Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with diferences between winter and summer levels of solar insolation. The purpose of this study was to confrm this fnding using international data from 42% more collection sites and 25% more countries. Methods: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun's electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results: This analysis confrmed the results of the exploratory study with the same best model and slightly better statistical signifcance. There was a signifcant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefcients were signifcant at p<0.01. Conclusion: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed. Keywords: Bipolar disorder, Suicide, Sunlight, Solar insolation, Psychiatry, Circadian, Seasonal variatio

Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

Background Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun's electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.Peer reviewe

Effect of marriage on pre-existing psychoses

The relationship between marriage and mental illness is very complicated, and this issue commonly arises in psychotic illnesses. Psychosis is usually diagnosed at late adolescent and early adulthood. Being a disease of the age at which decision of marriage is taken, the question of whether to marry or not and whether marriage will lead to improvement or deterioration in psychoses is equally faced by patients, their family members, and treating psychiatrists. Mental disorders and problems in marriage are closely linked although there is a controversy about the sequence. In India, marriages are usually arranged by parents and are influenced by a number of factors such as astrological compatibility, caste regulation, geographic proximity, and expectations of dowry. We have worked for two decades in this area. The work summarizes as “Effect of marriage on clinical outcome of persons with bipolar affective disorder: A case–control study.” Married persons had experienced more episodes of illness and for longer duration. Males are more prone for illness than females in both groups (married and never married). Marriage did not influence the severity of illness in persons with bipolar affective disorder. The effects of marriage on women with schizophrenia are as follows: This study concluded that most of the patients and relatives were of the opinion that marriage can cure mental illness. Child birth was found to be a protective factor for decreasing separation in cases. Severity of mental illness was slightly higher in cases than comparison group. It was observed that with increasing severity of illness marital adjustment deteriorates with antagonistic interaction among members

A Comparative Study of Stress Among Students of Medicine, Engineering, and Nursing

Background: In today′s ultra competitive environment, students face more stress than ever - be it related to studies, examination, peer, teachers or parent′s pressure. Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment. On one hand, stress compels us to action. However, it can result in feelings of rejection, anger, and depression, leading to health problems such as headaches, upset stomach rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. Materials and Methods: A cross-sectional questionnaire-based survey of 100 randomly selected students each from Medical College Engineering College and 50 Nursing College was done. For reliability, anonymity and confidentiality were maintained. Stress was measured by using stress measurement scale having 24 Yes/No questions. The questionnaire was in English and Hindi so that language would not be problem. Results: Stress as an entity is universally present among students of all three streams, irrespective of age, sex, and other variables. Students in all three streams have shown denial to existence of problems, with maximum among nursing students. Medical and Engineering students had stress level of such a degree that requires clinical attention, while none of the nursing students belonged to this category. Conclusions: There is attitude among students of turning a blind eye toward existing stress which is a serious problem and may be harbinger of serious mental and psychosocial problems

Consciousness: State reductions, mental disorders and dimensions

Quantum mechanics and godel′s theorem are purely work and concept of physics. When applied to see how ways in which mind works is fascinating, at the same time at a very hypothetical level. Orch or model of consciousness explores neurological basis of consciousness and insight in psychiatric patients as well as in normal patients is also explained. Though many of these are proven concepts in physics and mathematics, there application in understanding of psychiatric phenomenon is still at hypothetical level

Commentary on: Factors influencing substance use among adolescent slum dwellers of Guwahati City, Assam

Adolescent being at risk for substance use has become a cause of concern. Hence, there arises a need to highlight the predictors and to address the range of problems caused by substance use. Here is a brief commentary on adolescent substance use