Risk factors for incidence and persistence of disability in chronic major depression and alcohol use disorders: longitudinal analyses of a population-based study

BackgroundMajor depression and alcohol use disorders are risk factors for incidence of disability. However, it is still unclear whether a chronic course of these health conditions is also prospectively associated with incidence of disability. The aim of the present study was, first, to confirm whether chronic major depression (MD) and alcohol use disorders (AUD) are, respectively, risk factors for persistence and incidence of disability in the general population; and then to analyze the role of help-seeking behavior in the course of disability among respondents with chronic MD and chronic AUD. MethodData from two assessments in the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed. Disability was measured by eight domains of the Short Form 12 Health Survey version 2 (SF-12). Generalized estimating equations and logistic regression models were run to estimate risk factors for persistence and incidence of disability, respectively. ResultsAnalyses conducted on data from the US general population showed that chronic MD was the strongest risk factor for incidence and persistence of disability in the social functioning, emotional role and mental health domains. Chronic AUD were risk factors for incidence and persistence of disability in the vitality, social functioning, and emotional role domains. Within the group of chronic MD, physical comorbidity and help-seeking were associated with persistent disability in most of the SF-12 domains. Help-seeking behavior was also associated with incidence of problems in the mental health domain for the depression group. Regarding the AUD group, comorbidity with physical health problems was a strong risk factor for persistence of disability in all SF-12 domains. Help-seeking behavior was not related to either persistence or incidence of disability in the chronic alcohol group. ConclusionsChronic MD and chronic AUD are independent risk factors for persistence and incidence of disability in the US general population. People with chronic MD seek help for their problems when they experience persistent disability, whereas people with chronic AUD might not seek any help even if they are suffering from persistent disability.<br/

The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression:a meta-analysis

BACKGROUND: There is growing recognition of the importance of both functioning and quality of life (QoL) outcomes in the treatment of depressive disorders, but the meta-analytic evidence is scarce. The objective of this meta-analysis of randomized controlled trials (RCTs) was to determine the absolute and relative effects of psychotherapy, pharmacotherapy and their combination on functioning and QoL in patients with depression. METHOD: One hundred and fifty-three outcome trials involving 29 879 participants with depressive disorders were identified through database searches in Pubmed, PsycINFO and the Cochrane Central Register of Controlled Trials. RESULTS: Compared to control conditions, psychotherapy and pharmacotherapy yielded small to moderate effect sizes for functioning and QoL, ranging from g = 0.31 to g = 0.43. When compared directly, initial analysis yielded no evidence that one of them was superior. After adjusting for publication bias, psychotherapy was more efficacious than pharmacotherapy (g = 0.21) for QoL. The combination of psychotherapy and medication performed significantly better for both outcomes compared to each treatment alone yielding small effect sizes (g = 0.32 to g = 0.39). Both interventions improved depression symptom severity more than functioning and QoL. CONCLUSION: Despite the small number of comparative trials for some of the analyses, this study reveals that combined treatment is superior, but psychotherapy and pharmacotherapy alone are also efficacious for improving functioning and QoL. The overall relatively modest effects suggest that future tailoring of therapies could be warranted to better meet the needs of individuals with functioning and QoL problems

Impact of multimorbidity on disability and quality of life in the Spanish older population

Background Population aging is closely related to high prevalence of chronic conditions in developed countries. In this context, health care policies aim to increase life span cost-effectively while maintaining quality of life and functional ability. There is still, however, a need for further understanding of how chronic conditions affect these health aspects. The aim of this paper is to assess the individual and combined impact of chronic physical and mental conditions on quality of life and disability in Spain, and secondly to show gender trends. Methods Cross-sectional data were collected from the COURAGE study. A total of 3,625 participants over 50 years old from Spain were included. Crude and adjusted multiple linear regressions were conducted to detect associations between individual chronic conditions and disability, and between chronic conditions and quality of life. Separate models were used to assess the influence of the number of diseases on the same variables. Additional analogous regressions were performed for males and females. Results All chronic conditions except hypertension were statistically associated with poor results in quality of life and disability. Depression, anxiety and stroke were found to have the greatest impact on outcomes. The number of chronic conditions was associated with substantially lower quality of life [ß for 4+ diseases: -18.10 (-20.95,-15.25)] and greater disability [ß for 4+ diseases: 27.64 (24.99,30.29]. In general, women suffered from higher rates of multimorbidity and poorer results in quality of life and disability. Conclusions Chronic conditions impact greatly on quality of life and disability in the older Spanish population, especially when co-occurring diseases are added. Multimorbidity considerations should be a priority in the development of future health policies focused on quality of life and disability. Further studies would benefit from an expanded selection of diseases. Policies should also deal with gender idiosyncrasy in certain cases

Changes in depression and suicidal ideation under severe lockdown restrictions during the first wave of the COVID-19 pandemic in Spain: a longitudinal study in the general population - RETRACTION

El texto del artículo original se encuentra disponible en http://hdl.handle.net/10486/70204

Efecto del sexo y la inclusión de glicerol en el pienso sobre la distribución de ácidos grasos en el triglicérido en ganado porcino

Concentration of C16:0 was higher and C18:1 y C18:2 lower in boars than in gilts in the subcutaneous fat of hams. Dietary inclusion of glycerol decrease C18:2 and PUFA concentration, thus decreasing fat unsaturation. Saturated fatty acids are concentrated in the external position of the triglyceride (Sn-1,3), while PUFA and MUFA are located preferentially in the inner position (Sn-2). No interaction was observed between position and either sex or dietary treatment. The PUFA/SAT index was affected by position, sex and dietary treatment, However, rations in which MUFA were involved were not significant. The C18:0/C18:2 index showed an interaction dietary treatment*position, in which the ratio is increased by dietary glycerol only in the Sn-1,3 position.Los machos castrados tuvieron una concentración más alta de C16:0 y más baja de C18:1 y C18:2 en la grasa subcutánea del jamón. La inclusión de glicerol en el pienso durante la fase de acabado produce una menor concentración de C18:2, del total de PUFA y, en consecuencia, una menor insaturación de la grasa. Los ácidos grasos saturados se concentraron especialmente en las posiciones externas (Sn-1,3), mientras que los MUFA y PUFA lo hicieron preferentemente en la posición central (Sn-2). No se observaron interacciones de la posición de los ácidos grasos individuales debidas al sexo o a la alimentación. La relación PUFA/SAT resultó significativa respecto a la posición, el sexo y la alimentación. Sin embargo, los índices en los que participan los MUFA son mucho más constantes e independientes del sexo y la alimentación. El cociente C18:0/C18:2 muestra una interacción glicerol*posición, de modo que dicho cociente aumenta específicamente en la posición 1,3 cuando los cerdos reciben glicerol, pero no se afecta (o lo hace con muy poca intensidad) en la posición 2

Estimating the global burden of disease of mild mental retardation and cardiovascular diseases from environmental lead exposure.

Abstract The disease burden from exposure to lead resulting in mild mental retardation (due to IQ point decreases) and cardiovascular outcomes (due to increases in blood pressure) was estimated at a global level. Blood lead levels were compiled from the literature for 14 geographical regions defined by the World Health Organization according to location and adult and child mortality rates. Adjustments were applied to these levels, where appropriate, to account for recent changes relating to the implementation of leadreduction programs and the lower levels seen in rural populations. It is estimated that mild mental retardation and cardiovascular outcomes resulting from exposure to lead amount to almost 1% of the global burden of disease, with the highest burden in developing regions. This estimate can be used to assess the magnitude of the benefits that could be accrued by increasing the global coverage of lead-reduction programs.

Working definitions, subjective and objective assessments and experimental paradigms in a study exploring social withdrawal in schizophrenia and Alzheimer's disease

Social withdrawal is one of the first and common signs of early social dysfunction in a number of important neuropsychiatric disorders, likely because of the enormous amount and complexity of brain processes required to initiate and maintain social relationships (Adolphs, 2009). The Psychiatric Ratings using Intermediate Stratified Markers (PRISM) project focusses on the shared and unique neurobiological basis of social withdrawal in schizophrenia, Alzheimer and depression. In this paper, we discuss the working definition of social withdrawal for this study and the selection of objective and subjective rating scales to assess social withdrawal chosen or adapted for this project. We also discuss the MRI and EEG paradigms selected to study the systems and neural circuitry thought to underlie social functioning and more particularly to be involved in social withdrawal in humans, such as the social perception and the social affiliation networks. A number of behavioral paradigms were selected to assess complementary aspects of social cognition. Also, a digital phenotyping method (a smartphone application) was chosen to obtain real-life data.This work was supported by the European Union Horizon 2020 Innovative Medicines Initiative 2 Joint Undertaking grant 115916 for the project ‘Psychiatric ratings using intermediate stratified markers

Worldwide mapping of initiatives that integrate population cohorts

[Resumen no disponible

The influence of depression on risk development of acute cardiovascular diseases in the female population aged 25&#x2013;64 in Russia

Background. Recent studies showed that depression was an independent predictor of mortality from cardio-vascular disease in healthy women. Objective. To explore the effect of depression (D) on relative risk (RR) of myocardial infarction (MI) and stroke for 16 years (1995&#x2013;2010) in the female population aged 25&#x2013;64 years from Novosibirsk, Russia. Materials and methods. Under the third screening of the WHO &#x201C;MONICA-psychosocial&#x201D; (MOPSY) programme, a cohort of women aged 25&#x2013;64 years (N=560) was surveyed. Women were followed for 16 years for the incidence of MI and stroke (1995&#x2013;2010). D was measured at the baseline examination by means of test &#x201C;MOPSY&#x201D;. Participants having stroke, MI, arterial hypertension, coronary artery diseases and diabetes in their medical history at the baseline were excluded from this analysis. Results. The prevalence of D in women aged 25&#x2013;64 years was 55.2%. With the growth of D levels, positive self-rated health reduced and almost 100% of those women have complaints about their health, but considered the care of their health insufficient. Women with major D significantly extended negative behavioural habits: smoking and unsuccessful attempts to give up, low physical activity, and less likely to follow a diet (healthy food). Major D associated with high job strain and family stress. Relative risk (RR) of MI development in women with D during 16 years of study was higher in 2.53 cases (p&#x003C;0.05) and risk of stroke was higher in 4.63 cases (p&#x003C;0.05). Conclusions. The prevalence of D in women aged 25&#x2013;64 years was &#x003E;50%. Women with D had a 2.53-fold risk of MI and 4.63-fold risk of stroke during the 16 years of follow-up

Cross-disorder and disorder-specific deficits in social functioning among schizophrenia and Alzheimer's disease patients

BACKGROUND: Social functioning is often impaired in schizophrenia (SZ) and Alzheimer's disease (AD). However, commonalities and differences in social dysfunction among these patient groups remain elusive.MATERIALS AND METHODS: Using data from the PRISM study, behavioral (all subscales and total score of the Social Functioning Scale) and affective (perceived social disability and loneliness) indicators of social functioning were measured in patients with SZ (N = 56), probable AD (N = 50) and age-matched healthy controls groups (HC, N = 29 and N = 28). We examined to what extent social functioning differed between disease and age-matched HC groups, as well as between patient groups. Furthermore, we examined how severity of disease and mood were correlated with social functioning, irrespective of diagnosis.RESULTS: As compared to HC, both behavioral and affective social functioning seemed impaired in SZ patients (Cohen's d's 0.81-1.69), whereas AD patients mainly showed impaired behavioral social function (Cohen's d's 0.65-1.14). While behavioral indices of social functioning were similar across patient groups, SZ patients reported more perceived social disability than AD patients (Cohen's d's 0.65). Across patient groups, positive mood, lower depression and anxiety levels were strong determinants of better social functioning (p's &lt;0.001), even more so than severity of disease.CONCLUSIONS: AD and SZ patients both exhibit poor social functioning in comparison to age- and sex matched HC participants. Social dysfunction in SZ patients may be more severe than in AD patients, though this may be due to underreporting by AD patients. Across patients, social functioning appeared as more influenced by mood states than by severity of disease.</p