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Fovet T, Orlov N, Dyck M, Allen P, Mathiak K, Jardri R. Translating Neurocognitive Models of Auditory-Verbal Hallucinations into Therapy: Using Real-time fMRI-Neurofeedback to Treat Voices. Front Psychiatry 2016; 7:103. [PMID: 27445865 PMCID: PMC4921472 DOI: 10.3389/fpsyt.2016.00103] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/31/2016] [Indexed: 12/31/2022] Open
Abstract
Auditory-verbal hallucinations (AVHs) are frequent and disabling symptoms, which can be refractory to conventional psychopharmacological treatment in more than 25% of the cases. Recent advances in brain imaging allow for a better understanding of the neural underpinnings of AVHs. These findings strengthened transdiagnostic neurocognitive models that characterize these frequent and disabling experiences. At the same time, technical improvements in real-time functional magnetic resonance imaging (fMRI) enabled the development of innovative and non-invasive methods with the potential to relieve psychiatric symptoms, such as fMRI-based neurofeedback (fMRI-NF). During fMRI-NF, brain activity is measured and fed back in real time to the participant in order to help subjects to progressively achieve voluntary control over their own neural activity. Precisely defining the target brain area/network(s) appears critical in fMRI-NF protocols. After reviewing the available neurocognitive models for AVHs, we elaborate on how recent findings in the field may help to develop strong a priori strategies for fMRI-NF target localization. The first approach relies on imaging-based "trait markers" (i.e., persistent traits or vulnerability markers that can also be detected in the presymptomatic and remitted phases of AVHs). The goal of such strategies is to target areas that show aberrant activations during AVHs or are known to be involved in compensatory activation (or resilience processes). Brain regions, from which the NF signal is derived, can be based on structural MRI and neurocognitive knowledge, or functional MRI information collected during specific cognitive tasks. Because hallucinations are acute and intrusive symptoms, a second strategy focuses more on "state markers." In this case, the signal of interest relies on fMRI capture of the neural networks exhibiting increased activity during AVHs occurrences, by means of multivariate pattern recognition methods. The fine-grained activity patterns concomitant to hallucinations can then be fed back to the patients for therapeutic purpose. Considering the potential cost necessary to implement fMRI-NF, proof-of-concept studies are urgently required to define the optimal strategy for application in patients with AVHs. This technique has the potential to establish a new brain imaging-guided psychotherapy for patients that do not respond to conventional treatments and take functional neuroimaging to therapeutic applications.
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Affiliation(s)
- Thomas Fovet
- Univ Lille, CNRS, UMR-9193, psyCHIC team & CHU Lille, Psychiatry Dpt (CURE), Fontan Hospital , Lille , France
| | - Natasza Orlov
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London , London , UK
| | - Miriam Dyck
- Department of Psychiatry, Psychotherapy and Psychosomatics, JARA-Brain, RWTH Aachen University , Aachen , Germany
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK; Department of Psychology, University of Roehampton, London, UK
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, JARA-Brain, RWTH Aachen University , Aachen , Germany
| | - Renaud Jardri
- Univ Lille, CNRS, UMR-9193, psyCHIC team & CHU Lille, Psychiatry Dpt (CURE), Fontan Hospital , Lille , France
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8352
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Valiengo LDCL, Stella F, Forlenza OV. Mood disorders in the elderly: prevalence, functional impact, and management challenges. Neuropsychiatr Dis Treat 2016; 12:2105-14. [PMID: 27601905 PMCID: PMC5003566 DOI: 10.2147/ndt.s94643] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Despite the lower prevalence of severe mood disorders in the elderly as compared to younger adults, late-life depression and bipolar disorder (BD) are more strongly associated with negative outcomes related to the presence of medical comorbidities, cognitive deficits, and increased suicide risk and overall mortality. The mechanisms that contribute to these associations are probably multifactorial, involving pathological factors related directly and indirectly to the disease itself, ranging from biological to psychosocial factors. Most of the accumulated knowledge on the nature of these associations derives from naturalistic and observational studies, and controlled data are still scarce. Nonetheless, there has clearly been a recent growth of the scientific interest on late-life BD and geriatric depression. In the present study, we review the most relevant studies on prevalence, clinical presentation, and cognitive/functional impact of mood disorders in elderly. Several clinical-epidemiological studies were dedicated to the study of the prevalence of mood disorders in old age in distinct settings; however, fewer studies investigated the underlying neurobiological findings and treatment specificities in late-life depression and BD. In the present study, we further discuss the implications of these findings on the management of mood disorders in older adults.
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Affiliation(s)
- Leandro da Costa Lane Valiengo
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Sao Paulo
| | - Florindo Stella
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Sao Paulo; Biosciences Institute, Universidade Estadual Paulista, Rio Claro, Brazil
| | - Orestes Vicente Forlenza
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Sao Paulo
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8353
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Orellana AM, Kinoshita PF, Leite JA, Kawamoto EM, Scavone C. Cardiotonic Steroids as Modulators of Neuroinflammation. Front Endocrinol (Lausanne) 2016; 7:10. [PMID: 26909067 PMCID: PMC4754428 DOI: 10.3389/fendo.2016.00010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 01/22/2016] [Indexed: 01/13/2023] Open
Abstract
Cardiotonic steroids (CTS) are a class of specific ligands of the Na(+), K(+)- ATPase (NKA). NKA is a P-type ATPase that is ubiquitously expressed and although well known to be responsible for the maintenance of the cell electrochemical gradient through active transport, NKA can also act as a signal transducer in the presence of CTS. Inflammation, in addition to importantly driving organism defense and survival mechanisms, can also modulate NKA activity and memory formation, as well as being relevant to many chronic illnesses, neurodegenerative diseases, and mood disorders. The aim of the current review is to highlight the recent advances as to the role of CTS and NKA in inflammatory process, with a particular focus in the central nervous system.
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Affiliation(s)
- Ana Maria Orellana
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Paula Fernanda Kinoshita
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Jacqueline Alves Leite
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Elisa Mitiko Kawamoto
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Cristoforo Scavone
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
- *Correspondence: Cristoforo Scavone,
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8354
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Davies SJC, Pearson RM, Stapinski L, Bould H, Christmas DM, Button KS, Skapinakis P, Lewis G, Evans J. Symptoms of generalized anxiety disorder but not panic disorder at age 15 years increase the risk of depression at 18 years in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort study. Psychol Med 2016; 46:73-85. [PMID: 26315278 PMCID: PMC4886844 DOI: 10.1017/s003329171500149x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 07/06/2015] [Accepted: 07/08/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) and panic disorder (PD) differ in their biology and co-morbidities. We hypothesized that GAD but not PD symptoms at the age of 15 years are associated with depression diagnosis at 18 years. METHOD Using longitudinal data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort we examined relationships of GAD and PD symptoms (measured by the Development and Well-Being Assessment) at 15 years with depression at 18 years (by the Clinical Interview Schedule - Revised) using logistic regression. We excluded adolescents already depressed at 15 years and adjusted for social class, maternal education, birth order, gender, alcohol intake and smoking. We repeated these analyses following multiple imputation for missing data. RESULTS In the sample with complete data (n = 2835), high and moderate GAD symptoms in adolescents not depressed at 15 years were associated with increased risk of depression at 18 years both in unadjusted analyses and adjusting for PD symptoms at 15 years and the above potential confounders. The adjusted odds ratio (OR) for depression at 18 years in adolescents with high relative to low GAD scores was 5.2 [95% confidence interval (CI) 3.0-9.1, overall p < 0.0001]. There were no associations between PD symptoms and depression at 18 years in any model (high relative to low PD scores, adjusted OR = 1.3, 95% CI 0.3-4.8, overall p = 0.737). Missing data imputation strengthened the relationship of GAD symptoms with depression (high relative to low GAD scores, OR = 6.2, 95% CI 3.9-9.9) but those for PD became weaker. CONCLUSIONS Symptoms of GAD but not PD at 15 years are associated with depression at 18 years. Clinicians should be aware that adolescents with GAD symptoms may develop depression.
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Affiliation(s)
- S. J. C. Davies
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
- Geriatric Psychiatry Division, CAMH, University of Toronto, Toronto, Canada
| | - R. M. Pearson
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - L. Stapinski
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - H. Bould
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - D. M. Christmas
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - K. S. Button
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - P. Skapinakis
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - G. Lewis
- Division of Psychiatry, University College London, London, UK
| | - J. Evans
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
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8355
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Fábregas BC, Vieira ÉLM, Moura AS, Carmo RA, Ávila RE, Abreu MNS, Prossin AR, Teixeira AL. A Follow-Up Study of 50 Chronic Hepatitis C Patients: Adiponectin as a Resilience Biomarker for Major Depression. Neuroimmunomodulation 2016; 23:88-97. [PMID: 27035148 DOI: 10.1159/000444531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 02/05/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Major depression (MD) is a condition associated with both hepatitis C virus (HCV) infection and pegylated interferon (IFN)-α treatment. IFN induces a depressive syndrome that is associated with an inflammatory profile. We aimed to investigate whether there is any specific alteration in plasma biomarkers associated with MD. METHODS HCV-monoinfected patients, with and without IFN treatment, were followed up for 18 months and went through structured psychiatric evaluation. We assessed plasma levels of brain-derived neurotrophic factor, tumor necrosis factor (TNF) and its soluble type 1 and type 2 receptors (sTNFR1 and sTNFR2, respectively), and adipokines (adiponectin, leptin and resistin) using ELISA. RESULTS Among the 50 patients included in the study, 14 were treated with IFN during the follow-up. Being older, not married, presenting higher body mass index, higher liver inflammatory activity, lower baseline adiponectin levels and use of IFN were associated with MD development. Higher levels of sTNFR1 during IFN treatment were associated with sustained virological response. The lack of a control group without HCV infection did not allow any assumption of a biomarker change exclusively due to the infection itself. CONCLUSION Adiponectin may be a resilience biomarker for MD in HCV-infected patients.
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Affiliation(s)
- Bruno C Fábregas
- Tropical Medicine Program, School of Medicine, Municipal Health Division/Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Abstract
Poor adherence to treatment is a common cause of medical treatment failure. Studying adherence is complicated by the potential for the study environment to impact adherence behavior. Studies performed without informing patients about adherence monitoring must balance the risks of deception against the potential benefits of the knowledge to be gained. Ethically monitoring a patient's adherence to a treatment plan without full disclosure of the monitoring plan requires protecting the patient's rights and upholding the fiduciary obligations of the investigator. Adherence monitoring can utilize different levels of deception varying from stealth monitoring, debriefing after the study while informing the subject that some information had been withheld in regard to the use of adherence monitoring (withholding), informed consent that discloses some form of adherence monitoring is being used and will be disclosed at the end of the study (authorized deception), and full disclosure. Different approaches offer different benefits and potential pitfalls. The approach used must balance the risk of nondisclosure against the potential for confounding the adherence monitoring data and the potential benefits that adherence monitoring data will have for the research subjects and/or other populations. This commentary aims to define various methods of adherence monitoring and to provide a discussion of the ethical considerations that accompany the use of each method and adherence monitoring in general as it is used in clinical research.
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Affiliation(s)
- Nupur U Patel
- Department of Dermatology, Center for Dermatology Research
| | - Blake A Moore
- Department of Dermatology, Center for Dermatology Research
| | - Rebekah F Craver
- Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research
- Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Correspondence: Steven R Feldman, Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, 4618 Country Club Road Winston-Salem, NC 27104, USA, Tel +1 336 716 7740, Fax +1 336 716 7732, Email
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8357
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Rahimi A, Ahmadpanah M, Shamsaei F, Cheraghi F, Sadeghi Bahmani D, Holsboer-Trachsler E, Brand S. Effect of adjuvant sleep hygiene psychoeducation and lorazepam on depression and sleep quality in patients with major depressive disorders: results from a randomized three-arm intervention. Neuropsychiatr Dis Treat 2016; 12:1507-15. [PMID: 27382293 PMCID: PMC4922769 DOI: 10.2147/ndt.s110978] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Sleep disturbances are a common co-occurring disturbance in patients with major depressive disorders (MDDs) and accordingly deserve particular attention. Using a randomized design, we investigated the effects of three different adjuvant interventions on sleep and depression among patients with MDD: a sleep hygiene program (SHP), lorazepam (LOR), and their combination (SHP-LOR). METHODS A total of 120 outpatients with diagnosed MDD (mean age: 48.25 years; 56.7% females) and treated with a standard SSRI (citalopram at 20-40 mg at therapeutic level) were randomly assigned to one of the following three conditions: SHP (n=40), LOR (1 mg/d; n=40), SHP-LOR (1 mg/d; n=40). At the beginning and at the end of the study 8 weeks later, patients completed two questionnaires, the Pittsburgh Sleep Quality Index to assess sleep and the Beck Depression Inventory to assess symptoms of depression. RESULTS Sleep disturbances decreased over time and in all groups. No group differences or interactions were observed. Symptoms of depression decreased over time and in all three groups. Reduction in symptoms of depression was greatest in the SHP-LOR group and lowest in the LOR group. CONCLUSION The pattern of results suggests that all three adjuvant treatments improved symptoms of sleep disturbances and depression, with greater benefits for the SHP-LOR for symptoms of depression, but not for sleep. Nevertheless, risks and benefits of benzodiazepine prescriptions should be taken into account.
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Affiliation(s)
- Alireza Rahimi
- Behavioral Disorders and Substances Abuses Research Center, Hamadan University of Medial Sciences, Hamadan
| | - Mohammad Ahmadpanah
- Behavioral Disorders and Substances Abuses Research Center, Hamadan University of Medial Sciences, Hamadan
| | - Farshid Shamsaei
- Behavioral Disorders and Substances Abuses Research Center, Hamadan University of Medial Sciences, Hamadan
| | - Fatemeh Cheraghi
- Research Center for Chronic Disease Care at Home, Hamadan University of Medial Sciences, Hamadan, Iran
| | - Dena Sadeghi Bahmani
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS)
| | - Edith Holsboer-Trachsler
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS)
| | - Serge Brand
- Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS); Department of Sport, Exercise, and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland
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8358
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Ando K, Soshi T, Nakazawa K, Noda T, Okada T. Risk Factors for Problematic Behaviors among Forensic Outpatients under the Medical Treatment and Supervision Act in Japan. Front Psychiatry 2016; 7:144. [PMID: 27605915 PMCID: PMC4995802 DOI: 10.3389/fpsyt.2016.00144] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 08/02/2016] [Indexed: 12/30/2022] Open
Abstract
The Medical Treatment and Supervision Act (MTSA) was enacted in 2005 in Japan to promote the reintegration of clinical offenders with mental disorders into society. Under the MTSA, individuals who committed serious crimes in a state of insanity or diminished responsibility are diverted from the criminal justice system to the mental health system. Based on court decisions about MTSA-based treatment, clinical offenders have an obligation to engage in rehabilitation within their local community under the guidance of mental health professionals. However, patients under MTSA-based clinical treatments have faced various problems in the course of treatment, because of psychiatric as well as other static or dynamic factors, and sometimes have committed problematic behaviors, such as violence and medical non-compliance. Hence, this study aimed to clarify factors related to patients' inclusion in MTSA-based outpatient treatment and additionally, their commitment of problematic behaviors, based on confidential data acquired during a four-year government survey period (National Center of Neurology and Psychiatry) from MTSA enactment (July 15, 2005) to December 31, 2009. In total, we recruited 441 clinical offenders receiving MTSA-based outpatient treatment from 158 nationwide facilities. To evaluate related factors, we collected demographic, psychiatric, forensic, clinical treatment, and social service information. Statistical analyses demonstrated that predominant profiles of patients included male gender, younger age, low school history, psychiatric diagnoses (F1, F2, and F3), and no correctional or outpatient history before MTSA-based treatment. F1 or substance use diagnosis, in particular, was increasingly correlated with other factors, such as male gender, older age, and correctional history before MTSA treatment. Among the 441 patients, 189 (43%) committed problematic behaviors in the course of the MTSA-based outpatient treatment. Risk factors for patients' commitment of problematic behaviors comprised F1 diagnosis and inpatient history before MTSA-based treatment inclusion. In summary, reduction of overall problematic behaviors under the MTSA outpatient likely makes progress by focal attention to patients with psychiatric disorders caused by substance use and/or a past inpatient history for more severe psychiatric symptoms. This work is of ongoing and future importance in the domain of forensic community treatment, to connect risk-enhancing factors with risk management.
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Affiliation(s)
- Kumiko Ando
- Department of Forensic Psychiatry, National Center of Neurology and Psychiatry, National Institute of Mental Health , Tokyo , Japan
| | - Takahiro Soshi
- Department of Forensic Psychiatry, National Center of Neurology and Psychiatry, National Institute of Mental Health , Tokyo , Japan
| | - Kanako Nakazawa
- Department of Forensic Psychiatry, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan; Department of Psychiatry, National Center of Neurology and Psychiatry, National Center Hospital, Tokyo, Japan
| | - Takamasa Noda
- Department of Psychiatry, National Center of Neurology and Psychiatry, National Center Hospital , Tokyo , Japan
| | - Takayuki Okada
- Department of Forensic Psychiatry, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan; Section of Psychiatry and Behavioral Science, Tokyo Medical and Dental University Graduate School, Bunkyo-ku, Tokyo, Japan
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8359
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von Kardorff E, Soltaninejad A, Kamali M, Eslami Shahrbabaki M. Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia - a qualitative exploratory study. Nord J Psychiatry 2016; 70:248-54. [PMID: 26524243 DOI: 10.3109/08039488.2015.1084372] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Caregivers of people with mental illnesses often experience a wide range of burdens. Although many studies have confirmed burdens among family caregivers of mentally ill relatives in general, specific knowledge regarding the concrete everyday hassle and existential sorrows from the caregiverś subjective reasoning perspective is lacking. Furthermore, there is little evidence on the possible different effects of affective disorders and schizophrenia on the quality of burden; this is also true with regard to the role of cultural traditions and lay beliefs. AIMS The aim of this study was to explore the specific burdens experienced by caregivers of patients with schizophrenia and affective disorders. METHODS A qualitative study was conducted by semi-structured interviews with 45 caregivers of patients with schizophrenia and affective disorders. Data were analysed by qualitative content analysis. RESULTS Eleven encumbering themes resulted from the interviews including incertitude, unawareness, emotional burden, stigma and blame, financial burden, physical burden, restriction in routine, disruption in routine, dissatisfaction with family, relatives, and acquaintances, troubles with patients' adherence to medication, and problems with health services and governmental support. CONCLUSIONS Caring for a person with mental illness affects caregivers emotionally, financially, physically, and it elicits some restrictions in their routine (daily hassles). Finally, it causes conflicts in family relationships. Despite some differences regarding perceived burden among caregivers of schizophrenia and affective disorders, a common pattern of burden could be identified. Thus, authorities should provide adequate financial, educational, and psychosocial supports for caregivers of mental illnesses.
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Affiliation(s)
- Ernst von Kardorff
- a Institute for Rehabilitation Sciences , Faculty of Arts and Humanities IV, Humboldt University of Berlin , Berlin , Germany
| | - Ali Soltaninejad
- b Institute for Rehabilitation Sciences , Faculty of Arts and Humanities IV, Humboldt University of Berlin , Berlin , Germany
| | - Mohammad Kamali
- c Department of Rehabilitation Administration , Faculty of Rehabilitation Sciences, Iran University of Medical Sciences , Tehran , Iran
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8360
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Prabhakaran MCA, Patel VR, Ganjiwale DJ, Nimbalkar MS. Factors associated with internet addiction among school-going adolescents in Vadodara. J Family Med Prim Care 2016; 5:765-769. [PMID: 28348987 PMCID: PMC5353810 DOI: 10.4103/2249-4863.201149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: The internet is an important modern means of obtaining information and communicating with others which has converted the world into a global village. At the same time, increasing internet use among adolescents is also likely to pose a major public health concern that is internet addiction (IA). The aim was to assess the prevalence of IA among school-going adolescents and factors associated with IA. Methods: A cross-sectional study was designed to survey adolescents studying in 8th to 11th standard of five schools of Vadodara. Information regarding sociodemography and various patterns of internet use were obtained using survey forms. IA test (IAT) was used to screen for IA. Descriptive analysis, univariate analysis, and logistic regression were done to analyze the data. Results: Seven hundred and twenty-four participants that completed IAT were analyzed. Internet use prevalence was 98.9%. Prevalence of IA was 8.7%. Male gender, owning a personal device, hours of internet use/day, use of smartphones, permanent login status, use of internet for chatting, making online friends, shopping, watching movies, online gaming, searching information online and instant messaging were found to be associated significantly with IA in univariate analysis. Internet use for online friendships was found to be a significant predictor of IA (odds ratio [OR] =2.4), and internet use for searching information was found to be protective (OR = 0.20) against IA on logistic regression. Conclusions: IA is prevalent in the adolescent population and requires awareness and intervention. Characteristics of internet usage found to be associated with IA needs to be considered while developing strategies for interventions.
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Affiliation(s)
- M C Anusha Prabhakaran
- Department of Psychiatry, Pramukhswami Medical College, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - V Rajvee Patel
- Department of Psychiatry, Pramukhswami Medical College, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - D Jaishree Ganjiwale
- Department of Community Medicine and Central Research Services, Pramukhswami Medical College, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - M Somashekhar Nimbalkar
- Department of Pediatrics, Pramukhswami Medical College, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
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8361
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Task-dependent and polarity-specific effects of prefrontal transcranial direct current stimulation on cortical activation during word fluency. Neuroimage 2015; 140:134-40. [PMID: 26748077 DOI: 10.1016/j.neuroimage.2015.12.047] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 12/17/2015] [Accepted: 12/28/2015] [Indexed: 11/23/2022] Open
Abstract
Targeted modulation of cortical functions by non-invasive brain stimulation is widely used for the investigation of the neurophysiological signatures of executive functions and put forward as a potential specific treatment for its disorders. To further investigate the underlying mechanisms, we performed two experiments involving 46 subjects that performed a semantic and a phonological verbal fluency task (VFT) as well as a simple speech-production task after application of 1mA anodal or cathodal transcranial direct current stimulation (tDCS) to the left inferior frontal gyrus (IFG). Brain activation was measured by functional near-infrared spectroscopy (fNIRS) during task performance. Neither preceding anodal nor cathodal tDCS was found to modulate VFT performance of either difficulty. However, preconditioning with anodal tDCS increased brain activity during the VFT whereas a trendwise decrease of activation was found after cathodal stimulation. Notably, this difference was not found with simple speech production. These findings support the notion of a polarity-specific malleability of neuronal network activity underlying speech production by tDCS. Most importantly, the task-specificity of the modulatory effect observed after the end of stimulation demonstrates lasting neurophysiological effects of tDCS that are reflected in modifications of cortical excitability by challenging cognitive tasks.
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8362
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Garcia DM, Sheehan MC. Extreme Weather-driven Disasters and Children’s Health. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2015; 46:79-105. [DOI: 10.1177/0020731415625254] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Extreme weather events such as heat waves, extreme precipitation, and storm surges are likely to become more frequent and intense with climate change. Extreme weather-driven disasters (EWDDs) cause a substantial burden of childhood mortality and morbidity worldwide. We reviewed the published literature on EWDDs and their health impacts on children, and developed a conceptual model based on complex systems thinking to identify the health risks, vulnerabilities, and capacities of children in the context of EWDDs as a means of informing areas for adaptive intervention. We found that direct and indirect physical and mental impacts of EWDDs on child health are abundant and interrelate in complex ways. The literature review and modeling demonstrated the centrality of resilience at the level of the child and his or her direct environment, suggesting that mental health status may play a key role in a child’s experience of numerous other health outcomes of EWDDs. EWDDs interact with environmental and social systems and with individual children and their contexts in complex ways, the impacts of which are nonlinear and difficult to predict. Traditional perspectives on climate change-driven health impacts often overlook complex bio-psychosocial interactions, suggesting a need to work on preventive strategies to reduce vulnerability and build individual child resilience.
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Affiliation(s)
| | - Mary C. Sheehan
- Johns Hopkins Bloomberg School of Public Health, Maryland, USA
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Brown MA, Bishnoi RJ, Dholakia S, Velligan DI. Methodological issues associated with preclinical drug development and increased placebo effects in schizophrenia clinical trials. Expert Rev Clin Pharmacol 2015; 9:591-604. [PMID: 26696325 DOI: 10.1586/17512433.2016.1135734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent failures to detect efficacy in clinical trials investigating pharmacological treatments for schizophrenia raise concerns regarding the potential contribution of methodological shortcomings to this research. This review provides an examination of two key methodological issues currently suspected of playing a role in hampering schizophrenia drug development; 1) limitations on the translational utility of preclinical development models, and 2) methodological challenges posed by increased placebo effects. Recommendations for strategies to address these methodological issues are addressed.
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Affiliation(s)
- Matt A Brown
- a Department of Psychiatry , University of Texas Health Science Center at San Antonio , San Antonio , TX , USA
| | - Ram J Bishnoi
- a Department of Psychiatry , University of Texas Health Science Center at San Antonio , San Antonio , TX , USA
| | - Sara Dholakia
- a Department of Psychiatry , University of Texas Health Science Center at San Antonio , San Antonio , TX , USA
| | - Dawn I Velligan
- a Department of Psychiatry , University of Texas Health Science Center at San Antonio , San Antonio , TX , USA
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8364
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Executive function is affected in autism spectrum disorder, but does not correlate with intelligence. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2015; 9:39-50. [PMID: 26724269 DOI: 10.1016/j.rpsm.2015.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/14/2015] [Accepted: 10/18/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Studies of executive function in autism spectrum disorder without intellectual disability (ASD-WID) patients are contradictory. We assessed a wide range of executive functioning cognitive domains in a sample of children and adolescents with ASD-WID and compared them with age-, sex-, and intelligence quotient (IQ)-matched healthy controls. METHODS Twenty-four ASD-WID patients (mean age 12.8±2.5 years; 23 males; mean IQ 99.20±18.81) and 32 healthy controls (mean age 12.9±2.7 years; 30 males; mean IQ 106.81±11.02) were recruited. RESULTS Statistically significant differences were found in all cognitive domains assessed, with better performance by the healthy control group: attention (U=185.0; P=.0005; D=0.90), working memory (T51.48=2.597; P=.006; D=0.72), mental flexibility (U=236.0; P=.007; D=0.67), inhibitory control (U=210.0; P=.002; D=0.71), and problem solving (U=261.0; P=0.021; D=0.62). These statistically significant differences were also found after controlling for IQ. CONCLUSION Children and adolescents with ASD-WID have difficulties transforming and mentally manipulating verbal information, longer response latency, attention problems (difficulty set shifting), trouble with automatic response inhibition and problem solving, despite having normal IQ. Considering the low executive functioning profile found in those patients, we recommend a comprehensive intervention including work on non-social problems related to executive cognitive difficulties.
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8365
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Marek GJ, Day M, Hudzik TJ. The Utility of Impulsive Bias and Altered Decision Making as Predictors of Drug Efficacy and Target Selection: Rethinking Behavioral Screening for Antidepressant Drugs. ACTA ACUST UNITED AC 2015; 356:534-48. [DOI: 10.1124/jpet.115.229922] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 12/22/2015] [Indexed: 11/22/2022]
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8366
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Pantelyat A, Syres C, Reichwein S, Willis A. DRUM-PD: The use of a drum circle to improve the symptoms and signs of Parkinson's disease (PD). Mov Disord Clin Pract 2015; 3:243-249. [PMID: 27340683 DOI: 10.1002/mdc3.12269] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Physical therapy can improve motor function in patients with PD. Music performance may be used to improve motor skills by rhythmic entrainment. Drumming has long been a part of traditional healing rituals worldwide, and is increasingly being utilized as a therapeutic strategy. METHODS This pilot controlled prospective cohort trial assessed feasibility and effects of twice-weekly group West African drum circle classes for 6 weeks on PD patients' quality of life, symptoms, motor findings, cognition, and mood. Ten patients with PD were recruited into the drum circle group. Ten patients with PD were matched pairwise to each of the drum circle participants, and enrolled in a no-intervention control group. Both groups completed the PD-specific Parkinson Disease Questionnaire (PDQ)-39 quality of life assessment and the Geriatric Depression Scale (GDS), and underwent motor and cognitive assessments by a rater blinded to group at baseline, 6 weeks, and 12 weeks. RESULTS Drummers had significantly improved PDQ-39 scores from baseline to 6 weeks (-5.8, p=0.042), whereas the control group's scores were unchanged. Walking performance was significantly faster at baseline for controls; after 6 weeks of drumming this difference was no longer significant, and remained non-significant at 12 weeks. The drummers trended (p=0.069) toward improvement in walking from baseline to 12 weeks. Other outcomes did not significantly change from baseline to 6 or 12 weeks. CONCLUSIONS Drum circle classes significantly and reversibly improved quality of life in patients with PD. This pilot trial's findings merit larger controlled investigations comparing drumming classes to established interventions in PD, such as physical therapy.
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Affiliation(s)
| | - Candace Syres
- Parkinson Disease and Movement Disorder Center at the University of Pennsylvania
| | - Suzanne Reichwein
- Parkinson Disease and Movement Disorder Center at the University of Pennsylvania
| | - Allison Willis
- Parkinson Disease and Movement Disorder Center at the University of Pennsylvania; Department of Neurology, University Perelman School of Medicine; Department of Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine
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8367
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Mirhosseini H, Moosavipoor SA, Nazari MA, Dehghan A, Mirhosseini S, Bidaki R, Yazdian-Anari P. Cognitive Behavioral Development in Children Following Maternal Postpartum Depression: A Review Article. Electron Physician 2015; 7:1673-9. [PMID: 26816593 PMCID: PMC4725423 DOI: 10.19082/1673] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 08/20/2015] [Indexed: 01/23/2023] Open
Abstract
Mothers’ constitute is a very important part of infants’ social environment and mediate their experience with the surrounding world. Postpartum depression, which is considered one of the most common and important psychiatric disorders, affects 10–15% of mothers, its causes are different. By investigating various sources, some effects of this disorder have been observed on the cognitive development of children, particularly among boys, such as language, intelligence quotient (IQ), and behavioral problems. Thus, it is imperative to study the effects of postpartum depression on children’s growth and development and to identify methods of reducing these effects. This review indicates that postpartum depression in mothers reduces children’s cognitive performance. The adverse effects of postpartum depression on children’s development seem to be mediated by the mother’s interpersonal behavior and the infant gender. The review of previous studies shows that postpartum depression reduces children’s cognitive performance by impairing maternal mental and behavioral care.
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Affiliation(s)
- Hamid Mirhosseini
- Ph.D. in Cognitive Neuroscience, Assistant Professor, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Ahmad Moosavipoor
- Pharmacologist, Faculty Member, Department of Pharmacology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ali Nazari
- Ph.D. in Cognitive Neuroscience, Associate Professor, Department of Educational Science and Psychology, Tabriz University, Tabriz, Iran
| | - Ahmad Dehghan
- General Physician, Managerial of Emergency Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sara Mirhosseini
- Medical Student, Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reza Bidaki
- Psychiatrist, Associate Professor, Department of Psychiatry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Pouria Yazdian-Anari
- Medical Student, Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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8368
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Neuroscience of drug craving for addiction medicine: From circuits to therapies. PROGRESS IN BRAIN RESEARCH 2015; 223:115-41. [PMID: 26806774 DOI: 10.1016/bs.pbr.2015.10.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Drug craving is a dynamic neurocognitive emotional-motivational response to a wide range of cues, from internal to external environments and from drug-related to stressful or affective events. The subjective feeling of craving, as an appetitive or compulsive state, could be considered a part of this multidimensional process, with modules in different levels of consciousness and embodiment. The neural correspondence of this dynamic and complex phenomenon may be productively investigated in relation to regional, small-scale networks, large-scale networks, and brain states. Within cognitive neuroscience, this approach has provided a long list of neural and cognitive targets for craving modulations with different cognitive, electrical, or pharmacological interventions. There are new opportunities to integrate different approaches for carving management from environmental, behavioral, psychosocial, cognitive, and neural perspectives. By using cognitive neuroscience models that treat drug craving as a dynamic and multidimensional process, these approaches may yield more effective interventions for addiction medicine.
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8369
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Penadés R, García-Rizo C, Bioque M, González-Rodríguez A, Cabrera B, Mezquida G, Bernardo M. The search for new biomarkers for cognition in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2015; 2:172-178. [PMID: 29114461 PMCID: PMC5609637 DOI: 10.1016/j.scog.2015.10.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The search for biomarkers in cognition has been the focus of a large part of the research on patients suffering from schizophrenia. The scientific literature is heterogeneous, and few studies establishing an integrative model of pathogenesis and therapeutic response are available in this field. In this review, we aimed to summarize three essential aspects correlated with cognitive performance: 1) the relationship between inflammation and cognition in schizophrenia, 2) the role of prolactin in cognition, and 3) the association between cognition and neurotrophic factors, particularly brain-derived neurotrophic factor (BDNF). Several studies support the association of inflammatory markers with cognitive status in schizophrenia. In recent decades, the development of effective therapies for cognitive impairment in schizophrenia has focused on the search for anti-inflammatory and immunomodulatory medications. Conversely, the implications of prolactin and its functions in cognition, the transition to psychosis and the diagnosis and prognosis of schizophrenia have been established independent of antipsychotic treatment. With regard to neurotrophic factors, a recent study has correlated BDNF levels with cognitive recovery in schizophrenic patients treated with cognitive remediation. We conclude that although there is a diversity of biomarkers focused on cognitive function in schizophrenia, BDNF is the biomarker that has accumulated the vast majority of evidence in the current literature.
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Affiliation(s)
- Rafael Penadés
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,University of Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | | | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit (BCSU).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit (BCSU).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,University of Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
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8370
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Miller LR, Jorgensen MJ, Kaplan JR, Seeds MC, Rahbar E, Morgan TM, Welborn A, Chilton SM, Gillis J, Hester A, Rukstalis M, Sergeant S, Chilton FH. Alterations in levels and ratios of n-3 and n-6 polyunsaturated fatty acids in the temporal cortex and liver of vervet monkeys from birth to early adulthood. Physiol Behav 2015; 156:71-8. [PMID: 26705667 DOI: 10.1016/j.physbeh.2015.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 12/03/2015] [Accepted: 12/10/2015] [Indexed: 11/29/2022]
Abstract
Deficiencies in omega-3 (n-3) long chain polyunsaturated fatty acids (LC-PUFAs) and increases in the ratio of omega-6 (n-6) to n-3 LC-PUFAs in brain tissues and blood components have been associated with psychiatric and developmental disorders. Most studies have focused on n-3 LC-PUFA accumulation in the brain from birth until 2years of age, well before the symptomatic onset of such disorders. The current study addresses changes that occur in childhood and adolescence. Postmortem brain (cortical gray matter, inferior temporal lobe; n=50) and liver (n=60) from vervet monkeys fed a uniform diet from birth through young adulthood were collected from archived tissues. Lipids were extracted and fatty acid levels determined. There was a marked reduction in the ratio of n-6 LC-PUFAs, arachidonic acid (ARA) and adrenic acid (ADR), relative to the n-3 LC-PUFA, docosahexaenoic acid (DHA), in temporal cortex lipids from birth to puberty and then a more gradual decrease though adulthood. This decrease in ratio resulted from a 3-fold accumulation of DHA levels while concentrations of ARA remained constant. Early childhood through adolescence appears to be a critical period for DHA accretion in the cortex of vervet monkeys and may represent a vulnerable stage where lack of dietary n-3 LC-PUFAs impacts development in humans.
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Affiliation(s)
- Leslie R Miller
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Matthew J Jorgensen
- Department of Pathology, Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Jay R Kaplan
- Department of Pathology, Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Michael C Seeds
- The Center for Botanical Lipids and Inflammatory Disease Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Elaheh Rahbar
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Timothy M Morgan
- Department of Biostatistics, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Andrea Welborn
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Sarah M Chilton
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Julianne Gillis
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Austin Hester
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Mae Rukstalis
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Susan Sergeant
- The Center for Botanical Lipids and Inflammatory Disease Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Floyd H Chilton
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; The Center for Botanical Lipids and Inflammatory Disease Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
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8371
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Scholz AFM, Oldroyd C, McCarthy K, Quinn TJ, Hewitt J. Systematic review and meta-analysis of risk factors for postoperative delirium among older patients undergoing gastrointestinal surgery. Br J Surg 2015; 103:e21-8. [PMID: 26676760 DOI: 10.1002/bjs.10062] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/02/2015] [Accepted: 10/26/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Postoperative delirium (POD) is common after surgery. As age is a known risk factor, the increased ageing of the population undergoing surgery emphasizes the importance of the subject. Knowledge of other potential risk factors in older patients with surgical gastrointestinal diseases is lacking. The aim here was to collate and synthesize the published literature on risk factors for delirium in this group. METHODS Five databases were searched (MEDLINE, Web of Science, Embase, CINAHL(®) and PSYCinfo(®) ) between January 1987 and November 2014. The Newcastle-Ottawa Scale was used to rate study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods. RESULTS Eleven studies met the inclusion criteria; they provided a total of 1427 patients (318 with delirium and 1109 without), and predominantly included patients undergoing elective colorectal surgery. The incidence of POD ranged from 8·2 to 54·4 per cent. A total of 95 risk factors were investigated, illustrating wide heterogeneity in study design. Seven statistically significant risk factors were identified in pooled analysis: old age, American Society of Anesthesiologists (ASA) physical status grade at least III, body mass index, lower serum level of albumin, intraoperative hypotension, perioperative blood transfusion and history of alcohol excess. Patients with POD had a significantly increased duration of hospital stay and a higher mortality rate compared with those without delirium. CONCLUSION Delirium is common in older patients undergoing gastrointestinal surgery. Several risk factors were consistently associated with POD.
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Affiliation(s)
- A F M Scholz
- Institute of Primary Care and Public Health, Cardiff University, University Hospital, Llandough, Cardiff
| | - C Oldroyd
- Institute of Cardiovascular and Medical Sciences, Glasgow Royal Infirmary, Glasgow
| | - K McCarthy
- Department of Colorectal Surgery, North Bristol NHS Trust, Bristol, UK
| | - T J Quinn
- Institute of Cardiovascular and Medical Sciences, Glasgow Royal Infirmary, Glasgow
| | - J Hewitt
- Institute of Primary Care and Public Health, Cardiff University, University Hospital, Llandough, Cardiff
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8372
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O'Farrell K, Harkin A. Stress-related regulation of the kynurenine pathway: Relevance to neuropsychiatric and degenerative disorders. Neuropharmacology 2015; 112:307-323. [PMID: 26690895 DOI: 10.1016/j.neuropharm.2015.12.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/02/2015] [Accepted: 12/08/2015] [Indexed: 02/08/2023]
Abstract
The kynurenine pathway (KP), which is activated in times of stress and infection has been implicated in the pathophysiology of neurodegenerative and psychiatric disorders. Activation of this tryptophan metabolising pathway results in the production of neuroactive metabolites which have the potential to interfere with normal neuronal functioning which may contribute to altered neuronal transmission and the emergence of symptoms of these brain disorders. This review investigates the involvement of the KP in a range of neurological disorders, examining recent in vitro, in vivo and clinical discoveries highlights evidence to indicate that the KP is a potential therapeutic target in both neurodegenerative and stress-related neuropsychiatric disorders. Furthermore, this review identifies gaps in our knowledge with regard to this field which are yet to be examined to lead to a more comprehensive understanding of the role of KP activation in brain health and disease. This article is part of the Special Issue entitled 'The Kynurenine Pathway in Health and Disease'.
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Affiliation(s)
- Katherine O'Farrell
- Neuropsychopharmacology Research Group, School of Pharmacy and Pharmaceutical Sciences & Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Andrew Harkin
- Neuropsychopharmacology Research Group, School of Pharmacy and Pharmaceutical Sciences & Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland; Neuroimmunology Research Group, Department of Physiology, School of Medicine & Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland.
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8373
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Stumbo SP, Yarborough BJH, Janoff SL, Yarborough MT, McCarty D, Green CA. A qualitative analysis of family involvement in prescribed opioid medication monitoring among individuals who have experienced opioid overdoses. Subst Abus 2015; 37:96-103. [DOI: 10.1080/08897077.2015.1124479] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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8374
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Abstract
Pregnancy denial is rare yet reported and is often the result of complex psychosocial circumstances. We present an unusual case of pregnancy denial associated directly with both remote and ongoing trauma. A woman suddenly gave birth to a child in a hospital while visiting her other daughter, resulting in emergent labor and delivery as well as social work and psychiatric evaluation. Various atypical findings were noted, including pathological hair-pulling, alexithymia, indifference, and pregnancy denial. We offer a biopsychosocial conceptualization of the case, commenting on various possible processes including dissociation. The case also explores current states of knowledge regarding the interaction between impulse control disorders such as trichotillomania, dissociation, and trauma, with a call for future clinical and investigational attention to these interactions.
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8375
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Csoboth C, Witt EA, Villa KF, O'Gorman C. The humanistic and economic burden of providing care for a patient with schizophrenia. Int J Soc Psychiatry 2015; 61:754-61. [PMID: 25823542 DOI: 10.1177/0020764015577844] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Schizophrenia is a debilitating disorder that often requires the affected individual to receive part- or full-time care from a caregiver. AIMS The purpose of this study was to examine the humanistic and economic burden of caring for an individual with Schizophrenia with regard to the measures of quality of life (QoL), work productivity, healthcare resource use and estimated economic costs. METHODS Data for this study came from the 2012 US National Health and Wellness Survey (NHWS; n = 71,149). Specifically, this analysis focused on those individuals in the survey who indicated that they were currently the primary caregiver for an individual with Schizophrenia (C-SCZ; n = 174). These individuals were matched via two separate 1:2 propensity score matches with both caregivers of other disorders (C-Other; n = 294) and non-caregivers (Non-C; n = 294) on significant covariates. Individuals were then compared across the outcomes of QoL, work productivity, healthcare resource use and estimated economic costs. RESULTS C-SCZ respondents had worse outcomes on all outcomes measured than C-Other respondents and Non-C respondents even when controlling for significant differences between the groups on sociodemographic characteristics. However, due to the small sample sizes, these comparisons were only significant in most cases for the C-SCZ to Non-C comparisons. CONCLUSION Results indicate that caregivers of those with Schizophrenia experience a heightened humanistic and economic burden, especially relative to the burden experienced by non-caregivers. The fact that Schizophrenia not only affects the individual but also those who care for that individual is underscored by these results.
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8376
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Almeida AB, Nascimento ERPD, Rodrigues J, Zeferino MT, Souza AIJD, Hermida PMV. MOBILE EMERGENCY MEDICAL SERVICES IN THE PSYCHOLOGICAL CRISIS AND THE PSYCHOSOCIAL PARADIGM. TEXTO & CONTEXTO ENFERMAGEM 2015. [DOI: 10.1590/0104-0707201500003580014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The objective was to know the perception and interventions of basic support teams of the mobile emergency medical service in a situation of psychic crisis. This was a qualitative and descriptive research study conducted in the state of Santa Catarina, with four professional teams of the Basic Support Units in Mobile and Emergency Service. The data were collected from April to June of 2011, through semi-structured interviews. Collective Subject Discourse was used to organize and analyze data and to discuss the Psychosocial Paradigm. From the results, three discourses emerged with the main ideas: crisis behavior disorder and psychological instability; hallucinations and aggressiveness; intervention with physical or pharmacological restraint and referral. It is concluded that the concept of crisis is linked by professionals to the positivism of psychiatry, and pre-hospital care follows protocol measures in attending the person in mental crisis, far from the principles determined by the psychosocial paradigm.
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8377
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Penadés R, Garcia-Rizo C, Bioque M, González-Rodríguez A, Cabrera B, Mezquida G, Bernardo M. Búsqueda De Nuevos Biomarcadores De La Cognición En Esquizofrenia. Schizophr Res Cogn 2015. [DOI: 10.1016/j.scog.2015.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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8378
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Synaptic P-Rex1 signaling regulates hippocampal long-term depression and autism-like social behavior. Proc Natl Acad Sci U S A 2015; 112:E6964-72. [PMID: 26621702 DOI: 10.1073/pnas.1512913112] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Autism spectrum disorders (ASDs) are a group of highly inheritable mental disorders associated with synaptic dysfunction, but the underlying cellular and molecular mechanisms remain to be clarified. Here we report that autism in Chinese Han population is associated with genetic variations and copy number deletion of P-Rex1 (phosphatidylinositol-3,4,5-trisphosphate-dependent Rac exchange factor 1). Genetic deletion or knockdown of P-Rex1 in the CA1 region of the hippocampus in mice resulted in autism-like social behavior that was specifically linked to the defect of long-term depression (LTD) in the CA1 region through alteration of AMPA receptor endocytosis mediated by the postsynaptic PP1α (protein phosphase 1α)-P-Rex1-Rac1 (Ras-related C3 botulinum toxin substrate 1) signaling pathway. Rescue of the LTD in the CA1 region markedly alleviated autism-like social behavior. Together, our findings suggest a vital role of P-Rex1 signaling in CA1 LTD that is critical for social behavior and cognitive function and offer new insight into the etiology of ASDs.
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8379
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Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2015; 2015:218980. [PMID: 26693477 PMCID: PMC4676992 DOI: 10.1155/2015/218980] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/04/2015] [Indexed: 12/20/2022]
Abstract
Introduction. Behavioral and psychological symptoms of dementia (BPSD) are defined as a group of symptoms of disturbed perceptive thought content, mood, or behavior that include agitation, depression, apathy, repetitive questioning, psychosis, aggression, sleep problems, and wandering. Care of patients with BPSD involves pharmacological and nonpharmacological interventions. We reviewed studies of nonpharmacological interventions published in the last 10 years. Methods. We performed a systematic review in Medline and Embase databases, in the last 10 years, until June 2015. Key words used were (1) non-pharmacological interventions, (2) behavioral symptoms, (3) psychological symptoms, and (4) dementia. Results. We included 20 studies published in this period. Among these studies, program activities were more frequent (five studies) and the symptoms more responsive to the interventions were agitation. Discussion. Studies are heterogeneous in many aspects, including size sample, intervention, and instruments of measures. Conclusion. Nonpharmacological interventions are able to provide positive results in reducing symptoms of BPSD. Most studies have shown that these interventions have important and significant efficacy.
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8380
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Hashimoto R, Nakazawa T, Tsurusaki Y, Yasuda Y, Nagayasu K, Matsumura K, Kawashima H, Yamamori H, Fujimoto M, Ohi K, Umeda-Yano S, Fukunaga M, Fujino H, Kasai A, Hayata-Takano A, Shintani N, Takeda M, Matsumoto N, Hashimoto H. Whole-exome sequencing and neurite outgrowth analysis in autism spectrum disorder. J Hum Genet 2015; 61:199-206. [PMID: 26582266 PMCID: PMC4819764 DOI: 10.1038/jhg.2015.141] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 10/23/2015] [Accepted: 10/28/2015] [Indexed: 12/27/2022]
Abstract
Autism spectrum disorder (ASD) is a complex group of clinically heterogeneous neurodevelopmental disorders with unclear etiology and pathogenesis. Genetic studies have identified numerous candidate genetic variants, including de novo mutated ASD-associated genes; however, the function of these de novo mutated genes remains unclear despite extensive bioinformatics resources. Accordingly, it is not easy to assign priorities to numerous candidate ASD-associated genes for further biological analysis. Here we developed a convenient system for identifying an experimental evidence-based annotation of candidate ASD-associated genes. We performed trio-based whole-exome sequencing in 30 sporadic cases of ASD and identified 37 genes with de novo single-nucleotide variations (SNVs). Among them, 5 of those 37 genes, POGZ, PLEKHA4, PCNX, PRKD2 and HERC1, have been previously reported as genes with de novo SNVs in ASD; and consultation with in silico databases showed that only HERC1 might be involved in neural function. To examine whether the identified gene products are involved in neural functions, we performed small hairpin RNA-based assays using neuroblastoma cell lines to assess neurite development. Knockdown of 8 out of the 14 examined genes significantly decreased neurite development (P<0.05, one-way analysis of variance), which was significantly higher than the number expected from gene ontology databases (P=0.010, Fisher's exact test). Our screening system may be valuable for identifying the neural functions of candidate ASD-associated genes for further analysis and a substantial portion of these genes with de novo SNVs might have roles in neuronal systems, although further detailed analysis might eliminate false positive genes from identified candidate ASD genes.
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Affiliation(s)
- Ryota Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takanobu Nakazawa
- iPS Cell-Based Research Project on Brain Neuropharmacology and Toxicology, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
| | - Yoshinori Tsurusaki
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yuka Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuki Nagayasu
- iPS Cell-Based Research Project on Brain Neuropharmacology and Toxicology, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
| | - Kensuke Matsumura
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
| | - Hitoshi Kawashima
- Genomic Science Laboratories, Sumitomo Dainippon Pharma Co., Ltd., Osaka, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazutaka Ohi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satomi Umeda-Yano
- Department of Molecular Neuropsychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, National Institute of Physiological Sciences, Aichi, Japan
| | - Haruo Fujino
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Atsushi Kasai
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
| | - Atsuko Hayata-Takano
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan.,Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
| | - Norihito Shintani
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
| | - Masatoshi Takeda
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hitoshi Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan.,iPS Cell-Based Research Project on Brain Neuropharmacology and Toxicology, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan.,Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
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8381
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Perioperative Cognitive Protection-Cognitive Exercise and Cognitive Reserve (The Neurobics Trial): A Single-blind Randomized Trial. Clin Ther 2015; 37:2641-50. [PMID: 26598177 DOI: 10.1016/j.clinthera.2015.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/12/2015] [Accepted: 10/13/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE The Neurobics Trial is a single-blind, parallel-group, randomized, controlled trial. The main study objective is to compare effectiveness of preoperative cognitive exercise versus no intervention for lowering the incidence of postoperative delirium. Enrollment began March 2015 and is ongoing. METHODS Eligible participants include patients older than 60 years of age scheduled for nonemergent, noncardiac, nonneurological surgery at our institution. Patients provide consent and are screened at our Outpatient Preoperative Assessment Clinic to rule out preexisting cognitive dysfunction, significant mental health disorders, and history of surgery requiring general anesthesia in the preceding 6 months. Participants meeting criteria are randomized to complete 1 hour daily of electronic tablet-based cognitive exercise for 10 days before surgery or no preoperative intervention. Compliance with the effective dose of 10 total hours of preoperative exercise is verified on return of the patient for surgery with time logs created by the software application and by patient self-reporting. After surgery, patients are evaluated for delirium in the postanesthesia recovery area, and then twice daily for the remainder of their hospitalization. Additionally, postoperative quality of recovery is assessed daily, along with pain scores and opiate use. More comprehensive cognitive assessments are completed just before discharge for baseline comparison, and quality of recovery is assessed via telephone interview 7, 30, and 90 days post-surgery. The primary outcome is the incidence of delirium during the postoperative hospitalization period. Randomization is computer generated, with allocation concealment in opaque envelopes. All postoperative assessments are completed by blinded study personnel. FINDINGS The study is actively recruiting with 19 patients having provided consent to date, and a total of 264 patients is required for study completion; therefore, no data analysis is currently under way (www.clinicaltrials.gov; NCT02230605). IMPLICATIONS To our knowledge, the Neurobics Trial is the first randomized, controlled study to investigate the effectiveness of a significant preoperative cognitive exercise regimen for the prevention of delirium after noncardiac, nonneurological surgery in elderly patients.
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8382
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Zarrouq B, Bendaou B, Elkinany S, Rammouz I, Aalouane R, Lyoussi B, Khelafa S, Bout A, Berhili N, Hlal H, Nejjari C, El Rhazi K. Suicidal behaviors among Moroccan school students: prevalence and association with socio-demographic characteristics and psychoactive substances use: a cross-sectional study. BMC Psychiatry 2015; 15:284. [PMID: 26572129 PMCID: PMC4647598 DOI: 10.1186/s12888-015-0680-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/09/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Suicidal behavior is a major cause of injury and death worldwide, especially among adolescents and young adults. Few studies have tackled this issue in the Arab world. The present study investigated the prevalence and the risk factors of suicidal behaviors among Moroccan school students. METHODS From April 2012 to November 2013, a cross-sectional study was conducted in the North-Centre region of Morocco among students in public secondary schools selected using stratified cluster random sampling. The data were collected via anonymous self-administered questionnaires. The Mini International Neuropsychiatric Interview was used in its Moroccan Colloquial Arabic version to assess suicidality according to the DSM-IV criteria. RESULTS A total of 3020 students (53 % boys) aged 11-23 years (average age = 16 ± 2.1 years) were included in the study. The prevalence of suicide ideation, suicide planning and suicide attempts during the last month were 15.7, 6.3, and 6.5 % respectively. Univariate analyses demonstrated that suicidal behaviors followed different epidemiological patterns. According to the multivariate analyses, the risk factors for all suicidal behaviors among Moroccan school students were the female gender, middle school level, urban locations, low family income, parents' divorce, tobacco consumption and psychoactive substances (alcohol and cannabis) use. CONCLUSIONS The intervention of preventive programs has become an emergency to overcome the issue of suicidality in Morocco. Further researches on adolescents' suicidal behaviors are suggested to update temporal data and assess the effectiveness of potential interventions.
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Affiliation(s)
- Btissame Zarrouq
- Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco. .,Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco. .,Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdillah University, B.P 1893, Route Sidi Harazem, Km 2.2, Fez, Morocco.
| | - B. Bendaou
- Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco ,Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - S. Elkinany
- Department of English, Dhar El Mahraz Faculty of literature and human sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - I. Rammouz
- Laboratory of Clinical Neurosciences, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - R. Aalouane
- Laboratory of Clinical Neurosciences, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - B. Lyoussi
- Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - S. Khelafa
- Department of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - A. Bout
- Department of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - N. Berhili
- Department of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - H. Hlal
- Department of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - C. Nejjari
- Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - K. El Rhazi
- Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
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8383
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Raglio A, Bellandi D, Baiardi P, Gianotti M, Ubezio MC, Zanacchi E, Granieri E, Imbriani M, Stramba-Badiale M. Effect of Active Music Therapy and Individualized Listening to Music on Dementia: A Multicenter Randomized Controlled Trial. J Am Geriatr Soc 2015; 63:1534-9. [PMID: 26289682 DOI: 10.1111/jgs.13558] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the effects of active music therapy (MT) and individualized listening to music (LtM) on behavioral and psychological symptoms of dementia (BPSDs) in persons with dementia (PWDs). DESIGN Randomized controlled trial. SETTING Nine Italian institutions. PARTICIPANTS Persons with moderate to severe dementia and BPSDs (N = 120) were randomized to one of three treatments. INTERVENTIONS All groups received standard care (SC), and two groups attended 20 individualized MT or LtM sessions, twice a week, in addition to SC. MEASUREMENTS The Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Cornell-Brown Scale for Quality of Life in Dementia (CBS-QoL) were administered before treatment, after treatment, and at follow-up to evaluate behavioral and psychological outcomes. A specific coding scheme (Music Therapy Check List-Dementia) was used to evaluate the MT process. RESULTS Behavioral assessment did not show significant differences between groups. All groups showed a reduction over time in NPI global score (P ≤ .001), CSDD (P = .001), and CBS-QoL (P = .01). The NPI global score fell 28% in the MT group, 12% in the LtM group, and 21% in the SC group at the end of treatment. An exploratory post hoc analysis showed similar within-group improvements for the NPI Delusion, Anxiety, and Disinhibition subscales. In the MT group, communication and relationships between the music therapists and PWDs showed a positive albeit nonsignificant trend during treatment. CONCLUSION The addition of MT or LtM to standard care did not have a significant effect on BPSDs in PWDs. Further studies on the effects of the integration of standard care with different types of music interventions on BPSD in PWD are warranted.
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Affiliation(s)
- Alfredo Raglio
- Department of Public Health and Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Neurology Clinic, Department of Biomedical and Surgical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Paola Baiardi
- Scientific Direction, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy
| | | | | | | | - Enrico Granieri
- Neurology Clinic, Department of Biomedical and Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Marcello Imbriani
- Department of Public Health and Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Department of Occupational Medicine, Ergonomics and Disability, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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8384
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Brown SA. Building SuperModels: emerging patient avatars for use in precision and systems medicine. Front Physiol 2015; 6:318. [PMID: 26594179 PMCID: PMC4635220 DOI: 10.3389/fphys.2015.00318] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 10/20/2015] [Indexed: 12/19/2022] Open
Affiliation(s)
- Sherry-Ann Brown
- Division of Cardiovascular Diseases, Department of Medicine, Mayo ClinicRochester, MN, USA
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8385
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De J, Wand APF. Delirium Screening: A Systematic Review of Delirium Screening Tools in Hospitalized Patients. THE GERONTOLOGIST 2015; 55:1079-99. [DOI: 10.1093/geront/gnv100] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 06/04/2015] [Indexed: 11/14/2022] Open
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8386
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Nephew BC, Murgatroyd C, Pittet F, Febo M. Brain Reward Pathway Dysfunction in Maternal Depression and Addiction: A Present and Future Transgenerational Risk. ACTA ACUST UNITED AC 2015; 1:105-116. [PMID: 27617302 PMCID: PMC5013732 DOI: 10.17756/jrds.2015-017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Two research areas that could benefit from a greater focus on the role of the reward pathway are maternal depression and maternal addiction. Both depression and addiction in mothers are mediated by deficiencies in the reward pathway and represent substantial risks to the health of offspring and future generations. This targeted review discusses maternal reward deficits in depressed and addicted mothers, neural, genetic, and epigenetic mechanisms, and the transgenerational transmission of these deficits from mother to offspring. Postpartum depression and drug use disorders may entail alterations in the reward pathway, particularly in striatal and prefrontal areas, which may affect maternal attachment to offspring and heighten the risk of transgenerational effects on the oxytocin and dopamine systems. Alterations may involve neural circuitry changes, genetic factors that impact monoaminergic neurotransmission, as well as growth factors such as BDNF and stress-associated signaling in the brain. Improved maternal reward-based preventative measures and treatments may be specifically effective for mothers and their offspring suffering from depression and/or addiction.
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Affiliation(s)
- Benjamin C Nephew
- Department of Biomedical Sciences, Section of Neuroscience and Reproductive Biology, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | | | - Florent Pittet
- Department of Biomedical Sciences, Section of Neuroscience and Reproductive Biology, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Marcelo Febo
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
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8387
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Ray KD, Mittelman MS. Music therapy: A nonpharmacological approach to the care of agitation and depressive symptoms for nursing home residents with dementia. DEMENTIA 2015; 16:689-710. [DOI: 10.1177/1471301215613779] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Depression, agitation, and wandering are common behaviors associated with dementia and frequently observed among nursing home residents. Even with pharmacological treatment, behaviors often persist, hindering quality of life for elders, their family, and paid caregivers. This study examined the use of music therapy for treatment of these symptoms among 132 people with moderate to severe dementia in nursing homes. Participants were evaluated for depressive symptoms, agitation, and wandering to determine their predominate behavior. There were two assessments, two weeks apart, prior to intervention, followed by a two-week intervention, and two follow-up assessments, also two weeks apart. A repeated measures ANOVA determined that after two weeks of music therapy, symptoms of depression and agitation were significantly reduced; there was no change for wandering. Multivariate analyses confirmed a relationship between music therapy and change in neuropsychiatric symptoms associated with dementia. Results suggest widespread use of music therapy in long-term care settings may be effective in reducing symptoms of depression and agitation.
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8388
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Meyer-Rochow VB, Hakko H, Ojamo M, Uusitalo H, Timonen M. Suicides in Visually Impaired Persons: A Nation-Wide Register-Linked Study from Finland Based on Thirty Years of Data. PLoS One 2015; 10:e0141583. [PMID: 26509899 PMCID: PMC4624868 DOI: 10.1371/journal.pone.0141583] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/09/2015] [Indexed: 11/19/2022] Open
Abstract
Focusing on seasonality, gender, age, and suicide methods a Finnish nation-wide cohort-based study was carried out to compare suicide data between sighted, visually-impaired (WHO impairment level I-II, i.e., visual acuity >0.05, but <0.3) and blind (WHO impairment level III-V, i.e., visual acuity <0.05) victims. Standardized mortality ratios (SMR) of age- and gender-matched populations from official 1982-2011 national registers were used. Group differences in categorical variables were assessed with Pearson's Chi-square or Fisher's Exact test and in continuous variables with Mann-Whitney U-test. Seasonality was assessed by Chi-square for multinomials; ratio of observed to expected number of suicides was calculated with 95% confidence level. Hanging, poisoning, drowning, but rarely shooting or jumping from high places, were preferred suicide methods of the blind. Mortality was significantly increased in the visually impaired (SMR = 1.3; 95% CI 1.07-1.61), but in gender-stratified analyses the increase only affected males (1.34; 95% CI = 1.06-1.70) and not females (1.24; 95% CI 0.82-1.88). Age-stratified analyses identified blind males of working age rather than older men (as in the general population) as a high risk group that requires particular attention. The statistically significant spring suicide peak in blind subjects mirrors that of sighted victims and its possible cause in the blind is discussed.
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Affiliation(s)
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Matti Ojamo
- Finnish Federation and Register of the Visually Impaired, Helsinki, Finland
| | - Hannu Uusitalo
- Department of Ophthalmology, University of Tampere, Tampere, Finland
| | - Markku Timonen
- Center for Life Course Epidemiology and Systems Medicine, University of Oulu, Oulu, Finland
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8389
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Patil VM, Noronha V, Joshi A, Muddu V, Dhumal S, Bhattacharjee A, Prabhash K. Compliance With Neoadjuvant Chemotherapy in T4 Oral Cancers: Place, Person, Socioeconomic Status, or Assistance. J Glob Oncol 2015; 1:65-72. [PMID: 28804775 PMCID: PMC5539870 DOI: 10.1200/jgo.2015.000265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Approximately 15% to 20% of our patients with head and neck cancer receiving neoadjuvant chemotherapy (NACT) discontinue therapy because of various nonmedical reasons. We sought to analyze the factors associated with treatment default and noncompliance among these patients. PATIENTS AND METHODS We performed a retrospective analysis of patients with T4 oral cancer treated with NACT between January 2011 and December 2012. We included patients who discontinued treatment for nonmedical reasons before the second cycle of NACT. The factors analyzed were income, education, socioeconomic status, age, sex, place of residence, habits, and payment pattern (government supported or personal capacity). Pearson χ2 test was used to identify significant factors associated with noncompliance. RESULTS Of 486 patients, 91 patients (18.7%) were noncompliant. Percentages of noncompliant patients in the age groups < 30, between 30 and 60, and > 60 years were 25.0%, 17.4%, and 25.5%, respectively (P = .27). Percentages of noncompliance in patients residing within the city, same state, or different state were 20.7%, 20.9%, and 17.1%, respectively (P = .44). Noncompliance rates were 20.3%, 15.7%, 18.1%, and 22.5% in upper middle, lower middle, upper lower, and lower economic strata, respectively (P = .60). Similarly, there was no significant difference in noncompliance according to occupation, education level, payment pattern, sex, or habits. CONCLUSION Our analysis failed to identify any specific significant factor associated with noncompliance with NACT among our patients with T4 oral cancers.
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8390
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Abstract
With the increasing life expectancy, the geriatric population has been increasing over the past few decades. By the year 2050, it is projected to compose more than a fifth of the entire population, representing a 147% increase in this age group. There has been a steady increase in the number of medical and psychiatric disorders, and a large percentage of geriatric patients are now presenting to the emergency department with such disorders. The management of our progressively complex geriatric patient population will require an integrative team approach involving emergency medicine, psychiatry, and hospitalist medicine.
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Affiliation(s)
- Veronica Sikka
- Orlando VA Medical Center Emergency Medicine, Richmond, VA, USA; Emergency Medicine, UCF School of Medicine, Orlando, FL, USA.
| | - S Kalra
- Department of Research and Innovation, St Luke's University Health Network, Bethlehem, PA, USA
| | - Sagar Galwankar
- Orlando VA Medical Center Emergency Medicine, Richmond, VA, USA
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8391
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Bijl N, Thys C, Wittevrongel C, De la Marche W, Devriendt K, Peeters H, Van Geet C, Freson K. Platelet studies in autism spectrum disorder patients and first-degree relatives. Mol Autism 2015; 6:57. [PMID: 26500752 PMCID: PMC4619313 DOI: 10.1186/s13229-015-0051-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/16/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Platelets have been proven to be a useful cellular model to study some neuropathologies, due to the overlapping biological features between neurons and platelets as granule secreting cells. Altered platelet dense granule morphology was previously reported in three autism spectrum disorder (ASD) patients with chromosomal translocations that disrupted ASD candidate genes NBEA, SCAMP5, and AMYSIN, but a systematic analysis of platelet function in ASD is lacking in contrast to numerous reports of elevated serotonin levels in platelets and blood as potential biomarker for ASD. METHODS We explored platelet count, size, epinephrine-induced activation, and dense granule ATP secretion in a cohort of 159 ASD patients, their 289 first-degree relatives (103 unaffected siblings, 99 mothers, and 87 fathers), 45 adult controls, and 65 pediatric controls. For each of the responses separately, a linear mixed model with gender as a covariate was used to compare the level between groups. We next investigated the correlation between platelet function outcomes and severity of impairments in social behavior (social responsiveness score (SRS)). RESULTS The average platelet count was increased in ASD patients and siblings vs. controls (ASD 320.3 × 10(9)/L, p = 0.003; siblings 332.0 × 10(9)/L, p < 0.001; controls 283.0 × 10(9)/L). The maximal platelet secretion-dependent aggregation response to epinephrine was not significantly lower for ASD patients. However, secondary wave responses following stimulation with epinephrine were more frequently delayed or absent compared to controls (ASD 52 %, siblings 45 %, parents 53 %, controls 22 %, p = 0.002). In addition, stimulated release of ATP from dense granules was reduced in ASD patients, siblings, and parents vs. controls following activation of platelets with either collagen (ASD 1.54 μM, p = 0.001; siblings 1.51 μM, p < 0.001; parents 1.67 μM, p = 0.021; controls 2.03 μM) or ADP (ASD 0.96 μM, p = 0.003; siblings 1.00 μM, p = 0.012; parents 1.17 μM, p = 0.21; controls 1.40 μM). Plasma serotonin levels were increased for ASD patients (n = 20, p = 0.005) and siblings (n = 20, p = 0.0001) vs. controls (n = 16). No significant correlations were found in the different groups between SRS scores and count, size, epinephrine aggregation, or ATP release. CONCLUSIONS We report increased platelet counts, decreased platelet ATP dense granule secretion, and increased serotonin plasma levels not only in ASD patients but also in their first-degree relatives. This suggests that potential genetic factors associated with platelet counts and granule secretion can be associated with, but are not fully penetrant for ASD.
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Affiliation(s)
- Nora Bijl
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Gasthuisberg Campus, O & N I, Herestraat 49-b911, 3000 Leuven, Belgium ; The LAuRes Consortium, KU Leuven, Leuven, Belgium
| | - Chantal Thys
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Gasthuisberg Campus, O & N I, Herestraat 49-b911, 3000 Leuven, Belgium
| | - Christine Wittevrongel
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Gasthuisberg Campus, O & N I, Herestraat 49-b911, 3000 Leuven, Belgium
| | - Wouter De la Marche
- Department of Neurosciences, Research Group Psychiatry, KU Leuven, Leuven, Belgium ; The LAuRes Consortium, KU Leuven, Leuven, Belgium
| | | | - Hilde Peeters
- Department of Human Genetics, KU Leuven, Leuven, Belgium ; The LAuRes Consortium, KU Leuven, Leuven, Belgium
| | - Chris Van Geet
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Gasthuisberg Campus, O & N I, Herestraat 49-b911, 3000 Leuven, Belgium ; The LAuRes Consortium, KU Leuven, Leuven, Belgium
| | - Kathleen Freson
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Gasthuisberg Campus, O & N I, Herestraat 49-b911, 3000 Leuven, Belgium ; The LAuRes Consortium, KU Leuven, Leuven, Belgium
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8392
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Yetish G, Kaplan H, Gurven M, Wood B, Pontzer H, Manger PR, Wilson C, McGregor R, Siegel JM. Natural sleep and its seasonal variations in three pre-industrial societies. Curr Biol 2015; 25:2862-2868. [PMID: 26480842 DOI: 10.1016/j.cub.2015.09.046] [Citation(s) in RCA: 200] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/01/2015] [Accepted: 09/18/2015] [Indexed: 12/12/2022]
Abstract
How did humans sleep before the modern era? Because the tools to measure sleep under natural conditions were developed long after the invention of the electric devices suspected of delaying and reducing sleep, we investigated sleep in three preindustrial societies [1-3]. We find that all three show similar sleep organization, suggesting that they express core human sleep patterns, most likely characteristic of pre-modern era Homo sapiens. Sleep periods, the times from onset to offset, averaged 6.9-8.5 hr, with sleep durations of 5.7-7.1 hr, amounts near the low end of those industrial societies [4-7]. There was a difference of nearly 1 hr between summer and winter sleep. Daily variation in sleep duration was strongly linked to time of onset, rather than offset. None of these groups began sleep near sunset, onset occurring, on average, 3.3 hr after sunset. Awakening was usually before sunrise. The sleep period consistently occurred during the nighttime period of falling environmental temperature, was not interrupted by extended periods of waking, and terminated, with vasoconstriction, near the nadir of daily ambient temperature. The daily cycle of temperature change, largely eliminated from modern sleep environments, may be a potent natural regulator of sleep. Light exposure was maximal in the morning and greatly decreased at noon, indicating that all three groups seek shade at midday and that light activation of the suprachiasmatic nucleus is maximal in the morning. Napping occurred on <7% of days in winter and <22% of days in summer. Mimicking aspects of the natural environment might be effective in treating certain modern sleep disorders.
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Affiliation(s)
- Gandhi Yetish
- Department of Anthropology, University of New Mexico, MSC01-1040, Albuquerque, NM 87131, USA
| | - Hillard Kaplan
- Department of Anthropology, University of New Mexico, MSC01-1040, Albuquerque, NM 87131, USA
| | - Michael Gurven
- Department of Anthropology, University of California, Santa Barbara, 1210 Cheadle Hall, Santa Barbara, CA 93106, USA
| | - Brian Wood
- Department of Anthropology, Yale University, 10 Sachem Street, New Haven, CT 06511, USA
| | - Herman Pontzer
- Department of Anthropology, Hunter College, 695 Park Avenue, New York, NY 10065, USA
| | - Paul R Manger
- School of Anatomical Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Charles Wilson
- Department of Neurology and Brain Research Institute, University of California, Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Ronald McGregor
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jerome M Siegel
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90095, USA; VA Greater Los Angeles Healthcare System, 16111 Plummer Street, Los Angeles, CA 91343 USA; Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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8393
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Sauvaget A, Trojak B, Bulteau S, Jiménez-Murcia S, Fernández-Aranda F, Wolz I, Menchón JM, Achab S, Vanelle JM, Grall-Bronnec M. Transcranial direct current stimulation (tDCS) in behavioral and food addiction: a systematic review of efficacy, technical, and methodological issues. Front Neurosci 2015; 9:349. [PMID: 26500478 PMCID: PMC4598576 DOI: 10.3389/fnins.2015.00349] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/14/2015] [Indexed: 01/29/2023] Open
Abstract
Objectives: Behavioral addictions (BA) are complex disorders for which pharmacological and psychotherapeutic treatments have shown their limits. Non-invasive brain stimulation, among which transcranial direct current stimulation (tDCS), has opened up new perspectives in addiction treatment. The purpose of this work is to conduct a critical and systematic review of tDCS efficacy, and of technical and methodological considerations in the field of BA. Methods: A bibliographic search has been conducted on the Medline and ScienceDirect databases until December 2014, based on the following selection criteria: clinical studies on tDCS and BA (namely eating disorders, compulsive buying, Internet addiction, pathological gambling, sexual addiction, sports addiction, video games addiction). Study selection, data analysis, and reporting were conducted according to the PRISMA guidelines. Results: Out of 402 potential articles, seven studies were selected. So far focusing essentially on abnormal eating, these studies suggest that tDCS (right prefrontal anode/left prefrontal cathode) reduces food craving induced by visual stimuli. Conclusions: Despite methodological and technical differences between studies, the results are promising. So far, only few studies of tDCS in BA have been conducted. New research is recommended on the use of tDCS in BA, other than eating disorders.
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Affiliation(s)
- Anne Sauvaget
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Clinical Investigation Unit 18-BALANCED "BehaviorAL AddictioNs and ComplEx Mood Disorders", University Hospital of Nantes Nantes, France ; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Benoît Trojak
- Department of Psychiatry and Addictology, University Hospital of Dijon Dijon, France ; Behavioral Addictions Program, NANT New Addictions New Treatments, Addiction Division, Department of Mental Health and Psychiatry, University Hospital of Geneva Geneva, Switzerland
| | - Samuel Bulteau
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Clinical Investigation Unit 18-BALANCED "BehaviorAL AddictioNs and ComplEx Mood Disorders", University Hospital of Nantes Nantes, France
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | - Ines Wolz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Salud Mental, Instituto de Salud Carlos III Barcelona, Spain
| | - Sophia Achab
- Behavioral Addictions Program, NANT New Addictions New Treatments, Addiction Division, Department of Mental Health and Psychiatry, University Hospital of Geneva Geneva, Switzerland
| | - Jean-Marie Vanelle
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Clinical Investigation Unit 18-BALANCED "BehaviorAL AddictioNs and ComplEx Mood Disorders", University Hospital of Nantes Nantes, France
| | - Marie Grall-Bronnec
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Clinical Investigation Unit 18-BALANCED "BehaviorAL AddictioNs and ComplEx Mood Disorders", University Hospital of Nantes Nantes, France ; EA 4275 "Biostatistics, Clinical Research and Subjective Measures in Health Sciences", University of Nantes Nantes, France
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8394
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Cuzzocrea F, Barberis N, Costa S, Larcan R. RELATIONSHIP BETWEEN ALEXITHYMIA, PARENTING STYLE, AND PARENTAL CONTROL. Psychol Rep 2015; 117:580-96. [PMID: 26444844 DOI: 10.2466/21.10.pr0.117c22z7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research on the relationship between parental alexithymia and parenting is relatively scarce. The purpose of this study was to investigate the relationships between parental alexithymia and three styles of parenting (authoritarian, authoritative, and permissive) and the relationships between parental alexithymia and two domains of psychological control (dependency and achievement). The participants were 946 parents ages 29-60 years (mothers: n = 473, M age = 44.6 yr., SD = 4.7; fathers: n = 473, M age = 48.1 yr., SD = 5.1) of children ages 11-18 years. All participants completed a sociodemographic questionnaire, the Toronto Alexithymia Scale-20 (TAS-20), the Parental Authority Questionnaire-Revised (PAQ-R), and the Dependency-Oriented and Achievement-Oriented Psychological Control Scale (DAPCS). Structural Equation Modeling (SEM) was used to examine whether alexithymia could predict the three parenting styles (authoritarian, authoritative, and permissive) and the two domains of psychological control (dependency and achievement). The first model showed that alexithymia was a positive predictor of authoritative and permissive parenting and a negative predictor of authoritarian parenting in both paternal and maternal data. The second model showed that, in both paternal and maternal data, alexithymia was a positive predictor of both dependency-oriented psychological control (DPC) and achievement-oriented psychological control (APC).
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Affiliation(s)
| | - Nadia Barberis
- 1 Department of Human and Social Science, University of Messina, Italy
| | - Sebastiano Costa
- 1 Department of Human and Social Science, University of Messina, Italy
| | - Rosalba Larcan
- 1 Department of Human and Social Science, University of Messina, Italy
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8395
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Sanchez-Gistau V, Romero S, Moreno D, de la Serna E, Baeza I, Sugranyes G, Moreno C, Sanchez-Gutierrez T, Rodriguez-Toscano E, Castro-Fornieles J. Psychiatric disorders in child and adolescent offspring of patients with schizophrenia and bipolar disorder: A controlled study. Schizophr Res 2015; 168:197-203. [PMID: 26363969 DOI: 10.1016/j.schres.2015.08.034] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Early clinical manifestations predating schizophrenia (SZ) and bipolar disorder (BP) have not been fully characterized. Child offspring studies are a valuable opportunity to study the natural history of the illness from its earliest stages. However, there is limited evidence assessing young offspring of SZ and BP simultaneously. We set out to assess rates of psychiatric disorders in child and adolescent offspring of SZ and BP, relative to offspring of community controls, so as to characterize the early phenotype of the disorders comparatively. METHODS SZ and BP parents with offspring aged 7-17years were recruited through adult mental health services of two tertiary hospitals. Community control (CC) parents were recruited from the same geographical area. Ninety BP-offspring, 41 SZ-offspring and 107 CC-offspring were assessed using the K-SADS-PL by child psychiatrists blinded to parental status. Differences in prevalence of psychiatric disorders between groups were adjusted for confounders and for sibling correlation using generalised estimating equations. RESULTS We found a gradient of clinical severity and social disadvantage between SZ, BP and CC-offspring. After adjusting for socio-demographic confounders, SZ and BP-offspring presented higher rates of attention deficit hyperactivity disorder (ADHD) than CC-offspring. ADHD was more prevalent in SZ-offspring than BP-offspring, and BP-offspring presented a higher prevalence of depression than CC-offspring. CONCLUSIONS The higher rates of ADHD in SZ-offspring suggest that abnormal neurodevelopmental processes may exert a stronger influence in SZ than BP. Follow-up of these children will help elucidate the role of ADHD and depression phenotypes in predicting future transition to SZ or BP.
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Affiliation(s)
- Vanessa Sanchez-Gistau
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain.
| | - Soledad Romero
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| | - Dolores Moreno
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Gisela Sugranyes
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Carmen Moreno
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Teresa Sanchez-Gutierrez
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Elisa Rodriguez-Toscano
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Institute Clinic of Neurosciences, University of Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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8396
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Agarwal SM, Venkatasubramanian G. The relevance of translational neuroscience in psychiatry residency training: Commentary on "Torous et al. A proposed solution to integrating cognitive-affective neuroscience and neuropsychiatry in psychiatry residency training: The time is now". Asian J Psychiatr 2015; 17:131-2. [PMID: 26386741 DOI: 10.1016/j.ajp.2015.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Sri Mahavir Agarwal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
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8397
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Abstract
OBJECTIVE Magnesium deficiency has been associated with anxiety in humans, and rodent studies have demonstrated the gut microbiota to impact behaviour. METHODS We investigated the impact of 6 weeks of dietary magnesium deficiency on gut microbiota composition and anxiety-like behaviour and whether there was a link between the two. A total of 20 C57BL/6 mice, fed either a standard diet or a magnesium-deficient diet for 6 weeks, were tested using the light-dark box anxiety test. Gut microbiota composition was analysed by denaturation gradient gel electrophoresis. RESULTS We demonstrated that the gut microbiota composition correlated significantly with the behaviour of dietary unchallenged mice. A magnesium-deficient diet altered the gut microbiota, and was associated with altered anxiety-like behaviour, measured by decreased latency to enter the light box. CONCLUSION Magnesium deficiency altered behavior. The duration of magnesium deficiency is suggested to influence behaviour in the evaluated test.
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8398
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Magierski R, Sobow T. Benefits and risks of add-on therapies for Alzheimer's disease. Neurodegener Dis Manag 2015; 5:445-62. [DOI: 10.2217/nmt.15.39] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Despite three decades of intensive research, the efforts of scientific society and industry and the expenditures, numerous attempts to develop effective treatments for Alzheimer's disease have failed. Currently, approved and widely used medications to treat cognitive deficits in Alzheimer's disease are symptomatic only and show at best modest efficacy. In this context, the need to develop a successful, disease-modifying treatment is loudly expressed. One way to achieve this goal is the use of add-on therapies or various combinations of existing ‘conventional’ drugs. Results of several clinical studies and post hoc analyses of combination therapy with all cholinesterase inhibitors and memantine are published. Moreover, there is a need for studies on long-term efficacy of combination therapy in Alzheimer's.
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Affiliation(s)
- Radoslaw Magierski
- Department of Old Age Psychiatry & Psychotic Disorders, Medical University of Lodz, 92–216 Lodz, Czechoslowacka Street 8/10, Poland
| | - Tomasz Sobow
- Department of Medical Psychology, Medical University of Lodz, 91–425 Lodz, Sterlinga Street 5, Poland
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8399
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Goldberg X, Soriano-Mas C, Alonso P, Segalàs C, Real E, López-Solà C, Subirà M, Via E, Jiménez-Murcia S, Menchón JM, Cardoner N. Predictive value of familiality, stressful life events and gender on the course of obsessive-compulsive disorder. J Affect Disord 2015; 185:129-34. [PMID: 26172984 DOI: 10.1016/j.jad.2015.06.047] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/29/2015] [Accepted: 06/29/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Familiality, stressful life events (SLE) and gender significantly affect the onset of obsessive-compulsive disorder (OCD). However, their combined impact on the probability of OCD chronicity is largely unknown. With the objective of clarifying their predictive value, we tested a model of interaction effects between these influences. METHODS A sample of 449 patients with OCD was systematically assessed for familial loading, exposure to stressful life events, gender and course of the disease at the OCD referral unit at Bellvitge University Hospital. Multiple ordinal logistic regression was used to test interaction models. RESULTS Familiality presented a main negative association with chronicity (OR=0.83, CI97.5%=0.70-0.98). This association was additively moderated by both exposure to SLE before onset and gender, and showed a positive slope among female patients not exposed to SLE before onset (Familiality*SLEbo: OR=0.69, CI97.5%=0.47-1; Familiality*gender: OR=1.30, CI97.5%=0.91-1.84). LIMITATIONS The findings are based on cross-sectional data. Assessment of course is based on a retrospective measure, which may imply the possibility of overestimation of chronicity. CONCLUSIONS The predictive value of familiality on the course of OCD is only partially informative as both SLEbo and gender modify the association. When other risk factors are included in the model, familiality may predict decreased chances of chronicity. The mediation effects identified could explain the discrepancies found in previous research on this topic. Increased chances of presenting a chronic course of OCD may be found in association with familial vulnerability among female patients not exposed to SLEbo.
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Affiliation(s)
- Ximena Goldberg
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain.
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Cinto Segalàs
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain
| | - Eva Real
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain
| | - Clara López-Solà
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Marta Subirà
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Esther Via
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Physiopathology, Obesity and Nutrition CIBER (CIBERobn), Carlos III Health Institute, Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Narcís Cardoner
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
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8400
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Fleming PJ, Agnew-Brune C. Current Trends in the study of Gender Norms and Health Behaviors. Curr Opin Psychol 2015; 5:72-77. [PMID: 26075291 DOI: 10.1016/j.copsyc.2015.05.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Gender norms are recognized as one of the major social determinants of health and gender norms can have implications for an individual's health behaviors. This paper reviews the recent advances in research on the role of gender norms on health behaviors most associated with morbidity and mortality. We find that (1) the study of gender norms and health behaviors is varied across different types of health behaviors, (2) research on masculinity and masculine norms appears to have taken on an increasing proportion of studies on the relationship between gender norms and health, and (3) we are seeing new and varied populations integrated into the study of gender norms and health behaviors.
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Affiliation(s)
- Paul J Fleming
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 302 Rosenau Hall, Chapel Hill, NC 27599-7440, (tel) 630-777-0160, (fax) 919-966-2921
| | - Christine Agnew-Brune
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 302 Rosenau Hall, Chapel Hill, NC 27599-7440
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