Is the association of alcohol use disorders with major depressive disorder a consequence of undiagnosed bipolar-II disorder?

Background: There is emerging evidence that there is a spectrum of expression of bipolar disorder. This paper uses the well-established patterns of comorbidity of mood and alcohol use disorder to test the hypothesis that application of an expanded concept of bipolar-II (BP-II) disorder might largely explain the association of alcohol use disorders (AUD) with major depressive disorder (MDD). Method: Data from the Zurich study, a community cohort assessed over 6 waves from ages 20/21 to 40/41, were used to investigate the comorbidity between mood disorders and AUD. Systematic diagnostic criteria were used for alcohol abuse, alcohol dependence, MDD, and BP-II. In addition to DSM criteria, two increasingly broad definitions of BP-II were employed. Results: There was substantially greater comorbidity for the BP-II compared to major depression and for alcohol dependence compared to alcohol abuse. The broadest concept of BP-II explained two thirds of all cases of comorbidity of AUD with major depressive episodes (MDE). In fact, the broader the definition of BP-II applied, the smaller was the association of AUD with MDD, up to non-significance. In the majority of cases, the onset of bipolar manifestations preceded that of drinking problems by at least 5 years. Conclusions: The findings that the comorbidity of mood disorders with AUD was primarily attributable to BP-II rather than MDD and that bipolar symptoms usually preceded alcohol problems may encourage new approaches to prevention and treatment of AU

Flight Operations Analysis Tool

Flight Operations Analysis Tool (FLOAT) is a computer program that partly automates the process of assessing the benefits of planning spacecraft missions to incorporate various combinations of launch vehicles and payloads. Designed primarily for use by an experienced systems engineer, FLOAT makes it possible to perform a preliminary analysis of trade-offs and costs of a proposed mission in days, whereas previously, such an analysis typically lasted months. FLOAT surveys a variety of prior missions by querying data from authoritative NASA sources pertaining to 20 to 30 mission and interface parameters that define space missions. FLOAT provides automated, flexible means for comparing the parameters to determine compatibility or the lack thereof among payloads, spacecraft, and launch vehicles, and for displaying the results of such comparisons. Sparseness, typical of the data available for analysis, does not confound this software. FLOAT effects an iterative process that identifies modifications of parameters that could render compatible an otherwise incompatible mission set

Chronic fatigue and its psychiatric comorbidity in two minority populations.

Chronic fatigue and its psychiatric comorbidity in two minority populations

Spirituality and attempted suicide among American Indians

American Indians exhibit suicide-related behaviors at rates much higher than the general population. This study examines the relation of spirituality to the lifetime prevalence of attempted suicide in a probability sample of American Indians. Data were derived from a cross-sectional sample of 1456 American Indian tribal members (age range 15-57 yr) who were living on or near their Northern Plains reservations between 1997 and 1999. Data were collected by personal interviews. Commitment to Christianity was assessed using a measure of beliefs. Commitment to tribal cultural spirituality (or forms of spirituality deriving from traditions that predate European contact) was assessed using separate measures for beliefs and spiritual orientations. Results indicated that neither commitment to Christianity nor to cultural spirituality, as measured by beliefs, was significantly associated with suicide attempts (ptrend for Christianity=0.22 and ptrend for cultural SPIRITUALITY=0.85). Conversely, commitment to cultural spirituality, as measured by an index of spiritual orientations, was significantly associated with a reduction in attempted suicide (ptrend=0.01). Those with a high level of cultural spiritual orientation had a reduced prevalence of suicide compared with those with low level of cultural spiritual orientation. (OR=0.5, 95% CI=0.3, 0.9). This result persisted after simultaneous adjustment for age, gender, education, heavy alcohol use, substance abuse and psychological distress. These results are consistent with anecdotal reports suggesting the effectiveness of American Indian suicide-prevention programs emphasizing orientations related to cultural spirituality.USA Religion Spirituality Suicide American Indians Measurement