Kaleidoscope

Following earlier research showing that the single-item ‘depressed mood’ component of the Hamilton Rating Scale for Depression (HRSD) was most sensitive to medication change, Hieronymus et al 4 undertook a patient-level mega-analysis of 11 randomised controlled trials, exploring dose-dependent changes to this single item (rather than the summed total HRSD). Clinical, demographic, neurocognitive and psychosocial factors were evaluated, and factors predicting conversion to a psychotic illness were high levels of unusual thought content and suspiciousness, greater decline in social functioning, lower verbal learning and memory performance, slower speed of processing and younger age at baseline. Participants with greater accuracy showed more directional modulation (i.e. the angle of the trajectory in the 2D conceptual space of neck/leg length and Christmas symbols) of the fMRI BOLD signal in the ventral aspect of the medial prefrontal cortex, with correlated activity in the entorhinal cortex suggesting multiple areas were responding with the same ‘conceptual’ trajectory preference. [...]we've all been stumped by a smart (or smarmy) student asking us to explain the phenomenological difference between a hallucination and a dream.