"Now he walks and walks, as if he didn't have a home where he could eat": food, healing, and hunger in Quechua narratives of madness

In the Quechua-speaking peasant communities of southern Peru, mental disorder is understood less as individualized pathology and more as a disturbance in family and social relationships. For many Andeans, food and feeding are ontologically fundamental to such relationships. This paper uses data from interviews and participant observation in a rural province of Cuzco to explore the significance of food and hunger in local discussions of madness. Carers’ narratives, explanatory models, and theories of healing all draw heavily from idioms of food sharing and consumption in making sense of affliction, and these concepts structure understandings of madness that differ significantly from those assumed by formal mental health services. Greater awareness of the salience of these themes could strengthen the input of psychiatric and psychological care with this population and enhance knowledge of the alternative treatments that they use. Moreover, this case provides lessons for the global mental health movement on the importance of openness to the ways in which indigenous cultures may construct health, madness, and sociality. Such local meanings should be considered by mental health workers delivering services in order to provide care that can adjust to the alternative ontologies of sufferers and carers

Traditional use of the Andean flicker (Colaptes rupicola) as a galactagogue in the Peruvian Andes

This paper explores the use of the dried meat and feathers of the Andean Flicker (Colaptes rupicola) to increase the milk supply of nursing women and domestic animals in the Andes. The treatment is of preColumbian origin, but continues to be used in some areas, including the village in the southern Peruvian highlands where I do ethnographic research. I explore the factors giving rise to and sustaining the practice, relate it to other galactagogues used in the Andes and to the use of birds in ethnomedical and ethnoveterinary treatments in general, and situate it within the general tendency in the Andes and elsewhere to replicate human relations in the treatment of valuable livestock. The bird's use as a galactagogue appears to be motivated by both metaphorical associations and its perceived efficacy, and conceptually blends human and animal healthcare domains

RNAi-mediated serotonin transporter suppression rapidly increases serotonergic neurotransmission and hippocampal neurogenesis

Open Access: This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License.-- et al.Current antidepressants, which inhibit the serotonin transporter (SERT), display limited efficacy and slow onset of action. Here, we show that partial reduction of SERT expression by small interference RNA (SERT-siRNA) decreased immobility in the tail suspension test, displaying an antidepressant potential. Moreover, short-term SERT-siRNA treatment modified mouse brain variables considered to be key markers of antidepressant action: reduced expression and function of 5-HT(1A)-autoreceptors, elevated extracellular serotonin in forebrain and increased neurogenesis and expression of plasticity-related genes (BDNF, VEGF, Arc) in hippocampus. Remarkably, these effects occurred much earlier and were of greater magnitude than those evoked by long-term fluoxetine treatment. These findings highlight the critical role of SERT in serotonergic function and show that the reduction of SERT expression regulates serotonergic neurotransmission more potently than pharmacological blockade of SERT. The use of siRNA-targeting genes in serotonin neurons (SERT, 5-HT(1A)-autoreceptor) may be a novel therapeutic strategy to develop fast-acting antidepressants.This research was supported by grants from Spanish Ministry of Science and Innovation-CDTI, with the participation of the DENDRIA Consortium; from Instituto de Salud Carlos III PI10/00290 and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM, P91C). Structural funds of the European Union, through the National Applied Research Projects (R+D+I 2008/11) and from the Catalan Government (grant 2009SGR220) are also acknowledged.Peer Reviewe

Expression of aquaporin 4 (AQP4) in postmortem human brain cortex of subjects with different psychiatric disorders

Trabajo presentado al 39th annual meeting of Neuroscience celebrado en Chicago del 17 al 21 de octubre de 2009.Aquaporins are specialized water transport channels expressed in plasma membranes of water-permeable tissues that maintain water and ion homeostasis. Aquaporins 1 and 4 (AQP1 and AQP4) are the most important to fluid movements in mammalian brain. AQP4 has been implicated in the generation of brain edema, astrocyte migration, and in the control of neuronal excitability. These and other studies have turned it into an important drug target for treatment of diseases such as cerebral edema, mesial temporal lobe epilepsy, and a variant of multiple sclerosis. Moreover, over-expression changes of the gene coding for the AQP4 have been associated with bipolar disorder and major depression, and it has been described as necessary for the antidepressive action of fluoxetine. The aim of this study was to evaluate the immunoreactive protein density of AQP4 in postmortem prefrontal cortex samples of subjects with a previous diagnosis of three different mental disorders: major depression (MD, n=15), bipolar disorder (BD, n=19) and schizophrenia (SCH, n=22). Three groups of matched controls for gender, age and postmortem delay were included. Additionally, a group of suicide victims (n=12) with no previous diagnosis of mental disorder was also included. The immunodensities of the two isoforms of AQP4 (34 and 32 kDa) and beta-actin (used as internal control) were detected simultaneously by using specific primary and fluorescent secondary antibodies. The density of AQP1 was also quantified. All bands were quantified by densitometry and the relative density levels were normalized and expressed as a percentage of control samples. An increase of the density of the two AQP4 isoforms was detected in MD, BD, and SCH groups, while no changes were detected in the case of suicide. These changes were statistically significant for both the 32 and 34 kDa isoforms in BD (34 kDa: 118%, p0.05) in SCH and suicide (91%, p>0.05) groups. These results suggests an implication of aquaporins in neuropsychiatric disorders.Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; MICINN (SAF 2004/2784); MICINN (FIS 04/0190) and FEDER Funds.Peer Reviewe

Age of onset and duration of untreated psychosis in first episode psychosis: Interaction effects between cannabis and comt

Trabajo presentado a la 10ª Reunión anual de la Sociedad Española de Investigación sobre Cannabinoides celebrada en Santander del 26 al 28 de noviembre de 2009.Introduction: Age of onset and duration of untreated Psychosis (DUP) have been proposed as key factors in the prognosis of psychosis. Whereas gender differences in age of onset have been established and there is an emerging evidence of the association between cannabis use and an earlier age of onset, the role of other variables remains unclear. The Val158Met polymorphism of Catechol-O-Methyltransferase (COMT) has shown differences in clinical variables between genotypes and a possible association with an earlier age of onset. Additionally, an interaction between COMT genotype and cannabis has been previously found in the modulation of risk of psychosis. The aim of this study was to examine the effects of COMT genotype, cannabis and their interaction in the age of onset and DUP in a representative group of first episode psychosis patients. Methods: Aged of onset, DUP and cannabis consumption (regular user vs. sporadic or non-user) were assessed in 169 caucasian drug-naïve patients with a first-episode of non-affective psychosis. COMT polymorphism was typed using PCR of the relevant region followed by digestion with NlaIII and electrophoresis. A multivariate ANCOVA was performed with DUP and Age of onset as dependent variables, cannabis and COMT genotype as fixed factors and gender as a covariate. Results: The MANCOVA was significant for age of onset and DUP. Cannabis users had a significant earlier age of onset (F=16.887; p<0.001). Age of onset was later in the Met homozygote group (non significant, F=2.348; p=0.099). The cannabis-COMT interaction showed a significant effect in both DUP and age of onset (F=3.816; p=0.024). Post hoc analyses showed that differences between genotypes were only present in the non-cannabis users group. Conclusions: Cannabis users had an earlier age of onset and shorter DUPs. Val carriers had an earlier age of onset and longer DUPs, but only in the non-cannabis user group. Cannabis seems to modulate the age of onset and DUP in first episode psychosis independently of gender and to moderate the effect of COMT Val158Met polymorphism.Peer Reviewe

Response to methylphenidate by adult and pediatric patients with attention-deficit/hyperactivity disorder: the Spanish multicenter DIHANA study.

Journal Article;BACKGROUND The purpose of this multicenter Spanish study was to evaluate the response to immediate-release methylphenidate by children and adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), as well as to obtain information on current therapy patterns and safety characteristics. METHODS This multicenter, observational, retrospective, noninterventional study included 730 patients aged 4-65 years with a diagnosis of ADHD. Information was obtained based on a review of medical records for the years 2002-2006 in sequential order. RESULTS The ADHD predominantly inattentive subtype affected 29.7% of patients, ADHD predominantly hyperactive-impulsive was found in 5.2%, and the combined subtype in 65.1%. Overall, a significant lower Clinical Global Impression (CGI) score and mean number of DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision) symptoms by subtype were found after one year of treatment with immediate-release methylphenidate; CGI decreased from 4.51 to 1.69, symptoms of inattention from 7.90 to 4.34, symptoms of hyperactivity from 6.73 to 3.39, and combined subtype symptoms from 14.62 to 7.7. Satisfaction with immediate-release methylphenidate after one year was evaluated as "very satisfied" or "satisfied" by 86.90% of the sample; 25.75% of all patients reported at least one adverse effect. At the end of the study, 41.47% of all the patients treated with immediate-release methylphenidate were still receiving it, with a mean time of 3.80 years on therapy. CONCLUSION Good efficacy and safety results were found for immediate-release methylphenidate in patients with ADHD.Ye