Psychiatric symptoms of pediatric cancer pain.

This study investigated the contribution of pain to psychiatric symptoms in 43 hospitalized children and adolescents referred for psychiatric evaluation in a pediatric cancer center during a 1-yr period. Procedures included determination of the primary reason for referral, child and parent diagnostic interviews assessing pain history and psychiatric symptoms, and recommendations for improved pain control or other types of intervention and followup. Across the four referral categories (for symptoms of depression, cognitive/perceptual disturbance, anxiety, or disruptive behavior), approximately 20% of all consultations resulted in a primary recommendation for improved pain control. The findings suggest that pediatric cancer pain may go untreated when its manifestations are psychiatric. Implications for staff education, consultation-liaison psychiatry, and psychiatric nosology are discussed.

Effects of depression and ECT on anterograde memory.

This study investigated immediate and delayed recognition memory in depressed patients undergoing electroconvulsive therapy (ECT) and in matched, normal controls. At baseline, patients manifested a marked deficit in immediate memory (acquisition), but showed no deficit in delayed memory (retention). When retested 24-36 hr following the seventh ECT, patients showed reductions in both immediate and delayed memory performance. At retesting 4 days, on average, after the ECT course, immediate memory scores returned to baseline levels, but delayed memory performance remained impaired. The findings supported the classic claims that depression is associated with a deficit in the acquisition of information, whereas ECT has a more profound influence on the retention of information. This dissociative pattern could not be viewed as an artifact of task psychometric properties, nor of practice effects in control subjects.