Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions

CONTEXT: The physical health consequences of childhood psychosocial adversities may be as substantial as the mental health consequences, but whether this is the case remains unclear because much prior research has involved unrepresentative samples and a selective focus on particular adversities or physical outcomes. The association between early-onset mental disorders and subsequent poor physical health in adulthood has not been investigated. OBJECTIVE: To investigate whether childhood adversities and early-onset mental disorders are independently associated with increased risk of a range of adult-onset chronic physical conditions in culturally diverse samples spanning the full adult age range. DESIGN: Cross-sectional community surveys of adults in 10 countries. SETTING: General population. PARTICIPANTS: Adults (ie, aged ≥18 years; N = 18 303), with diagnostic assessment and determination of age at onset of DSM-IV mental disorders, assessment of childhood familial adversities, and age of diagnosis or onset of chronic physical conditions. MAIN OUTCOME MEASURES: Risk (ie, hazard ratios) of adult-onset (ie, at age >20 years) heart disease, asthma, diabetes mellitus, arthritis, chronic spinal pain, and chronic headache as a function of specific childhood adversities and early-onset (ie, at age <21 years) DSM-IV depressive and anxiety disorders, with mutual adjustment. RESULTS: A history of 3 or more childhood adversities was independently associated with onset of all 6 physical conditions (hazard ratios, 1.44 to 2.19). Controlling for current mental disorder made little difference to these associations. Early-onset mental disorders were independently associated with onset of 5 physical conditions (hazard ratios, 1.43 to 1.66). CONCLUSIONS: These results are consistent with the hypothesis that childhood adversities and early-onset mental disorders have independent, broad-spectrum effects that increase the risk of diverse chronic physical conditions in later life. They require confirmation in a prospectively designed study. The long course of these associations has theoretical and research implications

Cross-national epidemiology of DSM-IV major depressive episode

Background: Major depression is one of the leading causes of disability worldwide, yet epidemiologic data are not available for many countries, particularly low- to middle-income countries. In this paper, we present data on the prevalence, impairment and demographic correlates of depression from 18 high and low-to middle-income countries in the World Mental Health Survey Initiative. Methods: Major depressive episodes (MDE) as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DMS-IV) were evaluated in face-to-face interviews using the World Health Organization Composite International Diagnostic Interview (CIDI). Data from 18 countries were analyzed in this report (n = 89,037). All countries surveyed representative, population-based samples of adults. Results: The average lifetime and 12-month prevalence estimates of DSM-IV MDE were 14.6% and 5.5% in the ten high-income and 11.1% and 5.9% in the eight low- to middle-income countries. The average age of onset ascertained retrospectively was 25.7 in the high-income and 24.0 in low- to middle-income countries. Functional impairment was associated with recency of MDE. The female: male ratio was about 2: 1. In high-income countries, younger age was associated with higher 12-month prevalence; by contrast, in several low-to middle-income countries, older age was associated with greater likelihood of MDE. The strongest demographic correlate in high-income countries was being separated from a partner, and in low- to middle-income countries, was being divorced or widowed. Conclusions: MDE is a significant public-health concern across all regions of the world and is strongly linked to social conditions. Future research is needed to investigate the combination of demographic risk factors that are most strongly associated with MDE in the specific countries included in the WMH.(NIH/NIMH) United States National Institute of Mental Health[R01MH070884]John D. and Catherine T. MacArthur FoundationPfizer FoundationUSA Public Health Service[R13-MH066849]USA Public Health Service[R01-MH069864]USA Public Health Service[R01 DA016558](NIH) Fogarty International Center[FIRCA R03-TW006481]PAHO Pan American Health OrganizationEli Lilly & Company FoundationOrtho-McNeil Pharmaceutical, Inc.GlaxoSmithKlineSanofi-AventisBristol-Myers SquibbState of Brazil Research Foundation (FAPESP)[03/00204-3]Ministry of Social ProtectionEuropean Commission[QLG5-1999-01042]European Commission[SANCO 2004123]Piedmont Region (Italy)Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Spain[FIS 00/0028]Spanish Ministerio de Ciencia y Tecnologia[SAF 2000-158-CE]Departament de Salut, Generalitat de Catalunya, SpainInstituto de Salud Carlos III[CIBER CB06/02/0046]Instituto de Salud Carlos III[RETICS RD06/0011 REM-TAP]Government of IndiaWHOMinistry of HealthIsrael National Institute for Health Policy and Health Services ResearchNational Insurance Institute of IsraelJapan Ministry of Health, Labour and Welfare[H13-Shogai-023]Japan Ministry of Health, Labour and Welfare[H14-Tokubetsu-026]Japan Ministry of Health, Labour and Welfare[H16-Kokoro-013]Lebanese Ministry of Public HealthWHO (Lebanon)(NIH) Fogarty International, anonymous private donations to IDRAAC, LebanonJanssen CilagEli LillyRocheNovartisNational Institute of Psychiatry Ramon de la Fuente[INPRFMDIES 4280]CNPq National Council on Science and Technology[CONACyT-G30544-H]PanAmerican Health Organization (PAHO)New Zealand Ministry of Health, Alcohol Advisory CouncilHealth Research Council(NIH/NIMH) USA National Institute of Mental Health[R01-MH059575](NIH/NIMH) USA National Institute of Mental Health[RO1-MH61905]National Institute of Drug AbuseSouth African Department of HealthUniversity of MichiganNational Institute of Mental Health (NIH/NIMH)[U01-MH60220]National Institute of Drug Abuse (NIDA)Substance Abuse and Mental Health Services Administration (SAMHSA)Robert Wood Johnson Foundation (RWJF)[044708]John W. Alden TrustsAnalysis Group Inc.Eli Lilly CompanyEPI-QJohnson & Johnson PharmaceuticalsOrtho-McNeil Janssen Scientific AffairsPfizer Inc.Shire USA, Inc

results from the World Mental Health Survey Initiative

Purpose: Understanding the effects of war on mental disorders is important for developing effective post-conflict recovery policies and programs. The current study uses cross-sectional, retrospectively reported data collected as part of the World Mental Health (WMH) Survey Initiative to examine the associations of being a civilian in a war zone/region of terror in World War II with a range of DSM-IV mental disorders. Methods: Adults (n = 3370) who lived in countries directly involved in World War II in Europe and Japan were administered structured diagnostic interviews of lifetime DSM-IV mental disorders. The associations of war-related traumas with subsequent disorder onset-persistence were assessed with discrete-time survival analysis (lifetime prevalence) and conditional logistic regression (12-month prevalence). Results: Respondents who were civilians in a war zone/region of terror had higher lifetime risks than other respondents of major depressive disorder (MDD; OR 1.5, 95% CI 1.1, 1.9) and anxiety disorder (OR 1.5, 95% CI 1.1, 2.0). The association of war exposure with MDD was strongest in the early years after the war, whereas the association with anxiety disorders increased over time. Among lifetime cases, war exposure was associated with lower past year risk of anxiety disorders (OR 0.4, 95% CI 0.2, 0.7). Conclusions: Exposure to war in World War II was associated with higher lifetime risk of some mental disorders. Whether comparable patterns will be found among civilians living through more recent wars remains to be seen, but should be recognized as a possibility by those projecting future needs for treatment of mental disorders.publishersversionpublishe

Résolution procédurale ou récupération en mémoire des additions et multiplications élémentaires chez les enfants ?

Summary : Procedural resolution or direct retrieval in memory of simple addition and multiplication in children ? The present experiment aimed at studying the resolution of simple additions and multiplications in fifth-graders. The operations were those including two digits (2 to 9), except ties. The task was operation verification. The results showed that the operands' size effect and the priming effect ofthe sign were greater for addition than for multiplication. The results suggested that multiplication is solved by a direct retrieval of the answer from memory, whereas addition is solved by an algorithmic strategy. These results replicate those found by Roussel, Fayol and Barrouillet (2001) in adults, and are discussed in the scope of the ACT-R model (Anderson, 1993). Finally, this study suggested that, except for an increase of speed, the nature of the strategies used to solve simple additions and multiplications does not change with development. Key words : cognitive arithmetic, strategies, cognitive development, size effect, priming effect, interference effect.Résumé Les stratégies de résolution des additions et des multiplications simples ont été étudiées chez des élèves de CM2 à l'aide d'une tâche de vérification d'équations. Les effets de la taille des opérandes et de la présentation anticipée du signe étaient plus importants pour l'addition que pour la multiplication. Ces opérations seraient résolues par des stratégies différentes : la multiplication par récupération directe du résultat en mémoire, l'addition par utilisation d'une procédure algorithmique. Ces résultats répliquent ceux observés chez l'adulte par Roussel, Fayol et Barrouillet (2001), et sont discutés dans le cadre du modèle ACT-R (Anderson, 1993). Cette étude suggère enfin que les stratégies de résolution s'accélèrent avec l'âge mais ne changent pas de nature. Mots-clés : arithmétique cognitive, stratégies, développement cognitif, effet de taille, effet d'amorçage, effet d'interférence.Lépine Raphaëlle, Roussel Jean-Pierre, Fayol Michel. Résolution procédurale ou récupération en mémoire des additions et multiplications élémentaires chez les enfants ?. In: L'année psychologique. 2003 vol. 103, n°1. pp. 51-80

Defining bipolar mood states with quantitative measurement of inhibition/activation and emotional reactivity.

International audienceThe MATHYS scale, providing a score for inhibition/activation process and a score for emotional reactivity, is clearly useful to distinguish bipolar depressive episodes without manic symptoms from those with manic symptoms. This last type of depression appears to belong to a broad spectrum of mixed state. To go further we need to explore if these two types of depression are underlined by different mechanisms and what is the most appropriate treatment for each of them

Stellar coronography : two mono-axial configurations for an Achromatic Interfero-Coronograph

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Relapsing-remitting behavioural variant of frontotemporal dementia in a bipolar patient

We report the case of a bipolar I patient who was diagnosed with frontotemporal dementia at the age of 54 during a manic episode. Her neurological state improved when this episode ended. Each subsequent thymic relapse was associated with cognitive deficits which subsided when the patient became euthymic, even though SPECT continued to show the same frontal hypoperfusion. We here discuss the hypothesis that the cognitive reserve of this patient, a former journalist, may, except during her mood episodes, have provided her with sufficient resources to meet her life demands despite her underlying neurological disorder