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Shabat N, Bechor U, Yavnai N, Tatsa-Laur L, Shelef L. The Link Between Somatization and Dissociation and PTSD Severity in Veterans Who Sought Help From the IDF Combat Stress Reaction Unit. Mil Med 2024:usae118. [PMID: 38554277 DOI: 10.1093/milmed/usae118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/12/2024] [Accepted: 03/05/2024] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION This study aimed to examine the relationships between dissociative and somatic symptoms and how they might contribute to PTSD severity among ex-soldiers who sought help from the IDF Combat Stress Reaction Unit (CSRU). MATERIALS AND METHODS This cross-sectional study included 1,305 former compulsory, career, and reserve soldiers, who filled out self-report questionnaires on admission for evaluation at the CSRU. The study's dependent variables included two posttraumatic stress disorder measures (CAPS and PCL-5). The independent variables were the Dissociative Experience Scale and Brief Symptom Inventory. Background and service-related variables were also examined. RESULTS Spearman correlation revealed that the higher the level of somatization is, the higher the level of PTSD via PCL and CAPS. A significant positive association was found between somatization and dissociation (r = 0.544; P < 0.001). The higher the somatization level, the more severe the dissociation. A multivariate logistic regression analysis to predict severe PTSD revealed that the longer the time elapsed from the traumatic event (OR = 1.019, P = 0.015), the higher the risk for severe PTSD. The most prominent variables were dissociation (OR = 6.420, P < 0.001) and somatization (OR = 4.792, P < 0.001). The entire model reached 40.8% of the shared variance in the regression. CONCLUSIONS While there is direct reference to dissociation in the clinical assessment by PCL or CAPS, there is no such reference to somatization. Highly functioning combatants sometimes express their distress somatically. Our findings suggest regarding severe somatic symptoms as diagnostic criteria for PTSD.
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Affiliation(s)
- Nizan Shabat
- Department of Health and Well-Being, IDF's Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Uzi Bechor
- Department of Health and Well-Being, IDF's Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Nirit Yavnai
- Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University, Hadassah Ein Kerem Campus, Jerusalem 91120, Israel
| | - Lucian Tatsa-Laur
- Department of Health and Well-Being, IDF's Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Leah Shelef
- Department of Health and Well-Being, IDF's Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
- The School of Social Work, Sapir Academic College, D. N. Hof Ashkelon 79165, Israel
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Shelef L, Nir I, Tatsa-Laur L, Yavnai N, Gold N, Cohen G, Ben Yehuda A. Factors associated with self-harm behaviors during military service in the Israel Defense Forces, rates of such behaviors and their outcomes. MILITARY PSYCHOLOGY 2024; 36:158-167. [PMID: 38377251 PMCID: PMC10880502 DOI: 10.1080/08995605.2022.2151815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022]
Abstract
The military environment involves stressful situations that may trigger or aggravate suicidal behaviors, such as suicide attempts (SAs), which significantly increase the likelihood of future suicide. This cross-sectional study aims to assess risk factors for severe SAs and non-suicidal self-injury (NSSI) among Israel Defense Forces (IDF) soldiers. Data were retrieved from an IDF computerized self-harm surveillance database and were based on the criteria of the Columbia Suicide Severity Rating Scale (C-SSRS) and the Suicide Attempt Self-Injury Interview (SASII). The cohort included all 1,238 occurrences of self-harm behavior, during 2017-2021. Other investigated variables included adjustment difficulty (AD, as per IDF definition) and psychiatric diagnosis (PD) as reported by mental health officers (MHOs) during recruitment. Higher rates of adjustment difficulties were found among soldiers who had conducted NSSIs. Higher rates of previous psychiatric diagnoses were found among individuals with SAs, and their risk of dying by suicide during military service was twice as high (OR = 2.356; p < .001). If the latter also served in a combat unit, the risk was almost fourfold (OR = .3.860; p < .001). The current study demonstrates a clear difference between IDF soldiers who conduct NSSI vs. those conducting SA with regard to adjustment difficulty (as per IDF definition) and PD.
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Affiliation(s)
- Leah Shelef
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- The School of Social Work, Sapir Academic College, D.N. Hof Ashkelon, Israel
| | - Ishai Nir
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lucian Tatsa-Laur
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
| | - Nirit Yavnai
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Niv Gold
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
| | - Gadi Cohen
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
| | - Ariel Ben Yehuda
- Department of Health and Well-Being, Medical Corps, Israeli Defense Forces, Ramat Gan, Israel
- Shalvata Mental Health Center, Clalit Health Services, Hod Hasharon, Israel
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Shelef L, Bechor U, Ohayon O, Tatsa-Laur L, Antonovsky A. The Psychological Impact of Exposure to Battle on Medics: A Cross-Sectional Study of Ex-Soldiers Who Sought Help From the IDF Combat Reaction Unit. Mil Med 2024; 189:e781-e788. [PMID: 37721515 DOI: 10.1093/milmed/usad368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/31/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION The present study's central aim was to examine two questions: (1) Will there be differences in mental health outcomes between medics and non-medics who sought help at the Israeli Combat Reaction Unit (CRU)? (2) Will there be differences in mental health outcomes between combatants and non-combatants? MATERIALS AND METHODS This cross-sectional study included files of 1,474 Israeli Defense Forces ex-service members (89% combatants, of whom 13% were medics; 11% non-combatants, of whom 6% were medics), who filled out questionnaires on admission for evaluation at the CRU.Dependent variables were mental health measures and included two PTSD measures (Clinician-Administered PTSD Scale and PTSD Checklist for DSM-5), Beck Depression Inventory, Dissociative Experience Scale, and Brief Symptom Inventory. Military profession (medics vs. non-medics) and status (combatant vs. non-combatant) were the independent variables. Background variables were also examined. RESULTS We found no substantial differences between medics and non-medics in the mental health measures. When looking at combat and non-combat separately, the non-combat medics (CMs), in general, were in better mental health conditions than the other three groups- CMs, non-medic combatants, and non-medic non-combatants-all of whom had similar scores in the mental health measures. However, compared to the rest, non-CMs took considerably longer years before approaching the CRU. CONCLUSIONS The elapsed time to seek help for non-MCs was explained by their reluctance to seek help, not being combatants, and being medics who are portrayed as resilient. Recommendations for encouraging this subgroup to seek help were given.
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Affiliation(s)
- Leah Shelef
- The School of Social Work, Sapir Academic College, D. N. Hof Ashkelon 79165, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Uzi Bechor
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Ofir Ohayon
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Lucian Tatsa-Laur
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Avishai Antonovsky
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
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de Witte LD, Munk Laursen T, Corcoran CM, Kahn RS, Birnbaum R, Munk-Olsen T, Bergink V. A Sex-Dependent Association Between Doxycycline Use and Development of Schizophrenia. Schizophr Bull 2023; 49:953-961. [PMID: 36869773 PMCID: PMC10318877 DOI: 10.1093/schbul/sbad008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
BACKGROUND Doxycycline and minocycline are brain-penetrant tetracycline antibiotics, which recently gained interest because of their immunomodulatory and neuroprotective properties. Observational studies have suggested that exposure to these drugs may decrease the risk to develop schizophrenia, but results are inconsistent. The aim of this study was to investigate the potential association between doxycycline use and later onset of schizophrenia. DESIGN We used data from 1 647 298 individuals born between 1980 and 2006 available through Danish population registers. 79 078 of those individuals were exposed to doxycycline, defined as redemption of at least 1 prescription. Survival analysis models stratified for sex with time-varying covariates were constructed to assess incidence rate ratios (IRRs) for schizophrenia (ICD-10 code F20.xx), with adjustment for age, calendar year, parental psychiatric status, and educational level. RESULTS In the non-stratified analysis, there was no association between doxycycline exposure and schizophrenia risk. However, men who redeemed doxycycline had a significantly lower incidence rate for schizophrenia onset compared to men that did not (IRR 0.70; 95% CI 0.57-0.86). By contrast, women had a significantly higher incidence rate for schizophrenia onset, compared to women that did not redeem doxycycline prescriptions (IRR 1.23; 95% CI 1.08, 1.40). The effects were not found for other tetracycline antibiotics (IRR 1.00; 95% CI 0.91, 1.09). CONCLUSIONS Doxycycline exposure is associated with a sex-dependent effect on schizophrenia risk. The next steps are replication of the results in independent well-characterized population cohorts, as well as preclinical studies to investigate sex-specific effects of doxycycline on biological mechanisms implicated in schizophrenia.
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Affiliation(s)
- Lot D de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters VA Medical Center, Bronx, NY, USA
| | - Thomas Munk Laursen
- The National Center for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters VA Medical Center, Bronx, NY, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters VA Medical Center, Bronx, NY, USA
| | - Rebecca Birnbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Trine Munk-Olsen
- The National Center for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
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Weiser M, Frenkel O, Fenchel D, Tzur D, Sandin S, Janecka M, Levi L, Davidson M, Laor L, Fruchter E, Reichenberg A. Familial clustering of psychiatric disorders and low IQ. Psychol Med 2023; 53:2878-2884. [PMID: 34911593 DOI: 10.1017/s0033291721004852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although the ICD and DSM differentiate between different psychiatric disorders, these often share symptoms, risk factors, and treatments. This was a population-based, case-control, sibling study examining familial clustering of all psychiatric disorders and low IQ, using data from the Israel Draft-Board Registry on all Jewish adolescents assessed between 1998 and 2014. METHODS We identified all cases with autism spectrum disorder (ASD, N = 2128), severe intellectual disability (ID, N = 9572), attention-deficit hyperactive disorder (ADHD) (N = 3272), psychotic (N = 7902), mood (N = 9704), anxiety (N = 10 606), personality (N = 24 816), or substance/alcohol abuse (N = 791) disorders, and low IQ (⩾2 SDs below the population mean, N = 31 186). Non-CNS control disorders were adolescents with Type-1 diabetes (N = 2427), hernia (N = 29 558) or hematological malignancies (N = 931). Each case was matched with 10 age-matched controls selected at random from the Draft-Board Registry, with replacement, and for each case and matched controls, we ascertained all full siblings. The main outcome measure was the relative recurrence risk (RRR) of the sibling of a case having the same (within-disorder RRR) or a different (across-disorder RRR) disorder. RESULTS Within-disorder RRRs were increased for all diagnostic categories, ranging from 11.53 [95% confidence interval (CI): 9.23-14.40] for ASD to 2.93 (95% CI: 2.80-3.07) for personality disorders. The median across-disorder RRR between any pair of psychiatric disorders was 2.16 (95% CI: 1.45-2.43); the median RRR between low IQ and any psychiatric disorder was 1.37 (95% CI: 0.93-1.98). There was no consistent increase in across-disorder RRRs between the non-CNS disorders and psychiatric disorders and/or low IQ. CONCLUSION These large population-based study findings suggest shared etiologies among most psychiatric disorders, and low IQ.
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Affiliation(s)
- Mark Weiser
- Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Or Frenkel
- Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Daphna Fenchel
- Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Dorit Tzur
- Medical Corps, Israel Defense Force, Israel
| | - Sven Sandin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Magdalena Janecka
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Linda Levi
- Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | | | | | - Eyal Fruchter
- Medical Corps, Israel Defense Force, Israel
- Department of Psychiatry, Rambam Medical Center, Haifa, Israel
- Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Czepielewski LS, Alliende LM, Castañeda CP, Castro M, Guinjoan SM, Massuda R, Berberian AA, Fonseca AO, Gadelha A, Bressan R, Crivelaro M, Louzã M, Undurraga J, González-Valderrama A, Nachar R, Nieto RR, Montes C, Silva H, Langer ÁI, Schmidt C, Mayol-Troncoso R, Díaz-Zuluaga AM, Valencia-Echeverry J, López-Jaramillo C, Solís-Vivanco R, Reyes-Madrigal F, de la Fuente-Sandoval C, Crossley NA, Gama CS. Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects. Psychol Med 2022; 52:2177-2188. [PMID: 34158132 DOI: 10.1017/s0033291721002403] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. METHODS We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. RESULTS Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. CONCLUSIONS Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
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Affiliation(s)
- Letícia Sanguinetti Czepielewski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Psicologia, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Luz Maria Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
| | - Carmen Paz Castañeda
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
| | - Mariana Castro
- Research Group on Neurosciences as applied to Abnormal Behaviour (INAAC Group), FLENI-CONICET Neurosciences Institute, Buenos Aires, Argentina
- Department of Psychiatry and Mental Health (Fleni Teaching Unit) and Department of Physiology, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - Salvador M Guinjoan
- Department of Psychiatry and Mental Health (Fleni Teaching Unit), University of Buenos Aires School of Medicine. CONICET, Buenos Aires, Argentina
| | - Raffael Massuda
- Departamento de Psiquiatria, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | | | | | - Ary Gadelha
- Programa de Esquizofrenia, da Escola Paulista de Medicina Universidade Federal de São Paulo (PROESQ-EPM/UNIFESP). Laboratory of Integrative Neuroscience (LINC), Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Marisa Crivelaro
- PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil
| | - Mario Louzã
- PROJESQ (Programa de Esquizofrenia), Instituto de Psiquiatria do HCFMUSP, São Paulo, Brazil
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Alfonso González-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Rubén Nachar
- Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Rodrigo R Nieto
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Cristian Montes
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Hernan Silva
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Álvaro I Langer
- Instituto de Estudios Psicológicos, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
- Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Carlos Schmidt
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
- Brain, Cognition and Behavior PhD Program, University of Barcelona, Barcelona, Spain
| | - Rocío Mayol-Troncoso
- University Psychiatric Clinic, Clinical Hospital, Universidad de Chile, Santiago, Chile
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | - Ana M Díaz-Zuluaga
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Johanna Valencia-Echeverry
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Carlos López-Jaramillo
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Rodolfo Solís-Vivanco
- Laboratory of Neuropsychology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
- Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Nicolás A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Biomedical Imaging Center and Center for Integrative Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Clarissa S Gama
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Shaw S, Jana A, Kundu S. An analytical pathway of consumption expenditure with neighborhood deprivation and depression on cognitive health among elderly in India: A moderated mediation approach. J Affect Disord 2022; 308:249-258. [PMID: 35429519 DOI: 10.1016/j.jad.2022.04.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 01/22/2022] [Accepted: 04/10/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study aims to find the linkage between neighborhood deprivation and cognition with depression as a mediating factor while economic condition as a moderator. METHODS We have used the recent baseline wave-1 data of Longitudinal Aging Study in India (LASI), 2017-2018. The study was restricted to 60 and above population, consisting of males (14,931) and females (16,533). We have used moderated mediating model to understand the relationship between deprivation (X), cognition (Y) mediated through depression (M), moderated by economic condition (W), while controlling all possible confounders. RESULTS Neighborhood deprivation was positively associated with depression (β: 0.12; SE: 0.01) and inversely linked to cognition (β: -0.4; SE: 0.02). Deprivation had a strong indirect effect on cognition that was mediated by depression. Further, interaction of depression (M) and economic condition (W) was negatively associated (β = -0.03; SE: 0.01) with cognition (Y), indicating that lower economic section being more depressed with lower cognitive function. LIMITATIONS The study failed to capture other mental health aspects like stress and anxiety using the Depression, Anxiety and Stress Scale-21 items (DASS-21). CONCLUSIONS This study has found a link between higher economic condition with low deprivation and depression. Older individuals with better financial situation have improved cognitive level than their counterparts, who are also depressed. This study provides an opportunity to conduct future research on cognitive health in the face of population aging in India.
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Affiliation(s)
- Subhojit Shaw
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai 400088, India
| | - Arup Jana
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai 400088, India
| | - Sampurna Kundu
- Center of Social Medicine and Community Health, Jawaharlal Nehru University, Delhi 110067, India.
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Fico G, Oliva V, De Prisco M, Giménez-Palomo A, Sagué-Vilavella M, Gomes-da-Costa S, Garriga M, Solé E, Valentí M, Fanelli G, Serretti A, Fornaro M, Carvalho AF, Vieta E, Murru A. The U-shaped relationship between parental age and the risk of bipolar disorder in the offspring: A systematic review and meta-analysis. Eur Neuropsychopharmacol 2022; 60:55-75. [PMID: 35635997 DOI: 10.1016/j.euroneuro.2022.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/02/2022] [Accepted: 05/10/2022] [Indexed: 01/06/2023]
Abstract
Parenthood age may affect the risk for the development of different psychiatric disorders in the offspring, including bipolar disorder (BD). The present systematic review and meta-analysis aimed to appraise the relationship between paternal age and risk for BD and to explore the eventual relationship between paternal age and age at onset of BD. We searched the MEDLINE, Scopus, Embase, PsycINFO online databases for original studies from inception, up to December 2021. Random-effects meta-analyses were conducted. Sixteen studies participated in the qualitative synthesis, of which k = 14 fetched quantitative data encompassing a total of 13,424,760 participants and 217,089 individuals with BD. Both fathers [adjusted for the age of other parent and socioeconomic status odd ratio - OR = 1.29(95%C.I. = 1.13-1.48)] and mothers aged ≤ 20 years [(OR = 1.23(95%C.I. = 1.14-1.33)] had consistently increased odds of BD diagnosis in their offspring compared to parents aged 25-29 years. Fathers aged ≥ 45 years [adjusted OR = 1.29 (95%C.I. = 1.15-1.46)] and mothers aged 35-39 years [OR = 1.10(95%C.I. = 1.01-1.19)] and 40 years or older [OR = 1.2(95% C.I. = 1.02-1.40)] likewise had inflated odds of BD diagnosis in their offspring compared to parents aged 25-29 years. Early and delayed parenthood are associated with an increased risk of BD in the offspring. Mechanisms underlying this association are largely unknown and may involve a complex interplay between psychosocial, genetic and biological factors, and with different impacts according to sex and age range. Evidence on the association between parental age and illness onset is still tentative but it points towards a possible specific effect of advanced paternal age on early BD-onset.
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Affiliation(s)
- Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain
| | - Vincenzo Oliva
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain; Department of Neuroscience, Section of Psychiatry, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Anna Giménez-Palomo
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain
| | - Maria Sagué-Vilavella
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain
| | - Susana Gomes-da-Costa
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain
| | - Eva Solé
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain
| | - Marc Valentí
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michele Fornaro
- Department of Neuroscience, Section of Psychiatry, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Andre F Carvalho
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Vic., Australia 6 Perinatal Health Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Deakin University, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain.
| | - Andrea Murru
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 170 Villarroel st, 12-0, Barcelona, Catalonia 08036, Spain
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9
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Rethinking delusions: A selective review of delusion research through a computational lens. Schizophr Res 2022; 245:23-41. [PMID: 33676820 PMCID: PMC8413395 DOI: 10.1016/j.schres.2021.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 02/06/2023]
Abstract
Delusions are rigid beliefs held with high certainty despite contradictory evidence. Notwithstanding decades of research, we still have a limited understanding of the computational and neurobiological alterations giving rise to delusions. In this review, we highlight a selection of recent work in computational psychiatry aimed at developing quantitative models of inference and its alterations, with the goal of providing an explanatory account for the form of delusional beliefs in psychosis. First, we assess and evaluate the experimental paradigms most often used to study inferential alterations in delusions. Based on our review of the literature and theoretical considerations, we contend that classic draws-to-decision paradigms are not well-suited to isolate inferential processes, further arguing that the commonly cited 'jumping-to-conclusion' bias may reflect neither delusion-specific nor inferential alterations. Second, we discuss several enhancements to standard paradigms that show promise in more effectively isolating inferential processes and delusion-related alterations therein. We further draw on our recent work to build an argument for a specific failure mode for delusions consisting of prior overweighting in high-level causal inferences about partially observable hidden states. Finally, we assess plausible neurobiological implementations for this candidate failure mode of delusional beliefs and outline promising future directions in this area.
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10
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Myllyaho T, Siira V, Wahlberg KE, Hakko H, Tikkanen V, Läksy K, Roisko R, Niemelä M, Räsänen S. Dysfunctional family functioning in high socioeconomic status families as a risk factor for the development of psychiatric disorders in adoptees: the Finnish Adoptive Family Study of Schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1367-1377. [PMID: 33398497 DOI: 10.1007/s00127-020-02016-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/22/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE Earlier findings indicate that socioeconomic status (SES) of family associates with family functioning. This study examined the impacts of family functioning and genetic risk for schizophrenia on psychiatric morbidity of adoptees in families of high SES (HSES) and low SES (LSES). METHODS The study population is a subgroup of the Finnish Adoptive Family Study of Schizophrenia. Of the adoptees, 152 had high genetic risk for schizophrenia spectrum disorders (HR) and 151 adoptees had low risk (LR). Of the adoptees, 185 (HR = 94, LR = 91) were raised in high-SES (HSES) families and 118 (HR = 58, LR = 60) in low-SES (LSES) families. The family SES was determined by the occupational status of the main provider of the family. The functioning of adoptive families was assessed based on Global Family Ratings (GFRs) and psychiatric disorders on DSM-III-R criteria. RESULTS In the HSES families, the psychiatric morbidity of the adoptees was emphasized by HR (OR = 4.28, CI 2.14-8.56) and dysfunctional family processes (OR = 6.44, CI 2.75-15.04). In the LSES families, the adoptees´ psychiatric morbidity was almost significantly increased by HR (OR = 2.10, CI 0.99-4.45), but not by dysfunctional family processes (OR = 1.33, CI 0.53-3.34). CONCLUSIONS This study showed that in HSES families, dysfunctional family processes and HR for schizophrenia increased the likelihoods for the development of psychiatric disorders in adoptees. The results can be utilized in identifying risk factors in the development of psychiatric disorders and focusing preventative strategies on risk groups with acknowledging the importance of family functioning.
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Affiliation(s)
- Toni Myllyaho
- University of Oulu, Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
| | - Virva Siira
- Faculty of Education, University of Oulu, P.O. Box 2000, 90014, Oulu, Finland
| | - Karl-Erik Wahlberg
- University of Oulu, Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90014, Oulu, Finland
| | - Ville Tikkanen
- University of Oulu, Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Kristian Läksy
- Social Security Institute of Finland (SSI), Helsinki, Finland
| | - Riikka Roisko
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90014, Oulu, Finland
| | - Mika Niemelä
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90014, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Sami Räsänen
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90014, Oulu, Finland.,Faculty of Medicine, Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
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11
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Mohn-Haugen CR, Mohn C, Larøi F, Teigset CM, Øie MG, Rund BR. A systematic review of premorbid cognitive functioning and its timing of onset in schizophrenia spectrum disorders. Schizophr Res Cogn 2022; 28:100246. [PMID: 35251943 PMCID: PMC8892142 DOI: 10.1016/j.scog.2022.100246] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 11/24/2022]
Abstract
Cognitive impairments are core features of established schizophrenia spectrum disorders (SSD). However, it remains unclear whether specific cognitive functions are differentially impaired pre-onset and at what age these impairments can be detected. The purpose of this review was to elucidate these issues through a systematic summary of results from longitudinal studies investigating impairment in specific cognitive domains as antecedents of SSD. Relevant studies were identified by electronic and manual literature searches and included any original study of cognitive domains any time pre-onset of SSDs that included a control group. Effect sizes were calculated by domain for studies comparing high-risk participants who developed SSD with those who did not. The strongest evidence for impairment pre-onset was for mental processing speed, verbal learning and memory, executive function, and social cognition. Some verbal impairments, like language abilities at age 3 and verbal learning and memory at age 7, may develop as static deficits. Conversely, some non-verbal impairments, like mental processing speed, visuospatial abilities, and visual working memory manifest as developmental lag and become significant later in life. Most effect sizes were small to moderate, except for verbal fluency (d′ = 0,85), implying this impairment as central in high-risk participants who develop SSD. The present review documents extensive cognitive impairments pre-onset of SSD, and that these impairments start early in life, in line with the neurodevelopmental hypothesis of schizophrenia. Increased knowledge about cognitive impairments preonset can provide a better basis for understanding the complex pathogenesis of SSD as well as informing cognitive remediation programs. Specific cognitive domains evidence differential impairment pre-onset. Most effect sizes were small to moderate. Some verbal impairments develop as static deficits from early childhood. Some non-verbal impairments present as developmental lag and become apparent later. Impairments start early in life, in line with the neurodevelopmental hypothesis.
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Affiliation(s)
- Caroline Ranem Mohn-Haugen
- Research Department, Vestre Viken Hospital Trust, 3004 Drammen, Norway.,Department of Psychology, P. O. box 1094, Blindern, University of Oslo, 0317 Oslo, Norway
| | - Christine Mohn
- Norment Centre, Institute of Clinical Medicine, University of Oslo, P.O. box 4956, Nydalen, 0424 Oslo, Norway
| | - Frank Larøi
- Department of Psychology, P. O. box 1094, Blindern, University of Oslo, 0317 Oslo, Norway.,Psychology and Neuroscience of Cognition Research Unit, University of Liège, B-4000, Belgium
| | | | - Merete Glenne Øie
- Department of Psychology, P. O. box 1094, Blindern, University of Oslo, 0317 Oslo, Norway
| | - Bjørn Rishovd Rund
- Research Department, Vestre Viken Hospital Trust, 3004 Drammen, Norway.,Department of Psychology, P. O. box 1094, Blindern, University of Oslo, 0317 Oslo, Norway
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12
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Shakarchy N, Tatsa-Laur L, Kedem R, Ben Yehuda A, Shelef L. Risk Factors Associated With Various Severities of Suicidal and Non-Suicidal Self-Harm Among Israel Defense Forces Soldiers-A Nested Case-Control Study. Mil Med 2022; 188:usab541. [PMID: 35015892 DOI: 10.1093/milmed/usab541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/20/2021] [Accepted: 12/18/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Severe suicide attempt is a major risk factor for completed suicide. The aim of the present study was to focus on suicide behavior and timing to gain better understanding of these populations. METHOD The nested case-control retrospective study based on medical records of 246,866 soldiers, who demonstrated suicide attempts of varying severity, including death by suicide were compared with soldiers who did not demonstrate such behavior. RESULTS Risk for death by suicide was associated with males, military seniority of less than 12 months. High frequency of visits with mental health care professionals was associated with being severe suicide attempters (SAs). Moderate suicide attempts were associated with being a male, visiting a primary care physician frequently, and belonging to one of the two latest immigrant groups in Israel (Ethiopians and former Soviet Union). Mild suicide attempts were associated with having a psychiatric diagnosis on the enlistment day, visiting a mental health care professional at high or average frequency, visiting a primary care physician at high or average frequency, being a male, and being born in the former Soviet Union. While the proportion of males demonstrating suicidal behavior was higher than the females', severe SAs were higher among females. There was a clear tendency of female suicide attempters at all levels to act toward the end of their military service. CONCLUSIONS Although half of the SAs were females, their characteristics may be similar to those of the male SAs, contrary to the sex differences in suicide behavior among civilians.
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Affiliation(s)
- Nizan Shakarchy
- Medical Corps, Israel Defense Forces Ramat Gan 5262000, Israel
- Hadassah Medical School, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Lucian Tatsa-Laur
- Department of Health and Well-Being, IDF's Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Ron Kedem
- Department of Health and Well-Being, IDF's Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Ariel Ben Yehuda
- Department of Health and Well-Being, IDF's Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Leah Shelef
- Department of Health and Well-Being, IDF's Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
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13
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Warner AR, Lavagnino L, Glazier S, Hamilton JE, Lane SD. Inpatient Early Intervention for Serious Mental Illnesses Is Associated With Fewer Rehospitalizations Compared With Treatment as Usual in a High-volume Public Psychiatric Hospital Setting. J Psychiatr Pract 2022; 28:24-35. [PMID: 34989342 DOI: 10.1097/pra.0000000000000596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE High-acuity publicly funded inpatient psychiatric settings usually feature short lengths of stay and high readmission rates. This study examined the influence of an early intervention program for serious mental illnesses (SMI) on readmissions at 6 and 12 months postdischarge at a high-volume, urban public inpatient psychiatric hospital. METHODS The Early Onset Treatment Program (EOTP) is a cost-free, 90-day inpatient multidisciplinary service intervention program for uninsured patients who are within 5 years of SMI onset, funded as a pilot program by the Texas state legislature. Rehospitalization rates at 6 and 12 months were extracted from electronic medical records for EOTP participants (n=165) and comparison patients matched on demographics and diagnosis (n=155). The comparison group received treatment as usual at the same psychiatric hospital. Group re-admission rates were compared using logistic and Poisson regression analyses. RESULTS Group membership was a significant predictor of rehospitalization (P<0.0001) at both 6 and 12 months. Expressed as 1/odds ratio (OR), the EOTP group was less likely to readmit once and more than once at 6 months postdischarge (1/OR=3.82 and 4.74, respectively) compared with the non-EOTP group. The EOTP group was also less likely to readmit once and more than once at 12 months postdischarge (1/OR=2.96 and 3.51, respectively). CONCLUSIONS The results suggest that participation in the EOTP service in this high-acuity setting was significantly related to reduced likelihood of rehospitalization at 6 and 12 months. Several variables may account for this observation, including length of stay, longer medication adherence, environmental stability, and more individualized and extensive psychotherapy treatment.
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Affiliation(s)
- Alia R Warner
- WARNER, LAVAGNINO, GLAZIER, HAMILTON, LANE: Louis A. Faillace, MD, Department of Psychiatry & Behavioral Sciences, UTHealth McGovern Medical School, UTHealth Harris County Psychiatric Center, University of Texas Health Science Center at Houston, Houston, TX
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14
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Flesch-Kincaid Measure as Proxy of Socio-Economic Status on Twitter. INT J SEMANT WEB INF 2022. [DOI: 10.4018/ijswis.297037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Social media gives researchers an invaluable opportunity to gain insight into different facets of human life. Researchers put a great emphasis on categorizing the socioeconomic status (SES) of individuals to help predict various findings of interest. Forum uses, hashtags and chatrooms are common tools of conversations grouping. Crowdsourcing involves gathering intelligence to group online user community based on common interest. This paper provides a mechanism to look at writings on social media and group them based on their academic background. We analyzed online forum posts from various geographical regions in the US and characterized the readability scores of users. Specifically, we collected 10,000 tweets from the members of US Senate and computed the Flesch-Kincaid readability score. Comparing the Senators’ tweets to the ones from average internet users, we note 1) US Senators’ readability based on their tweets rate is much higher, and 2) immense difference among average citizen’s score compared to those of US Senators is attributed to the wide spectrum of academic attainment.
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15
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Trajectories of middle-aged and elderly people's chronic diseases Disability Adjusted Life Years (DALYs): cohort, socio-economic status and gender disparities. Int J Equity Health 2021; 20:179. [PMID: 34344369 PMCID: PMC8335861 DOI: 10.1186/s12939-021-01517-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/17/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The accelerated aging trend brought great chronic diseases burdens. Disabled Adjusted Life Years (DALYs) is a novel way to measure the chronic diseases burden. This study aimed to explore the cohort, socioeconomic status (SES), and gender disparities of the DALYs trajectories. METHODS A total of 15,062 participants (55,740 observations) comes from China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. Mixed growth curve model was adopted to predict the DALYS trajectories in 45-90 years old people influenced by different birth cohorts and SES. RESULTS We find significant cohort, SES (resident place, education level and income) disparities differences in the chronic diseases DALYs. For individuals of earlier cohort, DALYs are developed in a late age but grow fast with age but reversed for most recent cohorts. Living in urban, having higher SES level will decrease the growth rate with age, but converges for most recent cohorts. Meanwhile, DALYs disparities of resident place and education level show gender differentials that those for female are narrowed across cohort but for male are not. CONCLUSIONS The cohort effects on chronic diseases DALYs are accumulated with China's unique social, and political settings. There are large inequalities in early experiences, SES and DALYs. Efforts of reducing these inequalities must focus on the lower SES individuals and those living in rural areas, which greatly benefit individuals from recent cohorts.
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16
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Socio-economic position as a moderator of cardiometabolic outcomes in patients receiving psychotropic treatment associated with weight gain: results from a prospective 12-month inception cohort study and a large population-based cohort. Transl Psychiatry 2021; 11:360. [PMID: 34226496 PMCID: PMC8257637 DOI: 10.1038/s41398-021-01482-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 05/17/2021] [Accepted: 06/07/2021] [Indexed: 01/21/2023] Open
Abstract
Weight gain and metabolic complications are major adverse effects of many psychotropic drugs. We aimed to understand how socio-economic status (SES), defined as the Swiss socio-economic position (SSEP), is associated with cardiometabolic parameters after initiation of psychotropic medications known to induce weight gain. Cardiometabolic parameters were collected in two Swiss cohorts following the prescription of psychotropic medications. The SSEP integrated neighborhood-based income, education, occupation, and housing condition. The results were then validated in an independent replication sample (UKBiobank), using educational attainment (EA) as a proxy for SES. Adult patients with a low SSEP had a higher risk of developing metabolic syndrome over one year versus patients with a high SSEP (Hazard ratio (95% CI) = 3.1 (1.5-6.5), n = 366). During the first 6 months of follow-up, a significant negative association between SSEP and body mass index (BMI), weight change, and waist circumference change was observed (25 ≤ age < 65, n = 526), which was particularly important in adults receiving medications with the highest risk of weight gain, with a BMI difference of 0.86 kg/m2 between patients with low versus high SSEP (95% CI: 0.03-1.70, n = 99). Eventually, a causal effect of EA on BMI was revealed using Mendelian randomization in the UKBiobank, which was notably strong in high-risk medication users (beta: -0.47 SD EA per 1 SD BMI; 95% CI: -0.46 to -0.27, n = 11,314). An additional aspect of personalized medicine was highlighted, suggesting the patients' SES represents a significant risk factor. Particular attention should be paid to patients with low SES when initiating high cardiometabolic risk psychotropic medications.
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17
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Kirschner M, Shafiei G, Markello RD, Makowski C, Talpalaru A, Hodzic-Santor B, Devenyi GA, Paquola C, Bernhardt BC, Lepage M, Chakravarty MM, Dagher A, Mišić B. Latent Clinical-Anatomical Dimensions of Schizophrenia. Schizophr Bull 2020; 46:1426-1438. [PMID: 32744604 PMCID: PMC8496914 DOI: 10.1093/schbul/sbaa097] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Widespread structural brain abnormalities have been consistently reported in schizophrenia, but their relation to the heterogeneous clinical manifestations remains unknown. In particular, it is unclear whether anatomical abnormalities in discrete regions give rise to discrete symptoms or whether distributed abnormalities give rise to the broad clinical profile associated with schizophrenia. Here, we apply a multivariate data-driven approach to investigate covariance patterns between multiple-symptom domains and distributed brain abnormalities in schizophrenia. Structural magnetic resonance imaging and clinical data were derived from one discovery sample (133 patients and 113 controls) and one independent validation sample (108 patients and 69 controls). Disease-related voxel-wise brain abnormalities were estimated using deformation-based morphometry. Partial least-squares analysis was used to comprehensively map clinical, neuropsychological, and demographic data onto distributed deformation in a single multivariate model. The analysis identified 3 latent clinical-anatomical dimensions that collectively accounted for 55% of the covariance between clinical data and brain deformation. The first latent clinical-anatomical dimension was replicated in an independent sample, encompassing cognitive impairments, negative symptom severity, and brain abnormalities within the default mode and visual networks. This cognitive-negative dimension was associated with low socioeconomic status and was represented across multiple races. Altogether, we identified a continuous cognitive-negative dimension of schizophrenia, centered on 2 intrinsic networks. By simultaneously taking into account both clinical manifestations and neuroanatomical abnormalities, the present results open new avenues for multi-omic stratification and biotyping of individuals with schizophrenia.
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Affiliation(s)
- Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada
| | - Golia Shafiei
- McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada
| | - Ross D Markello
- McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada
| | - Carolina Makowski
- McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada
| | - Alexandra Talpalaru
- Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Montréal, Canada,Department of Biological and Biomedical Engineering, McGill University, Montréal, Canada
| | - Benazir Hodzic-Santor
- McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada
| | - Gabriel A Devenyi
- Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Montréal, Canada,Department of Psychiatry, McGill University, Montréal, Canada
| | - Casey Paquola
- McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada
| | - Boris C Bernhardt
- McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada
| | - Martin Lepage
- Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Montréal, Canada,Department of Psychiatry, McGill University, Montréal, Canada
| | - M Mallar Chakravarty
- Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Montréal, Canada,Department of Biological and Biomedical Engineering, McGill University, Montréal, Canada,Department of Psychiatry, McGill University, Montréal, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada
| | - Bratislav Mišić
- McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montreal, Canada,To whom correspondence should be addressed; tel: 514-398-1857, fax: 514-398-1857, e-mail:
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Shelef L, Tomer G, Tatsa-Laur L, Kedem R, Bonne O, Fruchter E. Risk factors for suicide in the Israeli army between the years 1992–2012: A case-control study. Eur Psychiatry 2020; 39:106-113. [DOI: 10.1016/j.eurpsy.2016.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 11/27/2022] Open
Abstract
AbstractObjectiveYoung age, availability of weapons, and stressful life events, increase the risk of suicide. The aim of the present study was to assess additional risk factors for suicide in the Israeli army.MethodsWe conducted a case-control study, to assess risk factors for suicide. The cases comprised soldiers who died by suicide during their military service (n = 462; 0.039% of all soldiers in the cohort). The control group consisted of soldiers who did not commit suicide but were in active service during the investigated period (n = 1,170,895; 99.96%). Predictor variables, including socio-demographic and psychiatric diagnoses, were considered.ResultsUsing a Generalized Linear Model with a Binary Logistic dependent variable to predict suicide, while controlling the effect of intervening variables, we found the following variables enhanced the risk for committing suicide: male (RR = 6.703; P < 0.001), country of origin: Ethiopia (RR = 4.555; P = 0.014), low socioeconomic status (RR = 1.448; P = 0.016) and low adjustment difficulties (RR = 2.324; P < 0.001). In addition, we found that in males only, Cluster B Personality Disorder (RR = 2.548; P = 0.027), low (RR = 1.657; P = 0.002), to average motivation to serve in a combat unit (RR = 1.322; P = 0.046) increased the risk for suicide.ConclusionsIDF Soldiers bearing a psychiatric diagnosis or severe adjustment difficulties remained tightly monitored through their military service, and were found to be at a lower risk for suicide. However, those enlisted with mild (low) difficulties, were found to be at greater risk for suicide, as well as soldiers whose country of origin is Ethiopia. Suicide prevention program should focus on monitoring soldiers with these risk factors, together with soldiers’ guidance regarding help seeking and de-stigmatizing suicide.
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Weiser M, Fenchel D, Frenkel O, Fruchter E, Burshtein S, Yehuda AB, Yoffe R, Bergman-Levi T, Reichenberg A, Davidson M, Sandin S. Understanding the association between advanced paternal age and schizophrenia and bipolar disorder. Psychol Med 2020; 50:431-437. [PMID: 30827282 DOI: 10.1017/s0033291719000242] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous studies reported an association between advanced paternal age at birth and increased risk for schizophrenia and bipolar disorder. While some hypothesize that this association is caused by de-novo mutations in paternal spermatozoa, others cite factors associated with psycho-social characteristics of fathers who have children at a late age. This study aims to test these hypotheses. METHODS A historical-prospective, population-based cohort study, performed by linking the Israeli Draft Board Registry and the Israeli National Psychiatric Hospitalization Registry (N = 916 439; 4488 with schizophrenia, 883 with bipolar disorder). Odds ratios (OR) and two-sided 95% confidence intervals (CI) were calculated by logistic regression models, using paternal age as predictor and risk for later hospitalizations for schizophrenia or bipolar disorder as outcome measure. Models were first fitted unadjusted, then adjusted for paternal age at birth of the first child. RESULTS In the unadjusted model, offspring of fathers aged 45 and above at birth had increased risk of schizophrenia (OR = 1.71, 95% CI 1.49-1.99) and bipolar disorder (OR = 1.63, 95% CI 1.16-2.24). However, taking into account paternal age at birth of first child, advanced paternal age was no longer associated with increased risk of schizophrenia (OR = 0.60, 95% CI 0.48-0.79) or bipolar disorder (OR = 1.03, 95% CI 0.56-1.90). CONCLUSIONS Controlling for paternal age at birth of the first offspring, advanced paternal age does not predict increased risk for schizophrenia or bipolar disorder. These data indicate that the association between advanced paternal age and having an offspring with schizophrenia and bipolar disorder is likely due to psychos-social factors, or common genetic variation associated with delayed initial fatherhood.
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Affiliation(s)
- Mark Weiser
- Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daphna Fenchel
- Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Or Frenkel
- Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Eyal Fruchter
- IDF Medical Corps, Israel
- Department of Psychiatry, Rambam Medical Center, Haifa, Israel
- Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Shimon Burshtein
- Department of Psychiatry, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | | | - Rinat Yoffe
- Department of Mental Health, Ministry of Health, Israel
| | | | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment at Mount Sinai, New York, NY, USA
| | - Michael Davidson
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sven Sandin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment at Mount Sinai, New York, NY, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Shelef L, Essami N, Birani A, Hartal M, Yavnai N. Personal and psychiatric characteristics among Druze soldiers attempting suicide during military service. J Affect Disord 2019; 256:486-494. [PMID: 31260831 DOI: 10.1016/j.jad.2019.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 04/22/2019] [Accepted: 06/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND A non-fatal suicide attempt is a strong predictor of suicide. This study aimed to examine personal characteristics and psychiatric diagnoses among Druze soldiers who attempted suicide during their military service. METHOD The research group (n = 180) included all Druze soldiers who had attempted suicide between the years 2008-2012 (This number encompassed 18.4% of all suicide attempts in the IDF during those years). Three control groups were examined: Jewish soldiers who had attempted suicide (n = 155), and two additional groups comprising Druze and Jewish combat soldiers who had not attempted suicide (n = 5,255 and n = 205,819, respectively). RESULTS While Druze soldiers were diagnosed with psychiatric conditions less frequently than their Jewish counterparts, the more prolonged time to diagnosis among Druze may account for increased severity at time of diagnosis, thus increasing the risk of suicide attempt. A multivariate analysis revealed that the odds of a suicide attempt among Druze soldiers were much higher than among Jewish soldiers (OR 20.53; p < .001). In addition, it was found that average and high socioeconomic levels, strong Hebrew language skills, and high intelligence levels were protective factors against attempted suicide (p < .001, R2 = 0.217). LIMITATIONS The three control groups were samples, while the research group (Druze attempters) consisted of all instances of attempted suicide during the study period. Comparing only samples would have offered less statistical power; therefore, using all the records in the research group improved accuracy.
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Affiliation(s)
- Leah Shelef
- Psychology Branch, Israel Air Force, Ramat Gan, Israel.
| | - Nabih Essami
- Military Track, The Hebrew University - Hadassah Medical School, Israel.
| | | | - Michael Hartal
- Military Track, The Hebrew University - Hadassah Medical School, Israel; Myers JDC Brookdale Institute, Israel.
| | - Nirit Yavnai
- Israel Defense Force Medical Corps, Ramat Gan, Israel.
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21
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Kodesh A, Levav I, Levine SZ. Exposure to Genocide and the Risk of Dementia. J Trauma Stress 2019; 32:536-545. [PMID: 31206904 DOI: 10.1002/jts.22406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 02/02/2019] [Accepted: 02/03/2019] [Indexed: 01/19/2023]
Abstract
Competing hypotheses stating that past genocide exposure reduces (owing to resilience) versus increases (owing to vulnerabilities) the risk of dementia are yet to receive empirical support. This study tested these competing hypotheses. Registry data were extracted on 51,752 Israeli residents without dementia from September 2002 to January 2012; individuals were born between 1901 and 1945, alive on January 2012, and followed-up for the risk of dementia between January 2013 and October 2017. Groups were classified as exposed to the European Holocaust, based on government recognition, or unexposed. Hazard ratios (HRs) from Cox regression models were used to quantify the risk of dementia between the groups, adjusting for demographic and diagnostic covariates; additionally, 12 sensitivity analyses were computed. In total 10,780 participants (20.8%) were exposed to the Holocaust and 5,584 (10.8%) were diagnosed with dementia during follow-up. Dementia rates were 16.5% in the Holocaust-exposed group and 9.3% in the unexposed group. In the primary analysis, the estimated unadjusted HR of dementia for the exposed compared to the unexposed group was 1.77, 95% CI [1.67, 1.87], and the adjusted HR was 1.21, 95% CI [1.15, 1.28]. Sensitivity analyses significantly replicated the primary results with similar point estimates, adjusted HRs = 1.18-1.28, all ps < .001; all HRs had a small effect size. The current study results are consistent with the hypothesis that exposure to the extreme adversities of genocide heightens vulnerability to the risk of dementia in later life.
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Affiliation(s)
- Arad Kodesh
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.,Meuchedet Healthcare, Department of Mental Health, Tel Aviv, Israel
| | - Itzhak Levav
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Stephen Z Levine
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Shelef L, Klomek AB, Fruchter E, Kedem R, Mann JJ, Zalsman G. Suicide ideation severity is associated with severe suicide attempts in a military setting. Eur Psychiatry 2019; 61:49-55. [PMID: 31288210 DOI: 10.1016/j.eurpsy.2019.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/12/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND There is an ongoing debate on the effectiveness of suicidal behavior prevention measures in the military. The association of three widely used tools with severe suicide attempts was assessed in this setting. METHODS Thirty-nine Israeli soldiers (59% males), mean age 19 yrs., who attempted suicide during military service were divided into two groups: severe (n = 14; 35.9%) and moderate suicide attempts, and were assessed using the Scale for Suicide Ideation (SSI), Suicide Intent Scale (SIS) and the Columbia Suicide Severity Rating Scale (C-SSRS). RESULTS Seven items from the SSI (p = 0.008), two items from SIS and one item from C-SSRS were associated with severe suicide attempts. Kendall's tau-b correlation with bootstrap demonstrated stability of these correlations. CONCLUSION Greater severity of suicidal ideation was associated with more severe suicide attempts. The combination of male gender, available firearms and current severe suicide ideation is high-risk danger sign in a military setting, even when reported intent to die is low.
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Affiliation(s)
- Leah Shelef
- Psychology Branch, Israeli Air Forces, Israel Defense Force, Ramat Gan, Israel
| | | | - Eyal Fruchter
- Psychiatry & Mental Health Division, Rambam Health Care Campus, Haifa, Israel
| | - Ron Kedem
- Medical Corps, Israel Defense Forces, Israel
| | - J John Mann
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York City, USA
| | - Gil Zalsman
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York City, USA; Geha Mental Health Center of the Clalit HMO, Petah Tiqwa, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Ayesa-Arriola R, Setién-Suero E, Neergaard KD, Belzunces ÀA, Contreras F, van Haren NEM, Crespo-Facorro B. Premorbid IQ subgroups in first episode non affective psychosis patients: Long-term sex differences in function and neurocognition. Schizophr Res 2018; 197:370-377. [PMID: 29275855 DOI: 10.1016/j.schres.2017.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/07/2017] [Accepted: 12/13/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Low IQ has been associated with schizophrenia, even to the point of being posited as a possible causal factor for psychosis. However, individuals with normal and high IQ also develop psychotic illnesses. The aim of this study was to characterize premorbid IQ subgroups at first episode of psychosis (FEP). METHODS The study sample comes from a large epidemiological, 3-year longitudinal, intervention program on psychosis containing individuals living in a catchment area in Spain. Estimated premorbid IQ (epIQ) scores were used to build low (<90), normal (90-110) and high (>110) epIQ subgroups in samples of FEP patients (N=292) and healthy controls (N=199). The epIQ subgroups were compared in sociodemographic, neuropsychological, clinical and premorbid characteristics. Long-term functional and cognitive outcome, with a focus on sex differences, were also explored. RESULTS Low-epIQ was more frequently found in FEP patients (28.8%) than in healthy controls (14.6%). Low-epIQ patients were more likely to have worse premorbid adjustment, belong to low socioeconomic status families, have less years of education, and to be single, unemployed, and younger. They presented more severe impairments in processing speed, executive and global cognitive function. Female patients with low-epIQ showed better baseline function and more stable outcome than males. CONCLUSIONS Our results indicate that low premorbid IQ is a morbid manifestation, easily detected in a subgroup of FEP patients that predicts poorer outcome particularly in males. This perspective provides important information for the tailoring of subgroup-specific early intervention programs for psychosis.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Karl David Neergaard
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Àuria Albacete Belzunces
- Psychiatry Department, Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Fernando Contreras
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatry Department, Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Neeltje E M van Haren
- Brain Centre Rudolf Magnus, Department of Psychiatry, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Shelef L, Brunstein Klomek A, Yavnai N, Shahar G. Perceived Stress and Intent to Die in Young Soldiers Who Attempt Suicide. CRISIS 2018; 39:144-148. [DOI: 10.1027/0227-5910/a000481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Intent to die is an important component of suicide risk assessment. The authors compared the predictive effect of two forms of stress – military and perceived – in intent to die by suicide among young adult Israeli soldiers with a history of suicide attempts. Depression, suicide ideation, and habituation/acquired capacity for suicidality served as covariates. Methods: Participants were 60 young adult soldiers in the Israeli Defense Force (ISF; aged 18–21 years), who made a suicide attempt during their military service. Study variables were assessed using self-report measures. Results: Intent to die by suicide correlated with suicide ideation, habituation/acquired capacity, depressive symptoms, and perceived stress. In a multiple regression analysis, perceived stress predicted intent to die (b = .44, p = .002) over and above the prediction by suicide ideation (b = .42, p = .013) and acquired capacity/habituation (b = .28, p = .023). Limitations: The cross-sectional design restricts causal inference. In addition, an exclusive reliance on self-report measures might have inflated shared method variance. Conclusions: Perceived stress captures a unique dimension of intent to die by suicide among young suicide attempters.
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Affiliation(s)
- Leah Shelef
- Israeli Air Force, Mental Health Unit, Medical Corps, Israel Defense Force, Ramat Gan, Israel
| | | | - Nirit Yavnai
- Medical Corps, Israel Defense Force, Ramat Gan, Israel
| | - Golan Shahar
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Assessment of functioning and disability in patients with schizophrenia using the WHO Disability Assessment Schedule 2.0 in a large-scale database. Eur Arch Psychiatry Clin Neurosci 2018; 268:65-75. [PMID: 28801847 DOI: 10.1007/s00406-017-0834-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/06/2017] [Indexed: 12/28/2022]
Abstract
Schizophrenia is a common mental disorder characterized by deficits in multiple domains of functioning. This study is arguably the first of its kind in Taiwan to examine, in a multifaceted and objective manner, the disability of patients with schizophrenia and the factors affecting it. A cross-sectional design was adopted to gather data from 24,299 patients with schizophrenia who were listed in the Taiwan Databank of Persons with Disabilities. The level of disability in these patients was measured using the World Health Organization Disability Assessment Schedule 2.0. Statistical analyses were conducted through the χ 2 statistic and Poisson regression. The highest level of disability was in participation and the lowest was in self-care. An analysis of disability in all six domains of functioning on the basis of sex, age, type of residence, and socioeconomic status (SES) showed significant differences (P < 0.05). Significant factors (P < 0.05) affecting disability in these domains were female gender, age, educational attainment, SES, type of residence, and employment status. The overall degree of disability in schizophrenia patients was moderate. Six domains were measured in this study. The degrees of disability in mobility and self-care were mild while cognition, getting along, life activities, and participation were moderate. Moreover, female gender, an age of 45 or older, low educational attainment, middle to low SES, staying at healthcare institutions, and unemployment were crucial factors affecting disability of the participants. Preventive and rehabilitation programs should be developed to delay disability and functional degeneration in schizophrenic patients with these characteristics.
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26
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Sands N, Elsom S, Corbett R, Keppich-Arnold S, Prematunga R, Berk M, Considine J. Predictors for clinical deterioration of mental state in patients assessed by telephone-based mental health triage. Int J Ment Health Nurs 2017; 26:226-237. [PMID: 27779363 DOI: 10.1111/inm.12267] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 11/30/2022]
Abstract
Patient safety research focussing on recognizing and responding to clinical deterioration is gaining momentum in generalist health, but has received little attention in mental health settings. The focus on early identification and prompt intervention for clinical deterioration enshrined in patient safety research is equally relevant to mental health, especially in triage and crisis care contexts, yet the knowledge gap in this area is substantial. The present study was a controlled cohort study (n = 817) that aimed to identify patient and service characteristics associated with clinical deterioration of mental state indicated by unplanned admission to an inpatient psychiatric unit following assessment by telephone-based mental health triage. The main objective of the research was to produce knowledge to improve understandings of mental deterioration that can be used to inform early detection, intervention, and prevention strategies at the point of triage. The results of the study found that the clinical profile of admitted patients was one of complexity and severity. Admitted patients were more likely to have had complex psychiatric histories with multiple psychiatric admissions, severe psychotic symptoms, a history of treatment non-adherence, and poorer social functioning than non-admitted patients.
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Affiliation(s)
- Natisha Sands
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Stephen Elsom
- Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Roshani Prematunga
- Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Julie Considine
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
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Use of analgesics in young adults as a predictor of health care utilization and pain prevalence: Israel defense forces experience. Pain 2017; 158:1145-1152. [PMID: 28282361 DOI: 10.1097/j.pain.0000000000000897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pain evaluation in large community studies is difficult. Analgesics can be a useful tool in estimating pain-related conditions in which analgesic use is highly regulated. In this study, we evaluated analgesics consumption patterns of regular Israel Defense Force soldiers. We have performed a historical cohort study of 665,137 young adults during active duty in 2002 to 2012. Analgesics were prescribed to 518,242 (78%) soldiers, mostly for musculoskeletal pain (69.3%), abdominal pain (12.7%), and headache (12.1%). Acute (1-14 days), subacute (15-90), and chronic (>90 days) analgesic use episodes were experienced by 396,987 (59.7%), 74,591 (11.2%), and 46,664 (7%) of the population. In a multivariate model, predictors for chronic analgesics use were as follows: low intelligence, service in a combat supporting unit, previous pain diagnosis, male sex, Israeli nativity, low socioeconomic status, and high body mass index. Low intelligence had the highest odds ratio for chronic analgesic consumption (2.1) compared with other predictors. Chronic analgesic use was associated with a significant increase in health care utilization cost per year (911$ per soldier vs 199$ for nonusers), increased sick leave days per year (7.09 vs 0.67 for nonusers), and higher dropout rate from combat units (25% vs 9.2% for nonusers). Chronic use of analgesics is common among young adults, and it is an important predictor for unsuccessful military service and high health care utilization costs. Further studies in other setups are indicated.
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Shelef L, Ayzen E, Yavnai N, Fruchter E, Sarid O. The contribution of the socio-demographic characteristics on suicidal ideation among Israeli soldiers. DISASTER AND MILITARY MEDICINE 2017; 2:5. [PMID: 28265439 PMCID: PMC5330142 DOI: 10.1186/s40696-016-0014-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/27/2016] [Indexed: 11/30/2022]
Abstract
Background Suicidal ideation is a risk factor for suicide attempt. The aim of the present study is to compare suicidal ideation of different groups with different distress. Methods 100 soldiers, aged 18–21, divided into four research cohorts: soldiers who had carried out a suicide attempt (n = 40); soldiers with a psychiatric diagnosis (n = 20); soldiers having high severity adjustment difficulties (n = 20); and a control group of soldiers, having neither a history of mental health diagnosis, nor adjustment difficulties (n = 20). All completed the suicide ideation scale. Results Half of the attempters had a psychiatric diagnosis (depression or anxiety) on the day of their enlistment and 37.5 % of them had a specified personality disturbance. The attempters were characterized by previously-attempted suicide (p < .01). The lowest mean values (M = 1.95, SD = .67) were among the attempter (F = 3.173, df = 3, p = .02) in motivation for military service. The variable expressing low motivation for military service was the sole predictor of suicide ideation (p = .032). Conclusions Early diagnosis facilitated better monitoring by military mental health officers.
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Affiliation(s)
- Leah Shelef
- Psychology Branch, Israel Air Force, Ramat-Gan, Israel.,Mental Health Department, Israel Defense Forces Medical Corps, Ramat-Gan, Israel
| | - Evyatar Ayzen
- Mental Health Department, Israel Defense Forces Medical Corps, Ramat-Gan, Israel
| | - Nirit Yavnai
- IDF Medical Corps, Israel Defense Forces, Ramat-Gan, Israel
| | - Eyal Fruchter
- Mental Health Department, Israel Defense Forces Medical Corps, Ramat-Gan, Israel
| | - Orly Sarid
- Department of Social Work, Faculty of Humanities & Social Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Relationship between anxiety and medical disorders among compulsory military service candidates between the years 1998-2013. Psychiatry Res 2016; 244:339-44. [PMID: 27517344 DOI: 10.1016/j.psychres.2016.07.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 07/22/2016] [Indexed: 11/24/2022]
Abstract
One of the most common psychiatric diagnoses among adolescents is anxiety disorder. Many of the anxiety symptoms are expressed physiologically, and therefore can mimic other medical conditions. The aim of this study was to examine the association between anxiety disorders and other medical conditions sharing common symptoms with anxiety (MDSCSA: Irritable Bowel Syndrome, asthma, migraine and hyperhidrosis). The study was based on the national database of the candidates for military service in Israel. Data for the years 1998-2013 was retrieved to create the study dataset. The final cohort population was comprised of 1,229,461 military service candidates. Anxiety prevalence and its association with other medical conditions sharing the same symptoms was examined in the cohort. The results showed significant statistical association between anxiety and IBS, asthma, migraine and hyperhidrosis. These findings support the fact that there is a clear association between anxiety disorder and the examined medical conditions. Moreover, in the military setting, the primary care physician has an important role in giving a correct diagnosis for soldiers presenting with symptoms that can be regarded both to anxiety and to other physical illnesses.
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Examining patient race and area predictors of inpatient admission for schizophrenia among hospital users in California. J Immigr Minor Health 2016; 16:1025-34. [PMID: 23636464 DOI: 10.1007/s10903-013-9831-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
According to international research African-Caribbean and Black African populations have increased risk of hospitalization for schizophrenia, compared to Whites. Less is known about admission risk for other racial-ethnic groups. This study investigated racial-ethnic differences in hospital admission for schizophrenia in California. It also investigated the influence of area social factors (racial-ethnic neighborhood composition, and per capita income) and health service factors (presence of primary care clinics). The study sample included individuals admitted to a California hospital during 1990-2005 with a primary appendicitis related diagnosis, and without a prior or concurrent indication of schizophrenia. The adjusted logistic model examined how patient racial-ethnicity (White, Black, Hispanic, Other), other personal, area social characteristics and presence of primary care clinics influenced hospital admissions for schizophrenia. Black individuals were almost twice as likely as Whites to be admitted while Hispanics and Other race individuals were less to be admitted. In addition, male sex, having more comorbidities and living in areas with greater proportions of non-Whites increased risk. The increased risk for Blacks compared to Whites was consistent with the existing literature. However, this is among the first studies to report that Hispanics had a reduced risk of admission for schizophrenia, compared to Whites. Future studies may want to include a broader range of health services to better understand patterns of care use among individuals with schizophrenia.
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31
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Fry CE, Langley K, Shelton KH. A systematic review of cognitive functioning among young people who have experienced homelessness, foster care, or poverty. Child Neuropsychol 2016; 23:907-934. [DOI: 10.1080/09297049.2016.1207758] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | - Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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Fuller-Thomson E, Hollister B. Schizophrenia and Suicide Attempts: Findings from a Representative Community-Based Canadian Sample. SCHIZOPHRENIA RESEARCH AND TREATMENT 2016; 2016:3165243. [PMID: 26977319 PMCID: PMC4764754 DOI: 10.1155/2016/3165243] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 12/13/2015] [Accepted: 12/14/2015] [Indexed: 11/17/2022]
Abstract
This study examined factors associated with suicide attempts among those with schizophrenia (n = 101) versus those without (n = 21,643) in a representative sample of noninstitutionalized Canadians. The lifetime prevalence of suicide attempts among persons with schizophrenia was 39.2% versus 2.8% of nonafflicted individuals. After adjusting for sociodemographics, childhood adversities, substance abuse/dependence, depression/anxiety, and chronic pain, those with schizophrenia had 6 times the odds (OR = 6.47) of attempting suicide. Among persons with schizophrenia, suicide attempts were associated with female gender (OR = 4.59), substance abuse/dependence (OR = 6.31), depression (OR = 4.93), and childhood physical abuse (OR = 5.75). Community-dwelling persons with schizophrenia appear to be at high risk for suicide attempts.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada M5S 1V4
| | - Bailey Hollister
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada M5S 1V4
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Falk J, Burström B, Dalman C, Jörgensen L, Bruce D, Nylén L. Employment and income among first-time cases diagnosed with non-affective psychosis in Stockholm, Sweden: a follow-up study 2004/2005-2010. Soc Psychiatry Psychiatr Epidemiol 2016; 51:259-67. [PMID: 26510416 DOI: 10.1007/s00127-015-1141-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Non-affective psychoses (F20-F29) are serious conditions causing a high degree of disability. Loss of income and increasing costs for personal care and treatment are severe consequences following the disorders, but less is known about employment and income in different social strata. The aim was to study these conditions among persons with non-affective psychosis compared to the general population, and possible social differentials. METHODS A population-based follow-up study with 530,350 persons (aged 18-44), including 756 first-time cases diagnosed with non-affective psychosis registered in in- or outpatient psychiatric care in 2005 or 2006. Age-standardised rates of non-employment, disability pension, social assistance and poverty were calculated at baseline and at follow-up in 2010. Odds ratios of poverty were estimated using logistic regression, adjusting for employment status, age, education and country of birth. RESULTS Before diagnosis, rates of non-employment, disability pension and social assistance were higher among persons with non-affective psychosis compared to the general population. At the follow-up, rates of disability pension had doubled, most pronounced among women with only compulsory education. Rates of social assistance were twice as high for foreign-born women. Among persons with non-affective psychosis, non-employment, lower education (among men) and being foreign born (among women) were associated with an increased risk of poverty at follow-up. CONCLUSIONS Poor employment and income conditions were found among persons with non-affective psychosis, but the social insurance system seemed to alleviate the poor income conditions. Early and preventative support to encourage employment and income security is needed, which could support recovery.
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Affiliation(s)
- Johanna Falk
- Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.
| | - Bo Burström
- Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden
| | - Christina Dalman
- Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden
| | - Lena Jörgensen
- Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden
| | - Daniel Bruce
- Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden
| | - Lotta Nylén
- Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden
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Clemmensen L, van Os J, Drukker M, Munkholm A, Rimvall MK, Væver M, Rask CU, Bartels-Velthuis AA, Skovgaard AM, Jeppesen P. Psychotic experiences and hyper-theory-of-mind in preadolescence--a birth cohort study. Psychol Med 2016; 46:87-101. [PMID: 26347066 DOI: 10.1017/s0033291715001567] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Knowledge on the risk mechanisms of psychotic experiences (PE) is still limited. The aim of this population-based study was to explore developmental markers of PE with a particular focus on the specificity of hyper-theory-of-mind (HyperToM) as correlate of PE as opposed to correlate of any mental disorder. METHOD We assessed 1630 children from the Copenhagen Child Cohort 2000 regarding PE and HyperToM at the follow-up at 11-12 years. Mental disorders were diagnosed by clinical ratings based on standardized parent-, teacher- and self-reported psychopathology. Logistic regression analyses were performed to test the correlates of PE and HyperToM, and the specificity of correlates of PE v. correlates of any Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) mental disorder. RESULTS Univariate analyses showed the following correlates of PE: familial psychiatric liability; parental mental illness during early child development; change in family composition; low family income; regulatory problems in infancy; onset of puberty; bullying; concurrent mental disorder; and HyperToM. When estimating the adjusted effects, only low family income, concurrent mental disorder, bullying and HyperToM remained significantly associated with PE. Further analyses of the specificity of these correlates with regard to outcome revealed that HyperToM was the only variable specifically associated with PE without concurrent mental disorder. Finally, HyperToM did not share any of the investigated precursors with PE. CONCLUSIONS HyperToM may have a specific role in the risk trajectories of PE, being specifically associated with PE in preadolescent children, independently of other family and child risk factors associated with PE and overall psychopathology at this age.
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Affiliation(s)
- L Clemmensen
- Child and Adolescent Mental Health Center,Mental Health Services,the Capital Region of Denmark,Denmark
| | - J van Os
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - M Drukker
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - A Munkholm
- Child and Adolescent Mental Health Center,Mental Health Services,the Capital Region of Denmark,Denmark
| | - M K Rimvall
- Child and Adolescent Mental Health Center,Mental Health Services,the Capital Region of Denmark,Denmark
| | - M Væver
- Department of Psychology,University of Copenhagen,Copenhagen,Denmark
| | - C U Rask
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital,Aarhus,Denmark
| | - A A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry,Groningen,The Netherlands
| | - A M Skovgaard
- Department of Public Health,University of Copenhagen,Copenhagen,Denmark
| | - P Jeppesen
- Child and Adolescent Mental Health Center,Mental Health Services,the Capital Region of Denmark,Denmark
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Velthorst E, Reichenberg A, Rabinowitz J, Levine SZ. Study of resilience and environmental adversity in midlife health (STREAM). Soc Psychiatry Psychiatr Epidemiol 2015; 50:1915-22. [PMID: 26464376 PMCID: PMC4654741 DOI: 10.1007/s00127-015-1126-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 09/21/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE The Jerusalem study of resilience and environmental adversity in midlife health (STREAM) was established to examine the prevalence of common mental and physical health issues in mid-adulthood in the inner city of Jerusalem, and to examine their association with lifespan psychosocial factors of vulnerability and resilience. METHOD Participants were 811 randomly selected individuals from 7000 individuals who were born and grew up in inner-Jerusalem. Participants were 34-44 years old during first wave of STREAM assessment. Initial telephone surveys took place in 2007-2008 and participants were followed-up for a second survey 1 year later. Upon funding, a new wave is planned for 2017-2018. Survey topics comprised common health problems (e.g., type 2 diabetes/migraine), health markers (e.g., BMI), and psychiatric vulnerabilities (e.g., anxiety, post-traumatic stress, depressive symptoms, psychosis). Other measures included socioeconomic status, creativity, life style behavior (e.g., smoking, exercise), social contact and adaptation to change. Survey data were retrospectively merged with data of national registry sources that included adverse psychosocial factors, psychiatric and social measures assessed across all developmental stages through midlife. This includes data available on birth factors, school achievement and adjustment, cognitive and behavioral functioning during young adulthood, psychiatric hospitalizations, immigration and socioeconomic status. RESULTS Results on health outcomes of the first STREAM wave indicate that prevalence rates of health problems are comparable to recent World Mental Health Surveys. CONCLUSIONS Apart from measures on adverse psychosocial factors, STREAM provides a cohort to examine resilience to developing health problems and having a poor health and functional outcome.
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Affiliation(s)
- Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY, 10029, USA.
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands.
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY, 10029, USA
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | | | - Stephen Z Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Cukierman-Yaffe T, Kasher-Meron M, Fruchter E, Gerstein HC, Afek A, Derazne E, Tzur D, Karasik A, Twig G. Cognitive Performance at Late Adolescence and the Risk for Impaired Fasting Glucose Among Young Adults. J Clin Endocrinol Metab 2015; 100:4409-16. [PMID: 26431506 DOI: 10.1210/jc.2015-2012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
CONTEXT Although dysglycemia is a risk factor for cognitive decline, it is unknown whether cognitive performance among young and apparently healthy adults affect the risk for impaired fasting glucose (IFG). OBJECTIVE This study aimed to characterize the relationship between cognitive function and the risk for IFG among young adults. DESIGN AND SETTING This was a retrospective cohort study utilizing data collected at pre-military recruitment assessments with information collected at the screening center of Israeli Army Medical Corps. PARTICIPANTS Normoglycemic adults (n = 17 348) (free of IFG and diabetes; mean age 31.0 ± 5.6 y; 87% men) of the Metabolic Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort with data regarding their General Intelligence Score (GIS), a comprehensive measure of cognitive function, at age 17 y. INTERVENTIONS Fasting plasma glucose was assessed every 3-5 y at scheduled visits. Cox proportional hazards models were applied. MAIN OUTCOMES MEASURES The main outcome of the study was incident IFG (≥ 100 mg/dL and <126 mg/dL) at scheduled visits. RESULTS During a median followup of 6.6 y, 1478 cases of IFG were recorded (1402 men). After adjustment for age and sex, participants in the lowest GIS category had a 1.9-fold greater risk for incident IFG compared with those in the highest GIS category. In multivariable analysis adjusted for age, sex, body mass index, fasting plasma glucose, family history of diabetes, country of origin, socioeconomic status, education, physical activity, smoking status, alcohol consumption, breakfast consumption, triglyceride level, white blood cell count, the risk for IFG was nearly doubled in the lowest GIS category compared with the highest GIS category (hazard ratio, 1.8; 95% confidence interval, 1.4-2.3; P < .001). These results persisted when GIS was treated as a continuous variable and when the model was adjusted also for body mass index at the end of followup. CONCLUSIONS This study demonstrates that lower cognitive function at late adolescence is independently associated with an elevated risk IFG in both men and women.
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Affiliation(s)
- Tali Cukierman-Yaffe
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Michal Kasher-Meron
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Eyal Fruchter
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Hertzel C Gerstein
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Estela Derazne
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Dorit Tzur
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Avraham Karasik
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Gilad Twig
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
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Shelef L, Kaminsky D, Carmon M, Kedem R, Bonne O, Mann JJ, Fruchter E. Risk factors for suicide attempt among Israeli Defense Forces soldiers: A retrospective case-control study. J Affect Disord 2015; 186:232-40. [PMID: 26253904 DOI: 10.1016/j.jad.2015.07.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 06/27/2015] [Accepted: 07/08/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND A major risk factor for suicide is suicide attempts. The aim of the present study was to assess risk factors for nonfatal suicide attempts. Methods The study's cohort consisted of 246,814 soldiers who were divided into two groups: soldiers who made a suicide attempt (n=2310; 0.9%) and a control group of soldiers who did not (n=244,504; 99.1%). Socio-demographic and personal characteristics as well as psychiatric diagnoses were compared. Results The strongest risk factors for suicide attempt were serving less than 12 months (RR=7.09) and a history of unauthorized absence from service (RR=5.68). Moderate risk factors were low socioeconomic status (RR=2.17), psychiatric diagnoses at induction (RR=1.94), non-Jewish religion (RR=1.92), low intellectual rating score (RR=1.84), serving in non-combat unit (RR=1.72) and being born in the former Soviet Union (RR=1.61). A weak association was found between male gender and suicide attempt (RR=1.36). Soldiers who met more frequently with a primary care physician (PCP) had a higher risk for suicide attempt, as opposed to a mental health professional (MHCP), where frequent meetings were found to be a protective factor (P<0.0001). The psychiatric diagnoses associated with a suicide attempt were a cluster B personality disorder (RR=3.00), eating disorders (RR=2.78), mood disorders (RR=2.71) and adjustment disorders (RR=2.26). LIMITATIONS Mild suicidal behavior constitutes a much larger proportion than among civilians and may have secondary gain thus distorting the suicidal behavior data. CONCLUSIONS Training primary care physicians as gatekeepers and improved monitoring, may reduce the rate of suicide attempts.
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Affiliation(s)
- Leah Shelef
- Psychology Branch, Israeli Air Force, Mental Health Unit, Medical Corps, Israel Defense Force, Israel
| | - Dan Kaminsky
- Military Track, The Hebrew University, Hadassah Medical School, Israel.
| | - Meytal Carmon
- Mental Health Unit, Medical Corps, Israel Defense Force, Israel
| | - Ron Kedem
- Statistican, Medical Corps, Israel Defense Force, Israel
| | - Omer Bonne
- Chair, Department of Psychiatry, The Hebrew University - Hadassah Medical School, Hadassah University Hospital, Israel
| | - J John Mann
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York City, USA
| | - Eyal Fruchter
- Mental Health Unit, Medical Corps, Israel Defense Force, Israel
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Cuesta MJ, Sánchez-Torres AM, Cabrera B, Bioque M, Merchán-Naranjo J, Corripio I, González-Pinto A, Lobo A, Bombín I, de la Serna E, Sanjuan J, Parellada M, Saiz-Ruiz J, Bernardo M. Premorbid adjustment and clinical correlates of cognitive impairment in first-episode psychosis. The PEPsCog Study. Schizophr Res 2015; 164:65-73. [PMID: 25819935 DOI: 10.1016/j.schres.2015.02.022] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/25/2015] [Accepted: 02/25/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND The extent to which socio-demographic, clinical, and premorbid adjustment variables contribute to cognitive deficits in first-episode schizophrenia spectrum disorders remains to be ascertained. AIMS To examine the pattern and magnitude of cognitive impairment in first-episode psychosis patients, the profile of impairment across psychosis subtypes and the associations with premorbid adjustment. METHODS 226 first-episode psychosis patients and 225 healthy controls were assessed in the PEPsCog study, as part of the PEPs study. RESULTS Patients showed slight to moderate cognitive impairment, verbal memory being the domain most impaired compared to controls. Broad affective spectrum patients had better premorbid IQ and outperformed the schizophrenia and other psychosis groups in executive function, and had better global cognitive function than the schizophrenia group. Adolescent premorbid adjustment together with age, gender, parental socio-economic status, and mean daily antipsychotic doses were the factors that best explained patients' cognitive performance. General and adolescent premorbid adjustment, age and parental socio-economic status were the best predictors of cognitive performance in controls. CONCLUSIONS Poorer premorbid adjustment together with socio-demographic factors and higher daily antipsychotic doses were related to a generalized cognitive impairment and to a lower premorbid intellectual reserve, suggesting that neurodevelopmental impairment was present before illness onset.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Jessica Merchán-Naranjo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Madrid, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario de Álava, University of the Basque Country, Vitoria, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón). University of Zaragoza, Spain
| | - Igor Bombín
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Reintegra Foundation, Oviedo, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clínic de Neurociències. Hospital Clínic Universitari, Barcelona, Spain
| | - Julio Sanjuan
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Clinic Hospital (INCLIVA), Valencia, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Madrid, Spain
| | - Jerónimo Saiz-Ruiz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Psychiatry Department, Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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Shelef L, Laur L, Fruchter E. Characteristics of the suicidal soldier in the Israeli Defense Force-a review of literature. DISASTER AND MILITARY MEDICINE 2015; 1:10. [PMID: 28265425 PMCID: PMC5329921 DOI: 10.1186/2054-314x-1-10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/05/2015] [Indexed: 11/18/2022]
Abstract
Suicide is the third leading cause of death among adolescents in most Western world countries. Similar findings have been reported among adolescents in Israel (including the Israeli army) in times of peace; nonetheless, suicide rate has decreased significantly in recent years. In Israel, IDF service is mandatory and adolescents are obligated to serve by law. Therefore, the IDF is responsible under state and moral law to care for the physical and mental health of its soldiers. Additionally, there is an understanding that the Israeli soldiers represent a mentally healthy population as prior to their enlistment they undergo a series of tests and evaluations to determine their suitability for service. The IDF is one of the few organizations in the world that is comprised of the majority of a country’s healthy adolescent population. International literature defines this population (i.e., the adolescent population) as having the highest risk of suicidality. Moreover, the risk of suicide increases in the face of two additional circumstances within the context of military service: the army service as a stressor and the availability of weapons. The IDF invests significant resources in delineating the characteristics of suicidal soldiers, realizing its importance for suicide prevention during military service. This article reviews studies regarding complete suicide cases of Israeli soldiers in the aim of characterising a ‘suicidal soldier’s profile’ to inform better screening and prevention policies.
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Affiliation(s)
- Leah Shelef
- Psychology Branch, Israeli Air Force, Kragujevac, Israel ; Mental Health Department, Israel Defense Force Medical Corps, Ramat Gan, Israel
| | - Lucian Laur
- Mental Health Department, Israel Defense Force Medical Corps, Ramat Gan, Israel
| | - Eyal Fruchter
- Mental Health Department, Israel Defense Force Medical Corps, Ramat Gan, Israel
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Kwok W. Is there evidence that social class at birth increases risk of psychosis? A systematic review. Int J Soc Psychiatry 2014; 60:801-8. [PMID: 24608029 DOI: 10.1177/0020764014524737] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In the 1950s, researchers showed an association between low socio-economic status (SES) and psychosis. Two competing theories social causation and social drift were proposed to explain the findings. In the intervening years, contrasting evidence emerged as some studies showed no association between SES and schizophrenia. At present, the nature of the relationship is still unclear; currently, there are no reviews in the literature examining the association between social class at birth and psychosis. AIM To search the literature to clarify the relationship between social class at birth, measured by paternal occupation at birth, and the risk of adult-onset psychosis. METHODS A systematic search of the literature using a combination of keywords in Group 1 together with the keywords in Group 2 was performed in October 2012 in the following online databases: (a) MEDLINE (1946-2012), (b) PubMed, (c) Embase (1980-2012), (d) PsycINFO (1806-2012) and (e) Web of Science (1899-2012). Reference lists were also hand searched. The search provided 3,240 studies; following screening of the titles and abstracts by inclusion and exclusion criteria and quality assessment of the full text, 14 studies were identified to be appropriate for the review. The keywords used for the search were as follows: Group 1 - social class, social status, socioeconomic, socio-economic, SES; Group 2 - psychosis, psychoses, schizophrenia. RESULTS Seven studies showed an association between low SES and psychosis. Four studies showed no association, and three studies showed an association with high SES. CONCLUSION There is not enough evidence to support the association between social class and psychosis. While some findings showed an association between low social class and psychosis, there were a number of conflicting studies showing no association or a link with higher social class. Interestingly, the results followed a temporal pattern, as all the studies conducted after 2001 supported an association between low SES at birth and psychosis. Four of the six studies employed a prospective design with large sample populations, indicating the need for further investigation.
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Affiliation(s)
- Wingfai Kwok
- School of Medicine, King's College London, London, UK
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Goldberg S, Werbeloff N, Fruchter E, Portuguese S, Davidson M, Weiser M. IQ and obesity in adolescence: a population-based, cross-sectional study. Pediatr Obes 2014; 9:419-26. [PMID: 24339055 DOI: 10.1111/j.2047-6310.2013.00203.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 09/03/2013] [Accepted: 09/09/2013] [Indexed: 12/20/2022]
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Low IQ is associated with high BMI in childhood. There are inconsistent findings on the association between low SES and high BMI. Youth with low IQ have been reported to have poorer health behaviors, such as poor nutrition and less physical activity. WHAT THIS STUDY ADDS Low IQ is significantly associated with obesity for both male and female adolescents, though more strongly for female adolescents. Physical activity has a mediating effect on the association between low IQ and obesity among both male and female adolescents, though more strongly for male adolescents. The association between low IQ and obesity is strongest among adolescents from high SES backgrounds. BACKGROUND Previous studies have shown an association between low intelligence quotient (IQ), high body mass index and low socioeconomic status (SES). OBJECTIVES This study examined the cross-sectional association between IQ and obesity, exploring the roles of gender, SES and physical activity in this association. METHODS Subjects were 235,663 male and 169,259 female adolescents assessed by the Israeli military draft board. RESULTS Low IQ was significantly associated with increased odds of obesity among male (odds ratio [OR] = 1.44, 95% confidence interval [CI] = 1.36-1.52) and female adolescents (OR = 1.61, 95% CI = 1.51-1.73); this association was significantly stronger among female adolescents. Sobel tests indicated that physical activity had a significant mediating effect on this association for male and female adolescents, although more strongly for male adolescents. Dividing the sample according to SES, the association between low IQ and obesity was strongest in the high SES group (male adolescents: OR = 1.26, 95% CI = 1.10-1.43, female adolescents: OR = 1.61, 95% CI = 1.38-1.89), even when controlling for physical activity. CONCLUSIONS The findings suggest that low IQ is associated with increased odds of obesity, particularly in female adolescents and in adolescents with high SES. Physical activity has a mediating effect on this association, although more strongly for male than for female adolescents. Public health measures on decreasing obesity might focus on these groups.
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Affiliation(s)
- S Goldberg
- Department of Psychiatry, Sheba Medical Center, Ramat Gan, Israel
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Twig G, Gluzman I, Tirosh A, Gerstein HC, Yaniv G, Afek A, Derazne E, Tzur D, Karasik A, Gordon B, Fruchter E, Lubin G, Rudich A, Cukierman-Yaffe T. Cognitive function and the risk for diabetes among young men. Diabetes Care 2014; 37:2982-8. [PMID: 25092683 DOI: 10.2337/dc14-0715] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diabetes is a risk factor for an accelerated rate of cognitive decline and dementia. However, the relationship between cognitive function and the subsequent development of diabetes is unclear. RESEARCH DESIGN AND METHODS We conducted a historical-prospective cohort study merging data collected at premilitary recruitment assessment with information collected at the Staff Periodic Examination Center of the Israeli Army Medical Corps. Included were men aged 25 years or older without a history of diabetes at the beginning of follow-up with available data regarding their general intelligence score (GIS), a comprehensive measure of cognitive function, at age 17 years. RESULTS Among 35,500 men followed for a median of 5.5 years, 770 new cases of diabetes were diagnosed. After adjustment for age, participants in the lowest GIS category had a 2.6-fold greater risk for developing diabetes compared with those in the highest GIS category. In multivariable analysis adjusted for age, BMI, fasting plasma glucose, sociogenetic variables, and lifestyle risk factors, those in the lowest GIS category had a twofold greater risk for incident diabetes when compared with the highest GIS category (hazard ratio 2.1 [95% CI 1.5-3.1]; P < 0.001). Additionally, participants in the lowest GIS category developed diabetes at a mean age of 39.5 ± 4.7 years and those in the highest GIS group at a mean age of 41.5 ± 5.1 years (P for comparison 0.042). CONCLUSIONS This study demonstrates that in addition to a potential causal link between diabetes and enhanced cognitive decline, lower cognitive function at late adolescence is independently associated with an elevated risk for future diabetes.
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Affiliation(s)
- Gilad Twig
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel Israel Defense Forces Medical Corps, Israel
| | - Israel Gluzman
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Tirosh
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA
| | - Hertzel C Gerstein
- Division of Endocrinology & Metabolism and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Gal Yaniv
- Israel Defense Forces Medical Corps, Israel Department of Radiology and Imaging, Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Israel Ministry of Health, Jerusalem, Israel
| | - Estela Derazne
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- Israel Defense Forces Medical Corps, Israel
| | - Avraham Karasik
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - Barak Gordon
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Fruchter
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gadi Lubin
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assaf Rudich
- Department of Clinical Biochemistry and Pharmacology and the National Institute of Biotechnology in the Negev, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Tali Cukierman-Yaffe
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel Gertner Institute for Epidemiology, Tel Hashomer, Israel
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Revheim N, Corcoran CM, Dias E, Hellmann E, Martinez A, Butler PD, Lehrfeld JM, DiCostanzo J, Albert J, Javitt DC. Reading deficits in schizophrenia and individuals at high clinical risk: relationship to sensory function, course of illness, and psychosocial outcome. Am J Psychiatry 2014; 171:949-59. [PMID: 25178752 PMCID: PMC4501394 DOI: 10.1176/appi.ajp.2014.13091196] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The ability to read passages of information fluently and with comprehension is a basic component of socioeconomic success. Reading ability depends on the integrity of underlying visual and auditory (phonological) systems. This study investigated the integrity of reading ability in schizophrenia relative to the integrity of underlying visual and auditory function. METHOD The participants were 45 schizophrenia patients, 19 clinical high-risk patients, and 65 comparison subjects. Reading was assessed using tests sensitive to visual or phonological reading dysfunction. Sensory, neuropsychological, and functional outcome measures were also obtained. RESULTS Schizophrenia patients displayed reading deficits that were far more severe (effect size >2.0) than would be predicted based on general neurocognitive impairments (effect size 1.0-1.4). The deficits correlated highly with both visual and auditory sensory measures, including impaired mismatch negativity generation (r=0.62, N=51, p=0.0002). Patients with established schizophrenia displayed both visual and phonological impairments, whereas high-risk patients showed isolated visual impairments. More than 70% of schizophrenia patients met criteria for acquired dyslexia, with 50% reading below eighth grade level despite intact premorbid reading ability. Reading deficits also correlated significantly (rp=0.4, N=30, p=0.03) with failure to match parental socioeconomic achievement, over and above contributions of more general cognitive impairment. CONCLUSIONS Patients with schizophrenia display severe deficits in reading ability that represent a potentially remediable cause of impaired socioeconomic function. Such deficits are not presently captured during routine clinical assessment. Deficits most likely develop during the years immediately surrounding illness onset and may contribute to the reduced educational and occupational achievement associated with schizophrenia.
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Affiliation(s)
- Nadine Revheim
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, New York 10962, USA
| | - Cheryl M. Corcoran
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, 1051 Riverside Drive, Unit 21, New York, NY 10032, USA
| | - Elisa Dias
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, New York 10962, USA
| | - Esther Hellmann
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, 1051 Riverside Drive, Unit 21, New York, NY 10032, USA
| | - Antigona Martinez
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, New York 10962, USA
| | - Pamela D. Butler
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, New York 10962, USA
| | - Jonathan M. Lehrfeld
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, New York 10962, USA
| | - Joanna DiCostanzo
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, New York 10962, USA
| | - Jennifer Albert
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, New York 10962, USA
| | - Daniel C. Javitt
- Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, New York 10962, USA,Division of Experimental Therapeutics, Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, 1051 Riverside Drive, Unit 21, New York, NY 10032, USA
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Abramovitch Y. Jung's understanding of schizophrenia: is it still relevant in the 'era of the brain'? THE JOURNAL OF ANALYTICAL PSYCHOLOGY 2014; 59:229-244. [PMID: 24673276 DOI: 10.1111/1468-5922.12071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Jung was highly committed to grasping the meaning of psychotic thinking, and left behind precious insights to treatment scattered through his works written between 1906 and 1958. The tendency of today's psychiatry is to attribute the psychotic process to alteration in the brain's anatomy, biochemistry and electrophysiology, thus exempting the subject, i.e. the afflicted person, from responsibility for attachment to reality and their sanity. Jung understood schizophrenia as an 'abaissement du niveau mental', a similar phenomenon to the one encountered in dreams, and caused by a peculiar 'faiblesse de la volonté'. He contested that complexes in schizophrenia, in contrast with neurotic disorders, are disconnected and can either never reintegrate to the psychic totality or can only join together in remission 'like a mirror broke into splinters' (Jung , para. 507). Accordingly, a person who does not fight for the supremacy of ego consciousness and has let themself be swayed by the intrusion of alien contents arising from the unconscious (even to the point of becoming fascinated by regression) is exposed to the danger of schizophrenia. The contemporary relevance of these notions and their necessity in understanding the psychotic process in the light of modern scientific findings are discussed.
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The course of vocational functioning in patients with schizophrenia: Re-examining social drift. SCHIZOPHRENIA RESEARCH-COGNITION 2014; 1:e41-e46. [PMID: 25254157 DOI: 10.1016/j.scog.2014.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Vocational functioning is markedly impaired in people with schizophrenia. In addition to low rates of employment, people with schizophrenia have been reported to be underachieved compared to other family members. Among the causes of this vocational impairment may be cognitive deficits and other skills deficits, as well as social factors impacting on opportunities for employment. In this study, we examined two separate samples of people with schizophrenia who differed in their educational and social backgrounds. We compared personal and maternal education in people with schizophrenia attending an outpatient rehabilitation facility (n = 57) or receiving outpatient services at a VA medical center (n = 39). The sample as a whole showed evidence of decline in vocational status from their best job to their most recent job. Patients attending a rehabilitation facility had completed less education than their mothers, while the VA patients completed more. Differences between personal and maternal education predicted the difference in status between best and latest jobs in the sample as a whole. VA patients were more likely to be living independently and performed better on a measure of functional capacity than the rehabilitation sample. These data implicate vocational decline in schizophrenia and also suggest that this decline may originate prior to the formal onset of the illness. At the same time, vocational outcomes appear to be related to social opportunities.
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Longitudinal association between epilepsy and schizophrenia: a population-based study. Epilepsy Behav 2014; 31:291-4. [PMID: 24269029 DOI: 10.1016/j.yebeh.2013.10.026] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 10/21/2013] [Accepted: 10/23/2013] [Indexed: 11/23/2022]
Abstract
A large number of studies have reported an association between epilepsy and major psychiatric conditions. This study investigated the association between epilepsy and later schizophrenia, utilizing a historical-prospective, population-based design. Of the 861,062 17-year-old male adolescents consecutively screened by the Israeli Draft Board and found free of major mental illness, 0.06% suffered from severe, treatment-refractory epilepsy, 0.25% had treated, controlled epilepsy, and 0.16% had a history of seizures which had abated 5 or more years prior to screening. Hospitalization for schizophrenia was ascertained through the Israeli National Psychiatric Hospitalization Case Registry, with an average follow-up of 9.6±1.0years (range: 1.0-10.0years). Risk of hospitalization was calculated using Cox regression analyses, compared to socioeconomic-adjusted risk of hospitalization in the general population of male adolescents. Among adolescents whose epilepsy was nonresponsive to medication, the adjusted risk of hospitalization was significantly increased for schizophrenia (HR=3.89, 95% CI=1.75-89.67). Male adolescents with successfully treated epilepsy were not at increased risk for schizophrenia. Male adolescents with severe, treatment-refractory epilepsy are at increased risk of later schizophrenia. Future studies attempting to understand the biology of this association might focus on this subset of patients, and these patients should be monitored for the appearance of psychosis.
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Selten JP, van der Ven E, Rutten BPF, Cantor-Graae E. The social defeat hypothesis of schizophrenia: an update. Schizophr Bull 2013; 39:1180-6. [PMID: 24062592 PMCID: PMC3796093 DOI: 10.1093/schbul/sbt134] [Citation(s) in RCA: 269] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
According to the social defeat (SD) hypothesis, published in 2005, long-term exposure to the experience of SD may lead to sensitization of the mesolimbic dopamine (DA) system and thereby increase the risk for schizophrenia. The hypothesis posits that SD (ie, the negative experience of being excluded from the majority group) is the common denominator of 5 major schizophrenia risk factors: urban upbringing, migration, childhood trauma, low intelligence, and drug abuse. The purpose of this update of the literature since 2005 is to answer 2 questions: (1) What is the evidence that SD explains the association between schizophrenia and these risk factors? (2) What is the evidence that SD leads to sensitization of the mesolimbic DA system? The evidence for SD as the mechanism underlying the increased risk was found to be strongest for migration and childhood trauma, while the evidence for urban upbringing, low intelligence, and drug abuse is suggestive, but insufficient. Some other findings that may support the hypothesis are the association between risk for schizophrenia and African American ethnicity, unemployment, single status, hearing impairment, autism, illiteracy, short stature, Klinefelter syndrome, and, possibly, sexual minority status. While the evidence that SD in humans leads to sensitization of the mesolimbic DA system is not sufficient, due to lack of studies, the evidence for this in animals is strong. The authors argue that the SD hypothesis provides a parsimonious and plausible explanation for a number of epidemiological findings that cannot be explained solely by genetic confounding.
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Affiliation(s)
- Jean-Paul Selten
- *To whom correspondence should be addressed; GGZ Leiden, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands; tel: 31-71-890-7209, fax: 31-71-890-8101, e-mail:
| | - Elsje van der Ven
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands;,Rivierduinen Psychiatric Institute, Leiden, The Netherlands
| | - Bart P. F. Rutten
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Elizabeth Cantor-Graae
- Section for Social Medicine and Global Health & Skåne University Hospital, Department of Clinical Sciences, Clinical Research Center, Lund University, Malmø, Sweden
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Yacobi A, Fruchter E, Mann JJ, Shelef L. Differentiating Army suicide attempters from psychologically treated and untreated soldiers: a demographic, psychological and stress-reaction characterization. J Affect Disord 2013; 150:300-5. [PMID: 23668905 DOI: 10.1016/j.jad.2013.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 04/08/2013] [Accepted: 04/09/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicide is the leading cause of death in most armies during peace-time. The recent dramatic rise in suicides in the US Army further focuses attention on the causes of suicidal behavior in the military. METHODS This study investigated demographic characteristics, psychological profile and stress-related risk factors associated with suicide attempts in Israelis aged 18-21 years, who served in the Army in 2009. Soldiers who attempted suicide (N=60) were compared to soldiers treated by a mental health professional, but reported no suicidal behavior (N=58), and to controls (N=50). RESULTS Suicide attempters had lower socioeconomic status and less cognitive ability compared with treated soldiers and untreated control soldiers. Only 25% of the suicide attempters had received mental healthcare prior to the attempt. The majority of the attempts were non-lethal (86.2%), and only 5.2% used firearms. Attempters had more previous suicide attempts (37.9%) and deliberate selfharm incidents (19.3%), compared to almost no such behaviors in the other two groups. Following the suicide attempt, 77% were diagnosed with moderate to severe mental disorders, 44.8% personality disorders and 8.6% mood disorders. Attempters reported higher levels of general stress compared to their peers in the other two groups. Being away from home and obeying authority were especially more stressful in attempters. CONCLUSIONS Young soldiers are less prone to seek mental health assistance, despite suffering from higher levels of stress. Screening is required to detect soldiers at risk for suicidal behavior and preventive intervention will require active outreach.
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Affiliation(s)
- A Yacobi
- Geha Mental Health Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Goldberg X, Alemany S, Fatjó-Vilas M, González-Ortega I, González-Pinto A, Cuesta MJ, Fañanás L. Twin-based study of the complex interplay between childhood maltreatment, socioeconomic status and adult memory. Eur Arch Psychiatry Clin Neurosci 2013. [PMID: 23188190 DOI: 10.1007/s00406-012-0382-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Childhood maltreatment and low socioeconomic status (SES) are considered stressful environmental events with lasting detrimental effects on adult mental health and associated cognitive performance, such as memory. However, the association between childhood maltreatment and low SES remains unclear, probably due to design limitations and putative confounding factors. Particular concerns have been raised on genetic influences, as genetic background may modulate the effects of environmental stressors. The aim of the present study was to examine the effect of childhood maltreatment on adult memory in low- and high-SES subjects, free of confounding due to other environmental and genetic influences. A monozygotic twin design based on 188 healthy adult subjects (94 twin pairs) from the general population was conducted. This design based on genetically identical individuals allowed disentangling the unique environmental effects of childhood maltreatment on memory, which was explored in low and high SES. Results showed that the unique environmental effects of childhood maltreatment were only evident in the high-SES group (β = -0.22; SE = 0.08; p < 0.01; 95 % CI = -0.375 to -0.066). By contrast, no evidence for this effect could be detected in the more stressful low-SES group. These results suggest that enriched environments may provide a more stable context where early stressful experiences can influence cognitive processes. This study provides preliminary support for the inclusion of environmental enrichment in studies addressing the impact of childhood maltreatment on adult cognition and psychiatric disorders.
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Affiliation(s)
- Ximena Goldberg
- Departament de Biologia Animal, Facultat de Biologia, Universitat de Barcelona, Insititut de Biomedicina de la, Barcelona, Spain.
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Ernst Nielsen R, Haugaard C, Olrik Wallenstein Jensen S, Munk-Jørgensen P, Østergaard Christensen T. Prediction of patient contacts by cognition in schizophrenia. Aust N Z J Psychiatry 2013; 47:637-45. [PMID: 23574875 DOI: 10.1177/0004867413484093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the correlations between cognitive function and clinical outcome variables. METHOD Patients diagnosed for the first time with schizophrenia between January 2004 and June 2010 were cognitively tested in conjunction with diagnostic procedures. Cognitive test data were connected to Danish healthcare registers and patients were followed in the registers from their first contact with psychiatric in- and outpatient care until October 2011. RESULTS Patients had impaired attention, processing speed and executive function as measured by Trail Making Test part B; their executive functions, as measured by the Wisconsin Card Sorting Test (WCST), and working memory, as measured by Rigshospitalet's digit span test, were unaffected as compared to norms. The admission rate, from schizophrenia diagnosis to the end of the study, was predicted by Trail Making Test part A, Rey's Auditory Verbal Learning Test (RAVLT), RAVLT (total learning), RAVLT (memory), d2 Test of Attention (total) and d2 type 2 error (error of commission), independent of gender, age and schizophrenia subtype. The length of hospitalization after the schizophrenia diagnosis was mainly determined by the schizophrenia subtype (schizophrenia simplex: incidence rate ratio (IRR) 0.24; 95% confidence interval (CI) 0.15-0.40, p < 0.001). Diagnosis was secondarily determined by deficits in attention and executive function, Trail Making Test part B, d2 Test of Attention (total), d2 type 1 error (error of omission), d2 type 2 error, and also by age and substance use disorder. The outpatient contact rate from schizophrenia diagnosis to the end of the study was predicted by d2 Test of Attention, Trail Making Test part A, and d2 type 2 error. The annual rate of criminal conviction, institutionalization and social retirement pension was mainly predicted by substance misuse. CONCLUSION Cognitive function only predicted hospitalization and outpatient contacts to a minor degree in a cohort of newly diagnosed patients with schizophrenia.
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Affiliation(s)
- René Ernst Nielsen
- Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark.
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