The 16th World Mental Health Day was held on the 10th October. Meanwhile there have been many interesting studies out this month. Associations have been found between schizophrenia and maternal haemoglobin (although these will require confirmatory studies), mild cognitive impairmental and oral health. Norwegian twins have provided information on the heritability of personality disorders whilst a recent study has provided more information on bipolar disorder in children, an area of much discussion.
In this cohort study of 6872 people, there was found to be a 4 fold increase in prevalence of schizophrenia spectrum disorders with maternal haemoglobin concentrations less than 10gm/dl and the authors recommend further studies to confirm the relationship (STT4). A study of 33 people with schizophrenia looked at smooth pursuit eye movements before treatment (patients were drug naive) and after treatment with olanzapine or risperidone. After treatment there was found to be a reduction in the gain of the eye movements which the authors speculate is related to serotonin’s role in sensorimotor processing (STT3). In this open-access article of a study of 119 people with first-episode psychosis (plus 107 controls) there was found to be an impairment in reinforcement and reversal learning (learning different responses for two stimuli and then reversing the responses). There was not a significant difference between the affective and non-affective psychosis groups. There was a significant association between reinforcement learning and negative symptoms however (STT1-3). In a 2-year follow-up of first episode psychosis, concurrent substance misuse was the most significant predictor of relapse (STT1). An MRI study of people with schizophrenia, at risk groups and controls found no significant difference between the groups in the prevalence of large cavum septum pellucidum, which has been thought of as a marker of midline neurodevelopmental abnormalities (STT3). In the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial, estimated 10-year risk for CHD was compared in 1125 people followed who had been followed for 18 months. There was found to be a significant increase for the Olanzapine group of 0.5% (SE 0.3) and for Quetiapine of 0.3% (SE 0.3). The risk was decreased for perphenazine -0.5% (SE 0.3), Risperidone -0.6% (SE 0.3) and Ziprasidone -0.6% (SE 0.4) (STT1). Ultra High Risk criteria predicted conversion from prodrome to psychosis in 16% of 292 help-seeking individuals (STT1).
In this prospective study of 38 patients with major depression (30 controls) there was found to be a significant reduction in grey matter volume in the hippocampus, right dorsomedial prefrontal cortex, left amygdala and anterior cingulum. There were also found to be differences in the grey matter volume changes between remitters and non-remitters (STT4).
Dementia and Mild Cognitive Impairment (MCI)
In a study of 1969 people (329 with MCI) the group with MCI were found to have an OR of 8.12 for delusions (95% CI 2.92-22.60) which however were rare in both groups. Apathy was more common in both groups with an OR of 4.53 although interestingly the OR for depression was 2.78 (STT1-3). Gingival bleeding was associated with reduced performance on the Serial Digit Learning Test and loss of periodontal attachment was associated with impairment in the Symbol Digit Substitution Test in the NHANES III Community sample of 5138 participants aged 20 to 59 years old (STT1-3).
Child and Adolescent Psychiatry
In the Archives of General Psychiatry there is free online access to a NIH funded study on Bipolar Disorder in children. This was an eight year follow-up study of 108 children (initially aged 7-16) showing at follow-up a higher prevalence of mania than the general population assessed using the WASH-U-KSADS (STT3). In a study of 1970 children there was found to be a significant association between high or chronic levels of peer victimisation (using various measures) and parenting behaviours, parental income and physical aggression in children (STT2).
There was found to be an association between major depressive disorder and CRP as well as a relationship between major depressive disorder and ischaemic heart disease which was independent of CRP in the EPIC-Norfolk study(STT4). In a study of 193 people admitted to hospital with coronary artery disease perceptions of serious consequences of CAD were found to influence adherence. One of the strongest predictors was ‘social desirability’ (STT1). In the Baltimore Longitudinal Study there was found to be no relationship between depression and carotid intimal media thickness in 566 participants examined between 1 and 15 years after inclusion (age 20-93 years)(STT4). The World Mental Health Survey which included 18 population surveys of households in 17 countries using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) found that people with Rheumatoid Arthritis had an OR of 1.9 for mood and anxiety disorders and 1.5 for alcohol abuse/dependence when compared to people without Rheumatoid Arthritis (STT1-2). In the PRIME North America Double Blind Treatment Study, converters to Schizophrenia were compared to non-converters. There was found to be no difference between the groups in terms of neuropsychological course. There was no significant impact on neuropsychological course of treatment with Olanzapine in the prodromal phase (STT2-3).
In the editorial in Nature Genetics there is discussion of a study in the same issue in which relatively common polymorphisms in structural variants are found to account for much of the variation between individuals in a population. In Brain and Behavioural Sciences there are some articles discussing the relationship between the body and language in evolution. A study of unmet need in East Timor looked at 1544 people in urban and rural areas and found a DSM-IV point prevalence of 1.35% for psychosis and 1.47% for PTSD and that psychosis was usually treated by traditional healers (STT2). An MRI study of hippocampal volume in medical doctors and controls with no tertiary education found no significant difference between the doctors and the control group. Length of time in medical practise also had no effect on volume. The authors conclude that as there is an effect for taxi drivers, hippocampal volume is most likely to increase in volume in response to a need for large scale spatial mapping. This is interesting as there are various studies correlating hippocampus volume with dementia. Given the differential role of the right and left hippocampus it would be interesting to examine the relationship between learning, learning a second language (which is protective against dementia) and right hippocampal grey matter volumes (STT5). A study of 1386 Norwegian twins found 38% heritability for Antisocial Personality Disorder, 35% heritability for Borderline Personality Disorder, 31% for Histrionic Personality Disorder and 24% for Narcissistic Personality Disorder. Antisocial Personality Disorder and Borderline Personality Disorder were found to be more closely related than the other disorders (STT3).
A study of 21 women has found that there are variations in hippocampal volume with the menstrual cycle, with an increase in anterior hippocampal volume and decrease in right dorsal basal ganglia volumes after menstruation, as well as an improvement in verbal declarative memory during this time (STT4). In the German Health Study (4181 people), 1/3 of a community sample were found to have sleep problems which in turn were significantly associated with mental disorder (AOR 3.58 95% 2.95-4.35). There was a much smaller AOR for physical illness (STT2). In 768 participants in the Rotterdam Study there was found to be a significant association between duration of sleep and total cholesterol levels which was predicted by length of time in bed and fragmented sleep (STT2). In the National Epidemiologic Study on Alcohol and Related Conditions (n = 43093) there was an association between higher than normal body weight and paranoid, avoidant and antisocial personality disorders in women, being underweight and schizoid personality disorder in women and being underweight and paranoid personality disorder in men (STT2).
The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.