Prospective associations of parental smoking, alcohol use, marital status, maternal satisfaction, and parental and childhood body mass index at 6.5 years with later problematic eating attitudes

Background: Few studies have prospectively investigated whether early-life exposures are associated with pre-adolescent eating attitudes. Objective: The objective of this study is to prospectively investigate associations of parental smoking, alcohol use, marital status, measures of maternal satisfaction, self-reported parental body mass index (BMI) and clinically measured childhood BMI, assessed between birth and 6.5 years, with problematic eating attitudes at 11.5 years. Methods: Observational cohort analysis nested within the Promotion of Breastfeeding Intervention Trial, a cluster-randomised trial conducted in 31 maternity hospitals and affiliated polyclinics in Belarus. Our primary outcome was a Children's Eating Attitudes Test (ChEAT) score ⩾22.5 (85th percentile), an indicator of problematic eating attitudes. We employed multivariable mixed logistic regression models, which allow inference at the individual level. We also performed instrumental variable (IV) analysis using parents' BMIs as instruments for the child's BMI, to assess whether associations could be explained by residual confounding or reverse causation. Subjects: Of the 17 046 infants enrolled between 1996 and 1997 across Belarus, 13 751 (80.7%) completed the ChEAT test at 11.5 years. Results: In fully adjusted models, overweight children at age 6.5 years had a 2.14-fold (95% confidence interval (CI): 1.82, 2.52) increased odds of having ChEAT scores ⩾85th percentile at age 11.5 years, and those who were obese had a 3.89-fold (95% CI: 2.95, 5.14) increased odds compared with normal-weight children. Children of mothers or fathers who were themselves overweight or obese were more likely to score ⩾85th percentile (P for trend ⩽0.001). IV analysis was consistent with a child's BMI causally affecting future eating attitudes. There was little evidence that parental smoking, alcohol use, or marital status or maternal satisfaction were associated with eating attitudes. Conclusion: In our large, prospective cohort in Belarus, both parental and childhood overweight and obesity at 6.5 years were associated with pre-adolescent problematic eating attitudes 5 years later

Связь полиморфизма генов СОМТ, DRD2/ANKK1, MTHFR, MIR137, DNMT3B с клиническими проявлениями шизофрении в остром периоде и в состоянии ремиссии

Updated view of genetic features of schizophrenia based on rare SNPs/CNVs with a huge influence on a disease and common SNPs with a small effect of each allele is presented. Altogether these genetic factors are acting to create neuropathophysiological disturbances observed in schizophrenia. Association of five polymorphisms MIR137 rs1625579, DRD2/ANKK1 rs1800497, MTHFR rs1801133, DNMT3B rs2424913, СОМТ rs4680 with the risk of schizophrenia in the Belarusian population, the level of symptoms of schizophrenia patients assessed by PANSS in the acute stage and remission, cognitive impairments, and treatment trajectory of schizophrenia patients during antipsychotic treatment were analyzed. The A/A-genotype of СОМТ rs4680 (р = 0.008) and the С/С-genotype of MTHFR rs1801133 (р = 0.02) are associated with the risk of schizophrenia among Belarusians. The T-allele of MTHFR rs1801133 is a risk factor of positive symptoms (р = 0.02). Combining the C/C-genotype (DNMT3B rs2424913) and the G-allele (COMT rs4680) is associated with a significant difference in negative symptoms level between men and women. The polymorphism of СОМТ rs4680 (р < 0.05) and the combination of СОМТ rs4680 + DRD2/ANKK1 rs1800497 (р = 0.005) as well as MTHFR rs1801133 + DNMT3B rs2424913 (р = 0.006) are related to the cognitive parameters measured by the WCST and Stroop test respectively. Schizophrenia patients who are the G-allele carriers of MIR137 rs1625579 demonstrated a more favorable negative symptom trajectory in comparison to Т/Тhomozygotes (F = 2.2, p = 0.03). The trajectory of negative symptoms (F = 2.2, p = 0.03) and general psychopathological symptoms (F = 4.3, p = 0.0001) is different between men and women under antipsychotic treatment. These differences are associated with a minor amount of alleles of MIR137 rs1625579, DRD2/ANKK1 rs1800497, MTHFR rs1801133 polymorphic sites.По современным представлениям, пациент, страдающий шизофренией, является, как правило, носителем одной или нескольких редких аллелей с высоким эффектом и ряда распространенных аллелей с малыми эффектами. Совместное действие генетических факторов реализуется определенными нейробиологическими путями, которые порождают спектр нейрофизиологических нарушений, наблюдаемых при шизофрении. В ходе исследования была проанализирована связь полиморфных сайтов MIR137 rs1625579, DRD2/ANKK1 rs1800497, MTHFR rs1801133, DNMT3B rs2424913, СОМТ rs4680 с риском возникновения шизофрении среди белорусов, степенью выраженности симптомов по шкале PANSS в остром периоде и в фазе ремиссии, когнитивными нарушениями и динамикой изменения симптоматической картины пациентов с шизофренией в период поддерживающей терапии антипсихотиками. Согласно полученным результатам, генотип A/AСОМТ rs4680 (р = 0,008) и генотип С/С MTHFR rs1801133 (р = 0,02) являются факторами риска развития шизофрении среди мужчин белорусской популяции. Выявлены множественные связи исследуемых локусов с различными видами симптомов и когнитивными параметрами. T-аллель MTHFR rs1801133 связан с риском формирования психотических симптомов (р = 0,02). Сочетание генотипа C/C (DNMT3B rs2424913) и G-аллеля (COMT rs4680) связано со значимыми различиями в уровне негативных симптомов между пациентами мужского и женского пола (p = 0,00009). Наиболее выражена связь локуса СОМТ rs4680 (р < 0,05) и комбинации локусов СОМТ rs4680 + DRD2/ANKK1 rs1800497 (р = 0,005) с когнитивными параметрами (оценка по Висконсинскому тесту сортировки карточек – ВТСК), а также комбинации локусов MTHFR rs1801133 + DNMT3B rs24 24913 (р = 0,006) с параметром теста Струпа. Также обнаружено, что пациенты с G-аллелем MIR137 rs1625579 демонстрируют более благоприятную динамику изменения негативной симптоматики (F = 2,2, p = 0,03) в сравнении с Т/Тгомозиготами. Обнаружены достоверные различия в траектории изменения негативной (F = 2,2, p = 0,03) и общей психопатологической симптоматики (F = 4,3, p = 0,0001) в период терапии между пациентами мужского и женского пола в зависимости от количества минорных аллелей по исследуемым полиморфным вариантам

Compulsory admissions of patients with mental disorders : State of the art on ethical and legislative aspects in 40 European countries

Background. Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. Methods. The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. Results. We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. Conclusions. We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.Peer reviewe

The association of early childhood cognitive development and behavioural difficulties with pre-adolescent problematic eating attitudes

10.1371/journal.pone.0104132PLoS ONE98e10413

Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries

BACKGROUND: Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. METHODS: The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. RESULTS: We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. CONCLUSIONS: We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions