Stigma and Discrimination in People Suffering with a Mood Disorder: A Cross-Sectional Study

Background. Much research is done on the stigma of mental illness, but little research has been done to characterize these phenomena from the perspective of people with mood disorders. Objective. To characterize the extent to which individuals with bipolar disorder and depression are stigmatized, determine factors related to higher levels of stigmatization, and assess the reliability of the Inventory of Stigmatizing Experiences in a population of people with a mood disorder. Methods. Two hundred and fourteen individuals with depression and bipolar disorder were recruited from a tertiary care psychiatric hospital and surveyed using the Inventory of Stigmatizing Experiences. Results. Participants reported high levels of stigma experiences and this did not differ by diagnosis (P = 0.578). However, people with bipolar disorder reported greater psychosocial impact of stigma on themselves and their family members compared to people with depression (P = 0.019). The two subscales produced internally consistent results with both populations. Conclusion. Stigma negatively affects those with both depression and bipolar disorder but appears to have a greater psychosocial impact on those with bipolar disorder

Stigma and Discrimination in People Suffering with a Mood Disorder: A Cross-Sectional Study

Background. Much research is done on the stigma of mental illness, but little research has been done to characterize these phenomena from the perspective of people with mood disorders. Objective. To characterize the extent to which individuals with bipolar disorder and depression are stigmatized, determine factors related to higher levels of stigmatization, and assess the reliability of the Inventory of Stigmatizing Experiences in a population of people with a mood disorder. Methods. Two hundred and fourteen individuals with depression and bipolar disorder were recruited from a tertiary care psychiatric hospital and surveyed using the Inventory of Stigmatizing Experiences. Results. Participants reported high levels of stigma experiences and this did not differ by diagnosis (P = 0.578). However, people with bipolar disorder reported greater psychosocial impact of stigma on themselves and their family members compared to people with depression (P = 0.019). The two subscales produced internally consistent results with both populations. Conclusion. Stigma negatively affects those with both depression and bipolar disorder but appears to have a greater psychosocial impact on those with bipolar disorder

Longitudinal changes in respiratory and upper limb function in a pediatric type III spinal muscular atrophy cohort after loss of ambulation

Introduction/Aims: Spinal muscular atrophy (SMA) type III is a relatively mild form of SMA. Few studies have investigated the changes in both respiratory and upper limb function within this population after loss of ambulation. The aim of this study was to assess change in percentage of predicted forced vital capacity (FVC% predicted) and change in the Revised Upper Limb Module (RULM) score in these patients throughout a 24-month period after loss of ambulation. Effect of scoliosis and its surgical correction, disease duration since loss of ambulation, weight, and height were also investigated. / Methods: Retrospective analyses were performed on 24 nonambulant SMA III patients from data collected at two centers in the United Kingdom. / Results: The FVC% predicted score showed a significant progressive deterioration of 17% over the 24-month period. Respiratory deterioration correlated significantly with age, weight, disease duration since loss of ambulation, and spinal correctional surgery. Longitudinal RULM data were available for 16 patients; a significant deterioration was observed with a mean decrease in score of 3 over 24 months. Age correlated negatively with RULM score, as did height and time since loss of ambulation. A significant positive correlation between FVC% predicted and RULM was demonstrated. / Discussion: This study highlights how SMA type III patients have progressive deterioration of respiratory and upper limb function after loss of ambulation. Combining data from these assessments could provide insight into clinical progression, inform clinical trials, and provide assistance in managing disease progression expectations for patients

DEAR project: Lunar dust surface interactions, risk and removal investigations

The DEAR project (Dusty Environment Application Research) investigates the interaction between lunar regolith and surfaces and components relevant for lunar exploration. Based on the TUBS regolith simulant which is representative in chemistry, size and shape properties to Moon soils to study the regolith transport, adhesion and strategies for cleaning. The regolith simulant will be applied to thermal, structural, optical sensor, sealing and other astronautic systems, providing input for requirements, justification and verification. The key applications are split in human space flight regolith investigations, wrinkled surface with random movement and hardware surfaces, flat material defined movement. The paper provides an overview of the DEAR project including a discussion of the first results, in particular vibration, shock and micro-vibration on regolith bearing surfaces. The investigation shall enable better understand the regolith layers interaction and the release mechanism, as well as potential cross contamination and cleaning strategies. The research is complemented by simulation of the regolith motion as parameter surface plasma interactions. The project is funded and supported by the European Space Agency (ESA). DEAR specifically addresses the development and testing of lunar dust removal strategies on optics, mechanisms and human space flight hardware (e.g., space suits). As the Moons regolith is known to be highly abrasive, electrically chargeable, and potentially chemically reactive, lunar dust might reduce the performance of hardware, such as cameras, thermal control surfaces and solar cells. The dust can cause malfunction on seals for on/off mechanisms or space suits. Of particular interest are risk assessment, avoidance, and cleaning techniques such as the use of electric fields to remove lunar dust from surfaces. Representative dust (e.g., regolith analogues of interesting landing sites) will be used in a dedicated test setup to evaluate risks and effects of lunar dust. We describe designs and methods developed by the DEAR consortium to deal with the regolith-related issues, in particular an electrode design to deflect regolith particles, cleaning of astronautical systems with CO2, design of a robotic arm for the testing within the DEAR chamber, regolith removal via shock, and regolith interaction with cleanroom textile

Optimal duration of risperidone or olanzapine adjunctive therapy to mood stabilizer following remission of a manic episode: A CANMAT randomized double-blind trial

Atypical antipsychotic adjunctive therapy to lithium or valproate is effective in treating acute mania. Although continuation of atypical antipsychotic adjunctive therapy after mania remission reduces relapse of mood episodes, the optimal duration is unknown. As many atypical antipsychotics cause weight gain and metabolic syndrome, they should not be continued unless the benefits outweigh the risks. This 52-week double-blind placebo-controlled trial recruited patients with bipolar I disorder (n=159) who recently remitted from a manic episode during treatment with risperidone or olanzapine adjunctive therapy to lithium or valproate. Patients were randomized to one of three conditions: discontinuation of risperidone or olanzapine and substitution with placebo at (i) entry (\u270-weeks\u27 group) or (ii) at 24 weeks after entry (\u2724-weeks\u27 group) or (iii) continuation of risperidone or olanzapine for the full duration of the study (\u2752-weeks\u27 group). The primary outcome measure was time to relapse of any mood episode. Compared with the 0-weeks group, the time to any mood episode was significantly longer in the 24-weeks group (hazard ratio (HR) 0.53; 95% confidence interval (CI): 0.33, 0.86) and nearly so in the 52-weeks group (HR: 0.63; 95% CI: 0.39, 1.02). The relapse rate was similar in the 52-weeks group compared with the 24-weeks group (HR: 1.18; 95% CI: 0.71, 1.99); however, sub-group analysis showed discordant results between the two antipsychotics (HR: 0.48, 95% CI: 0.17; 1.32 olanzapine patients; HR: 1.85, 95% CI: 1.00, 3.41 risperidone patients). Average weight gain was 3.2 kg in the 52-weeks group compared with a weight loss of 0.2 kg in the 0-weeks and 0.1 kg in the 24-weeks groups. These findings suggest that risperidone or olanzapine adjunctive therapy for 24 weeks is beneficial but continuation of risperidone beyond this period does not reduce the risk of relapse. Whether continuation of olanzapine beyond this period reduces relapse risk remains unclear but the potential benefit needs to be weighed against an increased risk of weight gain

Hematopoietic IKBKE limits the chronicity of inflammasome priming and metaflammation

Obesity increases the risk of developing life-threatening metabolic diseases including cardiovascular disease, fatty liver disease, diabetes, and cancer. Efforts to curb the global obesity epidemic and its impact have proven unsuccessful in part by a limited understanding of these chronic progressive diseases. It is clear that low-grade chronic inflammation, or metaflammation, underlies the pathogenesis of obesity-associated type 2 diabetes and atherosclerosis. However, the mechanisms that maintain chronicity and prevent inflammatory resolution are poorly understood. Here, we show that inhibitor of κB kinase epsilon (IKBKE) is a novel regulator that limits chronic inflammation during metabolic disease and atherosclerosis. The pathogenic relevance of IKBKE was indicated by the colocalization with macrophages in human and murine tissues and in atherosclerotic plaques. Genetic ablation of IKBKE resulted in enhanced and prolonged priming of the NLRP3 inflammasome in cultured macrophages, in hypertrophic adipose tissue, and in livers of hypercholesterolemic mice. This altered profile associated with enhanced acute phase response, deregulated cholesterol metabolism, and steatoheptatitis. Restoring IKBKE only in hematopoietic cells was sufficient to reverse elevated inflammasome priming and these metabolic features. In advanced atherosclerotic plaques, loss of IKBKE and hematopoietic cell restoration altered plaque composition. These studies reveal a new role for hematopoietic IKBKE: to limit inflammasome priming and metaflammation

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: Update 2013

The Canadian Network for Mood and Anxiety Treatments published guidelines for the management of bipolar disorder in 2005, with updates in 2007 and 2009. This third update, in conjunction with the International Society for Bipolar Disorders, reviews new evidence and is designed to be used in conjunction with the previous publications.The recommendations for the management of acute mania remain largely unchanged. Lithium, valproate, and several atypical antipsychotic agents continue to be first-line treatments for acute mania. Monotherapy with asenapine, paliperidone extended release (ER), and divalproex ER, as well as adjunctive asenapine, have been added as first-line options.For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, as well as olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first-line options. Lurasidone monotherapy and the combination of lurasidone or lamotrigine plus lithium or divalproex have been added as a second-line options. Ziprasidone alone or as adjunctive therapy, and adjunctive levetiracetam have been added as not-recommended options for the treatment of bipolar depression. Lithium, lamotrigine, valproate, olanzapine, quetiapine, aripiprazole, risperidone long-acting injection, and adjunctive ziprasidone continue to be first-line options for maintenance treatment of bipolar disorder. Asenapine alone or as adjunctive therapy have been added as third-line options. © 2012 John Wiley and Sons A/S