74 research outputs found
Testing the Paleolithic-human-warfare hypothesis of blood-injectiion phobia in the Balitmore ECA Follow-up Study-Towards a more etiologically-based conceptualization for DSM-V
Objective:
The
research
agenda
for
the
fifth
edition
of
the
Diagnostic
and
Statistical
Manual
of
Mental
Disorders
(DSM-V)
has
emphasized
the
need
for a
more
etiologically-based
classification
system,
especially
for
stress-induced
and
fear-circuitry
disorders.
Testable
hypotheses
based
on
threats
to
survival
during
particular
segments
of
the
human
era
of
evolutionary
adaptedness
(EEA)
may
be
useful
in
developing a
brain-evolution-based
classification
for
the
wide
spectrum
of
disorders
ranging
from
disorders
which
are
mostly
overconsolidationally
such
as
PTSD,
to
fear-circuitry
disorders
which
are
mostly
innate
such
as
specific
phobias.
The
recently
presented
Paleolithic-human-warfare
hypothesis
posits
that
blood–injection
phobia
can
be
traced
to a
“survival
(fitness)
enhancing”
trait,
which
evolved
in
some
females
of
reproductive-age
during
the
millennia
of
intergroup
warfare
in
the
Paleolithic
EEA.
The
study
presented
here
tests
the
key a
priori
prediction
of
this
hypothesis—that
current
blood–injection
phobia
will
have
higher
prevalence
in
reproductive-age
women
than
in
post-menopausal
women.
Method:
The
Diagnostic
Interview
Schedule
(version
III-R)
,
which
included a
section
on
blood
and
injection
phobia,
was
administered
to
1920
subjects
in
the
Baltimore
ECA
Follow-up
Study.
Results:
Data
on
BII
phobia
was
available
on
1724
subjects
(1078
women
and
646
males)
.
The
prevalence
of
current
blood–
injection
phobia
was
3.3%
in
women
aged
27–49
and
1.1%
in
women
over
age
50
(OR
3.05,
95%
CI
1.20–7.73)
.
[The
corresponding
figures
for
males
were
0.8%
and
0.7%
(OR
1.19,
95%
CI
0.20–7.14)]
.
Conclusions:
This
epidemiological
study
provides
one
source
of
support
for
the
Paleolithic-human-warfare
(Paleolithic-threat)
hypothesis
regarding
the
evolutionary
(distal)
etiology
of
bloodletting-related
phobia,
and
may
contribute
to a
more
brain-
evolution-based
re-conceptualization
and
classification
of
this
fear
circuitry-related
trait
for
the
DSM-V.
In
addition,
the
finding
reported
here
may
also
stimulate
new
research
directions
on
more
proximal
mechanisms
which
can
lead
to
the
development
of
evidence-based
psychopharmacological
preventive
interventions
for
this
common
and
sometimes
disabling
fear-circuitry
disorder
Prevalence and Comorbidity of Alcohol Dependence, Depression, and Anxiety Disorders in their Association with the Serotonin Transporter Gene
Introduction: Depression and anxiety disorders have been found to be highly comorbid in epidemiologic studies. Furthermore, the presence of the short allele of the serotonin transporter gene (5HTT) has been found to be associated with an increased prevalence of major depressive disorder (MDD), bipolar disorder, anxiety disorders, as well as personality disorders.
Aims: To examine the association of the 5HTT and the risk of prevalence and comorbidity for, Major Depressive Disorder, Bipolar Disorder, as well as several anxiety disorders in a sample of the Baltimore Epidemiologic Catchment Area Survey Follow-up Study.
Methods: We estimated lifetime prevalence and the risk of comorbidity for Major Depressive Disorder, Bipolar Disorder, Panic Disorder, Agoraphobia, Social Phobia, Obsessive Compulsive Disorder, Generalized Anxiety Disorder, Simple Phobia, Dysthymic Disorder. All subjects were evaluated by a psychiatrist using the Schedules for Clinical Assessment in Neuropsychiatry. In addition, we assessed the impact of the carrier status into the prevalence and comorbidity estimates of the aforementioned disorders.
Results: A significant association was found between an increased risk for the lifetime prevalence of Panic Disorder and the 5-HTT “s” polymorphism (OR (95% CI): 3.10 (1.33; 7.27). A higher risk for lifetime prevalence of Panic Disorder and the 5-HTT “s” polymorphism was found in women carriers as compared to men(OR (95% CI): 3.54 (1.41; 8.91)). Panic Disorder had significant comorbidities with Alcohol Dependence, Alcohol Abuse, MDD, Bipolar Disorder, Agoraphobia, Social Phobia, OCD, Simple Phobia and Adjustment Disorder. These associations were higher in women as compared to men carriers. Comorbidities for Simple Phobia were highly significant in males for most anxiety disorders and MDD.
Conclusions: There was a high prevalence of comorbidity amongst most of the anxiety disorders in this population. The effect of the 5HTT carrier status was only associated with an increment in the risk of having a Panic Disorder
The Delphi Delirium Management Algorithms. A practical tool for clinicians, the result of a modified Delphi expert consensus approach
Delirium is common in hospitalised patients, and there is currently no specific treatment. Identifying and treating underlying somatic causes of delirium is the first priority once delirium is diagnosed. Several international guidelines provide clinicians with an evidence-based approach to screening, diagnosis and symptomatic treatment. However, current guidelines do not offer a structured approach to identification of underlying causes. A panel of 37 internationally recognised delirium experts from diverse medical backgrounds worked together in a modified Delphi approach via an online platform. Consensus was reached after five voting rounds. The final product of this project is a set of three delirium management algorithms (the Delirium Delphi Algorithms), one for ward patients, one for patients after cardiac surgery and one for patients in the intensive care unit.</p
Five-Factor Model personality profiles of drug users
<p>Abstract</p> <p>Background</p> <p>Personality traits are considered risk factors for drug use, and, in turn, the psychoactive substances impact individuals' traits. Furthermore, there is increasing interest in developing treatment approaches that match an individual's personality profile. To advance our knowledge of the role of individual differences in drug use, the present study compares the personality profile of tobacco, marijuana, cocaine, and heroin users and non-users using the wide spectrum Five-Factor Model (FFM) of personality in a diverse community sample.</p> <p>Method</p> <p>Participants (<it>N </it>= 1,102; mean age = 57) were part of the Epidemiologic Catchment Area (ECA) program in Baltimore, MD, USA. The sample was drawn from a community with a wide range of socio-economic conditions. Personality traits were assessed with the Revised NEO Personality Inventory (NEO-PI-R), and psychoactive substance use was assessed with systematic interview.</p> <p>Results</p> <p>Compared to never smokers, current cigarette smokers score lower on Conscientiousness and higher on Neuroticism. Similar, but more extreme, is the profile of cocaine/heroin users, which score very high on Neuroticism, especially Vulnerability, and very low on Conscientiousness, particularly Competence, Achievement-Striving, and Deliberation. By contrast, marijuana users score high on Openness to Experience, average on Neuroticism, but low on Agreeableness and Conscientiousness.</p> <p>Conclusion</p> <p>In addition to confirming high levels of negative affect and impulsive traits, this study highlights the links between drug use and low Conscientiousness. These links provide insight into the etiology of drug use and have implications for public health interventions.</p
Recommended from our members
Genome-Wide Association Study in Obsessive-Compulsive Disorder: Results from the OCGAS
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive thoughts and urges and repetitive, intentional behaviors that cause significant distress and impair functioning. The OCD Collaborative Genetics Association Study (OCGAS) is comprised of comprehensively assessed OCD patients, with an early age of OCD onset. After application of a stringent quality control protocol, a total of 1 065 families (containing 1 406 patients with OCD), combined with population-based samples (resulting in a total sample of 5 061 individuals), were studied. An integrative analyses pipeline was utilized, involving association testing at SNP- and gene-levels (via a hybrid approach that allowed for combined analyses of the family- and population-based data). The smallest P-value was observed for a marker on chromosome 9 (near PTPRD, P=4.13×10−7). Pre-synaptic PTPRD promotes the differentiation of glutamatergic synapses and interacts with SLITRK3. Together, both proteins selectively regulate the development of inhibitory GABAergic synapses. Although no SNPs were identified as associated with OCD at genome-wide significance level, follow-up analyses of GWAS signals from a previously published OCD study identified significant enrichment (P=0.0176). Secondary analyses of high confidence interaction partners of DLGAP1 and GRIK2 (both showing evidence for association in our follow-up and the original GWAS study) revealed a trend of association (P=0.075) for a set of genes such as NEUROD6, SV2A, GRIA4, SLC1A2, and PTPRD. Analyses at the gene-level revealed association of IQCK and C16orf88 (both P<1×10−6, experiment-wide significant), as well as OFCC1 (P=6.29×10−5). The suggestive findings in this study await replication in larger samples
Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders
Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.Peer reviewe
Analysis of shared heritability in common disorders of the brain
ience, this issue p. eaap8757 Structured Abstract INTRODUCTION Brain disorders may exhibit shared symptoms and substantial epidemiological comorbidity, inciting debate about their etiologic overlap. However, detailed study of phenotypes with different ages of onset, severity, and presentation poses a considerable challenge. Recently developed heritability methods allow us to accurately measure correlation of genome-wide common variant risk between two phenotypes from pools of different individuals and assess how connected they, or at least their genetic risks, are on the genomic level. We used genome-wide association data for 265,218 patients and 784,643 control participants, as well as 17 phenotypes from a total of 1,191,588 individuals, to quantify the degree of overlap for genetic risk factors of 25 common brain disorders. RATIONALE Over the past century, the classification of brain disorders has evolved to reflect the medical and scientific communities' assessments of the presumed root causes of clinical phenomena such as behavioral change, loss of motor function, or alterations of consciousness. Directly observable phenomena (such as the presence of emboli, protein tangles, or unusual electrical activity patterns) generally define and separate neurological disorders from psychiatric disorders. Understanding the genetic underpinnings and categorical distinctions for brain disorders and related phenotypes may inform the search for their biological mechanisms. RESULTS Common variant risk for psychiatric disorders was shown to correlate significantly, especially among attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), and schizophrenia. By contrast, neurological disorders appear more distinct from one another and from the psychiatric disorders, except for migraine, which was significantly correlated to ADHD, MDD, and Tourette syndrome. We demonstrate that, in the general population, the personality trait neuroticism is significantly correlated with almost every psychiatric disorder and migraine. We also identify significant genetic sharing between disorders and early life cognitive measures (e.g., years of education and college attainment) in the general population, demonstrating positive correlation with several psychiatric disorders (e.g., anorexia nervosa and bipolar disorder) and negative correlation with several neurological phenotypes (e.g., Alzheimer's disease and ischemic stroke), even though the latter are considered to result from specific processes that occur later in life. Extensive simulations were also performed to inform how statistical power, diagnostic misclassification, and phenotypic heterogeneity influence genetic correlations. CONCLUSION The high degree of genetic correlation among many of the psychiatric disorders adds further evidence that their current clinical boundaries do not reflect distinct underlying pathogenic processes, at least on the genetic level. This suggests a deeply interconnected nature for psychiatric disorders, in contrast to neurological disorders, and underscores the need to refine psychiatric diagnostics. Genetically informed analyses may provide important "scaffolding" to support such restructuring of psychiatric nosology, which likely requires incorporating many levels of information. By contrast, we find limited evidence for widespread common genetic risk sharing among neurological disorders or across neurological and psychiatric disorders. We show that both psychiatric and neurological disorders have robust correlations with cognitive and personality measures. Further study is needed to evaluate whether overlapping genetic contributions to psychiatric pathology may influence treatment choices. Ultimately, such developments may pave the way toward reduced heterogeneity and improved diagnosis and treatment of psychiatric disorders
- …