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The media and intellectuals’ response to medical publications: the anti-depressants’ case

April 24, 2013 Comments off

The media and intellectuals’ response to medical publications: the anti-depressants’ case

Source: Annals of General Psychiatry

During the last decade, there was a debate concerning the true efficacy of anti-depressants. Several papers were published in scientific journals, but many articles were also published in the lay press and the internet both by medical scientists and academics from other disciplines or representatives of societies or initiatives. The current paper analyzes the articles authored by three representative opinion makers: one academic in medicine, one academic in philosophical studies, and a representative of an activists’ group against the use of anti-depressants. All three articles share similar gaps in knowledge and understanding of the scientific data and also are driven by an ‘existential-like’ ideology. In our opinion, these articles have misinterpreted the scientific data, and they as such may misinform or mislead the general public and policy makers, which could have a potential impact upon public health. It seems that this line of thought represents another aspect of the stigma attached to people suffering from mental illness.

Categories: Annals of General Psychiatry, media and entertainment, prescription drugs, public health

Toxoplasma gondii Infection and Self-directed Violence in Mothers

July 10, 2012 Comments off

Toxoplasma gondii Infection and Self-directed Violence in Mothers
Source: Archives of General Psychiatry

Context
Two studies based on clinical samples have found an association between Toxoplasma gondii infection and history of suicide attempt. To our knowledge, these findings have never been replicated in a prospective cohort study.

Objective
To examine whether T gondii–infected mothers have an increased risk of self-directed violence, violent suicide attempts, and suicide and whether the risk depends on the level of T gondii IgG antibodies.

Design
Register-based prospective cohort study. Women were followed up from the date of delivery, 1992 to 1995 until 2006.

Setting
Denmark.

Participants
A cohort of 45,788 women born in Denmark whose level of Toxoplasma-specific IgG antibodies was measured in connection with child birth between 1992 and 1995.

Main Outcome Measures
Incidence rates of self-directed violence, violent suicide attempts, and suicide in relation to T gondii seropositivity and serointensity.

Results
T gondii–infected mothers had a relative risk of self-directed violence of 1.53 (95% CI, 1.27-1.85) compared with noninfected mothers, and the risk seemed to increase with increasing IgG antibody level. For violent suicide attempts, the relative risk was 1.81 (95% CI, 1.13-2.84) and for suicide, 2.05 (95% CI, 0.78-5.20). A similar association was found for repetition of self-directed violence, with a relative risk of 1.54 (95% CI, 0.98-2.39).

Conclusion
Women with a T gondii infection have an increased risk of self-directed violence.

See: Women Infected With Common Parasite Have Increased Risk of Attempting Suicide, Study Finds (Science Daily)

Categories: Annals of General Psychiatry, diseases and conditions, mental health and substance abuse

Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

July 2, 2012 Comments off

Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

Source: Annals of General Psychiatry

Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA). In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications.

Categories: Annals of General Psychiatry, autism spectrum disorders, mental health and substance abuse

Development of the Global Disability Scale (GloDiS): preliminary results

May 23, 2012 Comments off
Source:  Annals of General Psychiatry
Background
The assessment of functioning and disability is an important part of clinical evaluation, since it measures disease burden and reflects the effectiveness of therapeutic planning and interventions. The aim of the current study was to develop a self-report instrument on the basis of a review of the literature, compatible with the World Health Organization (WHO) approach.
Methods
The review of the literature led to the development of the Global Disability Scale (GloDiS), with 25 items assessing different aspects of disability. The study sample included 728 persons from vulnerable populations (homeless, jobless, very low income, single parent families and so on (29.12% males and 70.88% females; age 55.96 +/- 15.22 years). The protocol also included the State-Trait Anxiety Inventory (STAI) and the Center for Epidemiologic Studies Depression Scale (CES-D). The statistical analysis included factor analysis, item analysis and analysis of covariance (ANCOVA).
Results
The factor analysis revealed the presence of four factors explaining 71% of total variance (everyday functioning, social and interpersonal functioning, severity and mental disability). The Cronbach alpha value for the whole scale was 0.95 and for subscales the range of values was 0.74 to 0.94.
Discussion
The results of the current study suggest that the GloDiS has the potential to serve as a reliable and valid tool for assessing functioning and disability. Further research is needed to prove that it could be useful across countries, populations and diseases, and on whether it provides data that are culturally meaningful and comparable. It can be used in surveys and in clinical research settings and it can generate information of use in evaluating health needs and the effectiveness of interventions to reduce disability and improve health.

+ Full Paper (PDF)

Categories: Annals of General Psychiatry, disabilities, international, social and cultural issues
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