High Incidence Of Affective Disorders Research Articles

Lithium levels in drinking water predicted the ratio of attempted to completed suicides in regions with high incidence of affective disorders: Insights from ecological study

IntroductionLithium has demonstrated significant antisuicidal effects: it significantly reduces the high excess overall mortality of patients with affective disorders. MethodsPublic drinking water samples were collected in 53 Lithuanian municipalities during a two-month period. Linear models used lithium level in public drinking water as predictor and ratio of suicide attempts to suicide mortality as outcomes across the municipalities. ResultsLithium in drinking water predicted the ratio of attempted to completed suicides (A/S) nonlinearly, described by a U-shaped curve. The curves for visualization of the association of incidence of affective disorders and suicide standard mortality rate with lithium level displayed significant suicide curve decrements and invers direction in affective disorders curve. Multivariate regression model for ratio A/S in high lithium exposure group (> 7 µg/L, N = 26) suggests that the lithium level can explain 54.3 % of variance of ratio A/S in municipalities with exposure of lithium above median and with high incidence of affective disorders. ConclusionsThe findings provide confirmatory evidence that in municipalities with high incidence of affective disorders higher lithium levels in the public drinking water are associated with higher ratio A/S due to an unchanging number of suicide attempts and due to decreasing suicide lethal outcomes. LimitationsNevertheless, the methods employed detected several factors with well-established associations with suicide. Finally, cohort, prospective or intervention studies are needed to verify the causal inverse relationship of these variables and to speculate the mechanism for this relationship.

The role of sociability in social instability stress: Behavioral, neuroendocrine and monoaminergic effects

Extensive literature has reported a link between social stress and mental health. In this complex relationship, individual strategies for coping with social stress are thought to have a possible modulating effect, with sociability being a key factor. Despite the higher incidence of affective disorders in females and sex-related neurochemical differences, female populations have been understudied. The aim of the present study was, therefore, to analyze the behavioral, neuroendocrine, and neurochemical effects of stress in female OF1 mice, paying special attention to social connectedness (female mice with high vs low sociability). To this end, subjects were exposed to the Chronic Social Instability Stress (CSIS) model for four weeks. Although female mice exposed to CSIS had increased arousal, there was no evidence of depressive-like behavior. Neither did exposure to CSIS affect corticosterone levels, although it did increase the MR/GR ratio by decreasing GR expression. Female mice exposed to CSIS had higher noradrenaline and dopamine levels in the hippocampus and striatum respectively, with a lower monoaminergic turnover, resulting in an increased arousal. CSIS increased serotonin levels in both the hippocampus and striatum. Similarly, CSIS was found to reduce kynurenic acid, 3-HK, and IDO and iNOS enzyme levels in the hippocampus. Interestingly, the observed decrease in IDO synthesis and the increased serotonin and dopamine levels in the striatum were only found in subjects with high sociability. These highly sociable female mice also had significantly lower levels of noradrenaline in the striatum after CSIS application. Overall, our model has produced neuroendocrine and neurochemical but not behavioral changes, so it has not allowed us to study sociability in depth. Therefore, a model that induces both molecular and behavioral phenotypes should be applied to determine the role of sociability.

Chronic social instability stress down-regulates IL-10 and up-regulates CX3CR1 in tumor-bearing and non-tumor-bearing female mice

Extensive literature has reported a link between stress and tumor progression, and between both of these factors and mental health. Despite the higher incidence of affective disorders in females and the neurochemical differences according to sex, female populations have been understudied. The aim of this study was therefore to analyze the effect of stress on tumor development in female OF1 mice. For this purpose, subjects were inoculated with B16F10 melanoma cells and exposed to the Chronic Social Instability Stress (CSIS) model. Behavioral, neurochemical and neuroendocrine parameters were analyzed. Female mice exposed to CSIS exhibited reduced body weight and increased arousal, but there was no evidence of depressive behavior or anxiety. Exposure to CSIS did not affect either corticosterone levels or tumor development, although it did provoke an imbalance in cerebral inflammatory cytokines, decreasing IL-10 expression (IL-6/IL-10 and TNF-α/IL-10); chemokines, increasing CX3CR1 expression (CX3CL1/CX3CR1); and glucocorticoid receptors, decreasing GR expression (MR/GR). In contrast, tumor development did not alter body weight and, although it did alter behavior, it did so to a much lesser extent. Tumor inoculation did not affect corticosterone levels, but increased the MR/GR ratio in the hippocampus and provoked an imbalance in cerebral inflammatory cytokines and chemokines, although differently from stress. These results underscore the need for experimental approaches that allow us to take sex differences into account when exploring this issue, since these results appear to indicate that the female response to stress is mediated by mechanisms different from those often proposed in relation to male mice.

Creative minds and neurosciences…

Creativity is the ability to generate original ideas in the arts or sciences, leaving traditional stereotypes behind, ultimately introducing innovation to the social context in which they arise. It has been associated with "divergent thinking" which prioritizes the generation of multiple solutions, different from traditional ones. Some authors have observed creative individuals present higher incidence of affective disorders, possibly related to hypomania or disinhibition. Similarly, “creativity” has been described in patients with frontotemporal dementia, a brain region linked with creativity on fMRI. Creativity is one of the most salient characteristics that human beings possess.

Detection of Cognitive Malingering or Suboptimal Effort in Defendants Undergoing Competency to Stand Trial Evaluations

The present study evaluated the usefulness of two popular tests of cognitive malingering in a real-life forensic setting. Only 25 of 166 defendants referred for competency to stand trial evaluations claimed to have memory problems. Compared with the rest of the defendants, these individuals had a significantly higher incidence of affective disorders and lower incidence of psychotic disorders. Almost half failed both the Rey 15-Item Test (RFT) and the Test of Memory Malingering (TOMM), and 64% failed one or both. Seven of the eight suspected malingerers diagnosed with psychotic disorders failed both the RFT and TOMM. The incidence of psychotic disorders was significantly higher in those who failed the RFT than those who passed and somewhat higher in those who failed the TOMM than those who passed. The possibility that some defendants scored below the recommended cutoff scores because of intellectual limitations or concentration problems stemming from their psychotic illness is discussed.

Serotonin synthesis is lower in the cortical areas of female than male healthy participants as measured with α-[11C]methyl-L-tryptophan positron emission tomography

Dysregulation of the brain serotonergic system is a contributing factor to mood disorders. There are also reports suggesting a greater incidence of mood disorders in female patients. Serotonin (5-HT) synthesis is the first important step in serotonergic neurotransmission. The study of brain 5-HT synthesis was greatly improved by development of the -[11C]methyl-L-tryptophan (-MTrp) positron emission tomography (PET) imaging method. We reported before that 5-HT synthesis is reduced more in female than male subjects after tryptophan depletion, and that there are some region specific differences in 5-HT synthesis between male and female controls and patients with major depression. The objective of the present investigation was to compare 5-HT synthesis in male and female subjects using Statistical Parametric Mapping (SPM-2). Twenty-eight female (meanStandard Deviation (SD); 33.217.2 years) and thirty-one male (29.812.8 years) healthy volunteers were scanned for sixty minutes, and venous blood samples were taken at progressively increasing time intervals after injection of up to 10 mCi of tracer. The functional images of the brain trapping constant, which was shown in rats to correlate with 5-HT synthesis, were transferred to the standardized 3-D space and colocalized with each participant's MRI. The final functional images had a resolution of 8.29.510.5 mm. The voxel based comparison was done using clusters with 100 voxels and with the height p<0.001. There was no cluster in which synthesis was greater in females than that in males, while there are seven clusters in which synthesis was lower in females than in males. The clusters showing difference are (see Figure 1): left frontal lobe middle and inferior frontal gyrus (BA 44), left and right parietal lobe supramarginal gyrus, left and right inferior parietal lobe (BA 40), left temporal lobe superior temporal gyrus, left limbic lobe cingulate gyrus and right posterior cingulate, right occipital lobe (precuneus; BA31), and left inferior frontal gyrus (BA 44 and BA 45). It is interesting to note that only cortical areas show significant differences between two genders. Because a relatively large cluster size was used in the comparisons smaller structures such as the amygdala and raphe nuclei would be missed. Some of the structures (e.g. cingulate, frontal lobe) showing a difference in synthesis between male and female subjects have been suggested to be involved in mood disorders. The lower 5-HT synthesis in female participants may be related to the higher incidence of affective disorders in that group.

Depression in North Carolina social workers: Implications for practice and research

This article explores depression in social workers, examines the potential negative professional consequences--that is, impairment--and investigates the personal and occupational variables associated with depression. One thousand active NASW members were anonymously surveyed as a part of the study Work and Well-Being: A Study of North Carolina Social Workers, which explored a variety of health, work, and personal variables. The study found that 19% of the sample scored above the threshold on the Center for Epidemiologic Studies-Depression Scale measuring depressive symptoms, 16% had seriously considered suicide at some time in their lives, 20% were currently taking medication for depression, and 60% self-evaluated as depressed either currently or at some time in the past. Both occupational and personal variables were related to depressive symptoms. Key words: depression; impairment; social workers ********** Although social workers provide more mental health services than professionals in any other discipline (Center for Mental Health Services, 1999) little is known about their own mental health. Research about social workers is largely limited to studies about burnout, and a thorough review of the literature found very little information about depression among social workers. Yet, depression could be an important issue for social workers, not only because depression is found in high numbers in the general population, but also because it has been found to be even higher in caregiving professionals (Deutsch, 1985). One study of helping professionals reported a 57% lifetime rate of depression (Deutsch), and another from the United Kingdom found rates of depression to be higher in social workers than in the other helping professionals studied (Bennett, Evans, & Tattersall, 1993). Other disciplines have examined depression and other mental health concerns among their memberships, although the findings are limited and no recent studies have been conducted. Past estimates suggest that physicians suffer at least as many emotional problems, have a higher rate of suicide, and have a higher incidence of affective disorders than those of a comparable socioeconomic status (Doyle & Cline, 1983). Among studies of medical students, estimates for psychiatric illness ranged from 15% to 46% (Doyle & Cline). The field of psychology has reported that emotional distress exists in its ranks as well. Self-reports of depression and burnout were as high as 32%, and proxy reports for depression and burnout were as high as 63% (Wood, Klein, Cross, Lammers, & Elliott, 1985). Studies of depression among nurses are largely unpublished dissertations or studies of nurses outside the United States, and they typically report widely varying prevalence rates while exploring depression in relation to stress, burnout, and occupational risk factors (Baba, Galperin, & Lituchy, 1998; Lam, Ross, Cass, Quine, & Lazarus, 1999; Maurier & Northcott, 2000). Although depression can have serious personal consequences for any individual, depression in caregiving professionals may diminish the quality of their practice, creating negative consequences for their clients. Impairment, the negative professional consequence of any kind of distress, is not well defined or researched. The lack of comprehensive population-based studies makes it difficult to ascertain the prevalence of impairment (Flaherty & Richman, 1993). One study that addressed impairment reported that 62% of psychologists in the survey sample admitted working when too distressed to be effective, even though 85% of them believed it was unethical to practice when this distressed (Pope, Tabachnick, & Keith-Spiegel, 1987). Two models that explain impairment in helping professionals have emerged from the literature--burnout and compassion fatigue. With their origins in empirical generalization, each model was developing into an explanatory theory with very different notions of causality. …

ECT-induced interictal delirium in patients with a history of a CVA.

Earlier works have documented a high incidence of affective disorders in patients with a history of a cerebrovascular accident (CVA). In general, electroconvulsive therapy (ECT) has been reported to be effective in treating depressed patients with a history of CVA. Recent works have shown that preexisting structural brain changes may predispose patients to develop interictal ECT-induced delirium. However, the incidence of ECT-induced interictal delirium in patients with a history of CVA has not been directly studied. In this pilot study, the authors examined the incidence of ECT-induced interictal delirium in 14 depressed CVA patients compared with 14 elderly depressed controls (without a history of CVA). Interestingly, the overall incidence of delirium was identical in both groups (28.5%). However, consistent with previous works, some patients who had had a recent CVA involving the caudate nucleus appeared more likely to develop delirium. Thirteen of the 14 depressed CVA patients (92%) showed a moderate to significant improvement in their depressive symptoms from ECT. None of the patients developed significant cardiac complications during ECT.

Affective disorders among pathological gamblers seeking treatment.

Clinical impressions and psychological testing suggest that pathological gamblers demonstrate a high incidence of affective disorders. To assess the frequency of such disorders, the Schedule for Affective Disorders and Schizophrenia was administered to 50 patients admitted successively to the gambling treatment program of a VA hospital. Seventy-six percent of the subjects were diagnosed as having major depressive disorder and 38% as having hypomanic disorder according to the Research Diagnostic Criteria. The patients with major depressive disorder and one patient with schizoaffective disorder, depressed type, were significantly more likely to miss work often due to gambling. A large number of patients displayed suicidal tendencies.

Treatment of depression in the elderly. General clinical considerations.

Epidemiological investigations indicate that there is a high incidence of affective disorders in the elderly. Women predominate over men which may be due to diagnostic problems. It is a general assumption that socio- and psychogenic factors, somatic illness and treatment with drugs have etiological importance for affective disorders in the elderly. This assumption needs further investigation, however. Post mortem investigations have shown that there are biochemical changes in the brain in the elderly and in dementia disorders, indicating that there is a reduced activity in the serotoninergic and cholinergic systems. These biochemical changes may increase vulnerability to affective disorders in the elderly and in demented patients. When discussing the cause of the high incidence of affective disorders among the elderly a chain of factors must be considered. Psychogenic and sociogenic factors may precipitate the disease but biochemical disturbances related to the ageing process may make the individual vulnerable to affective disorders. Theoretically zimelidine seems to be the drug of choice when treating affective disorders in the elderly.