Lifetime Diagnosis Research Articles

First episode depression during the perinatal period is associated with atopic diseases and persistently increased eosinophil and basophil levels.

A previous diagnosis of depression is a strong predictor for perinatal depression, apart from other mental disorders, stress, and atopies. It is less clear which factors interfere if perinatal depression occurs as a first depression episode (fePND). We examined the associations with atopies and related blood parameters using data of CoLaus|PsyCoLaus. Newly occurring depression during the perinatal period but not recurrent depression was associated with a lifetime diagnosis of allergies and asthma together with persistently increased levels of basophils and eosinophils. The results imply that immune function may play a relevant role in the risk of a fePND. If confirmed and detailed, these findings could serve as the basis for designing preliminary prevention strategies by observing eosinophil and basophil levels as well as symptoms of atopic diseases before/during pregnancy.

Association of psychiatric history with hypertension among adults who present for metabolic and bariatric surgery

BackgroundPsychiatric diagnoses are common among adults with severe obesity (body mass index [BMI] ≥40 kg/m2) and may be associated with hypertension. ObjectivesTo determine the association between lifetime and current psychiatric diagnoses, separately, with hypertension, uncontrolled blood pressure (BP), and systolic BP (SBP) among adults with severe obesity undergoing metabolic and bariatric surgery (MBS). SettingAcademic medical center. MethodsOutcomes were identified from electronic medical records. Psychiatric diagnoses were assessed by clinical interview and included any bipolar and related disorder or depressive disorders, anxiety, alcohol use disorder, substance use disorder, post-traumatic stress disorder, and eating disorders. Adjusted odds ratios for the association between psychiatric diagnoses and hypertension and uncontrolled BP, separately, were calculated using logistic regression. Linear regression was used to determine the association of psychiatric diagnoses with SBP. Models were adjusted for age, sex, race, and BMI. ResultsThere were 281 participants with mean age of 40.5 years (standard deviation = 10.9) and BMI of 45.9 kg/m2 (standard deviation = 6.2). Participants were predominantly women (86.5%) and Black (57.2%). Overall, 44.8% had hypertension and 32.5% of these individuals had uncontrolled BP. The adjusted odds ratios for hypertension was higher (2.95; 95% confidence interval 1.48–5.87) and SBP was greater (3.50 mm Hg; P = .048) among participants with a lifetime diagnosis of anxiety compared with those without. Participants with any current psychiatric diagnosis had a higher SBP compared to those who did not have a current psychiatric diagnosis (3.62 mm Hg; P = .029). ConclusionsA diagnosis of anxiety during the lifetime of patients undergoing MBS was associated with almost three times increased odds of hypertension.

CHRONIC HEART FAILURE EPIDEMIOLOGY IN KAZAKHSTAN AND OTHER COUNTRIES

The article discusses the etiologic factors contributing to chronic heart failure (CHF) development, as well as CHF main causes. Statistics on CHF prevalence and mortality in Kazakhstan over the past decades is presented in brief. Clinical guidelines of the Kazakhstan Cardiology Society describe many risk factors for CHF in detail, including both underlying and concomitant diseases. According to statistics, 4.7 % of Kazakhstan population (approximately 320,000 people) suffer from CHF. The most common causes or concomitant diseases contributing to CHF development are arterial hypertension, coronary heart disease, chronic kidney disease, atrial fibrillation, postinfarction cardiosclerosis, diabetes mellitus, obesity, malignant neoplasms, chronic obstructive pulmonary disease and chronic anemia. The highest incidence of cardiovascular diseases (CVD) is observed in Almaty – 4 %. Mortality from circulatory system diseases in the Republic of Kazakhstan decreased from 207.4 cases per 100,000 people in 2012 to 178.92 cases in 2016. Differences in approaches to CHF coding in the structure of clinical and pathological diagnosis significantly affect data accuracy on CHF prevalence and mortality. These differences are due to the fact that CHF is not an independent disease; it is rather a complication. When we speak about CHF as a disease, we usually consider it as a deuteropathy. Thus, CHF often does not have a code in the structure of the lifetime diagnosis and it is not considered as the primary cause of death in the case of fatality. As a result, we understand the significant impact of CHF on mortality, but do not have an accurate idea of the real scale of the problem.

Sex differences in insomnia and hypersomnia complaints during major depressive episode: Results from a national sample

BackgroundSex differences in sleep disturbances during major depressive episodes (MDE) have been suggested. This study compares the prevalence, sociodemographic characteristics, and psychiatric comorbidity associated with sleep complaints specific to each sex among adults with MDE. These findings are crucial for precise diagnosis, personalized treatment, and improved clinical outcomes. MethodsIn a large nationally representative prospective survey, we used multi-adjusted logistic regression models including sociodemographic characteristics, psychiatric comorbidity, and depression severity to examine whether associations differ between men and women. ResultsAmong women, 93.3 % reported at least one type of sleep complaints (i.e., trouble falling asleep, early morning awakening or hypersomnia) while 91.0 % of men did, with respectively 78.3 % and 77.2 % of insomnia complaints, and 46.2 % and 41.3 % of hypersomnia complaints. Women with sleep complaints were more likely to be black, with lower individual incomes, have histrionic personality disorder or a specific phobia. Conversely, men with sleep complaints were more likely to have a lifetime diagnosis of mania spectrum disorder, generalized anxiety disorder, drug use disorder, as well as dependent and schizotypal personality disorders. Surprisingly, being “never married” has emerged as a protective factor against sleep complaints in women, while posing as a risk factor in men compared to other marital statuses. Differences and specificities were also noted concerning subtypes of insomnia and hypersomnia complaints. LimitationsThe cross-sectional design means the associations found do not imply causality. ConclusionsThese findings provide insights into the complex relationship between sleep and depression in men and women, highlighting the need for personalized interventions.

Clinical associations with treatment resistance in depression: An electronic health record study

Treatment resistance is common in major depressive disorder (MDD), yet clinical risk factors are not well understood. Using a discovery-replication design, we conducted phenome-wide association studies (PheWASs) of MDD treatment resistance in two electronic health record (EHR)-linked biobanks. The PheWAS included participants with an MDD diagnosis in the EHR and at least one antidepressant (AD) prescription. Participant lifetime diagnoses were mapped to phecodes. PheWASs were conducted for three treatment resistance outcomes based on AD prescription data: number of unique ADs prescribed, ≥1 and ≥2 CE switches. Of the 180 phecodes significantly associated with these outcomes in the discovery cohort (n = 12,558), 71 replicated (n = 8,206). In addition to identifying known clinical factors for treatment resistance in MDD, the total unique AD prescriptions was associated with additional clinical variables including irritable bowel syndrome, gastroesophageal reflux disease, symptomatic menopause, and spondylosis. We calculated polygenic risk of specific-associated conditions and tested their association with AD outcomes revealing that genetic risk for many of these conditions is also associated with the total unique AD prescriptions. The number of unique ADs prescribed, which is easily assessed in EHRs, provides a more nuanced measure of treatment resistance, and may facilitate future research and clinical application in this area.

Study of parasitosis in laboratory mice and rats in different types of vivariums

The purpose of the research is to study the parasite fauna in laboratory rats and mice in SPF-status and open-type vivariums and to compare the infection rate depending on the maintenance type within each type of samples.Materials and methods. The studies were conducted using life-time diagnosis (flotation method and Scotch-tape test), and the material were fecal samples from laboratory rodents and litter samples. Ten percent of the vivarium population and all newly arrived mice and rats in quarantine were examined. Fifty-four individual samples from pure line mice, and 24 litter samples were examined. A total of 234 samples were collected from the laboratory rats: 93 individual samples, 55 combined samples, and 17 sawdust samples; 69 samples were examined by Scotch-tape test.Results and discussion. Twenty six percent of the laboratory SPF vivarium mice were found to have protozoa: Giardia muris (11.1%) and Trichomonas sp. (20.4%). Nematodes Aspiculuris tetraptera (51.0%) and Syphacia obvelata (20.6%), and cestode Rodentolepis nana (12.0%) were recorded in the open-type vivarium mice. The laboratory open-type vivarium rats were found to have nematodes S. muris (up to 60.9%), A. tetraptera (5.4%), Trichosomoides crassicauda (1.8%), cestode R. nana (27.3%), protozoa Eimeria sp. (7.2%) and Giardia sp. (9.0%). The compared infection of individual with combined mouse fecal samples showed statistically significant differences for all parasites in general and for individual species. Pairwise comparisons of the infection showed that the combined sample detected R. nana statistically significantly more often versus the individual sample (27.3 vs. 5.4%, P < 0.001). The comparison of the infection depending on the type of rat maintenance within each sample type did not show statistically significant differences.

Maternal perspectives on the intergenerational transmission of eating disorders

BackgroundStudies indicate that the children of mothers who have eating disorders are at an increased risk of developing eating disorders themselves. The aim of this qualitative study was to broaden and extend current understandings of the experiences of mothers with eating disorders. The present report focuses on maternal perspectives, experiences, and support needs in relation to the intergenerational transmission of eating disorders.MethodSemi-structured online interviews were conducted with parents living in the UK, USA, and Australia. Participants were eighteen mothers with a self-reported lifetime diagnosis of one or more eating disorders, who had experienced symptoms since becoming a parent, and who had at least one child aged 2 years or older. Data were analysed using reflexive thematic analysis.ResultsFour major themes relating to the impacts of having an eating disorder on children and intergenerational transmission were identified. These were: impacts (maternal perspectives on the ways having an eating disorder impacted their children, and their reflections around having been impacted by their own parents); breaking the cycle (strategies employed by mothers in efforts to prevent their children developing eating disorders of their own); communicating about the eating disorder (maternal experiences around disclosing or not disclosing having an eating disorder to their children); and support needs (maternal and perceived familial support needs in relation to breaking cycles of intergenerational transmission).ConclusionsFor mothers with eating disorders, concerns about the potential impacts on their children and fears about intergenerational transmission are salient, and these may vary for children at different ages. The mothers who participated in our study described engaging in a number of conscious strategies in efforts to manage the risks of eating disorder development in their children, but implementing these strategies was not without challenges. Implications for preventative programs to reduce the intergenerational transmission of eating disorders are discussed.

Causes of death in individuals with lifetime major depression: a comprehensive machine learning analysis from a community-based autopsy center

BackgroundDepression can be associated with increased mortality and morbidity, but no studies have investigated the specific causes of death based on autopsy reports. Autopsy studies can yield valuable and detailed information on pathological ailments or underreported conditions. This study aimed to compare autopsy-confirmed causes of death (CoD) between individuals diagnosed with major depressive disorder (MDD) and matched controls. We also analyzed subgroups within our MDD sample, including late-life depression and recurrent depression. We further investigated whether machine learning (ML) algorithms could distinguish MDD and each subgroup from controls based on their CoD.MethodsWe conducted a comprehensive analysis of CoD in individuals who died from nontraumatic causes. The diagnosis of lifetime MDD was ascertained based on the DSM-5 criteria using information from a structured interview with a knowledgeable informant. Eleven established ML algorithms were used to differentiate MDD individuals from controls by simultaneously analyzing different disease category groups to account for multiple tests. The McNemar test was further used to compare paired nominal data.ResultsThe initial dataset included records of 1,102 individuals, among whom 232 (21.1%) had a lifetime diagnosis of MDD. Each MDD individual was strictly paired with a control non-psychiatric counterpart. In the MDD group, the most common CoD were circulatory (67.2%), respiratory (13.4%), digestive (6.0%), and cancer (5.6%). Despite employing a range of ML models, we could not find distinctive CoD patterns that could reliably distinguish individuals with MDD from individuals in the control group (average accuracy: 50.6%; accuracy range: 39-59%). These findings were consistent even when considering factors within the MDD group, such as late-life or recurrent MDD. When comparing groups with paired nominal tests, no differences were found for circulatory (p=0.450), respiratory (p=0.790), digestive (p=1.000), or cancer (p=0.855) CoD.ConclusionsOur analysis revealed that autopsy-confirmed CoD exhibited remarkable similarity between individuals with depression and their matched controls, underscoring the existing heterogeneity in the literature. Future research should prioritize more severe manifestations of depression and larger sample sizes, particularly in the context of CoD related to cancer.

Benzodiazepine Prescription Patterns After Mild Traumatic Brain Injury inU.S. Military Service Members.

Clinical practice guidelines (CPGs) and clinical recommendations (CRs) are developed to aide and guide providers in treating a variety of conditions, including traumatic brain injury (TBI). There is little knowledge on the impact that CPGs and CRs have on provider practice. One TBI recommendation that was able to be tracked in medical record codes was the use of benzodiazepines (BZD). Because of potential for misuse, diversion, addiction, cognitive impairment, and brain healing interference, the DoD and Department of Veterans Affairs (VA) jointly discourage prescribing BZD after TBI. As part of an effort to look at translation of CPG guidance into clinical practice, our objective was to examine the issuance of BZD prescriptions, including dose, type, and prescribing provider, prescribing setting, and primary diagnosis at issuance among U.S. service members with mild Traumatic Brian Injury (mTBI). Using DoD data sourced from the Comprehensive Ambulatory/Professional Encounter Record (CAPER) databases of the Military Health System (MHS) Medical Data Repository (MDR), we identified all U.S. service members with a first lifetime diagnosis of mTBI from October 1, 2015 to September 30, 2016. Data on prescriptions issued to this group during a period of active treatment for a mTBI were obtained from the Pharmacy Detail Transaction Service (PDTS) databases of the MDR and identified BZD prescriptions based on the American Hospital Formulary Service (AHFS) therapeutic classification system. We validated coding assumptions through structured review of the clinical record contained within the Armed Forces Health Longitudinal Technology Application (AHLTA) of 30 randomly selected cohort members. Among U.S. service members, 4.5% filled a BZD prescription while under active medical treatment for a recent mTBI. These service members were more likely female and older when compared to their counterparts not prescribed BZD. Among service members under active treatment for mTBI during the study period, 52.6% (n = 7,935) filled a prescription; of these, 8.5% (n = 676) filled a BZD prescription. Of U.S. service members filing a BZD prescription while undergoing active treatment for an mTBI, 64.6% (n = 437) filled prescriptions for BZD and antidepressants, 54.9% (n = 371) filled prescriptions for both BZD and NSAIDS, and 42.2% (n = 285) concurrently filled prescriptions for BZD and opioids. This effort to examine the translation of CPG recommendations into practice through evaluation of medical record data indicates that providers are prescribing BZD to patients under active treatment for an acute mTBI. The mTBI CPG recommends that the BZD class of medications be avoided in patients healing from brain injury. However, the team recognizes there are confounding factors that may impact the medications that are prescribed for patients with mTBI. Additional work to understand how CPGs and CRs are received and utilized by providers may elucidate opportunities to close the gap between clinical practice guidance and clinical practice.

Medical Debt and the Mental Health Treatment Gap Among US Adults

Medical debt is common in the US and may hinder timely access to care for mental disorders. To estimate the prevalence of medical debt among US adults with depression and anxiety and its association with delayed and forgone mental health care. Cross-sectional, nationally representative survey study of US adult participants in the 2022 National Health Interview Survey who had current or lifetime diagnoses of depression or anxiety. Self-reported lifetime clinical diagnoses of depression and anxiety; moderate to severe symptoms of current depression (Patient Health Questionnaire-8 score ≥10) and anxiety (Generalized Anxiety Disorder-7 score ≥10) irrespective of lifetime diagnoses; and past-year medical debt. Self-reported delaying and forgoing mental health care because of cost in the past year. Among 27 651 adults (15 050 [54.4%] female; mean [SD] age, 52.9 [18.4] years), 5186 (18.2%) reported lifetime depression, 1948 (7.3%) reported current depression, 4834 (17.7%) reported lifetime anxiety, and 1689 (6.6%) reported current anxiety. Medical debt was more common among adults with lifetime depression (19.9% vs 8.6%; adjusted prevalence ratio [aPR], 1.97; 95% CI, 1.96-1.98), lifetime anxiety (19.4% vs 8.8%; aPR, 1.91; 95% CI, 1.91-1.92), current depression (27.3% vs 9.4%; aPR, 2.34; 95% CI, 2.34-2.36), and current anxiety (26.2% vs 9.6%; aPR, 2.24; 95% CI, 2.24-2.26) compared with adults without the respective mental disorders. Medical debt was associated with delayed health care among adults with lifetime depression (29.0% vs 11.6%; aPR, 2.68; 95% CI, 2.62-2.74), lifetime anxiety (28.0% vs 11.5%; aPR, 2.45; 95% CI, 2.40-2.50), current depression (36.9% vs 17.4%; aPR, 2.25; 95% CI, 2.13-2.38), and current anxiety (38.4% vs 16.9%; aPR, 2.48; 95% CI, 2.35-2.66) compared with those without these diagnoses. Medical debt was associated with forgone health care among adults with lifetime depression (29.4% vs 10.6%; aPR, 2.66; 95% CI, 2.61-2.71), lifetime anxiety (28.2% vs 10.7%; aPR, 2.63; 95% CI, 2.57-2.68), current depression (38.0% vs 17.2%; aPR, 2.35; 95% CI, 2.23-2.48), and current anxiety (40.8% vs 17.1%; aPR, 2.57; 95% CI, 2.43-2.75) compared with those without the diagnoses. Medical debt is prevalent among adults with depression and anxiety and may contribute to the mental health treatment gap. In the absence of structural reform, new policies are warranted to protect against this financial barrier to mental health care.

Borderline personality features in relationship to childhood trauma in unipolar depressive and bipolar disorders

BackgroundChildhood trauma, including emotional neglect, emotional abuse, physical abuse, and sexual abuse, may contribute to borderline personality features like affective instability, identity problems, negative relationships, and self-harm. This study aims to explore how different types of childhood trauma affect these features in bipolar versus unipolar depressive disorders. MethodsWe included 839 participants of the Netherlands Study of Depression and Anxiety (NESDA) with a lifetime diagnosis of major depressive disorder single episode (MDDS; N = 443), recurrent major depressive disorder (MDD-R; N = 331), or bipolar disorder (BD; N = 65). Multivariate regression was used to analyze data from the Childhood Trauma Interview and borderline features (from the self-report Personality Assessment Inventory). ResultsOn average, participants were 48.6 years old (SD: 12.6), with 69.2 % being women, and 50.3 % of participants assessed positive for childhood trauma. Adjusted analyses revealed that participants diagnosed with BD, followed by MDD-R, exhibited the highest number of borderline personality features. Additionally, within the entire group, a strong association was found between childhood trauma, especially emotional neglect, and the presence of borderline personality features. ConclusionGiven the high prevalence of childhood trauma and borderline personality features, screening for these factors in individuals with mood disorders is crucial. Identifying these elements can inform and enhance the management of the often fluctuating and complex nature of these comorbid conditions, leading to more effective and tailored treatment strategies.

Mental health and weight regain after bariatric surgery: associations between weight regain and psychiatric and eating-related comorbidities.

Weight regain is a common outcome of weight loss interventions. Mental health-related comorbidities, among other factors, can mediate weight regain regardless of the implemented treatment modality. This study explores whether postoperative psychopathological comorbidities are associated with weight regain after bariatric surgery. This cross-sectional study recruited 90 outpatients who underwent Roux-en-Y gastric bypass surgery. Anthropometric measurements were collected retrospectively from medical charts. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorder-IV (DSM-IV) Axis I Disorders (SCID-I) was applied to evaluate psychiatry diagnoses. Validated self-report instruments were used to assess depression, anxiety, alcohol use, impulsivity, binge eating, and body image dissatisfaction. Weight regain was defined as a ≥20% increase from the maximum weight lost. Level of evidence: Level III, cross-sectional study based on a well-designed study. Overall, 55.6% of participants experienced weight regain. Notably, mental disorders such as current binge-eating disorder and lifetime diagnoses including bulimia nervosa, alcohol abuse/dependence, and obsessive-compulsive disorder were significantly associated with weight regain. However, controlled analysis found that, for mental disorders, only current binge-eating disorder (odds ratio [OR] 6.3, 95% confidence interval [CI] 1.26-31.06, p = 0.024) remained associated with weight regain. Eating-related psychopathologies also associated with weight regain included binge eating (d = 0.55; p = 0.013), eating disinhibition (d = 0.76; p = 0.001), higher hunger levels (d = 0.39; p = 0.004), and non-planning trait impulsivity (d = 0.69; p = 0.0001). Postoperative presence of psychopathological comorbidities, such as eating psychopathology and trait impulsivity, were associated with weight regain after bariatric surgery. These findings highlight the importance of addressing mental health in individuals experiencing postsurgical weight regain.

Self-reported health profiles of trauma victims with and without psychiatric histories

BackgroundThis study examined associations between self-reported trauma exposure and physical health status after control of vari-ance associated with psychiatric disturbance. Physical and mental health diagnoses were examined among participants with and without histories of trauma and post-traumatic stress disorder (PTSD).Participants and procedureCollege (n = 2,320) and national (n = 663) respondents were surveyed to identify trauma histories defined using the primary DSM-5 diagnostic criterion for PTSD. Respondents also identified lifetime diagnoses for a range of medical and psychiatric conditions. They were also asked to provide a self-assessment of their own current physical health status using a ten-point scaling metric.ResultsSupport was found for all three hypotheses: (H1) Self-identified trauma was associated with higher prevalence rates for 16 of 18 medical diagnoses; (H2) PTSD diagnoses were associated with higher prevalence rates than trauma alone for 6 of 16 medical conditions; and (H3) Self-reported trauma was associated with higher prevalence rates for 7 of 18 medical condi-tions among respondents who denied psychiatric histories.ConclusionsTrauma exposure both with and without co-occurring psychiatric illness was associated with substantially higher rates of self-reported physical illness. Practitioners and researchers should recognize the potential significance of self-identified trauma and the range of potential biosocial implications that may warrant monitoring.

Contamination fear during the COVID-19 pandemic in patients with lifetime obsessive compulsive disorder and healthy controls: A longitudinal cohort study

BackgroundThe COVID-19 pandemic could be considered a 'symptom provocation test,' which may trigger specific OCD and other psychiatric symptoms. Therefore, we aimed to compare the long-term impact of the pandemic on fear of COVID-19, and contamination, depressive and anxiety symptoms in three groups: individuals with OCD with and without pre-pandemic contamination symptoms and healthy controls. MethodsFrom April 2020 to February 2022, we administered 16 online questionnaires on 138 persons with a lifetime diagnosis of OCD and 373 healthy controls. We evaluated outcomes related to fear of COVID-19, cleaning obsessions and compulsions, anxiety, and depressive symptoms. Using mixed models, we compared the trajectories among persons with OCD who had pre-pandemic contamination symptoms, those without such symptoms, and healthy controls. ResultsPre-pandemic contamination symptoms were significantly associated with higher fear of COVID-19, contamination symptoms, anxiety, and depressive symptoms. Persons with OCD without pre-pandemic contamination symptoms scored, on average, quite similarly to healthy controls. ConclusionsOnly in persons with pre-pandemic contamination symptoms did the pandemic provoke more fear of COVID-19 and contamination symptoms than in controls. It seems that stress caused by external factors, does not tri trigger OCD symptoms unless there is a connection to the subtype of OCD.

Enhancing the accuracy of register-based metrics: Comparing methods for handling overlapping psychiatric register entries in Finnish healthcare registers.

Healthcare registers are invaluable resources for research. Partly overlapping register entries and preliminary diagnoses may introduce bias. We compare various methods to address this issue and provide fully reproducible open-source R scripts. We used all Finnish healthcare registers 1969-2020, including inpatient, outpatient and primary care. Four distinct models were formulated based on previous reports to identify actual admissions, discharges, and discharge diagnoses. We calculated the annual number of treatment events and patients, and the median length of hospital stay (LOS). We compared these metrics to non-processed data. Additionally, we analyzed the lifetime number of individuals with registered mental disorders. Overall, 2,130,468 individuals had a registered medical contact related to mental disorders. After processing, the annual number of inpatient episodes decreased by 5.85%-10.87% and LOS increased by up to 3days (27.27%) in years 2011-2020. The number of individuals with lifetime diagnoses reduced by more than 1 percent point (pp) in two categories: schizophrenia spectrum (3.69-3.81pp) and organic mental disorders (1.2-1.27pp). The methods employed in pre-processing register data significantly impact the number of inpatient episodes and LOS. Regarding lifetime incidence of mental disorders, schizophrenia spectrum disorders require a particular focus on data pre-processing.

Assessment of the epizootic situation of dourine in horses in the North Caucasus and Southern Federal Districts of the Russian Federation from 2020 to 2022

Relevance. Accidental disease is an actual disease of horses in many countries, including Russia, where cases of the disease have been registered in 16 administrative territories. In the Russian Federation, the proportion of accidental illness is about 47% in the general infectious and parasitic pathology of horses. The mortality rate is high, up to 30–50%, sometimes higher. The treatment of sick animals is prohibited.The purpose of the study is to study the epizootic situation of accidental illness in the North Caucasus and Southern Federal Districts, where a high density of horse population is registered.Methods. The epizootic situation of accidental equine disease from 2020 to 2022 was studied based on the materials of annual reports submitted by the state veterinary laboratories of the Russian Federation.The complement binding reaction (CFT) is the main method of lifetime diagnosis of accidental illness.Results. Serological studies for accidental equine disease from 2020 to 2022 were performed in all subjects of the North Caucasus and Southern Federal Districts. It has been established that the epizootic situation of accidental illness in the territory of the Southern Federal District is prosperous, and in a number of regions of the North Caucasus Federal District it is tense. Thus, specific antibodies to the causative agent of accidental disease were detected in the North Caucasus Federal District in 36 cases, including in the Republic of Dagestan — 27, in the Chechen Republic — 4, in the Kabardino-Balkarian Republic — 3, in the Karachay-Cherkess Republic — 2. Thus, the epizootic situation in the South of Russia is different.

Clozapine Efficacy and Adverse Drug Reactions Among a Nationwide Study of 1021 Australians Prescribed Clozapine: The ClozaGene Study.

The ClozaGene Study is a nationwide cohort of adults who have been treated with clozapine. While clozapine is indicated in the management of treatment-resistant schizophrenia, it is associated with a considerable adverse drug reaction (ADR) burden, and not all patients achieve adequate symptomatic response. The current study focuses on self-reported experiences of clozapine use and response, clozapine-associated ADRs, and mental health comorbidity. A total of 1021 participants (41.0% female; aged 46.2 ± 10.6 years [range 18-66]) were recruited via a mail-out based on prescriptions for clozapine. Participants completed a self-report questionnaire. Most participants (90.1%, n = 912) were living with schizophrenia while 41.5% reported a lifetime diagnosis of depression, 15.6% bipolar disorder, and 8.1% schizoaffective disorder. Clozapine was currently prescribed to 944 (92.5%) participants and 37.8% of these participants self-reported currently taking additional antipsychotic medication. Nearly 3 quarters of participants living with schizophrenia reported that clozapine helped control their schizophrenia symptoms moderately to very well. The most commonly reported ADRs were sialorrhea (80.3%), weight gain (71.0%), constipation (56.9%), and sedation (52.8%). The prevalence of clozapine cessation due to clozapine-induced myocarditis and neutropenia was 1% and 0.4%, respectively. Our findings highlight the high rate of psychotic and metabolic symptoms and ADRs among adults prescribed clozapine in the general Australian population. Future genomic analyses will focus on identifying genetic variants influencing clozapine treatment response and side effects.

Psychosocial and medication interventions to stop or reduce alcohol consumption during pregnancy.

Despite the known harms, alcohol consumption is common in pregnancy. Rates vary between countries, and are estimated to be 10% globally, with up to 25% in Europe. To assess the efficacy of psychosocial interventions and medications to reduce or stop alcohol consumption during pregnancy. We searched the Cochrane Drugs and Alcohol Group Specialised Register (via CRSLive), Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO, from inception to 8 January 2024. We also searched for ongoing and unpublished studies via ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). All searches included non-English language literature. We handsearched references of topic-related systematic reviews and included studies. We included randomised controlled trials that compared medications or psychosocial interventions, or both, to placebo, no intervention, usual care, or other medications or psychosocial interventions used to reduce or stop alcohol use during pregnancy. Our primary outcomes of interest were abstinence from alcohol, reduction in alcohol consumption, retention in treatment, and women with any adverse event. We used standard Cochrane methodological procedures. We included eight studies (1369 participants) in which pregnant women received an intervention to stop or reduce alcohol use during pregnancy. In one study, almost half of participants had a current diagnosis of alcohol use disorder (AUD); in another study, 40% of participants had a lifetime diagnosis of AUD. Six studies took place in the USA, one in Spain, and one in the Netherlands. All included studies evaluated the efficacy of psychosocial interventions; we did not find any study that evaluated the efficacy of medications for the treatment of AUD during pregnancy. Psychosocial interventions were mainly brief interventions ranging from a single session of 10 to 60 minutes to five sessions of 10 minutes each. Pregnant women received the psychosocial intervention approximately at the end of the first trimester of pregnancy, and the outcome of alcohol use was reassessed 8 to 24 weeks after the psychosocial intervention. Women in the control group received treatment as usual (TAU) or similar treatments such as comprehensive assessment of alcohol use and advice to stop drinking during pregnancy. Globally, we found that, compared to TAU, psychosocial interventions may increase the rate of continuously abstinent participants (risk ratio (RR) 1.34, 95% confidence interval (CI) 1.14 to 1.57; I2 =0%; 3 studies; 378 women; low certainty evidence). Psychosocial interventions may have little to no effect on the number of drinks per day, but the evidence is very uncertain (mean difference -0.42, 95% CI -1.13 to 0.28; I2 = 86%; 2 studies; 157 women; very low certainty evidence). Psychosocial interventions probably have little to no effect on the number of women who completed treatment (RR 0.98, 95% CI 0.94 to 1.02; I2 = 0%; 7 studies; 1283 women; moderate certainty evidence). None of the included studies assessed adverse events of treatments. We downgraded the certainty of the evidence due to risk of bias and imprecision of the estimates. Brief psychosocial interventions may increase the rate of continuous abstinence among pregnant women who report alcohol use during pregnancy. Further studies should be conducted to investigate the efficacy and safety of psychosocial interventions and other treatments (e.g. medications) for women with AUD. These studies should provide detailed information on alcohol use before and during pregnancy using consistent measures such as the number of drinks per drinking day. When heterogeneous populations are recruited, more detailed information on alcohol use during pregnancy should be provided to allow future systematic reviews to be conducted. Other important information that would enhance the usefulness of these studies would be the presence of other comorbid conditions such as anxiety, mood disorders, and the use of other psychoactive substances.

Mental Health and Sociodemographic Correlates of Child Sexual Abuse

Abstract Background: Child sexual abuse (CSA) has long-term deleterious effects on mental health. The prevalence of CSA is more in females than males. A lifetime diagnosis of anxiety, depression, eating disorders, posttraumatic stress disorder (PTSD), sleep disorders, and suicide attempts has been associated with a history of sexual abuse. Few studies have focused on the role of temperament and the relationship between psychiatric morbidity and sociodemographic variables. Aim: This study aimed to assess the relationship between psychiatric morbidity and sociodemographic variables in cases of CSA. Methodology: After ethical approval, 168 consecutive survivors of an alleged history of child sexual assault brought by the police were enrolled after informed consent from legal guardians and assent from survivors. A specially designed semi-structured pro forma was used to collect data. Psychiatric morbidity was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders-5. Scales assessing temperament, perceived social support and global functioning, were used. Results: Seventy-seven percent of survivors in this study had psychiatric morbidity. Adjustment problems were more in children with slow-to-warm temperament. A positive family history of mental illness was significant in major depressive disorder (MDD) but not in PTSD. Those with a history of being assaulted multiple times (36 out of 42) had a higher chance of developing MDD. Conclusion: This study highlights that the adjustment problems were more in children with slow-to-warm temperament, highlighting the need for targeted and timely intervention in this subgroup of CSA survivors. This study shows an association between childhood environmental adverse event and development of psychiatric morbidity.

Alpha event-related decreases during encoding in adults with ADHD – An investigation of sustained attention and working memory processes

BackgroundExecutive functioning deficits are central to established neuropsychological models of ADHD. Oscillatory activity, particularly the alpha rhythm (8–12 Hz) has been associated with cognitive impairments in ADHD. However, most studies to date examined such neural mechanisms underlying executive dysfunction in children and adolescents with ADHD, raising the question of whether and to what extent those ADHD-related working memory impairments are still present in adults. To this end, the current study aimed to investigate the role of alpha event-related decreases (ERD) during working memory processes in adults with and without ADHD. MethodsWe collected electroencephalographic (EEG) data from 85 adults with a lifetime diagnosis of ADHD and 105 controls (aged 32–64), while they performed a continuous performance (CPT) and a spatial delayed response working memory task (SDRT). Time-frequency and independent component analysis (ICA) was used to identify alpha (8–12 Hz) clusters to examine group and condition effects during the temporal profile of sustained attention and working memory processes (encoding, maintenance, retrieval), loads (low and high) and trial type (go and nogo). ResultsIndividuals with ADHD exhibited higher reaction time-variability in SDRT, and slower response times in SDRT and CPT, despite no differences in task accuracy. Although working memory load was associated with stronger alpha ERD in both tasks and both groups (ADHD, controls), we found no consistent evidence for attenuated alpha ERD in adults with ADHD, failing to replicate effects reported in children. In contrast, when looking at the whole sample, the correlations of alpha power during encoding with inattention and hyperactivity-impulsivity symptoms were significant, replicating prior findings in children with ADHD, but suggesting an alternate source for these effects in adults. ConclusionsOur results corroborate the robustness of alpha as a marker of visual attention and suggest that occipital alpha ERD normalizes in adulthood, but with unique contributions of centro-occipital alpha ERD, suggesting a secondary source. This implies that deviations in processes other than previously reported visuospatial cortex engagement may account for the persistent symptoms and cognitive deficits in adults with a history of ADHD.