Dopamine transporter binding in social anxiety disorder: the effect of treatment with escitalopram.

Social anxiety disorder (SAD) is characterised by fear of social or performance situations where the individual is exposed to unfamiliar people or to possible scrutiny by others. The literature on dopamine ligands and dopamine genotypes in SAD is however inconsistent. In this study we measured the effects of SSRI pharmacotherapy on dopamine transporter (DAT) binding in patients with SAD, also addressing variability in DAT genotype. Adult subjects meeting DSM-IV criteria for generalised SAD were studied before and after 12 weeks of pharmacotherapy with the selective serotonin reuptake inhibitor (SSRI) escitalopram. DAT single photon emission computed tomography (SPECT) using (123)I-FP-CIT was performed at baseline, and repeated at 12 weeks. Striatal DAT binding was analysed for changes following therapy, and for correlations with clinical efficacy, in the whole group as well as for a subgroup with the A10/A10 DAT genotype. The study included 14 subjects (9 male, 5 female) with a mean (SD) age of 41 (±13) years. The subjects' Liebowitz Social Anxiety Scale (LSAS) score was significantly decreased following pharmacotherapy. In the combined group the left caudate and left putamen showed clusters of increased DAT binding after therapy. The left caudate changes were also observed in the subgroup of 9 A10/A10 homozygotes. However no correlation was found between improved symptoms and DAT binding. The changes found in DAT binding in the caudate and putamen may be due to serotonergic activation of dopamine function by SSRI therapy. This is consistent with previous work indicating decreased DAT binding in SAD, and increased DAT binding after SSRI administration.

Personality and mental health: an investigation of South African police trainees.

The relationship between personality and mental health was investigated in one cohort of police trainees at a South African police academy (1145 police recruits; 648 men, 497 women). Male trainees reported less somatisation, depression, anxiety, and phobic anxiety symptoms and lower harm avoidance as well as higher persistence than female trainees. A cluster analysis based on the personality scores was used to identify three clusters with personality profiles characterized as Vulnerable, Healthy, and Intermediate profiles. Sociodemographic variables and temperament and character domain scores contributed separately and differentially to the explanation of variance in mental health symptom scores. Selection tools should be developed to identify vulnerable individuals in terms of personality characteristics during selection and prior to training, to prevent later problems with stress reactions. Additional training modules focusing on coping skills could possibly reduce vulnerability to stress in some trainees.