It is unclear what determines duration of untreated psychosis (DUP) in schizophrenia and why long DUP predicts poor outcome.
First, to test the hypothesis that specific patterns of symptoms and ...social functioning acting before treatment prolong DUP. Second, to clarify the mechanisms linking DUP with recovery after treatment.
Two hundred and forty-eight consecutive first admissions with schizophrenia were interviewed to assess DUP, symptoms and social functioning at admission, and symptoms were re-assessed after 6-12 weeks.
Median DUP was 12 weeks. Long DUP was predicted by poor insight, social isolation and preserved coping skills, but not by demographic factors. Even allowing for all these variables, long DUP predicted poor outcome.
Longer DUP results partly from a pattern of symptoms and social functioning which reduces concern by the sufferer and relevant others. DUP's relationship to outcome is strongest in the initial months of psychosis. This has implications for targeting early intervention.
Introduction
Suicide is criminalized in more than 100 countries around the world. A dearth of research exists into the effect of suicide legislation on suicide rates and available statistics are ...mixed.
Materials and methods
This study investigates 10,353 suicide deaths in Ireland that took place between 1970 and 2000. Irish 1970–2000 annual suicide data were obtained from the Central Statistics Office and modelled via a negative binomial regression approach. We examined the effect of suicide legislation on different age groups and on both sexes. We used Bonferroni correction for multiple modelling. Statistical analysis was performed using the R statistical package version 3.1.2. The coefficient for the effect of suicide act on overall suicide deaths was −9.094 (95 % confidence interval (CI) −34.086 to 15.899), statistically non-significant (
p
= 0.476). The coefficient for the effect suicide act on undetermined deaths was statistically significant (
p
< 0.001) and was estimated to be −644.4 (95 % CI −818.6 to −469.9).
Conclusion
The results of our study indicate that legalization of suicide is not associated with a significant increase in subsequent suicide deaths. However, undetermined death verdict rates have significantly dropped following legalization of suicide.
Health beliefs influence health behaviours and have been shown to influence outcomes in a variety of illnesses, treatments and preventative interventions.
We aimed to measure health beliefs in first ...episode psychosis with the hypotheses that their structure would resemble that in physical illness (diabetes) and would correlate with prior duration of untreated psychosis and later attitudes to treatment.
The Multidimensional Health Locus of Control scale was used in a sample of 50 people with schizophrenia during the first episode and at 18-month follow-up, 51 diabetic controls and 51 normal controls.
Schizophrenia patients, both at first episode and 18 months later, had a pattern of health beliefs that was similar to those of the patients with diabetes and significantly different to the normal controls. There were significant associations between internal locus of control score and short DUP, and between external locus of control score and a positive attitude to medication as measured by the Drug Attitudes Inventory.
Health beliefs in first episode schizophrenia correlate with determinants of outcome.
Difficulties in acute psychiatric admissions Haley, Clifford; Chitty, R. N.
Psychiatric bulletin of the Royal College of Psychiatrists,
02/1995, Volume:
19, Issue:
2
Journal Article
The peripheral terminals of primary sensory neurons detect histamine and non-histamine itch-provoking ligands through molecularly distinct transduction mechanisms. It remains unclear, however, ...whether these distinct pruritogens activate the same or different afferent fibers. Using a strategy of reversibly silencing specific subsets of murine pruritogen-sensitive sensory axons by targeted delivery of a charged sodium-channel blocker, we found that functional blockade of histamine itch did not affect the itch evoked by chloroquine or SLIGRL-NH2, and vice versa. Notably, blocking itch-generating fibers did not reduce pain-associated behavior. However, silencing TRPV1(+) or TRPA1(+) neurons allowed allyl isothiocyanate or capsaicin, respectively, to evoke itch, implying that certain peripheral afferents may normally indirectly inhibit algogens from eliciting itch. These findings support the presence of functionally distinct sets of itch-generating neurons and suggest that targeted silencing of activated sensory fibers may represent a clinically useful anti-pruritic therapeutic approach for histaminergic and non-histaminergic pruritus.
Overweight and obesity are associated with type 2 diabetes, non-alcoholic fatty liver disease, cardiovascular disease and cancer, but all fat is not equal, as storing excess lipid in subcutaneous ...white adipose tissue (SWAT) is more metabolically favorable than in visceral fat. Here, we uncover a critical role for mTORC2 in setting SWAT lipid handling capacity. We find that subcutaneous white preadipocytes differentiating without the essential mTORC2 subunit Rictor upregulate mature adipocyte markers but develop a striking lipid storage defect resulting in smaller adipocytes, reduced tissue size, lipid re-distribution to visceral and brown fat, and sex-distinct effects on systemic metabolic fitness. Mechanistically, mTORC2 promotes transcriptional upregulation of select lipid metabolism genes controlled by PPARγ and ChREBP, including genes that control lipid uptake, synthesis, and degradation pathways as well as Akt2, which encodes a major mTORC2 substrate and insulin effector. Further exploring this pathway may uncover new strategies to improve insulin sensitivity.
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•Rictor is deleted specifically in developing subcutaneous but not visceral or brown fat•Developing subcutaneous fat requires mTORC2 to establish maximum lipid storing capacity•mTORC2 regulates expression of diverse lipid metabolism genes during adipogenesis•Inhibiting mTORC2 during SWAT development has sex-specific consequences
Storing excess lipid in subcutaneous fat is more metabolically favorable than in visceral fat. Hsiao et al. show that mTORC2 is required during subcutaneous fat development to establish lipid handling capacity. Without mTORC2, developing subcutaneous fat is reduced and lipid is redistributed to other depots, causing gender-specific consequences.
Amplification and overexpression of the HER-2 oncogene in breast cancer is felt to be stable over the course of disease and concordant between primary tumor and metastases. Therefore, patients with ...HER-2-negative primary tumors rarely will receive anti-Her-2 antibody (trastuzumab, Herceptin) therapy. A very sensitive blood test was used to capture circulating tumor cells (CTCs) and evaluate their HER-2 gene status by fluorescence in situ hybridization. The HER-2 status of the primary tumor and corresponding CTCs in 31 patients showed 97% agreement, with no false positives. In 10 patients with HER-2-positive tumors, the HER-2/chromosome enumerator probe 17 ratio in each tumor was about twice that of the corresponding CTCs (mean 6.64 ± 2.72 vs. 2.8 ± 0.6). Hence, the ratio of the CTCs is a reliable surrogate marker for the expected high ratio in the primary tumor. Her-2 protein expression of 10 CTCs was sufficient to make a definitive diagnosis of the HER-2 gene status of the whole population of CTCs in 19 patients with recurrent breast cancer. Nine of 24 breast cancer patients whose primary tumor was HER-2-negative each acquired HER-2 gene amplification in their CTCs during cancer progression, i.e., 37.5% (95% confidence interval of 18.8-59.4%). Four of the 9 patients were treated with Herceptin-containing therapy. One had a complete response and 2 had a partial response.
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