Change in incidence rates for psychosis in different ethnic groups in south London: findings from the Clinical Record Interactive Search-First Episode Psychosis (CRIS-FEP) study

Background: A higher incidence of psychotic disorders has been consistently reported among black and other minority ethnic groups, particularly in northern Europe. It is unclear whether these rates have changed over time. Methods: We identified all individuals with a first episode psychosis who presented to adult mental health services between 1 May 2010 and 30 April 2012 and who were resident in London boroughs of Lambeth and Southwark. We estimated age-and-gender standardised incidence rates overall and by ethnic group, then compared our findings to those reported in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses (ÆSOP) study that we carried out in the same catchment area around 10 years earlier. Results: From 9109 clinical records we identified 558 patients with first episode psychosis. Compared with ÆSOP, the overall incidence rates of psychotic disorder in southeast London have increased from 49.4 (95% confidence interval (CI) 43.6–55.3) to 63.1 (95% CI 57.3–69.0) per 100 000 person-years at risk. However, the overall incidence rate ratios (IRR) were reduced in some ethnic groups: for example, IRR (95% CI) for the black Caribbean group reduced from 6.7 (5.4–8.3) to 2.8 (2.1–3.6) and the ‘mixed’ group from 2.7 (1.8–4.2) to 1.4 (0.9–2.1). In the black African group, there was a negligible difference from 4.1 (3.2–5.3) to 3.5 (2.8–4.5). Conclusions: We found that incidence rates of psychosis have increased over time, and the IRR varied by the ethnic group. Future studies are needed to investigate more changes over time and determinants of change

Identification of R-Spondin Gene Signature Predictive of Metastatic Progression in BRAFV600E-Positive Papillary Thyroid Cancer

Papillary thyroid carcinoma (PTC) is the most common malignancy of the thyroid gland and early stages are curable. However, a subset of PTCs shows an unusually aggressive phenotype with extensive lymph node metastasis and higher incidence of locoregional recurrence. In this study, we investigated a large cohort of PTC cases with an unusual aggressive phenotype using a high-throughput RNA sequencing (RNA-Seq) to identify differentially regulated genes associated with metastatic PTC. All metastatic PTC with mutated BRAF (V600E) but not BRAF wild-type expressed an up-regulation of R-Spondin Protein 4 (RSPO4) concomitant with an upregulation of genes involved in focal adhesion and cell-extracellular matrix signaling. Further immunohistochemistry validation confirmed the upregulation of these target genes in metastatic PTC cases. Preclinical studies using established PTC cell lines support that RSPO4 overexpression is associated with BRAF V600E mutation and is a critical upstream event that promote activation of kinases of focal adhesion signaling known to drive cancer cell locomotion and invasion. This finding opens up the potential of co-targeting B-Raf, RSPO and focal adhesion proteins as a pharmacological approach for aggressive BRAF V600E PTC

Compulsory admission at first presentation to services for psychosis: does ethnicity still matter? Findings from two population-based studies of first episode psychosis

Objectives Compared with the majority population, those from minority ethnic groups in the UK are more likely to be admitted compulsorily during a first episode of psychosis (FEP). We investigated whether these disparities in pathways in to care continue. Methods We analysed data from two first episode psychosis studies, conducted in the same geographical area in south London 15 years apart: the Aetiology and Ethnicity in Schizophrenia and Other Psychosis (AESOP) and the Clinical Record Interactive Search-First Episode Psychosis (CRIS-FEP) studies. The inclusion/exclusion criteria for case ascertainment for first episode psychosis were identical across the two studies. We performed multivariable logistic regression to estimate odds of compulsory admission by ethnic group, controlling for confounders. Participants Two hundred sixty-six patients with first episode psychosis, aged 18–64 years, who presented to mental health services in south London in 1997–1999 and 446 with FEP who presented in 2010–2012. Results When the two samples were compared, ethnic differences in compulsory admission appear to have remained the same for black African patients, i.e. three times higher than white British in both samples: AESOP (adj. OR = 3.96; 95% CI = 1.80–8.71) vs. CRIS-FEP (adj. OR = 3.12; 95% CI = 1.52–6.35). Black Caribbean patients were three times more likely to be compulsorily admitted in AESOP (adj. OR = 3.20; 95% CI = 1.56–6.54). This was lower in the CRIS-FEP sample (adj. OR = 1.68; 95% CI = 0.71–3.98) and did not meet conventional levels for statistical significance. Conclusion Ethnicity is strongly associated with compulsory admissions at first presentation for psychosis with evidence of heterogeneity across groups, which deserves further research

Examining relationships between climate change and mental health in the Circumpolar North

Indigenous people living in the Circumpolar North rely, to varying degrees, on the natural environment and the resources it provides for their lifestyle and livelihoods. As a consequence, these Northern Indigenous peoples may be more sensitive to global climate change, which has implications for food security, cultural practices, and health and well-being. To date, most research on the human dimensions of climate change in the Circumpolar North has focused on biophysical issues and their consequences, such as changing sea ice regimes affecting travel to hunting grounds or the effects of melting permafrost on built infrastructure. Less is known about how these changes in the environment affect mental health and well-being. In this paper, we build upon existing research, combined with our community-based research and professional mental health practices, to outline some pathways and mechanisms through which climate change may adversely impact mental health and well-being in the Circumpolar North. Our analysis indicates that mental health may be affected by climate change due to changes to land, ice, snow, weather, and sense of place; impacts to physical health; damage to infrastructure; indirect impacts via media, research, and policy; and through the compounding of existing stress and distress. We argue that climate change is likely an emerging mental health challenge for Circumpolar Indigenous populations and efforts to respond through research, policy, and mental health programming should be a priority. We conclude by identifying next steps in research, outlining points for policy, and calling for additional mental health resources that are locally responsive and culturally relevant

Immigration, Social Environment and Onset of Psychotic Disorders

The recent decade has been characterized by a resurging interest for socio-environmental determinants of psychotic disorders, largely as a result of findings from studies of migration and psychotic disorders. This contribution reviews recent meta-analytic findings which confirm higher incidence rates of schizophrenia and related disorders among first- and second-generation immigrants than in nonimmigrant populations, as well as substantial risk variation according to both ethnic minority groups and host society contexts. The relevance of social contexts in the onset of psychosis is also suggested by incidence variation according to the neighbourhood level ethnic density. While limited, an emerging literature suggests potential variations in psychotic-like experiences and at-risk mental states according to ethnic minority status. We then discuss the meaning of findings from migrant studies, as well as integrative models that attempt to account for ethnic variations in the incidence of psychosis and psychotic-like phenomena. In conclusion, there remain numerous gaps in our understanding of the relation between migration, ethnicity, social contexts and the onset of psychosis and we propose future research avenues to address these. In particular, there is a need for multilevel approaches integrating disciplines and methodologies across the psychosis continuum. © 2012 Bentham Science Publishers

Match/mismatch between the Mytilus edulis larval supply and seston quality: effect on recruitment

International audienceWe considered Cushing's match/mismatch theory in a heterotrophic environment and hypothesized that settlement and recruitment success in blue mussel are higher when the food supply is rich in polyunsaturated and essential fatty acids (PUFA/EFA). To test this hypothesis, we monitored larval development as well as fatty acid composition in trophic resources during two successive reproductive seasons. The decoupling we found between the presence of competent larvae in the water column and settlement rates strongly suggests that metamorphosis is delayed until conditions are suitable. In both years, the major mussel settlement peak was synchronized with a phytoplanktonic pulse rich in EFA, consisting of a large autotrophic bloom in 2007 and a short but substantial peak of picoeukaryotes in 2008. These results suggest a "trophic settlement trigger'' that indirectly affects recruitment by strongly improving the settlement rate. Despite similar larval settlement rates during both years, the lower 2007 recruitment likely resulted from a mismatch with a high lipid-quality trophic resource. The seasonal trophic conditions differed greatly between the two years, with fatty acids profiles reflecting heterotrophic plankton production in 2007 and mostly autotrophic production in 2008. In agreement with Cushing's theory, our results highlight a match/mismatch, related to the food lipid quality rather than food quantity. For the first time, we show that the recruitment in marine bivalves may be dependent on phytoplanktonic pulses characterized by high levels of PUFA