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Intensive Therapy Effects Seen on Brains of Patients with Obsessive-Compulsive Disorder

By MedImaging staff writers
Posted on 05 Feb 2008

In a study that may significantly improve the understanding of how cognitive-behavioral therapy affects the brain, researchers have shown that significant changes in activity in specific regions of the brain can be produced with as little as four weeks of daily therapy in patients with obsessive-compulsive disorder (OCD).

This discovery could have important clinical implications, according to lead investigator Sanjaya Saxena, M.D., director of the Obsessive-Compulsive Disorders Program at the University of California, San Diego (UCSD; USA) School of Medicine, whose findings were published on line January 16, 2008, of the journal Molecular Psychiatry. "The study is exciting because it tells us more about how cognitive-behavioral therapy works for OCD, and shows that both robust clinical improvements and changes in brain activity occur after only four weeks of intensive treatment,” said Dr. Saxena.

OCD is an anxiety disorder in which individuals have unreasonable fears or worries that they try to manage through ritualized compulsive behaviors to reduce the anxiety. For example, a patient may experience the urgent need to engage in specific rituals, such as hand washing or repeatedly checking that the oven is off or the front door is locked.

Past studies utilizing functional brain imaging studies of patients with OCD have demonstrated that elevated activity along the frontal-subcortical circuits of the brain decreases in response to treatment with serotonin reuptake inhibitor (SRI) medications or cognitive-behavioral therapy. However, clinical improvement of OCD symptoms was expected to require up to 12 weeks of behavioral therapy or medication treatment, the standard treatments for OCD. Only a few studies have looked at how therapy affects brain function, and all previous research had examined changes over several months of treatment.

Dr. Saxena and colleagues at the David Geffen School of Medicine at the University of California, Los Angles (UCLA; USA) made two unique discoveries in their study of 10 OCD patients and 12 control subjects. "First of all, we discovered significant changes in brain activity solely as the result of four weeks of intensive cognitive-behavioral therapy,” said Dr. Saxena. "Secondly, these changes were different than those seen in past studies after a standard 12-week therapeutic approach using SRI medications or weekly behavioral therapy.”

The investigators obtained positron emission tomography (PET) scans of the 10 OCD patients both before and after they received four weeks of a therapy known as "exposure and response prevention,” which gradually desensitizes patients to things that provoke obsessional fears or worries.

"This is the primary kind of therapy used for OCD. It teaches patients to pay attention to their internal experiences and tolerate scary thoughts without having to act on them,” said Dr. Saxena. "They learn that nothing terrible happens if they refrain from their usual compulsive behaviors.”

The normal, control individuals received no treatment and were scanned twice, several weeks apart, and metabolic changes in the brain were compared between the two groups. After four weeks of therapy and without any changes in medication, the OCD patients showed significant improvements in OCD symptoms, depression, anxiety, and overall functioning.

The PET scans of OCD patients demonstrated significant decreases in glucose metabolism--a measure of brain cell activity in the right and left thalamus after treatment. These are areas of the brain involved in OCD and where changes have been seen in numerous past studies after longer-term treatment.

However, the PET scans in this study also showed a significant increase in activity in an area of the brain called the right dorsal anterior cingulate cortex, a region involved in re-evaluation and suppression of negative emotions. Increasing activity in this region corresponded to the OCD patients' improvement in clinical symptoms after the four-week course of intensive therapy. Activity in this area had previously been found to increase after cognitive-behavioral therapy for major depression. Therefore, the researchers theorized that response to cognitive-behavioral therapy across a variety of disorders might require activation of the dorsal anterior cingulate cortex.

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59 (!!!!! 3360.0330352783): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

60 (!!!!! 2276.8974304199): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

61 (!!!!! 28840.065002441): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (!!!!! 4225.0156402588): SELECT fid FROM jos_deeppockets WHERE id=270230000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=270230000 AND published='1' LIMIT 1

63 (!!!!! 7536.8881225586): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

64 (!!!!! 3688.0970001221): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 7912.1589660645): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 5095.9587097168): select jos_google_plus.link from jos_google_plus where cat=10

67 (228.1665802002): select jos_linkedin.link from jos_linkedin where cat=10

68 (370.02563476562): SELECT fid FROM jos_deeppockets WHERE id=270230000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=270230000 AND published='1' LIMIT 1

69 (36.954879760742): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

70 (869.9893951416): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=270230000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (300.88424682617): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=270230000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (243.9022064209): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (386.95335388184): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (162.12463378906): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (137.0906829834): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (122.7855682373): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (162.12463378906): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (131.84547424316): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (!!!!! 2205.8486938477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (427.9613494873): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=270230000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (44.107437133789): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=270230000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (216.96090698242): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (!!!!! 3649.9500274658): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (309.94415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (169.99244689941): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (170.94612121582): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (188.11225891113): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1044.0349578857): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

105 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

106 (920.05729675293): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=270230000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1933.0978393555): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=270230000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 3085.1364135742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

109 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

110 (!!!!! 1981.0199737549): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=270230000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (689.98336791992): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=270230000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1064.0621185303): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (665.90309143066): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (!!!!! 1266.9563293457): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

115 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

116 (490.90385437012): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

117 (159.97886657715): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

118 (!!!!! 2084.9704742432): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

119 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

120 (382.1849822998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

121 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

122 (492.09594726562): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 51847.9347229): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (906.94427490234): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=270230000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=270230000 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (49.114227294922): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (34.809112548828): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (142.81272888184): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (92.029571533203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (394.10591125488): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (44.107437133789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (92.983245849609): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (!!!!! 3651.8573760986): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (108.00361633301): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (456.09474182129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (325.91819763184): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (!!!!! 2291.9178009033): SELECT name FROM jos_deeppockets WHERE id=213

138 (57.93571472168): SELECT name FROM jos_deeppockets WHERE id=213

139 (!!!!! 3952.0263671875): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (679.01611328125): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

142 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

143 (!!!!! 16976.118087769): TRUNCATE TABLE jos_trademed_module

144 (638.96179199219): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=270230000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (885.009765625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=270230000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 2204.8950195312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 4316.8067932129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 7684.2308044434): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

149 (!!!!! 5711.7938995361): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

150 (!!!!! 1322.0310211182): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (688.07601928711): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

152 (131.13021850586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

153 (92.983245849609): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=270230000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=270230000 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (327.11029052734): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

155 (51.021575927734): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

156 (33.855438232422): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (176.90658569336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

158 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=270230000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=270230000 AND published='1' LIMIT 1

159 (!!!!! 3734.827041626): select jos_twitters.link from jos_twitters where cat=10

160 (179.76760864258): select jos_facebook.link from jos_facebook where cat=10

161 (121.11663818359): select jos_google_plus.link from jos_google_plus where cat=10

162 (283.00285339355): select jos_linkedin.link from jos_linkedin where cat=10

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