Esmeralda types) and dacite-rhyolite (Palmas type) sequences from South Brazil, which is consistent with the short-lived character of this volcanism and its rapid succession by the high-Ti sequence. (C) 2010 Elsevier B.V. All rights reserved.

Discovery of two distinct red clumps in NGC 419: a rare snapshot of a cluster at the onset of degeneracy

Colour-magnitude diagrams (CMDs) of the Small Magellanic Cloud (SMC) star cluster NGC 419, derived from Hubble Space Telescope (HST)/Advanced Camera for Surveys (ACS) data, reveal a well-delineated secondary clump located below the classical compact red clump typical of intermediate-age populations. We demonstrate that this feature belongs to the cluster itself, rather than to the underlying SMC field. Then, we use synthetic CMDs to show that it corresponds very well to the secondary clump predicted to appear as a result of He-ignition in stars just massive enough to avoid e(-)-degeneracy settling in their H-exhausted cores. The main red clump instead is made of the slightly less massive stars which passed through e(-) degeneracy and ignited He at the tip of the red giant branch. In other words, NGC 419 is the rare snapshot of a cluster while undergoing the fast transition from classical to degenerate H-exhausted cores. At this particular moment of a cluster`s life, the colour distance between the main-sequence turn-off and the red clump(s) depends sensitively on the amount of convective core overshooting, Lambda(c). By coupling measurements of this colour separation with fits to the red clump morphology, we are able to estimate simultaneously the cluster mean age (1.35(-0.04)(+0.11) Gyr) and overshooting efficiency (Lambda(c) = 0.47(-0.04)(+0.14)). Therefore, clusters like NGC 419 may constitute important marks in the age scale of intermediate-age populations. After eye inspection of other CMDs derived from HST/ACS data, we suggest that the same secondary clump may also be present in the Large Magellanic Cloud clusters NGC 1751, 1783, 1806, 1846, 1852 and 1917.