Eyes first! Eye processing develops before face processing in children.

Faces and eyes are critical social stimuli which adults process with ease, but how this expertise develops is not yet understood. Neural changes associated with face and eye processing were investigated developmentally using ERPs (N170), in 128 subjects (4-15 year olds and adults). Stimuli included upright faces to assess configural processing, eyes and inverted faces to assess feature-based processing. N170 was present in the youngest children with similar patterns of face sensitivity seen in adults. Development of N170 to upright faces continued until adulthood, suggesting slow maturation of configural processing. In contrast, N170 was shorter latency and much larger to eyes than faces in children and was mature by 11 years, suggesting the early presence of an eye detector, with a rapid maturational course.

Direction of gaze effects on early face processing: eyes-only versus full faces.

The N170 event-related potential (ERP) reflects an early stage of face processing. We wished to determine if it would also index the intuitively important information provided by direction of gaze. Two studies were run. In one, stimuli included full faces with the eyes looking forward, to the left or closed; in the other study the stimuli included eyes-only, looking forward, left or closed. Gaze direction had no effects on amplitude, but longer latencies were found for faces with eyes closed. With eyes-only stimuli, more marked effects on latencies and borderline effects on amplitudes were seen. We suggest that there can only be limited evidence of gaze-specific sensitivity in ERP studies in humans, without eye movement.

Is the face-sensitive N170 the only ERP not affected by selective attention?

We assessed the effect of directed attention on early neurophysiological indices of face processing, measuring the N170 event-related potential (ERP). Twelve subjects were tested on two tasks each in which they attended either to eyes only or to faces with eyes closed, presented within series of facial and control stimuli. Consistent with the ERP literature, N170 was recorded to facial stimuli at posterior temporal electrodes and a concomitant positive peak at the vertex, with latencies around 150 ms for faces and 174 ms for eyes. However, unlike fMRI studies, neither the latency nor the amplitude of the peaks were sensitive to the target/non-target status of either the eyes or the face stimuli. This suggests that early stages of face processing indexed by N 170 are automatic and unmodified by selective attention.

Mismatch negativity to speech stimuli in 8-month-old infants and adults.

The mismatch negativity (MMN) was measured in 15 normal awake 8-month-old infants and 10 adults to the speech consonants /da/ and /ta/. ERPs were analyzed at 11 electrodes (Fz, Cz, Pz, C3, C4, T3, T4, T5, T6, P3, P4). Four-hundred trials were presented: the /da/ standards with 80% probability and the /ta/ deviants with 20% probability. The ISI was 600 ms. An MMN was observed for both adults and infants but with different scalp distributions. A clear infant MMN was observed only at C3 and T3 electrodes, whereas the adult MMN was present at Fz, Cz, C3, C4 and Pz. A repeated-measures ANOVA on the normalized summed area between 200 and 250 ms revealed an age (adult vs. infant) x electrode interaction. Paired t-tests indicated that adults and infants showed significant differences at the C3, Cz, T3, Pz and T6 electrodes. The adult MMN was largest at Cz and C3 whereas the infant MMN was largest at T3. These data are discussed in terms of possible maturational changes in the MMN.

General practice patients on long-term psychotropic drugs. A controlled investigation.

In a health centre, 3.6% of the registered patients were found to have received at least one prescription for psychotropic drugs in each quarter of a year. These patients were mainly elderly and female. Psychiatric interviews were held with randomly selected index patients, and with matched controls. Most index patients reported taking psychotropic drugs for several years, mainly anxiolytics, antidepressants and non-barbiturate hypnotics, and mainly in low dosage. Index patients had much higher levels of psychiatric morbidity, as shown by the Present State Examination, history of specialist psychiatric treatment, and previous drug overdoses. In index patients the main diagnoses were neurotic depression and phobic disorder. Index patients reported more problems with finances and with social isolation.

The effects of non-prescribing of anxiolytics in general practice. I. Controlled evaluation of psychiatric and social outcome.

Ninety one patients with new episodes of minor affective disorder were selected by their general practitioners as suitable for anxiolytic medication. Half the patients were allocated randomly to a drug-group (anxiolytic medication), and half to a non-drug group (brief counselling without anxiolytics). Psychiatric and social assessments were made (i) at initial consultation when treatment was started; (ii) one month later; (iii) seven months later. Before treatment the two groups were similar on all main variables. On the General Health Questionnaire, 85 per cent of patients were psychiatric cases before treatment, 40 per cent at one month and 30 per cent at seven months. Similar improvements were found with other measures of psychiatric state (Profile of Mood States; Present State Examination) and social functioning (SAS-M). Improvements were similar and parallel in the two groups. Neither group of patients increased their consumption of alcohol, tobacco or non-prescribed drugs. The non-drug group did not make increased demands on the doctors' time.

Hysterectomy and psychiatric disorder: II. Demographic psychiatric and physical factors in relation to psychiatric outcome.

One hundred and fifty-six patients with menorrhagia of benign origin were interviewed before hysterectomy, and again six months (n = 147) and 18 months (n = 148) after the operation. Psychiatric outcome, measured in terms of PSE cases detected at 18 months, was strongly associated with pre-operative mental state, neuroticism, previous psychiatric history, and family psychiatric history. No association was found with organic pathology in the uterus, bilateral oophorectomy or demographic variables.