modulator (CREM)-knockout mice exhibit significantly lower anxiety behaviour than wildtyp mice (Maldonado R et al., 1999). In addition CREM has been shown to play a pivotal role in the hypothalamo-pituitary-adrenal axis which is disturbed in panic disorder (Abelson et al. 1996). In the present study, we therefore searched for genetic variants in the human CREM gene in patients with panic disorder and their possible association with the disorder. We performed a systematic mutation screening of the complete coding region as well as the regulatory regions of CREM and its alternative product ICER by means of SSCA in a sample of 40 patients with panic disorder (DSM-III-R). Polymorphisms were identified by direct sequencing. Allele frequencies were determined in the extended sample of 88 patients and matched healthy controls using RFLP and fragment analysis. So far six polymorphisms have been detected: four single nucleotide substitutions in CREM promotors 1 and 4, one trinucleotide repeat polymorphism in ICER promo- tor 2 (8 – 11 ATT repeats) and a single aminoacid substi- tution in CREM exon glut II. A significant excess of the 8-repeat allele of the ATT trinucleotide repeat poly- morphism in panic disorder was observed (p=0.02). This corresponded to an even more significant underrepresen- tation of the 9-repeat allele (p=0.01). To evaluate the relevance of these findings, replications in independent samples and a functional characterisation of the trinucle- otide repeat polymorphism are necessary.
References Maldonado R, Smadja C, Mazzucchelli C, Sassone-Corsi P, Mazucchelli C. Altered emotional and locomotor res- ponses in mice deficient in the transcription factor CREM. Proc Natl Acad Sci USA 1999; 96(24):14094-9. Abelson JL, Curtis GC. Hypothalamic-pituitary-adrenal axis activity in panic disorder. 24-hour secretion of corti- cotropin and cortisol. Arch Gen Psychiatry 1996; 53(4):323-31.
German J Psychiatry 2001; 4: S2 Spontaneous electrodermal activity thought content: Arousal, worry and GAD
Gerlach, A. L., Upatel, T. & Rist, F. University of Münster & Christoph Dornier Foundation
Introduction: According to DSM-IV the defining feature of Generalized Anxiety Disorder (GAD) is constant worry- ing which is phenomenologically related to current con- cerns. Heightened physiological arousal is also a hallmark of GAD. In the ICD-10 hyperarousal is characterized as the defining feature of GAD. Nikula et. al. (1991,1993) demonstrated that non-specific electrodermal skin fluc- tuations (NSF) are associated with current concerns in students. We planned to evaluate the link between this physiological marker and worrying in GAD. Method: We recruited 32 GAD patients and 31 controls. To induce worrying, we asked the participants to watch two different sets of video clips. One half watched clips which were related to worry topics, the other half watched
clips related to neutral topics. Then participants were asked to report whatever came to their mind whenever they were prompted by a beep. Half of twenty prompts were triggered by NSF’s measured online the other half was triggered randomly. Results: We found no differences in heart rate and skin conductance levels between groups. NSF’s were associated with more anxious thoughts and a reduced feeling of control in the GAD group. Controls reported less pleas- ant thoughts when prompted by NSF’s as compared to random prompts.
References: Nikula,R. (1991). Psychological Correlates of Nonspecific Skin Conductance Responses. Psychophy-siology, 28(1), 86-90. Nikula,R., Klinger,E., & Larson-Gutman,M.K. (1993). Current Concerns and Electrodermal Reactivity: Re- sponses to Words and Thoughts. Journal of Personality, 61(1), 63-84.
German J Psychiatry 2001; 4: S2 Intensity of anxiety after acute vestibular di- sorder as a critical life event
Godemann F, Linden M, Heipp E, Dörr P Department of Psychiatry, Free University of Berlin
Background: Critical life events induce intense emotions. The most common emotion is anxiety. It remains open which factors determine intensity and course of anxiety after a critical life event. To elucidate such factors we studied patients during the six weeks after an acute vesti- bular disorder. Methods: 69 patients were interviewed for anxiety at three time points during the six weeks after an acute vestibular event. Subsequently, the influence of cognitive, personality and disorder variables on intensity and course of anxiety were evaluated. Results: Acute vestibular disorder is a critical life event because it is accompanied by intense anxiety. Catastrophi- sizing and dysfunctional cognitions (p<0.01) partly explain the intensity of anxiety directly after the loss of vestibular function. In most patients anxiety decreases in parallel with the remission of vertigo. A relevant subgroup (n=10, 14.5%) remains anxious or even experiences an increase in anxiety. Cognitive parameters, personality dimensions and coping styles do not explain the differen- tial course of the experience of anxiety. Conclusions: The acute vestibular disorder is successfully coped with by most patients. Dysfunctional fears contri- bute to the intensity of the acutely experienced anxiety due to this critical life event. It still remains open though why part of the patients do not recover from their acute anxiety.