Childhood neglect predicts the course of major depression in a tertiary care sample: a follow-up study

Abstract Background The course of depression is poorer in clinical settings than in the general population. Several predictors have been studied and there is growing evidence that a history of childhood maltreatment consistently predicts a poorer course of depression. Methods Between 2008 and 2012, we assessed 238 individuals suffering from a current episode of major depression. Fifty percent of these (N = 119) participated in a follow-up study conducted between 2012 and 2014 that assessed sociodemographic and clinical variables, the history of childhood abuse and neglect (using the Adverse Childhood Experience questionnaire), and the course of depression between baseline and follow-up interview (using the Life Chart method). The Structured Clinical Interview for DSM-IV-TR was used to assess diagnosis at baseline and follow-up interview. Statistical analyses used the life table survival method and Cox proportional hazard regression tests. Results Among 119 participants, 45.4% did not recover or remit during the follow-up period. The median time to remission or recovery was 28.9 months and the median time to the first recurrence was 25.7 months. Not being married, a chronic index depressive episode, comorbidity with an anxiety disorder, and a childhood history of physical neglect independently predicted a slower time to remission or recovery. The presence of three or more previous depression episodes and a childhood history of emotional neglect were independent predictors of depressive recurrences. Conclusions Childhood emotional and physical neglect predict a less favorable course of depression. The effect of childhood neglect on the course of depression was independent of sociodemographic and clinical variables

Beneficial Effect of Tempol, a Membrane-Permeable Radical Scavenger, on Inflammation and Osteoarthritis in In Vitro Models

Osteoarthritis (OA) is one of the most common and widespread diseases which is highly disabling for humans. This makes OA a chronic disease for which it is urgent to find new therapeutic strategies. The inflammatory state in OA contributes to its progression through multiple mechanisms involving the recruitment of phagocytes and leukocytes, inflammatory response, and reactive oxygen species (ROS) production. Tempol (4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl) is classifiable as a piperidine nitroxide, with excellent antioxidant effects, while its anti-inflammatory role is not yet clear. On this basis, we explored its promising biological properties in two in vitro model:, macrophage (J774) and chondrocyte (CC) cell lines. With this aim in mind, we induced inflammation in J774 and CC using lipopolysaccharide (LPS) and Interleukin1β (IL-1β), and after 24, 72 and 168 h of tempol treatment analyzed their effects on cytotoxicity and anti-inflammatory activity. Our data suggested that tempol treatment is able to reduce inflammation and nitrite production in LPS-induced J774 as well as reducing the production of proinflammatory mediators including cytokines, enzymes, and metalloproteases (MMPs) in IL-1β-stimulated CC. Thus, since inflammation and oxidative stress have a crucial role in the pathogenesis and progression of OA, tempol could be considered as a new therapeutic approach for this pathology

Innovations et modifications clés des descriptions cliniques et exigences pour le diagnostic du chapitre sur les troubles mentaux, comportementaux et neurodéveloppementaux de la CIM-11 de l’OMS

International audienceEn mai 2019, l’Assemblée mondiale de la santé de l’Organisation mondiale de la santé (OMS) a approuvé la Classification internationale des maladies et des problèmes de santé connexes (CIM-11) pour les statistiques de mortalité et de morbidité. La version statistique de la CIM-11 est entrée en vigueur le 1er janvier 2022. Cet article décrit le processus de révision de la CIM-11 entrepris par l’OMS dans l’élaboration d’une version pour spécialistes de la santé mentale, due pour publication en 2022. Cet effort sans précédent a impliqué des experts, des organisations et membres du public de diverses régions du monde. Nous décrivons également les essais sur le terrain a travers l’internet et en clinique qui ont été utilisés pour vérifier la validité, l’utilité clinique, la fiabilité et l’acceptabilité au sens large de la classification avant sa publication. L’accent est mis sur les aspects du développement de la CIM-11 qui ont fait appel à des parties prenantes francophones. Enfin, le plan de formation des cliniciens et de mise en œuvre de la CIM-11 est discuté

Comparative distribution and validity of DSM-IV and DSM-5 diagnoses of eating disorders in adolescents from the community

Objectives: DSM-5 changes for eating disorders (EDs) aimed to reduce preponderance of non-specified cases and increase validity of specific diagnoses. The objectives were to estimate the combined effect of changes on prevalence of EDs in adolescents and examine validity of diagnostic groupings. Method: A total of 3043 adolescents (1254 boys and 1789 girls, Mage=14.19years, SD=1.61) completed self-report questionnaires including the Eating Disorder Diagnostic Scale. Results: Prevalence of full-threshold EDs increased from 1.8% (DSM-IV) to 3.7% (DSM-5), with a higher prevalence of bulimia nervosa (1.6%) and the addition of the diagnosis of purging disorder (1.4%); prevalence of binge eating disorder was unchanged (0.5%), and non-specified cases decreased from 5.1% (DSM-IV) to 3.4% (DSM-5). Validation analyses demonstrated that DSM-5 ED subgroups better captured variance in psychopathology than DSM-IV subgroups. Discussion: Findings extend results from previous prevalence and validation studies into the adolescent age range. Improved diagnostic categories should facilitate identification of EDs and indicate targeted treatments

Coronary and cerebrovascular population-based registers in Europe : are morbidity indicators comparable? : results from the EUROCISS Project

Background: The EUROCISS Project (European Cardiovascular Indicators Surveillance Set), as part of the Health Monitoring Programme financed by the European Commission, has been implemented to develop health indicators and recommendations for the monitoring of cardiovascular diseases (CVDs). Morbidity data are rarely available in the different countries and when available, they are very rarely comparable. The aims of this paper are to list the existing population-based registers of acute myocardial infarction (AMI) and stroke in Europe, describe their methodology, and discuss their comparability. Methods: using a questionnaire a comprehensive and updated picture on available sources of information, data, indicators, and methods were collected for population-based registers. The information requested generally included: the studied disease; the scope of the study (geographical area, temporal duration, age range, population); adopted methodologies (case definition, ICD coding for mortality and hospital discharge records, linkage and validation methods); morbidity indicators (attack rate, incidence, prevalence, case fatality rate). Results: Belgium, Denmark, Finland, France, Germany, Italy, Norway, Spain, and Sweden have ongoing population-based registers for AMI. Denmark, Finland, France, Germany, Italy, Norway, and Sweden have ongoing population-based registers for stroke. Selection procedures of events, differences in age range, different validation procedures and methods make the results from these registers difficult to compare. Conclusions: Population-based registers provide the best indicators for AMI and stroke, such as attack rate and case fatality. Registers cover large samples of the population, usually regions or large municipalities. The comparability of data across countries depends on standardization, case definition, completeness, proper linkage, common diagnostic criteria and validation procedures. Given the high burden of AMI and stroke, efforts are needed in implementing registers in all European countries.This project has received financial support from the European Commission, Directorate General for Health and Consumer Protection – Grant Agreement n. SI2.292277 (2000CVG3–508)

The ICD-11 developmental field study of reliability of diagnoses of high-burden mental disorders: results among adult patients in mental health settings of 13 countries

Reliable, clinically useful, and globally applicable diagnostic classification of mental disorders is an essential foundation for global mental health. The World Health Organization (WHO) is nearing completion of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11). The present study assessed inter-diagnostician reliability of mental disorders accounting for the greatest proportion of global disease burden and the highest levels of service utilization – schizophrenia and other primary psychotic disorders, mood disorders, anxiety and fear-related disorders, and disorders specifically associated with stress – among adult patients presenting for treatment at 28 participating centers in 13 countries. A concurrent joint-rater design was used, focusing specifically on whether two clinicians, relying on the same clinical information, agreed on the diagnosis when separately applying the ICD-11 diagnostic guidelines. A total of 1,806 patients were assessed by 339 clinicians in the local language. Intraclass kappa coefficients for diagnoses weighted by site and study prevalence ranged from 0.45 (dysthymic disorder) to 0.88 (social anxiety disorder) and would be considered moderate to almost perfect for all diagnoses. Overall, the reliability of the ICD-11 diagnostic guidelines was superior to that previously reported for equivalent ICD-10 guidelines. These data provide support for the suitability of the ICD-11 diagnostic guidelines for implementation at a global level. The findings will inform further revision of the ICD-11 diagnostic guidelines prior to their publication and the development of programs to support professional training and implementation of the ICD-11 by WHO member states

Squalenoyl Adenosine Nanoparticles Provide Neuroprotection After Stroke And Spinal Cord Injury

There is an urgent need to develop new therapeutic approaches for the treatment of severe neurological trauma, such as stroke and spinal cord injuries. However, many drugs with potential neuropharmacological activity, like adenosine, are inefficient upon systemic administration because of their fast metabolisation and rapid clearance from the bloodstream. Here, we show that the conjugation of adenosine to the lipid squalene and the subsequent formation of nanoassemblies allow a prolonged circulation of this nucleoside, to provide neuroprotection in mouse stroke and rat spinal cord injury models. The animals receiving systemic administration of squalenoyl adenosine nanoassemblies showed a significant improvement of their neurologic deficit score in the case of cerebral ischaemia, and an early motor recovery of the hindlimbs in the case of spinal cord injury. Moreover, in vitro and in vivo studies demonstrated that the nanoassemblies were able to extend adenosine circulation and its interaction with the neurovascular unit. This paper shows, for the first time, that a hydrophilic and rapidly metabolised molecule like adenosine may become pharmacologically efficient owing to a single conjugation with the lipid squalene.PubMedWo