The role of early experience in shaping behavioral and brain development and its implications for social policy.

This article provides a targeted review of the scientific literature on the effects of experience on early brain and behavioral development and later outcome as it pertains to risk for some forms of child psychopathology. It is argued that ample evidence exists indicating that the prenatal and early postnatal years likely represent a sensitive period with respect to the effects of stress on the developing nervous system and behavioral outcome, and with respect to the long-term beneficial effects of early interventions on brain and behavioral development for some genetically based disorders, such as phenylketonuria and autism. Moreover, evidence suggests that parental mental health during the first years of life has a significant influence on early brain activity and behavior, and long-term behavioral outcome. It is concluded that, although prevention and early intervention efforts should not exclusively focus on the earliest years of development, such efforts should begin during this period. By directing such efforts toward promoting optimal prenatal and infant-toddler development, the long-term negative consequences of factors that have their greatest influences during early development and which set the stage for future development can be minimized or avoided entirely. Several recommendations for public policy and future research pertaining to the effects of early experience on child outcome are offered.

Lack of relationship between menstrual cycle phase and mood in a sample of women with rapid cycling bipolar disorder.

BACKGROUND: Women are overrepresented in samples of patients with rapid cycling bipolar disorder (RCBD). To explore whether menstrually related mood changes might account for this gender difference, we studied the relationship between menstrual cycle phase and mood in a sample of premenopausal women with rapid cycling bipolar disorder (RCBD). METHODS: Twenty-five women with RCBD completed daily self-rating forms indicating their mood and days of menstruation for a minimum of three months. The data were analyzed for each individual and for the group as a whole, categorically (depression, euthymia, and hypomania) and ordinally (0-100, with 0 being "most depressed ever felt" and 100 being "most manic"), with and without normalization of the menstrual cycle to a 28-day cycle. RESULTS: None of the group analyses showed a significant effect of menstrual cycle on mood. Although some women did exhibit significant relationships between menstrual cycle phase and categorical mood state, there was no consistent pattern to the relationship. CONCLUSIONS: There was no systematic relationship between menstrual cycle and mood in a sample of women with RCBD.

Relationship between social rhythms and mood in patients with rapid cycling bipolar disorder.

Disruptions in the sleep-wake cycle frequently characterize affective illness and have led to a number of theories linking sleep-wake and/or circadian rhythm disturbance to affective illness. Recently, researchers have expanded these chronobiological theories to include the role of lifestyle regularity, or daily social rhythms. In this study, the Social Rhythm Metric (SRM) was used to explore the relationship between social rhythms and mood in patients with rapid cycling bipolar disorder and to compare the social rhythms of patients with those of healthy control subjects. Patients' SRM scores and activity level indices were significantly lower than those of control subjects. In addition, the timing of five, mostly morning, activities was phase delayed in patients compared to control subjects. Patients also demonstrated a phase delay in the timing of morning activities during depression compared to hypomania or euthymia. The phase changes in the timing of morning activities are consistent with other data implicating morning zeitgebers in the pathophysiology of rapid cycling bipolar disorder.

Effects of leuprolide-induced hypogonadism and testosterone replacement on sleep, melatonin, and prolactin secretion in men.

The possible role of gonadal steroids in regulating sleep and circadian rhythms in humans has received relatively little attention despite the importance of the topic to several clinical syndromes. Pharmacologically induced hypogonadism, with and without gonadal steroid replacement, provides an opportunity to examine these questions within a controlled experimental design. We used leuprolide acetate, with and without testosterone replacement, to study the role of testosterone in the regulation of sleep and of melatonin, PRL, and TSH secretion in men. Results from 10 men revealed significant decreases in 24-h PRL levels and in the percentage and time of stage 4 sleep in the hypogonadal state compared with testosterone replacement. There were no differences in melatonin or TSH secretion or in the timing or duration of sleep between the two hormonal conditions. These results indicate that testosterone has relatively specific and discrete effects on sleep and hormonal rhythms in men.