[Military service with adult attention deficit hyperactivity disorder: adaptability of affected soldiers on active service in the German Armed Forces]. / Wehrdienst mit Aufmerksamkeitsdefizit-/Hyperaktivitätssyndrom? : Anpassungsfähigkeit betroffener Soldaten an den Dienst in der Bundeswehr.

BACKGROUND: Due to various stressors, soldiers need a high level of social functioning. In those with ADHS, psychological problems and thus a disability for duty can result. MATERIAL AND METHODS: Thirty-six German Armed Forces members with ADHS who presented themselves as outpatients or inpatients in the Army Hospitals of Hamburg and Berlin between 2005 and 2007 were evaluated retrospectively and compared with a control group. The adaptability during duty was defined based on five criteria and statistical correlations with psychological status and psychosocial risk factors of the soldiers were evaluated. RESULTS: Of the soldiers with ADHS, 55.6% were able to continue their duty. Cumulative adaptability problems in the Army were significantly correlated with aggressive and dissocial symptoms and with partnership problems. The control group showed no correlations. CONCLUSIONS: The results show that adult ADHS does not automatically prevent a soldier from military duty and thus indicate that a differentiated judgement should be preferred.

Dopamine deficits and regulation of the cAMP second messenger system in brains of simian immunodeficiency virus-infected rhesus monkeys.

The basal ganglia, structures rich in the neurotransmitter dopamine, are primarily affected during human immunodeficiency virus (HIV) infection. The authors measured levels of dopamine and its metabolites, homovanillic acid and 3,4-dihydroxyphenylacetic acid, in brains of uninfected and simian immunodeficiency virus (SIV)-infected rhesus monkeys during the asymptomatic stage of the infection. Moreover, the authors investigated changes in cyclic adenosine monophosphate (cAMP) and cAMP response element-binding protein (CREB), two factors involved in the signaling pathway of dopamine. The brain regions examined were the nucleus accumbens and the corpus amygdaloideum, which are limbic structures of the basal ganglia that are involved in the pathophysiology of psychiatric disorders and substance abuse. Dopamine content was reduced in both regions of SIV-infected monkeys compared to uninfected animals. Moreover, dopamine deficits were associated with a decrease in expression of total CREB. Intracellular concentrations of cAMP were decreased in nucleus accumbens and remained unchanged in corpus amygdaloideum of SIV-infected macaques. Changes in dopamine signaling were not related to pathology or viral load of the investigated animals. The results suggest that dopamine defects precede neurologic deficits and implicate dysfunction of the dopaminergic system in the etiopathogenesis of HIV dementia. Therefore, affective complications in HIV subjects should not be interpreted only as reactive psychological changes. The alterations in the mesolimbic dopaminergic system during asymptomatic stage of SIV infection implicate a biological background for psychiatric disorders in HIV infection.