Bipolar disorder: Prevalence, help-seeking and use of mental health care in England. Findings from the 2014 Adult Psychiatric Morbidity Survey

Background: To date, the lifetime prevalence of Bipolar Disorder (BD) and BD patients’ access to mental health care in England has not been systematically studied. / Methods: We used data from the Adult Psychiatric Morbidity Survey 2014 (N = 7546). The Mood Disorders Questionnaire (MDQ) was used to screen for BD. Associations between sociodemographic and clinical variables and use of mental health services were investigated. Weighted regression modelling established factors associated with being in receipt of care for mental health problems over the last year. / Results: The lifetime prevalence of BD in the community in England was 1.7%. Approximately 40% had not received mental health care in the last year, and only 16.9% had received BD specific treatment. 14.6% had asked for a specific form of help but not received it. Psychopathology differed between individuals who successfully sought care and those who didn't. Obtaining care was independently associated with female sex (p<0.0001, odds ratio(OR):4.65 (Confidence Interval (CI):2.18–10.30), unemployment (p = 0.02, OR: 2.65 (C.I: 1.23–5.88) and suicidal ideation (p = 0.04, OR: 3.36, (C.I: 1.04–10.89). / Limitations: The MDQ is less sensitive than some of the longer measures, especially in the general population. Some between-group comparisons may have suffered from limited power. / Conclusions: The lifetime prevalence of BD in England was similar to rates worldwide. Most people with BD had not received any specific treatment for the condition in the last year, while 1 in 7 had requested specific help but did not receive it. Secondary mental health services in England for BD appear suboptimal

Mood as a mediator of the link between child sexual abuse and psychosis

The significance of affective changes in psychosis is increasingly acknowledged, as is the role of early traumatic events. In a previous paper, using data from the English Adult Psychiatric Morbidity Survey 2007 (APMS2007), strong associations between child sexual abuse (CSA) and psychosis were demonstrated, with some evidence of mediation by affect. In the current paper, we subjected the same dataset to formal tests of mediation. For CSA involving sexual intercourse, 38.5 % of the link was mediated, 30.0 % by depression and 8.5 % by anxiety. For all forms of contact abuse, 38.2 % was mediated, 29.1 % by depression and 9.1 % by anxiety

Mood instability : significance, definition and measurement

Mood instability is common, and an important feature of several psychiatric disorders. We discuss the definition and measurement of mood instability, and review its prevalence, characteristics, neurobiological correlates and clinical implications. We suggest that mood instability has underappreciated transdiagnostic potential as an investigational and therapeutic target

Can curriculum design influence medical students’ attitudes to psychiatry? A comparison of two different approaches

Medical students with poor attitudes toward psychiatry are unlikely to choose it as a career, and current psychiatry recruitment is inadequate for future NHS needs. Amending medical school curricula has been suggested as one solution. We performed a unique naturalistic mixed-methods cross-sectional survey of two sequential cohorts in a UK medical school, before and after the restructuring of the entire MBChB curriculum. As well as increasing integration with other specialties, the emphasis placed on psychiatry increased throughout the course, but the final psychiatry block reduced from 8 to 6 weeks. Students experiencing the refreshed curriculum had better attitudes to psychiatry and psychiatric patients and were more positive about psychiatry as a career for themselves and others, compared to students on the old curriculum. This was demonstrated both quantitatively using validated rating scales (12/30 questions ATP-30 and 1/6 questions PEAK-6) and qualitatively using free-text responses. Restructuring undergraduate medical curricula to enhance integration may yield added value, including the potential to improve attitudes to specialties previously learned in silos, such as psychiatry. This may improve recruitment and the understanding of mental health for all future doctors

The sleep phenotype of Borderline Personality Disorder : a systematic review and meta-analysis

Aim: To delineate the sleep profile of Borderline Personality Disorder (BPD). Method: A meta-analysis to synthesise findings on the objective and subjective sleep characteristics of BPD. Results: We identified 32 studies published between 1980 and December 2015. Meta-analysis indicated significant differences between BPD and healthy control groups across objective sleep continuity (sleep onset latency, total sleep time, sleep efficiency) and architecture (rapid eye movement latency/density, slow wave sleep) measures, and self-reported sleep problems (nightmares, sleep quality). Findings were independent of depression (in clinical and community populations), and concomitant psychotropic medication use. There were few significant differences between BPD and clinical (majority depressed) control groups. Conclusion: BPD is associated with comparable sleep disturbances to those observed in depression. These disturbances are not solely attributable to comorbid depression. Given growing evidence that sleep disturbance may exacerbate emotional dysregulation and suicide risk, treatments for BPD should explicitly address sleep problems. Future studies should utilise prospective designs to ascertain whether (and in which circumstances) sleep problems predate or follow the onset of the disorder

Web based software for the study of USDA soil taxonomy and classification of newly found soil

United States Department of Agriculture (USDA) Soil Taxonomy is based on soil properties that can be objectively observed and measured in the natural conditions as they exist today. There are many soil classification systems but USDA Soil Taxonomy is most accepted worldwide. Ontologies are the new form of knowledge representation that acts in synergy with agents and Semantic Web Architecture. Soil ontology developed for USDA soil taxonomy has been used to develop a query interface that will help in detailed study of soil taxonomy, classification of new soil as well as exchange knowledge between software agents and systems. This is a web based application having N-tier architecture. Application development environment is NetBeans 6.9 editor and Protégé. Web development technology is Java Server Pages (JSP). Programming languages JAVA and SPARQL are used for querying. Client interface is developed with Hyper Text Markup Language (HTML), Cascading Style Sheet (CSS) and JavaScript. Third tier of software consist of database which is in MS-SQL server 2005. Other two layers are Web Ontology Language (OWL) Ontology layer and Semantic Web Framework layer. OWL layer contains soil taxonomy information in the form of Ontology. Semantic Web Framework layer is implemented using JENA. In the search panel user can search anything related to USDA Soil Taxonomy, which comprises of twelve orders. However, this software contains information about seven soil orders reported in India. Domain experts can see and edit the knowledge base (i.e. Soil Ontology) or can suggest anything related to the creation of Soil Taxonomy Ontology through WebProtégé

Prevalence of psychosis in black ethnic minorities in Britain: analysis based on three national surveys

Purpose A considerable excess of psychosis in black ethnic minorities is apparent from clinical studies, in Britain, as in other developed economies with white majority populations. This excess is not so marked in population surveys. Equitable health service provision should be informed by the best estimates of the excess. We used national survey data to establish the difference in the prevalence of psychosis between black ethnic groups and the white majority in the British general population. Methods Analysis of the combined datasets (N = 26,091) from the British national mental health surveys of 1993, 2000 and 2007. Cases of psychosis were determined either by the use of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), or from a combination of screening items. We controlled for sex, age, social class, unemployment, design features and other putative confounders, using a Disease Risk Score. Results People from black ethnic minorities had an excess prevalence rate of psychosis compared with the white majority population. The OR, weighted for study design and response rate, was 2.72 (95 % CI 1.3–5.6, p = 0.002). This was marginally increased after controlling for potential confounders (OR = 2.90, 95 % CI 1.4–6.2, p = 0.006). Conclusions The excess of psychosis in black ethnic minority groups was similar to that in two previous British community surveys, and less than that based on clinical studies. Even so it confirms a considerable need for increased mental health service resources in areas with high proportions of black ethnic minority inhabitants