Physical activity and prevalence and incidence of mental disorders in adolescents and young adults

ABSTRACT Background Although positive effects of physical activity on mental health indicators have been reported, the relationship between physical activity and the development of specific mental disorders is unclear. Method A cross-sectional (12-month) and prospective-longitudinal epidemiological study over 4 years in a community cohort of 2548 individuals, aged 14-24 years at outset of the study. Physical activity and mental disorders were assessed by the DSM-IV Composite International Diagnostic Interview (CIDI) with an embedded physical activity module. Multiple logistic regression analyses controlling for age, gender and educational status were used to determine the cross-sectional and prospective associations of mental disorders and physical activity. Results Cross-sectionally, regular physical activity was associated with a decreased prevalence of any and co-morbid mental disorder, due to lower rates of substance use disorders, anxiety disorders and dysthymia. Prospectively, subjects with regular physical activity had a substantially lower overall incidence of any and co-morbid mental disorder, and also a lower incidence of anxiety, somatoform and dysthymic disorder. By contrast, the incidence of bipolar disorder was increased among those with regular physical activity at baseline. In terms of the population attributable fraction (PAF), the potential for preventive effects of physical activity was considerably higher for men than for women. Conclusions Regular physical activity is associated with a substantially reduced risk for some, but not all, mental disorders and also seems to reduce the degree of co-morbidity. Further examination of the evidently complex mechanisms and pathways underlying these associations might reveal promising new research targets and procedures for targeted preventio

Behandlung komorbider Störungen, Syndrome und Symptome der Posttraumatischen Belastungsstörung nach Missbrauchserfahrungen in der Kindheit mit STAIR-NT. Klinische Empfehlungen und Herausforderungen

Background: Early interpersonal traumatic events, such as childhood maltreatment, increase the risk of developing complex posttraumatic stress symptoms. The biphasic treatment program STAIR-NT (Skills Training for Affective and Interpersonal Regulation with Narrative Therapy), developed specifically for this patient group, combines interventions to improve emotion regulation and interpersonal skills with narrative therapy. Objective: Many affected patients with PTSD after childhood maltreatment also suffer from various comorbid mental disorders and symptoms that can affect and impede the course and outcome of treatment with STAIR-NT. Method: Based on experience from a current treatment study, we provide recommendations for integrating treatment of comorbid mental symptoms into STAIR-NT. Results / Conclusion: Training affective and interpersonal regulation skills in the first treatment phase offers various interventions to efficiently adapt transdiagnostic mechanisms such as emotion dysregulation. In cases of severe comorbid mental disorders or symptoms, adding disorder-specific interventions to STAIR-NT may be indicated.Hintergrund: Frühe interpersonelle traumatische Erfahrungen, wie Misshandlung und Missbrauch in Kindheit und Jugend, erhöhen das Risiko eine komplexe posttraumatische Belastungssymptomatik zu entwickeln. Das zwei-phasische Therapieprogramm STAIR-NT (Skillstraining zur affektiven und interpersonellen Regulation mit narrativer Therapie), das speziell für diese Gruppe von Patient_innen entwickelte wurde, kombiniert Interventionen zur Verbesserung der Emotionsregulation und der interpersonellen Fähigkeiten mit einer narrativen Therapie. Fragestellung: Viele der Betroffenen mit einer PTBS nach Misshandlung und Missbrauch in der Kindheit leiden unter einer Vielzahl komorbider psychischer Symptome, die den Verlauf und das Ergebnis der Behandlung mit STAIR-NT beeinflussen und behindern können. Methode: Basierend auf den Erfahrungen aus einer aktuellen Therapiestudie werden hier Empfehlungen für die Integration der Behandlung komorbider psychischer Symptomatik in STAIR-NT gegeben. Ergebnis / Schlussfolgerung: Vor allem das Training affektiver und interpersoneller Regulationsfähigkeiten in der ersten Therapiephase bietet vielfältige Interventionen zur Veränderung störungsübergreifender Mechanismen wie Emotionsdysregulation. Bei besonders schwerwiegender komorbider Symptomatik kann die zusätzliche Anwendung von störungsspezifischen Interventionen zur STAIR-NT indiziert sein

National registry for patients with inflammatory rheumatic diseases (IRD) infected with SARS-CoV-2 in Germany (ReCoVery): a valuable mean to gain rapid and reliable knowledge of the clinical course of SARS-CoV-2 infections in patients with IRD

Objectives: Patients with inflammatory rheumatic diseases (IRD) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be at risk to develop a severe course of COVID-19. The influence of immunomodulating drugs on the course of COVID-19 is unknown. To gather knowledge about SARS-CoV-2 infections in patients with IRD, we established a registry shortly after the beginning of the pandemic in Germany. Methods Using an online questionnaire (www.COVID19-rheuma.de.), a nationwide database was launched on 30 March 2020, with appropriate ethical and data protection approval to collect data of patients with IRD infected with SARS-CoV-2. In this registry, key clinical and epidemiological parameters-for example, diagnosis of IRD, antirheumatic therapies, comorbidities and course of the infection-are documented. Results Until 25 April 2020, data from 104 patients with IRD infected with SARS-CoV-2 were reported (40 males;63 females;1 diverse). Most of them (45%) were diagnosed with rheumatoid arthritis, 59% had one or more comorbidities and 42% were treated with biological disease-modifying antirheumatic drugs. Hospitalisation was reported in 32% of the patients. Two-thirds of the patients already recovered. Unfortunately, 6 patients had a fatal course. Conclusions: In a short time, a national registry for SARS-CoV2-infected patients with IRD was established. Within 4 weeks, 104 cases were documented. The registry enables to generate data rapidly in this emerging situation and to gain a better understanding of the course of SARS-CoV2-infection in patients with IRD, with a distinct focus on their immunomodulatory therapies. This knowledge is valuable for timely information of physicians and patients with IRD, and shall also serve for the development of guidance for the management of patients with IRD during this pandemic

Cyclosporine-A-induced nephrotoxicity in children with minimal-change nephrotic syndrome: long-term treatment up to 10 years

The impact of cyclosporine A (CsA) therapy in patients with steroid-dependent nephrotic-syndrome (SDNS) on long-term renal function is controversial. Data beyond 5 years are rare. Long-term renal function was evaluated in children with SDNS with and without CsA therapy, especially beyond 5 years. Twenty children were treated with CsA (study group) for a mean of 5.4 ± 2.2 years (ten patients for 5–11 years). Glomerular filtration rate (GFR) was calculated before and after 3 and 12 months and at latest follow-up of therapy. Fifteen children with cyclophosphamide-treated SDNS without CsA served as controls. In the study group, GFR decreased within 12 months from 136 ± 19 to 120 ± 31, to 114 ± 14 ml/min per 1.73 m2 at latest follow-up (p < 0.0001). Patients with CsA > 5 years had a GFR of 111 ± 14 ml/min per 1.73 m2 at latest follow-up without a GFR below 90 ml/min per 1.73 m2. No CsA toxicity was found in biopsies. In the control group, GFR dropped within 3 months, from 137 ± 27 to 130 ± 24, to 126 ± 19 ml/min per 1.73 m2 at latest follow-up (p = 0.1). Patients with and without nephrotoxic CsA therapy showed a drop in GFR. In CsA-treated patients, GFR was about 12% lower at latest follow-up compared with patients without nephrotoxic therapy but always remained within normal range. CsA seems to be safe, even in long-term treatment for more than 5 years

Expanding the clinical spectrum associated with defects in CNTNAP2 and NRXN1

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background Heterozygous copy-number and missense variants in CNTNAP2 and NRXN1 have repeatedly been associated with a wide spectrum of neuropsychiatric disorders such as developmental language and autism spectrum disorders, epilepsy and schizophrenia. Recently, homozygous or compound heterozygous defects in either gene were reported as causative for severe intellectual disability. Methods 99 patients with severe intellectual disability and resemblance to Pitt-Hopkins syndrome and/or suspected recessive inheritance were screened for mutations in CNTNAP2 and NRXN1. Molecular karyotyping was performed in 45 patients. In 8 further patients with variable intellectual disability and heterozygous deletions in either CNTNAP2 or NRXN1, the remaining allele was sequenced. Results By molecular karyotyping and mutational screening of CNTNAP2 and NRXN1 in a group of severely intellectually disabled patients we identified a heterozygous deletion in NRXN1 in one patient and heterozygous splice-site, frameshift and stop mutations in CNTNAP2 in four patients, respectively. Neither in these patients nor in eight further patients with heterozygous deletions within NRXN1 or CNTNAP2 we could identify a defect on the second allele. One deletion in NRXN1 and one deletion in CNTNAP2 occurred de novo, in another family the deletion was also identified in the mother who had learning difficulties, and in all other tested families one parent was shown to be healthy carrier of the respective deletion or mutation. Conclusions We report on patients with heterozygous defects in CNTNAP2 or NRXN1 associated with severe intellectual disability, which has only been reported for recessive defects before. These results expand the spectrum of phenotypic severity in patients with heterozygous defects in either gene. The large variability between severely affected patients and mildly affected or asymptomatic carrier parents might suggest the presence of a second hit, not necessarily located in the same gene.Peer Reviewe

Business travel and mobile workers

International audienceTransportation activity generated by businesses has been analyzed mainly with reference to freight flows and commuting trips. The area of employee business trips has been largely ignored, even though the literature – particularly that dealing with industrial economics – has endeavored to show both the central role played by face-to-face encounters in economic contact, and the decreased need for proximity as a prerequisite to such contact taking place in the first place. This paper takes this literature, both theoretical and empirical, as its base, and then aims to gain a more comprehensive understanding of the need for business travel and the profiles of mobile workers. It also investigates how the workers involved perceive, and how companies account for such mobility

Birth mode is associated with development of atopic dermatitis in infancy and early childhood

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Distribution and Abundance of MAAs in 33 Species of Microalgae across 13 Classes

We provide a direct comparison of the distribution and abundance of mycosporine-like amino acids (MAAs) in a diverse range of microalgal cultures (33 species across 13 classes) grown without supplementary ultraviolet radiation (UV). We compare the MAAs in cultures with those present in characterised natural phytoplankton populations from the English Channel. We detected 25 UV absorbing compounds including at least two with multiple absorption maxima. We used LC-MS to provide chemical characterisation of the six most commonly occurring MAAs, namely, palythene, palythine, mycosporine-glycine, palythenic acid, porphyra-334 and shinorine. MAAs were abundant (up to 7 pg MAA cell−1) in 10 species, with more minor and often unknown MAAs in a further 11 cultures. Shinorine was the most frequently occurring and abundant MAA (up to 6.5 pg cell−1) and was present in all but two of the MAA-containing species. The study provides further insight into the diversity and abundance of MAAs important from an ecological perspective and as potential source of natural alternatives to synthetic sunscreens