Mental Chronic Diseases Research Articles

Corticosterone affects the differentiation of a neuronal cerebral cortex-derived cell line through modulation of the nicotinic acetylcholine receptor

Chronic exposure to stress hormones has an impact on brain structures relevant to cognition. Nicotinic acetylcholine receptors (AChRs) are involved in numerous cognitive processes including learning and memory formation. In order to better understand the molecular mechanisms of chronic stress-triggered mental disease, the effect of corticosterone (CORT) on the biology of AChRs was studied in the neuronal cell line CNh. We found that chronic treatment with CORT reduced the expression levels of the α7-type neuronal AChR and, to a lesser extent, of α4-AChR. CORT also delayed the acquisition of the mature cell phenotype in CNh cells. Chronic nicotine treatment affected the differentiation of CNh cells and exerted a synergistic effect with CORT, suggesting that AChR could participate in signaling pathways that control the cell cycle. Overexpression of α7-AChR-GFP abolished the CORT effects on the cell cycle and the specific α7-AChR inhibitor, methyllycaconitine, mimicked the proliferative action exerted by CORT. Whole-cell voltage-clamp recordings showed a significant decrease in nicotine-evoked currents in CORT-treated cells. Taken together, these observations indicate that AChRs, and the α7-AChR in particular, could act as modulators of the differentiation of CNh cells and that CORT could impair the acquisition of a mature phenotype by affecting the function of this AChR subtype.

Comorbid Mental and Physical Health and Health Access in Cambodian Refugees in the US

Little research has been conducted on the prevalence of physical health problems in Cambodian refugees and the relationship between their mental and physical health. We identified the relationship between mental and physical health problems and barriers to healthcare access in Cambodian refugee adults. We used a cross-sectional survey design with a snowball sample of 136 Cambodian refugee adult residents of Connecticut and Western Massachusetts. 61% reported being diagnosed with three or more physical conditions and 73% with depression, posttraumatic stress disorder (PTSD) or both. Language and transportation problems were the primary barriers to accessing care. Participants with probable comorbid PTSD and depression had 1.850 times more physical health problems than those without either condition (p > .001; CI 1.334-2.566). Age moderated this relationship. Participants who had been diagnosed with both depression and PTSD reported a consistent number of health conditions across the age span while those who had no mental health conditions or only one of the two reported fewer health conditions when they were younger and more when they were older. These two groups were significantly different from the group reporting both. There is a significant relationship between chronic comorbid mental and physical health diseases affecting Cambodian refugees resettled in the US Having comorbid depression and PTSD puts Cambodian refugees at risk for physical health problems no matter their age. It is vital that those treating Cambodian genocide survivors identify and treat their prevalent comorbid health conditions. Language and transportation barriers must be addressed to improve access to mental and physical health care in this population.

Assessment of health status and quality of life of homeless persons in Belgrade, Serbia

Homelessness is a problem with social, medical, economic, political and other implications. Despite a large number of studies, reports about health-related quality of life (HRQoL) of homeless persons remain sparse. There is a summary of consistent evidence that homeless people have higher prevalence of chronic disease (mental and somatic) than general population. The aim of this study was to assess HRQoL and depression in homeless persons in Belgrade, to describe their sociodemographic factors and health status (the presence of chronic mental and somatic diseases and addiction disorders) and analyse impact of sociodemographic factors and health status to HRQoL and depression of homeless persons. The study was conducted in the Shelter for Adult and Elderly Persons in Belgrade, from January 1 to January 31, 2012. A set of questionnaires used in survey included Serbian translation of SF-36 questionnaire, Serbian translation of Beck Depression Inventory-II (BDI-II) and sociodemographic questionnaire. Statistical analysis was performed by descriptive and analytic methods. Our study sample consisted of 104 adult participants. The majority of them were male (74%) and the mean age in the sample was 48.2 +/- 13.0 years. We have found that 35.6% participants had lifetime diagnosis of psychiatric disorder, most frequently depression (lifetime prevalence of 15.4% in the study group). The history of suicide attempts was registered in 28 (26.9%) participants. Lifetime illicit drugs use was reported by 12.5%, daily smoking by 82.7% and daily alcohol consumption by 8.7% of the participants. Most common somatic chronic diseases were cardiovascular while chronic lung diseases were the second most frequent. Single chronic disaese was present in 33 (31.7%) of the participants and comorbidity of 2 chronic diseases was present in 20 of them. A statistically significant difference between participants HRQoL SF-36 domain scores and norms of general population was found only for role physical domain (lower in homeless, p < 0.001). ANOVA showed no statistically significant difference in SF-36 HRQoL domain and composite scores between different age groups, nor did marital status, education level, length of homelessness, alcohol use or smoking significantly affect the HRQoL. The mean BDI-II score in the studied population was 19.1 +/- 11.6. Severe depression was registered in 20.2% of the participants, moderate in 23.1%, mild in 19.2% and minimal in 37.5%. A highly significant negative correlation was verified between BDI-II and all domains and composite scores of SF-36 (p < 0.001). Measures for prevention of homelessness should include: foundation of national registry of homeless persons, development of systemic multisectorial cooperation and special psychosocial intervention strategies. In homeless population, health care measures should be focused on prevention and treatment of mental health disorders and chronic somatic diseases.

Exploring drug-target interaction networks of illicit drugs

BackgroundDrug addiction is a complex and chronic mental disease, which places a large burden on the American healthcare system due to its negative effects on patients and their families. Recently, network pharmacology is emerging as a promising approach to drug discovery by integrating network biology and polypharmacology, allowing for a deeper understanding of molecular mechanisms of drug actions at the systems level. This study seeks to apply this approach for investigation of illicit drugs and their targets in order to elucidate their interaction patterns and potential secondary drugs that can aid future research and clinical care.ResultsIn this study, we extracted 188 illicit substances and their related information from the DrugBank database. The data process revealed 86 illicit drugs targeting a total of 73 unique human genes, which forms an illicit drug-target network. Compared to the full drug-target network from DrugBank, illicit drugs and their target genes tend to cluster together and form four subnetworks, corresponding to four major medication categories: depressants, stimulants, analgesics, and steroids. External analysis of Anatomical Therapeutic Chemical (ATC) second sublevel classifications confirmed that the illicit drugs have neurological functions or act via mechanisms of stimulants, opioids, and steroids. To further explore other drugs potentially having associations with illicit drugs, we constructed an illicit-extended drug-target network by adding the drugs that have the same target(s) as illicit drugs to the illicit drug-target network. After analyzing the degree and betweenness of the network, we identified hubs and bridge nodes, which might play important roles in the development and treatment of drug addiction. Among them, 49 non-illicit drugs might have potential to be used to treat addiction or have addictive effects, including some results that are supported by previous studies.ConclusionsThis study presents the first systematic review of the network characteristics of illicit drugs, their targets, and other drugs that share the targets of these illicit drugs. The results, though preliminary, provide some novel insights into the molecular mechanisms of drug addiction. The observation of illicit-related drugs, with partial verification from previous studies, demonstrated that the network-assisted approach is promising for the identification of drug repositioning.

Role of Melatonin in Schizophrenia

Schizophrenia is a chronic mental disease that disturbs several cognitive functions, such as memory, thought, perception and volition. Schizophrenia’s biological etiology is multifactorial and is still under investigation. Melatonin has been involved in schizophrenia since the first decades of the twentieth century. Research into melatonin regarding schizophrenia has followed two different approaches. The first approach is related to the use of melatonin as a biological marker. The second approach deals with the clinical applications of melatonin as a drug treatment. In this paper, both aspects of melatonin application are reviewed. Its clinical use in schizophrenia is emphasized.

Euthanasia in the Netherlands: Consultation and Review

The Netherlands was the first country in which euthanasia (defined as the active termination of life by a physician at the request of the patient) and physician-assisted suicide (PAS) were legally permitted under specific circumstances. Much controversy exists regarding the moral legitimacy of assistance in dying, if this involves actively and deliberately shortening the life of the patient. This is particularly the case if patients do not (or do not only) suffer from somatic illnesses, but instead (or also) suffer from mental disturbance, such as in the case of chronic mental illness or Alzheimer's disease.

HIGH risk of chronic pain in women with LOW education, LOW socio-economic status, and LOW mood

[ In this issue of the Scandinavian Journal of Pain Thomten et al. ublish an interesting study on chronic pain in women indicating hat depressive symptoms may have a mediating role in the high isk of developing chronic pain inwomenwith low socio-economic tatus [1]. Their study confirms what Eriksen et al. have reported n their publications from the ongoing health surveys in Denmark or almost two decades [2]: low education and depression in midle aged women are significantly associated with persistent pain onditions. We do not know what is the egg and what is the hen: oes low mental mood and depression cause chronic pain [3,4]? r does a persistent pain condition and the accompanying stress n mental energy, working abilities, social interactions and finanial strain cause depression [3,4]? Or is the explanation that some nfortunate persons have a shared vulnerability to both chronic ain and mental diseases such as depression, possibly through a ysfunctional brain dopamine system as suggested by Taiminen t al. [5]. It is not possible to successfully treat chronic pain withut treating the accompanying depression as suggested by Linton nd Bergbom [3] and strongly supported by Nicholas [4]. It is also ot possible to help a complex chronic pain patient with a massive urden of socio-economic problems in addition to the pain conition without helping the patient with her (most often women) conomic and social problems as emphasized by Hagelberg [6] and ho et al. [7,8]. The study by Thomten et al. [1] in this issue of the candinavian Journal of Pain is therefore a valuable reminder that hronic pain is strongly associated with the socio-economic status f the patient and that those who try to help these unfortunate omen face a complex challenge where a truly multidisciplinary eam approach is necessary [9]. The social worker, the psychologist nd psychiatrist [3,4,10], the physiotherapist [11], as well as speialists inwomen’s diseases [11] aremore important than the “pain pecialist” using pharmacology and interventional techniques. All of these aspects of chronic pain among women have been eviewed and discussed in-depth during the three first years of our ublishing the Scandinavian Journal of Pain [1,3–11]. As founding ditor-in-Chief, I am grateful for all the enthusiastic contributors to

A study of the combined effects of the EHD3 and FREM3 genes in patients with major depressive disorder

Major depressive disorder (MDD) is a common chronic mental disease with diverse clinical presentation. Although the genome-wide association study (GWAS) has remarkably facilitated the understanding of genetic mechanisms of MDD at a deep molecular level, the combined effect of these disease-underlying genes still needs further investigation. A total of 1,062 unrelated patients with MDD and 992 unrelated healthy subjects were recruited from a Chinese Han population to test 16 MDD-associated genes identified by GWAS. A tag SNP-based linkage-disequilibrium map was then constructed over the loci that showed MDD association in the study sample. Of the 16 genes tested, EHD3 and FREM3 were associated with MDD in the Chinese population. The conditional test showed disease association for the rs619002(EHD3)-rs1112714(FREM3) combination (P = 0.0059) and for the rs644926(EHD3)-rs13130123(FREM3) combination (P = 0.007), of which a reduced risk was found for the rs619002(G)-rs1112714(T) combination (OR = 0, P = 4.02 × 10(-6) ) and for the rs644926(A)-rs11938298(G) combination (OR = 0.12, 95% CI = 0.035-0.39, P = 3.85 × 10(-6) ). Quantitative trait analysis revealed that rs13130123 in the FREM3 locus was strongly associated with the insomnia early symptom in patients carrying the rs619002(G) allele (P = 0.001) and those carrying the rs644926(A) allele (P = 0.00077). The combined effect of the EHD3 and FREM3 genes may play an important role in developing MDD. © 2012 Wiley Periodicals, Inc.

WHOQOL – OLD and WHOQOL – BREF concepts as tools for assessment of quality of life of older people in old people’s homes

The article offers a survey of partial results of research into quality of life of older people in old people’s homes. Old people’s homes constitute only one of the elements of care for older people and they are intended particularly for persons whose self-sufficiency is reduced due to age or health handicap, chronic mental disease or some type of dementia and whose situation requires the regular help of another person. At present, great stress is put on the quality of the services provided, but that quality is closely related to the quality of life of the older people. The goal of the research was to ascertain the level of quality of life of older people living in old people’s homes and to assess the quality of life in different life domains. The main research question said: which factors influence significantly the quality of life of older people in old people’s homes? The basic set consisted of inhabitants of South Bohemian Region of 60 years and more. 2 selective sets were made from that basic set. The first set was made, through intentional selection, of residents of old people’s homes in South Bohemian Region where the criteria of inclusion were: age above 60, willingness to cooperate and cognitive functions preserved at least to a degree that they are able to answer, by themselves or with assistance, credibly the questionnaire items. This set is identified with the abbreviation “DpS” (= domovy pro seniory = old people’s homes) for simplification. A set of older people living in home environment and having graduated from the University of the Third Age at the University of South Bohemia in Ceske Budějovice (Czech Republic) Assessment of quality of life of older people in old people’s homes serve as contrast group. That set is identified with the abbreviation “U3V” (= univerzita třetiho věku = University of the Third Age) in the tables. Higher level of activity and vitality than the levels typical for the basic set can be rightfully expected from the U3V older people; therefore their results are approached as contrast to the results of the older people from old people‘s homes. To identify the satisfaction in significant life domains, we use Czech versions of the questionnaires developed for the purpose of assessment of quality of life of older people by the WHO work group. The WHOQOL-OLD questionnaire is the first of them. The WHOQOL –BREF questionnaire of quality of life is used as additional module.

Cigarettes smoking and the risk of rehospitalization in patients with schizophrenia

Schizophrenia is a chronic mental disease which, in spite of adequate treatment, brings a high risk of relapse with frequent need for hospitalization. Among many factors affecting the frequency of hospitalization in patients diagnosed with schizophrenia, smoking cigarettes is one of them. Numerous research confirmed higher percentage of smoking schizophrenic patients as compared to patients suffering from other mental illnesses or healthy population. The prevalence of nicotine dependence among schizophrenic patients is explained, inter alia, by relationship with disease symptoms and side effects of the treatment and related attempts of self-medication. Lower premorbid functioning, more acute disease process, higher risk of relapse and somatic disease, are observed in smoking patients group diagnosed with schizophrenia. The course of schizophrenic process could be modified by smoking, through 1) neurobiological changes, as increasing of dopamine activity, 2) enzyme induction responsible for the drug metabolism, and related to this process changes of plasma concentration of neuroleptics. Complexity of the relation between smoking, course of schizophrenic process and risk of rehospitalisation, cannot draw definite conclusions and should be inspiration for further research.

Gender-specific role of the protein tyrosine phosphatase receptor type R gene in major depressive disorder

Major depressive disorder (MDD) is a common, chronic, and recurrent mental disease affecting millions of individuals worldwide. The precise mechanism by which the illness is developed remains unknown, but it has been accepted that a genetic component is very likely to be involved. Studies of the pathogenesis of MDD have implicated a reduced activity of the extracellular regulated kinase (ERK) signaling system. Protein tyrosine phosphatase, receptor type R (PTPRR) is a key negative regulator of the ERK signaling pathway and its expression is regulated by androgen. Therefore, it is worth testing whether the PTPRR gene could confer a risk of MDD. We genotyped 16 SNPs in the PTPRR locus with the MALDI-TOF-MS-based genotyping protocol in 517 patients with MDD and 455 controls among a Chinese Han population. The UNPHASED program was applied to analyze the genotyping data. Of the 16 SNPs selected, rs1513105 was the only one showing allelic association (χ2=9.019, p=0.0027) and genotypic association (χ2=8.813, df=2, p=0.012), of which the rs1513105(C) allele was associated with an increased risk of MDD (OR=1.331, 95% CI 1.104-1.604), but the rs1513105 association resulted mainly from female subjects (χ2=12.35, p=0.00044 for allelic association; χ2=11.26, df=2, p=0.0036 for genotypic association). Replication and functional study may be required to draw a firm conclusion. Our results suggest that the PTPRR gene may play a role in conferring risk of MDD in the female subjects.

Convergence of Two Independent Mental Disease Genes on the Protein Level: Recruitment of Dysbindin to Cell-Invasive Disrupted-In-Schizophrenia 1 Aggresomes

Both disrupted-in-schizophrenia 1 (DISC1) and dysbindin have been identified as schizophrenia candidate genes in independent genetic linkage studies. The proteins have been assigned distinct subcellular locations and functions. We investigated whether both proteins converge into a common pathway specific for schizophrenia or mental diseases. DISC1 and dysbindin were expressed as recombinant proteins with or without a fluorescent protein-tag in human or mouse neuroblastoma cells and as recombinant proteins in E. coli. Postmortem brains of patients with mental diseases from the Stanley Research Medical Institute's Consortium Collection were used to demonstrate molecular interactions in biochemically purified protein fractions. First, upon overexpression in neuroblastoma cells, DISC1 formed aggresomes that recruited homologous soluble C-terminal DISC1 fragment or heterologous dysbindin. Domains involved in binding could be mapped to DISC1 (316-597) and dysbindin (82-173), indicating a specific interaction. In addition, recruitment was demonstrated when externally added, purified DISC1 aggresomes penetrated recipient cells after coincubation. Second, a direct interaction between soluble DISC1 protein and dysbindin was demonstrated in a cell free system using E. coli-expressed proteins. Third, co-aggregation of DISC1 and dysbindin was demonstrated in postmortem brains for a subgroup of cases with chronic mental disease but not healthy control subjects. A direct interaction of soluble and insoluble DISC1 protein with dysbindin protein demonstrates convergence of so far considered independent mental disease genes by direct molecular interaction. Our findings highlight protein aggregation and recruitment as a biological mechanism in mental disease.

Physical Activity Levels And Health-related Quality Of Life In Italian University Students

Many studies demonstrated the benefit of significant levels of physical activity in reducing chronic diseases in the general adults from different world population. Little is known however, on the association between health-related quality of life (HRQoL) and physical activity (PA) levels in Italian population. PURPOSE: The aim of this study was to determine the association between different levels of PA (walking, moderate-intensity activity, vigorous-intensity activity), time spent sitting (S), and HRQoL. METHODS: We used the short version of IPAQ and SF-36 to assess PA levels, and HRQoL, respectively, in a random sample of 155 University students (age range 18-30 years old). RESULTS: Multiple regression analysis showed a significant relationship between PA (Kcal/week and METs/week) and Physical Functioning, Role Physical, General Health, Vitality and Physical Summary Component (PSC) score in female participants and Role Physical, Vitality, Social Functioning, Role Emotional, Mental Health and PSC score in male participants (multiple R range, 0.10-0.24). Vigorous PA and Walking were positively related to HRQoL (B range, 0.12-0.16), whereas time spent sitting was inversely related to Mental Summary Component (MSC) (B -0.11) and Role Physical (B -0.11) in female participants, and MSC (B -0.15) and General Health (B -0.12) in male participants. The multivariate model combining different levels of PA significantly predicted MSC (model F=38.096, df=5, p<0.001) and PSC (model F=55.527, df=5, p<0.001) score, and variance explained by the function was 5.41% and 7.70%, respectively. CONCLUSION: Our results confirm the evidence of a positive correlation between PA levels and HRQoL also among University students. The extension of this study to the Italian general population, stratified according to age, PA practice and intensity levels, looking for the correlation with healthy status, could support the importance of PA also in preventing some chronic physical and mental diseases. Supported by Regione Autonoma della Sardegna, R.L. n.17/99 art. 40.

P02-26 - The effects of psychodrama on depression among women with chronic mental disorder

IntroductionAt resent 3desaides management of chronic mental disorders at psychiatric health association tobe high attention.Purpose of studyDetermining effect of psychodrama on depression among women with chronic mental disorder.MethodsThis study was a quasi-experimental study that done in RAZI comprehensive psychiatric center. Community of this research consists of chronic mental patients bedridden at RAZI comprehensive psychiatric center that among them 30 women with chronic mental disease possess entrains criterions selected and with randomized permuted blokes’ allocation to two control and intervention groups. Then them depression examined with beck depression inventory (BDI). Then 12sessions hours long of psychodrama, 2ice per week, 6 weeks for intervention group enactment but control group received routine treatments. When the program ended depression of ills reexamined whit study instrument and analyzed with independent T test, paired T test kolmogroph smernophand Leven and covariance analyzes tests.ResultsMain of depression before and after intervention at control group was not significant but at Intervention group was significant (P = 0.000).At two groups after Intervention depression differences revolve significant (P = 0.000).Comparison between main of depression after psychodrama even after modification of age and before intervention depression effect by covariance analyzes at two groups showed significant deferens.ConclusionPsychodrama leads to decrease of depression at intervention group.

Insomnia and its correlates in a representative sample of the Greek population

BackgroundInsomnia is a major public health concern affecting about 10% of the general population in its chronic form. Furthermore, epidemiological surveys demonstrate that poor sleep and sleep dissatisfaction are even more frequent problems (10-48%) in the community. This is the first report on the prevalence of insomnia in Greece, a southeastern European country which differs in several socio-cultural and climatic aspects from the rest of European Community members. Data obtained from a national household survey (n = 1005) were used to assess the relationship between insomnia symptoms and a variety of sociodemographic variables, life habits, and health-related factors.MethodsA self-administered questionnaire with questions pertaining to general health and related issues was given to the participants. The Short Form-36 (Mental Health subscale), the Athens Insomnia Scale (AIS) as a measure of insomnia-related symptoms, and the International Physical Activity Questionnaire (IPAQ) were also used for the assessment.ResultsThe prevalence of insomnia in the total sample was 25.3% (n = 254); insomnia was more frequent in women than men (30.7% vs. 19.5%) and increased with age. Multiple regression analysis revealed a significant association of insomnia with low socio-economical status and educational level, physical inactivity, existence of a chronic physical or mental disease and increased number of hospitalizations in the previous year.ConclusionsThe present study confirms most findings reported from other developed countries around the world regarding the high prevalence of insomnia problems in the general population and their association with several sociodemographic and health-related predisposing factors. These results further indicate the need for more active interventions on the part of physicians who should suspect and specifically ask about such symptoms.

Gender and risk of depression in Saudi Arabia, a systematic review and meta-analysis.

Depression is one of the leading causes of mortality and morbidity worldwide. In the year 2000 depression accounted for 4.4% of the global disability adjusted life years (DALYs). The Kingdom of Saudi Arabia (KSA) has a population of 28 million people and is one of the countries experiencing demographic transition in its population structure. Improvements in socioeconomic status have been shown to be associated with increased chronic diseases including chronic mental diseases like depression, but still there is no comprehensive review summarizing the various reports currently existing in the literature. Although individual studies within Saudi Arabia have reported prevalence rates and risks, the quality of such studies need to be subjected to rigorous assessment and their findings pooled to give combined weighted evidence that will provide basis for targeted intervention. Pooled risks have the advantage of adjusting inherent variations within sampled populations and therefore providing more reliable estimates even though there are concerns about possible magnification of smaller individual risks.

Limited concordance between teachers, parents and healthcare professionals on the presence of chronic diseases in ID-adolescents

Evidence on teachers’ knowledge about somatic and mental chronic diseases among ID-adolescent compared to the knowledge parents and healthcare professionals have, is limited. The aim of this study is: (1) to assess the knowledge of teachers on the presence of chronic diseases in ID-adolescents; (2) to compare teachers with parents and healthcare professionals and parents with healthcare professionals regarding the knowledge on the presence of chronic diseases in ID-adolescents. We obtained data on 1044 ID-adolescents attending secondary schools, fully covering one region of the Netherlands. Teachers, parents and general practitioners (GPs) of the adolescents completed a questionnaire about the occurrence of chronic diseases in their child during the previous 12 months. The questionnaire was derived from the Dutch National Permanent Survey on Living Conditions questionnaire periodically administered in a representative population sample (n≈10,000). Concordance between teachers, parents and healthcare professionals on the presence of chronic diseases in ID-adolescents was relatively low. In about half of all 66 dyads the concordance was for the most part fair and just in 10 dyads good to very good; nine of these latter cases concerned somatic chronic diseases. In addition, teachers reported mostly lower prevalence rates of chronic diseases in ID-adolescents compared to the parents, in particular on mental chronic diseases. Although prevalence rates of chronic diseases among ID-adolescents are very high, knowledge on this among teachers is limited. While information on chronic diseases in ID-adolescents is available among different informants, the disagreement between them reflects different points of view between the informants and probably indicates a lack of communication. The communication among teachers, parents and GPs should be improved to combine the knowledge and information on the presence of chronic diseases in ID-adolescents. This may provide opportunities to improve the support of these adolescents in their school career and in their transition from school to work.

P02-340 - The effects of psychodrama on depression and mental state among women with chronic mental disorder

IntroductionAt resent 3desaides management of chronic mental disorders at psychiatric health association tobe high attention.Purpose of studyDetermining effect of psychodrama on depression among women with chronic mental disorder.MethodsThis study was a quasi-experimental study that done in RAZI comprehensive psychiatric center. Community of this research consists of chronic mental patients bedridden at RAZI comprehensive psychiatric center that among them 30 women with chronic mental disease possess entrains criterions selected and with randomized permuted blokes´ allocation to two control and intervention groups. Then them depression examined with beck depression inventory (BDI). Then 12sessions hours long of psychodrama, 2ice per week, 6 weeks for intervention group enactment but control group received routine treatments. When the program ended depression of ills reexamined whit study instrument and analyzed with independent T test, paired T test kolmogroph smernophand Leven and covariance analyzes tests.ResultsMain of depression before and after intervention at control group was not significant but at Intervention group was significant (P=0.000).At two groups after Intervention depression differences revolve significant (P=0.000). Comparison between main of depression after psychodrama even after modification of age and before intervention depression effect by covariance analyzes at two groups showed significant deferens.ConclusionPsychodrama leads to decrease of depression at intervention group.

Emotional and behavioural problems in adolescents with intellectual disability with and without chronic diseases

Adolescents with intellectual disability (ID) (ID-adolescents) and adolescents with chronic diseases are both more likely to have emotional and behavioural problems. The aim of this study was to assess the association between chronic diseases in ID-adolescents and emotional and behavioural problems in a large school-based sample. We obtained data on 1044 ID-adolescents, aged 12-18 years, attending secondary schools in the Netherlands. Parents of the adolescents completed the Dutch version of the Strengths and Difficulties Questionnaire and questions about chronic diseases in their child and about the background of the child. Prevalence rates of emotional and behavioural problems were generally high in ID-adolescents with chronic diseases (45%), compared with ID-adolescents without chronic diseases (17%). The likelihood of emotional and behavioural problems was high in ID-adolescents with two [odds ratios (OR) 4.47; 95% CI: 2.97-6.74] or more than two chronic diseases (OR 8.01; 95% CI: 5.18-12.39) and for ID-adolescents with mental chronic diseases (OR 4.56; 95% CI: 3.21-6.47). Also ID-adolescents with somatic chronic diseases had a high likelihood of emotional and behavioural problems (OR 1.99; 95% CI: 1.33-2.99), in particular in the combination of somatic and mental chronic diseases (OR 5.16; 95% CI: 3.46-7.71). The current study showed that chronic diseases in ID-adolescents, in particular mental chronic diseases, largely increase the likelihood of emotional and behavioural problems. This should be taken in the provision and planning of care for ID-adolescents.

Oligomer Assembly of the C-Terminal DISC1 Domain (640−854) Is Controlled by Self-Association Motifs and Disease-Associated Polymorphism S704C

Genetic studies have established a role of disrupted-in-schizophrenia-1 (DISC1) in chronic mental diseases (CMD). Limited experimental data are available on the domain structure of the DISC1 protein although multiple interaction partners are known including a self-association domain within the middle part of DISC1 (residues 403-504). The DISC1 C-terminal domain is deleted in the original Scottish pedigree where DISC1 harbors two coiled-coil domains and disease-associated polymorphisms at 607 and 704, as well as the important nuclear distribution element-like 1 (NDEL1) binding site at residues 802-839. Here, we performed mutagenesis studies of the C-terminal domain of the DISC1 protein (residues 640-854) and analyzed the expressed constructs by biochemical and biophysical methods. We identified novel DISC1 self-association motifs and the necessity of their concerted action for orderly assembly: the region 765-854 comprising a coiled-coil domain is a dimerization domain and the region 668-747 an oligomerization domain; dimerization was found to be a prerequisite for orderly assembly of oligomers. Consistent with this, disease-associated polymorphism C704 displayed a slightly higher oligomerization propensity. The heterogeneity of DISC1 multimers in vitro was confirmed with a monoclonal antibody binding exclusively to HMW multimers. We also identified C-terminal DISC1 fragments in human brains, suggesting that C-terminal fragments could carry out DISC1-dependent functions. When the DISC1 C-terminal domain was transiently expressed in cells, it assembled into a range of soluble and insoluble multimers with distinct fractions selectively binding NDEL1, indicating functionality. Our results suggest that assembly of the C-terminal domain is controlled by distinct domains including the disease-associated polymorphism 704 and is functional in vivo.