Mood instability, mental illness and suicidal ideas : results from a household survey

Purpose: There is weak and inconsistent evidence that mood instability (MI) is associated with depression, post traumatic stress disorder (PTSD) and suicidality although the basis of this is unclear. Our objectives were first to test whether there is an association between depression and PTSD, and MI and secondly whether MI exerts an independent effect on suicidal thinking over and above that explained by common mental disorders. Methods: We used data from the Adult Psychiatric Morbidity Survey 2007 (N = 7,131). Chi-square tests were used to examine associations between depression and PTSD, and MI, followed by regression modelling to examine associations between MI and depression, and with PTSD. Multiple logistic regression analyses were used to assess the independent effect of MI on suicidal thinking, after adjustment for demographic factors and the effects of common mental disorder diagnoses. Results: There are high rates of MI in depression and PTSD and the presence of MI increases the odds of depression by 10.66 [95 % confidence interval (CI) 7.51–15.13] and PTSD by 8.69 (95 % CI 5.90–12.79), respectively, after adjusting for other factors. Mood instability independently explained suicidal thinking, multiplying the odds by nearly five (odds ratio 4.82; 95 % CI 3.39–6.85), and was individually by some way the most important single factor in explaining suicidal thoughts. Conclusions: MI is strongly associated with depression and PTSD. In people with common mental disorders MI is clinically significant as it acts as an additional factor exacerbating the risk of suicidal thinking. It is important to enquire about MI as part of clinical assessment and treatment studies are required

ICAR: endoscopic skull‐base surgery

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Postpartum psychosis in bipolar disorder: no evidence of association with personality traits, cognitive style or affective temperaments

Background: Bipolar disorder has been associated with several personality traits, cognitive styles and affective temperaments. Women who have bipolar disorder are at increased risk of experiencing postpartum psychosis, however little research has investigated these traits and temperaments in relation to postpartum psychosis. The aim of this study is to establish whether aspects of personality, cognitive style and affective temperament that have been associated with bipolar disorder also confer vulnerability to postpartum psychosis over and above their known association with bipolar disorder. Methods: Personality traits (neuroticism, extraversion, schizotypy and impulsivity), cognitive styles (low self-esteem and dysfunctional attitudes) and affective temperaments (including cyclothymic and depressive temperaments) were compared between two groups of parous women with DSM-IV bipolar I disorder: i) 284 with a lifetime history of postpartum psychosis within 6 weeks of delivery (PP group), ii) 268 without any history of mood episodes with onset during pregnancy or within 6 months of delivery (no perinatal mood episode, No PME group). Results: After controlling for current mood state, and key demographic, clinical and pregnancy-related variables, there were no statistically significant differences between the PP and No PME groups on any of the personality, cognitive style or affective temperament measures. Conclusions: Personality traits, cognitive styles and affective temperaments previously shown to be associated with bipolar disorder in general were not specifically associated with the occurrence of postpartum psychosis. These factors may not be relevant for predicting risk of postpartum psychosis in women with bipolar disorder

Transport of Snow by the Wind: A Comparison Between Observations in Adélie Land, Antarctica, and Simulations Made with the Regional Climate Model MAR

For the first time a simulation of blowing snow events was validated in detail using one-month long observations (January 2010) made in Adélie Land, Antarctica. A regional climate model featuring a coupled atmosphere/blowing snow/snowpack model is forced laterally by meteorological re-analyses. The vertical grid spacing was 2 m from 2 to 20 m above the surface and the horizontal grid spacing was 5 km. The simulation was validated by comparing the occurrence of blowing snow events and other meteorological parameters at two automatic weather stations. The Nash test allowed us to compute effi- ciencies of the simulation. The regional climate model simulated the observed wind speed with a positive efficiency (0.69). Wind speeds higher than 12 m s−1 were underestimated. Positive efficiency of the simulated wind speed was a prerequisite for validating the blowing snow model. Temperatures were simulated with a slightly negative efficiency (−0.16) due to overestimation of the amplitude of the diurnal cycle during one week, probably because the cloud cover was underestimated at that location during the period concerned. Snowfall events were correctly simulated by our model, as confirmed by field reports. Because observations suggested that our instrument (an acoustic sounder) tends to overestimate the blowing snow flux, data were not sufficiently accurate to allow the complete validation of snow drift val- ues. However, the simulation of blowing snow occurrence was in good agreement with the observations made during the first 20 days of January 2010, despite the fact that the blowing snow flux may be underestimated by the regional climate model during pure blowing snow events. We found that blowing snow occurs in Adélie Land only when the 30-min wind speed value at 2 m a.g.l. is >10 m s−1. The validation for the last 10 days of January 2010 was less satisfactory because of complications introduced by surface melting and refreezing