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Page 1
. 2020 Nov 4;S0924-977X(20)30914-7.
doi: 10.1016/j.euroneuro.2020.10.005. Online ahead of print.

Proinflammatory mediators and their associations with medication and comorbid traits in children and adults with ADHD

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Proinflammatory mediators and their associations with medication and comorbid traits in children and adults with ADHD

Liu L Yang et al. Eur Neuropsychopharmacol. .

Abstract

Peripheral immune activation can influence neurodevelopment and is increased in autism, but is less explored in attention deficit hyperactivity disorder (ADHD). Patients with ADHD often display comorbid autism traits and gastrointestinal (GI) symptoms. Plasma protein levels of two acute phase reactants, C-reactive protein (CRP) and serum amyloid A (SAA), and two endothelial adhesion molecules, soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vascular cell adhesion molecule 1 (sVCAM-1), which share important roles in inflammation, were analyzed in 154 patients with ADHD and 61 healthy controls. Their associations with ADHD diagnosis, severity, medication and comorbid autistic symptoms, emotion dysregulation and GI symptoms were explored. The ADHD patients had increased levels of sICAM-1 and sVCAM-1 compared to healthy controls (p = 8.6e-05, p = 6.9e-07, respectively). In children with ADHD, the sICAM-1 and sVCAM-1 levels were higher among those with ADHD medication than among children (p = 0.0037, p = 0.0053, respectively) and adults (p = 3.5e-09, p = 1.9e-09, respectively) without ADHD medication. Among the adult ADHD patients, higher sICAM-1 levels were associated with increased comorbid autistic symptoms in the domains attention to detail and imagination (p = 0.0081, p = 0.00028, respectively), and higher CRP levels were associated with more GI symptoms (p = 0.014). sICAM-1 and sVCAM-1 levels were highly correlated with each other, and so were CRP and SAA levels. To conclude, vascular inflammatory activity may be overrepresented in ADHD, with elevated sICAM-1 and sVCAM-1 levels and this may in children be a consequence of current ADHD medication, and in adults relate to increased comorbid autistic symptoms. Replication is warranted.

Keywords: ADHD; Adhesion molecules; Autism; Inflammation; Stimulants.

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. 2020 Jul 24;1-48.
doi: 10.1017/S0954579420000620. Online ahead of print.

Early environmental risk factors for neurodevelopmental disorders - a systematic review of twin and sibling studies

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Early environmental risk factors for neurodevelopmental disorders - a systematic review of twin and sibling studies

Torkel Carlsson et al. Dev Psychopathol. .

Abstract

While neurodevelopmental disorders (NDDs) are highly heritable, several environmental risk factors have also been suggested. However, the role of familial confounding is unclear. To shed more light on this, we reviewed the evidence from twin and sibling studies. A systematic review was performed on case control and cohort studies including a twin or sibling within-pair comparison of neurodevelopmental outcomes, with environmental exposures until the sixth birthday. From 7,315 screened abstracts, 140 eligible articles were identified. After adjustment for familial confounding advanced paternal age, low birth weight, birth defects, and perinatal hypoxia and respiratory stress were associated with autism spectrum disorder (ASD), and low birth weight, gestational age and family income were associated with attention-deficit/hyperactivity disorder (ADHD), categorically and dimensionally. Several previously suspected factors, including pregnancy-related factors, were deemed due to familial confounding. Most studies were conducted in North America and Scandinavia, pointing to a global research bias. Moreover, most studies focused on ASD and ADHD. This genetically informed review showed evidence for a range of environmental factors of potential casual significance in NDDs, but also points to a critical need of more genetically informed studies of good quality in the quest of the environmental causes of NDDs.

Keywords: confounding factors; environmental exposure; neurodevelopmental disorders; systematic review; twin and sibling studies.

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. 2020 Oct;89:9-19.
doi: 10.1016/j.bbi.2020.05.056. Epub 2020 Jun 1.

Effects of a synbiotic on symptoms, and daily functioning in attention deficit hyperactivity disorder - A double-blind randomized controlled trial

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Free article

Effects of a synbiotic on symptoms, and daily functioning in attention deficit hyperactivity disorder - A double-blind randomized controlled trial

Elin Skott et al. Brain Behav Immun. .
Free article

Abstract

Some prebiotics and probiotics have been proposed to improve psychiatric symptoms in children with autism. However, few studies were placebo-controlled, and there is no study on persons with an attention deficit hyperactivity disorder (ADHD) diagnosis. Our aim was to study effects of Synbiotic 2000 on psychiatric symptoms and functioning in children and adults with ADHD without an autism diagnosis. Children and adults (n = 182) with an ADHD diagnosis completed the nine weeks randomized double-blind parallel placebo-controlled trial examining effects of Synbiotic 2000 on the primary endpoints ADHD symptoms, autism symptoms and daily functioning, and the secondary endpoint emotion regulation, measured using the questionnaires SNAP-IV, ASRS, WFIRS, SCQ, AQ and DERS-16. Levels at baseline of plasma C-reactive protein and soluble vascular cell adhesion molecule-1 (sVCAM-1), central to leukocyte-endothelial cell adhesion facilitating inflammatory responses in tissues, were measured using Meso Scale Discovery. Synbiotic 2000 and placebo improved ADHD symptoms equally well, and neither active treatment nor placebo had any statistically significant effect on functioning or sub-diagnostic autism symptoms. However, Synbiotic 2000, specifically, reduced sub-diagnostic autism symptoms in the domain restricted, repetitive and stereotyped behaviors in children, and improved emotion regulation in the domain of goal-directed behavior in adults. In children with elevated sVCAM-1 levels at baseline as well as in children without ADHD medication, Synbiotic 2000 reduced both the total score of autism symptoms, and the restricted, repetitive and stereotyped behaviors. In adults with elevated sVCAM-1 at baseline, Synbiotic 2000 significantly improved emotion regulation, both the total score and four of the five subdomains. To conclude, while no definite Synbiotic 2000-specific effect was detected, the analysis of those with elevated plasma sVCAM-1 levels proposed a reduction of autism symptoms in children and an improvement of emotion regulation in adults with ADHD. Trial registration number: ISRCTN57795429.

Keywords: Autism; Emotion reactivity; Inflammation; Lactic acid bacteria; Lactobacillus; Prebiotics; Probiotics; Repetitive behavior; Vascular cell adhesion molecule-1.

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. 2020 Dec;44(6):265-268.
doi: 10.1192/bjb.2020.28.

Psychoeducation and motivational interviewing to reduce relapses and increase patients' involvement in antipsychotic treatment: interventional study

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Free article

Psychoeducation and motivational interviewing to reduce relapses and increase patients' involvement in antipsychotic treatment: interventional study

Gabriella Bröms et al. BJPsych Bull. .
Free article

Abstract

Aims and method: To assess whether the combination of motivational interviewing and psychoeducation affects relapse rate and stimulates involvement of people with psychosis in their treatment. We conducted an interventional study including patients with schizophrenia or schizoaffective disorder treated with oral antipsychotics, without previous experience of long-acting injectable antipsychotics (LAIs). They were randomised to either psychoeducation with motivational interviewing or a control group. Hospital admissions 18 months before and after the intervention, and switches to LAIs 18 months after the intervention, were recorded.

Results: The two groups each comprised 101 participants. Fourteen from the intervention group and seven from the control group switched to LAIs. Five in the intervention group instigated the switch themselves, compared with zero controls (P = 0.06). Fourteen in the intervention group were readmitted to hospital during follow-up, compared with 23 in the control group (P = 0.14).

Clinical implications: Psychoeducation with motivational interviewing may increase patients' involvement in their treatment and reduce the relapse frequency.

Keywords: Motivational interviewing; adherence; antipsychotics; psychoeducation; schizophrenia.

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. 2019 Nov 26;9(1):317.
doi: 10.1038/s41398-019-0653-9.

Early exposure to antibiotic drugs and risk for psychiatric disorders: a population-based study

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Free PMC article

Early exposure to antibiotic drugs and risk for psychiatric disorders: a population-based study

Catharina Lavebratt et al. Transl Psychiatry. .
Free PMC article

Abstract

Early life exposure to infection, anti-infectives and altered immune activity have been associated with elevated risk of some psychiatric disorders. However, the risk from exposure in fetal life has been proposed to be confounded by familial factors. The hypothesis of this study is that antibiotic drug exposure during the fetal period and the first two postnatal years is associated with risk for later development of psychiatric disorders in children. All births in Finland between 1996 and 2012, 1 million births, were studied for antibiotic drug exposure: mothers during pregnancy and the children the first two postnatal years. The children were followed up for a wide spectrum of psychiatric diagnoses and psychotropic drug treatment until 2014. Cox proportional hazards modeling was used to estimate effects of antibiotic drug exposure on offspring psychiatric disorders. Modestly (10-50%) increased risks were found on later childhood development of sleep disorders, ADHD, conduct disorder, mood and anxiety disorders, and other behavioral and emotional disorders with childhood onset (ICD-10 F98), supported by increased risks also for childhood psychotropic medication. The prenatal exposure effects detected were not explained by explored familial confounding, nor by registered maternal infections. To conclude, this longitudinal nation-wide study shows that early life antibiotic drug exposure is associated with an increased risk for childhood development of psychopathology. Given the high occurrence of early-life antibiotic exposure, these findings are of public health relevance. Whether the associations reflect effects of the antibiotic drug use or of the targeted infections remains to be explored further.

Conflict of interest statement

The authors declare that they have no conflict of interest.

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Published Erratum
. 2019 Nov 5;9(1):16377.
doi: 10.1038/s41598-019-53159-5.

Publisher Correction: Mitochondrial DNA copy number is associated with psychosis severity and anti-psychotic treatment

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Free PMC article
Published Erratum

Publisher Correction: Mitochondrial DNA copy number is associated with psychosis severity and anti-psychotic treatment

Parvin Kumar et al. Sci Rep. .
Free PMC article

Abstract

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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Comparative Study
. 2019 Jun;49(6):2281-2290.
doi: 10.1007/s10803-018-03871-4.

Autism With and Without Regression: A Two-Year Prospective Longitudinal Study in Two Population-Derived Swedish Cohorts

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Free PMC article
Comparative Study

Autism With and Without Regression: A Two-Year Prospective Longitudinal Study in Two Population-Derived Swedish Cohorts

Lucy Thompson et al. J Autism Dev Disord. .
Free PMC article

Abstract

Two community-based cohorts of children with autism spectrum disorder, examined using similar assessment protocols, were pooled (n = 301) and subdivided according to history of regression. Those with regression (n = 62), 20.5% of the combined cohort, were contrasted with those without regression (n = 241) at first assessment (age range 19-60 months) and at 2-year follow-up on a range of measures. The regression group was significantly more functionally impaired, with regard to intellectual function (p < .001), language development (p < .001), and to severity of autism (p < .01) at both T1 and T2. Only 14 (23.3%) had a clearly identified underlying etiology [24 (18.6%) in the non-regressive group]. There were no significant differences between those who had regressed 'from normal' and those who had regressed 'from low' functioning.

Keywords: ASD; Autism; Developmental language disorder; Intellectual developmental disorder; Non-regressive autism; Regressive autism.

Conflict of interest statement

The authors have no conflict of interest.

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. 2018 Aug 24;8(1):12743.
doi: 10.1038/s41598-018-31122-0.

Mitochondrial DNA copy number is associated with psychosis severity and anti-psychotic treatment

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Free PMC article

Mitochondrial DNA copy number is associated with psychosis severity and anti-psychotic treatment

Parvin Kumar et al. Sci Rep. .
Free PMC article

Erratum in

Abstract

Mitochondrial pathology has been implicated in the pathogenesis of psychotic disorders. A few studies have proposed reduced leukocyte mitochondrial DNA (mtDNA) copy number in schizophrenia and bipolar disorder type I, compared to healthy controls. However, it is unknown if mtDNA copy number alteration is driven by psychosis, comorbidity or treatment. Whole blood mtDNA copy number was determined in 594 psychosis patients and corrected for platelet to leukocyte count ratio (mtDNAcnres). The dependence of mtDNAcnres on clinical profile, metabolic comorbidity and antipsychotic drug exposure was assessed. mtDNAcnres was reduced with age (β = -0.210, p < 0.001), use of clozapine (β = -0.110,p = 0.012) and risperidone (β = -0.109,p = 0.014), dependent on prescribed dosage (p = 0.006 and p = 0.026, respectively), and the proportion of life on treatment (p = 0.006). Clozapine (p = 0.0005) and risperidone (p = 0.0126) had a reducing effect on the mtDNA copy number also in stem cell-derived human neurons in vitro at therapeutic plasma levels. For patients not on these drugs, psychosis severity had an effect (β = -0.129, p = 0.017), similar to age (β = -0.159, p = 0.003) and LDL (β = -0.119, p = 0.029) on whole blood mtDNAcnres. Further research is required to determine if mtDNAcnres reflects any psychosis-intrinsic mitochondrial changes.

Conflict of interest statement

The authors declare no competing interests.

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Observational Study
. 2018 Jul 13;18(1):223.
doi: 10.1186/s12888-018-1803-y.

Health-related quality of life and burden of illness in adults with newly diagnosed attention-deficit/hyperactivity disorder in Sweden

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Free PMC article
Observational Study

Health-related quality of life and burden of illness in adults with newly diagnosed attention-deficit/hyperactivity disorder in Sweden

E Ahnemark et al. BMC Psychiatry. .
Free PMC article

Abstract

Background: This observational, cross-sectional, retrospective chart review aimed to identify factors determining health-related quality of life (HRQoL) in adults with newly diagnosed attention-deficit/hyperactivity disorder (ADHD) in Sweden.

Methods: Adult participants with a new clinical diagnosis of ADHD were enrolled from two specialist outpatient clinics in Stockholm, Sweden, from 2013 to 2015. Data extracted from patient records included demographics, clinical characteristics and comorbid psychiatric diagnoses identified using the Mini International Neuropsychiatric Interview (MINI). Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale - Self-reported (MADRS-S). The self-rated five-dimension EuroQol questionnaire (EQ-5D) was used to measure HRQoL. Predictors of EQ-5D index score were identified using multivariate linear regression adjusting for age, sex, education level, and main income source.

Results: The mean age of the 189 enrolled patients was 35.2 years (standard deviation [SD], 12.3), and 107 (57%) were female. Psychiatric comorbidities were present in 92 patients (49%), with anxiety and depression being the most common diagnoses. The mean EQ-5D index score was 0.63 (SD, 0.28). Low EQ-5D index scores were significantly associated with high MADRS-S scores, multiple comorbid psychiatric disorders, low educational achievement, female sex, and not having a main income derived from employment or self-employment.

Conclusions: These findings suggest that adults with newly diagnosed ADHD experience low HRQoL, which may often be exacerbated by psychiatric comorbidities such as anxiety and depression. Patients presenting with ADHD and psychiatric comorbidities in adulthood may require particular care and resources in the management of their ADHD.

Keywords: ADHD; HRQoL; Psychiatric comorbidities.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Regional Ethical Review Board in Stockholm and the need for consent was waived due to the retrospective nature of the study. The study was conducted in accordance with the ethical standards of the World Medical Association Declaration of Helsinki. The data-gathering form was based on the recommendations for neuropsychiatric investigations of patients with suspected ADHD described in recent guidelines (www.psykiatristid.se) and validated by a clinical expert.

Consent for publication

Not applicable.

Competing interests

Dr. Ewa Ahnemark is an employee of Shire and owns stock or stock options. The following authors have received compensation for serving as consultants or speakers for, or they or the institutions they work for have received research support or royalties from, the companies or organizations indicated: Dr. Marianne Di Schiena (Prima Child and Adult Psychiatry AB); Dr. Anne-Christine Fredman (Evolan, Lilly, Novartis, Servier, and Shire); Dr. Emma Medin (PAREXEL International); Dr. Jonas. K. Söderling (COMBINE Sweden, Novo Nordisk, and PAREXEL International); Dr. Ylva Ginsberg (Eli Lilly, HB Pharma, Janssen-Cilag, Lundbeck, and Novartis).

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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. 2019 Mar;47(2):121-126.
doi: 10.1177/1403494818758912. Epub 2018 Mar 1.

Mortality trends in external causes of death in people with mental health disorders in Sweden, 1987-2010

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Mortality trends in external causes of death in people with mental health disorders in Sweden, 1987-2010

Jonas Hällgren et al. Scand J Public Health. .

Abstract

Aim: We investigated mortality from external causes in Swedish people who had been hospitalised with a severe mental disorder.

Methods: Hospitalisations in people aged 15 years or older admitted to hospital with a main diagnosis of schizophrenia, bipolar mood disorder or unipolar mood disorder between 1987 and 2010 were linked to their causes of death.

Results: The mortality rate from all external causes was 20-fold higher in those with unipolar mood disorder, 15-fold higher in those with bipolar disorder and 12-fold higher in those with schizophrenia than in the general population. Over the study periods, the mortality rate declined more for people with unipolar mood disorder (-35%) and schizophrenia (-29%) than the total population (-25%) and those with bipolar mood disorder (-15%). The suicide rate declined most for those with unipolar mood disorder and schizophrenia (-42% for both) and less for the general population (-37%) and those with bipolar mood disorder (-21%). For external causes other than suicide, the mortality rate declined in the general population (-17%) but increased in people with schizophrenia (14%), bipolar mood disorder (30%) and unipolar mood disorder (52%).

Conclusions: People with mental disorders have high but declining excess mortality from suicide. Mortality from other external causes has increased, as has the gap in mortality rates between psychiatric patients and the general population.

Keywords: Depression; mortality; public mental health; suicide.

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. 2018 Mar 8;555(7695):190-196.
doi: 10.1038/nature25738. Epub 2018 Feb 21.

The Beaker phenomenon and the genomic transformation of northwest Europe

Iñigo Olalde  1 Selina Brace  2 Morten E Allentoft  3 Ian Armit  4 Kristian Kristiansen  5 Thomas Booth  2 Nadin Rohland  1 Swapan Mallick  1   6   7 Anna Szécsényi-Nagy  8 Alissa Mittnik  9   10 Eveline Altena  11 Mark Lipson  1 Iosif Lazaridis  1   6 Thomas K Harper  12 Nick Patterson  6 Nasreen Broomandkhoshbacht  1   7 Yoan Diekmann  13 Zuzana Faltyskova  13 Daniel Fernandes  14   15   16 Matthew Ferry  1   7 Eadaoin Harney  1 Peter de Knijff  11 Megan Michel  1   7 Jonas Oppenheimer  1   7 Kristin Stewardson  1   7 Alistair Barclay  17 Kurt Werner Alt  18   19   20 Corina Liesau  21 Patricia Ríos  21 Concepción Blasco  21 Jorge Vega Miguel  22 Roberto Menduiña García  22 Azucena Avilés Fernández  23 Eszter Bánffy  24   25 Maria Bernabò-Brea  26 David Billoin  27 Clive Bonsall  28 Laura Bonsall  29 Tim Allen  30 Lindsey Büster  4 Sophie Carver  31 Laura Castells Navarro  4 Oliver E Craig  32 Gordon T Cook  33 Barry Cunliffe  34 Anthony Denaire  35 Kirsten Egging Dinwiddy  17 Natasha Dodwell  36 Michal Ernée  37 Christopher Evans  38 Milan Kuchařík  39 Joan Francès Farré  40 Chris Fowler  41 Michiel Gazenbeek  42 Rafael Garrido Pena  21 María Haber-Uriarte  23 Elżbieta Haduch  43 Gill Hey  30 Nick Jowett  44 Timothy Knowles  45 Ken Massy  46 Saskia Pfrengle  9 Philippe Lefranc  47 Olivier Lemercier  48 Arnaud Lefebvre  49   50 César Heras Martínez  51   52   53 Virginia Galera Olmo  52   53 Ana Bastida Ramírez  51 Joaquín Lomba Maurandi  23 Tona Majó  54 Jacqueline I McKinley  17 Kathleen McSweeney  28 Balázs Gusztáv Mende  8 Alessandra Modi  55 Gabriella Kulcsár  24 Viktória Kiss  24 András Czene  56 Róbert Patay  57 Anna Endrődi  58 Kitti Köhler  24 Tamás Hajdu  59   60 Tamás Szeniczey  59 János Dani  61 Zsolt Bernert  60 Maya Hoole  62 Olivia Cheronet  14   15 Denise Keating  63 Petr Velemínský  64 Miroslav Dobeš  37 Francesca Candilio  65   66   67 Fraser Brown  30 Raúl Flores Fernández  68 Ana-Mercedes Herrero-Corral  69 Sebastiano Tusa  70 Emiliano Carnieri  71 Luigi Lentini  72 Antonella Valenti  73 Alessandro Zanini  74 Clive Waddington  75 Germán Delibes  76 Elisa Guerra-Doce  76 Benjamin Neil  38 Marcus Brittain  38 Mike Luke  77 Richard Mortimer  36 Jocelyne Desideri  78 Marie Besse  78 Günter Brücken  79 Mirosław Furmanek  80 Agata Hałuszko  80 Maksym Mackiewicz  80 Artur Rapiński  81 Stephany Leach  82 Ignacio Soriano  83 Katina T Lillios  84 João Luís Cardoso  85   86 Michael Parker Pearson  87 Piotr Włodarczak  88 T Douglas Price  89 Pilar Prieto  90 Pierre-Jérôme Rey  91 Roberto Risch  83 Manuel A Rojo Guerra  92 Aurore Schmitt  93 Joël Serralongue  94 Ana Maria Silva  95 Václav Smrčka  96 Luc Vergnaud  97 João Zilhão  85   98   99 David Caramelli  55 Thomas Higham  100 Mark G Thomas  13 Douglas J Kennett  101 Harry Fokkens  102 Volker Heyd  31   103 Alison Sheridan  104 Karl-Göran Sjögren  5 Philipp W Stockhammer  46   105 Johannes Krause  105 Ron Pinhasi  14   15 Wolfgang Haak  105   106 Ian Barnes  2 Carles Lalueza-Fox  107 David Reich  1   6   7
Affiliations
Free PMC article

The Beaker phenomenon and the genomic transformation of northwest Europe

Iñigo Olalde et al. Nature. .
Free PMC article

Erratum in

  • Erratum: The Beaker phenomenon and the genomic transformation of northwest Europe.
    Olalde I, Brace S, Allentoft ME, Armit I, Kristiansen K, Booth T, Rohland N, Mallick S, Szécsényi-Nagy A, Mittnik A, Altena E, Lipson M, Lazaridis I, Harper TK, Patterson N, Broomandkhoshbacht N, Diekmann Y, Faltyskova Z, Fernandes D, Ferry M, Harney E, de Knijff P, Michel M, Oppenheimer J, Stewardson K, Barclay A, Alt KW, Liesau C, Ríos P, Blasco C, Miguel JV, García RM, Fernández AA, Bánffy E, Bernabò-Brea M, Billoin D, Bonsall C, Bonsall L, Allen T, Büster L, Carver S, Navarro LC, Craig OE, Cook GT, Cunliffe B, Denaire A, Dinwiddy KE, Dodwell N, Ernée M, Evans C, Kuchařík M, Farré JF, Fowler C, Gazenbeek M, Pena RG, Haber-Uriarte M, Haduch E, Hey G, Jowett N, Knowles T, Massy K, Pfrengle S, Lefranc P, Lemercier O, Lefebvre A, Martínez CH, Olmo VG, Ramírez AB, Maurandi JL, Majó T, McKinley JI, McSweeney K, Mende BG, Modi A, Kulcsár G, Kiss V, Czene A, Patay R, Endrődi A, Köhler K, Hajdu T, Szeniczey T, Dani J, Bernert Z, Hoole M, Cheronet O, Keating D, Velemínský P, Dobeš M, Candilio F, Brown F, Fernández RF, Herrero-Corral AM, Tusa S, Carnieri E, Lentini L, Valenti A, Zanini A, Waddington C, Delibes G, Guerra-Doce E, Neil B, Brittain M, Luke M, Mortimer R, Desideri J, Besse M, Brücken G, Furmanek M, Hałuszko A, Mackiewicz M, Rapiński A, Leach S, Soriano I, Lillios KT, Cardoso JL, Pearson MP, Włodarczak P, Price TD, Prieto P, Rey PJ, Risch R, Guerra MAR, Schmitt A, Serralongue J, Silva AM, Smrčka V, Vergnaud L, Zilhão J, Caramelli D, Higham T, Thomas MG, Kennett DJ, Fokkens H, Heyd V, Sheridan A, Sjögren KG, Stockhammer PW, Krause J, Pinhasi R, Haak W, Barnes I, Lalueza-Fox C, Reich D. Olalde I, et al. Nature. 2018 Mar 21;555(7697):543. doi: 10.1038/nature26164. Nature. 2018. PMID: 29565364

Abstract

From around 2750 to 2500 bc, Bell Beaker pottery became widespread across western and central Europe, before it disappeared between 2200 and 1800 bc. The forces that propelled its expansion are a matter of long-standing debate, and there is support for both cultural diffusion and migration having a role in this process. Here we present genome-wide data from 400 Neolithic, Copper Age and Bronze Age Europeans, including 226 individuals associated with Beaker-complex artefacts. We detected limited genetic affinity between Beaker-complex-associated individuals from Iberia and central Europe, and thus exclude migration as an important mechanism of spread between these two regions. However, migration had a key role in the further dissemination of the Beaker complex. We document this phenomenon most clearly in Britain, where the spread of the Beaker complex introduced high levels of steppe-related ancestry and was associated with the replacement of approximately 90% of Britain's gene pool within a few hundred years, continuing the east-to-west expansion that had brought steppe-related ancestry into central and northern Europe over the previous centuries.

Conflict of interest statement

The authors declare no competing financial interests.

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Review
. 2018 Feb 9;6(1):2.
doi: 10.1186/s40345-017-0112-6.

Resilience concepts in psychiatry demonstrated with bipolar disorder

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Review

Resilience concepts in psychiatry demonstrated with bipolar disorder

David G Angeler et al. Int J Bipolar Disord. .
Free PMC article

Abstract

Background: The term resilience describes stress-response patterns of subjects across scientific disciplines. In ecology, advances have been made to clearly distinguish resilience definitions based on underlying mechanistic assumptions. Engineering resilience (rebound) is used for describing the ability of subjects to recover from adverse conditions (disturbances), and is the rate of recovery. In contrast, the ecological resilience definition considers a systemic change: when complex systems (including humans) respond to disturbances by reorganizing into a new regime (stable state) where structural and functional aspects have fundamentally changed relative to the prior regime. In this context, resilience is an emergent property of complex systems. We argue that both resilience definitions and uses are appropriate in psychology and psychiatry, but although the differences are subtle, the implications and uses are profoundly different.

Methods: We borrow from the field of ecology to discuss resilience concepts in the mental health sciences.

Results: In psychology and psychiatry, the prevailing view of resilience is adaptation to, coping with, and recovery (engineering resilience) from adverse social and environmental conditions. Ecological resilience may be useful for describing vulnerability, onset, and the irreversibility patterns of mental disorders. We discuss this in the context of bipolar disorder.

Conclusion: Rebound, adaptation, and coping are processes that are subsumed within the broader systemic organization of humans, from which ecological resilience emanates. Discerning resilience concepts in psychology and psychiatry has potential for a mechanistically appropriate contextualization of mental disorders at large. This might contribute to a refinement of theory and contextualize clinical practice within the broader systemic functioning of mental illnesses.

Keywords: Bipolar disorder; Ecological resilience; Ecological theory; Engineering resilience; Interdisciplinary research; Mental disorders; Stress-recovery.

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. 2017 Oct 4;13:2519-2526.
doi: 10.2147/NDT.S143234. eCollection 2017.

Children with borderline intellectual functioning and autism spectrum disorder: developmental trajectories from 4 to 11 years of age

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Free PMC article

Children with borderline intellectual functioning and autism spectrum disorder: developmental trajectories from 4 to 11 years of age

Martina Barnevik Olsson et al. Neuropsychiatr Dis Treat. .
Free PMC article

Abstract

Background: Studies on autism have tended to focus either on those with intellectual disability (ie, those with intellectual quotient [IQ] under 70) or on the group that is referred to as "high-functioning", that is, those with borderline, average or above average IQ. The literature on cognition and daily functioning in autism spectrum disorder combined specifically with borderline intellectual functioning (IQ 70-84) is limited.

Methods: From a representative group of 208 preschool children diagnosed with autism spectrum disorder, those 50 children in the group with borderline intellectual functioning at ages 4.5-6.5 years were targeted for follow-up at a median age of 10 years. A new cognitive test was carried out in 30 children. Parents were interviewed with a semi-structured interview together with the Vineland Adaptive Behavior Scales (n=41) and the Autism-Tics, attention-deficit/hyperactivity disorder (AD/HD) and other comorbidities inventory (A-TAC) (n=36).

Results: Most children of interviewed parents presented problems within several developmental areas. According to A-TAC and the clinical interview, there were high rates of attention deficits and difficulties with regulating activity level and impulsivity. Vineland Adaptive Behavior Scales composite scores showed that at school age, a majority of the children had declined since the previous assessment at ages between 4.5 and 6.5 years. Almost half the tested group had shifted in their IQ level, to below 70 or above 84.

Conclusion: None of the children assessed was without developmental/neuropsychiatric problems at school-age follow-up. The results support the need for comprehensive follow-up of educational, medical and developmental/neuropsychiatric needs, including a retesting of cognitive functions. There is also a need for continuing parent/family follow-up and support.

Keywords: A-TAC; AD/HD; Vineland; autism spectrum disorder; borderline intellectual functioning; developmental disorders.

Conflict of interest statement

Disclosure The authors report no conflicts of interests in this work.

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. 2017 Oct;41(5):254-259.
doi: 10.1192/pb.bp.116.055483.

Perceptions and knowledge of antipsychotics among mental health professionals and patients

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Perceptions and knowledge of antipsychotics among mental health professionals and patients

Lindah Cahling et al. BJPsych Bull. .
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Abstract

Aims and method To assess the patients' most influential concerns regarding long-acting injectable antipsychotics (LAIs) and mental health professionals' preconceptions about these concerns. For both groups, to assess the level of knowledge about LAIs. This cross-sectional study used semi-structured interviews of patients with schizophrenia or schizoaffective disorder (n = 164), nurses (n = 43) and physicians (n = 20). Results The mental health professionals overestimated many of the patients' fears of LAIs, and the expressed fears exceeded the actual experiences of patients already on LAIs. Acceptance to switch to LAIs was associated with shorter time from diagnosis. Nurses and patients disclosed limited knowledge of antipsychotics. Clinical implications Physicians and nurses should aim to identify the individual patient's concerns about LAIs in the discussion about choice of antipsychotic treatment early in the course of illness.

Conflict of interest statement

Declaration of interest L.Ö. has received speaker honoraria from Otsuka Pharma Scandinavia AB and H. Lundbeck AB, and has accepted travel and hospitality payment from Otsuka Pharma Scandinavia AB.

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. 2017 Aug 24;6(8):e158.
doi: 10.2196/resprot.6035.

Conventional Cognitive Behavioral Therapy Facilitated by an Internet-Based Support System: Feasibility Study at a Psychiatric Outpatient Clinic

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Conventional Cognitive Behavioral Therapy Facilitated by an Internet-Based Support System: Feasibility Study at a Psychiatric Outpatient Clinic

Kristoffer Nt Månsson et al. JMIR Res Protoc. .
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Abstract

Background: Cognitive behavioral therapies have been shown to be effective for a variety of psychiatric and somatic disorders, but some obstacles can be noted in regular psychiatric care; for example, low adherence to treatment protocols may undermine effects. Treatments delivered via the Internet have shown promising results, and it is an open question if the blend of Internet-delivered and conventional face-to-face cognitive behavioral therapies may help to overcome some of the barriers of evidence-based treatments in psychiatric care.

Objective: We evaluated the feasibility of an Internet-based support system at an outpatient psychiatric clinic in Sweden. For instance, the support system made it possible to send messages and share information between the therapist and the patient before and after therapy sessions at the clinic.

Methods: Nine clinical psychologists participated and 33 patients were enrolled in the current study. We evaluated the usability and technology acceptance after 12 weeks of access. Moreover, clinical data on common psychiatric symptoms were assessed before and after the presentation of the support system.

Results: In line with our previous study in a university setting, the Internet-based support system has the potential to be feasible also when delivered in a regular psychiatric setting. Notably, some components in the system were less frequently used. We also found that patients improved on common outcome measures for depressive and anxious symptoms (effect sizes, as determined by Cohen d, ranged from 0.20-0.69).

Conclusions: This study adds to the literature suggesting that modern information technology could be aligned with conventional face-to-face services.

Keywords: Internet-treatment; blended therapy; cognitive behavioral therapy; psychiatry.

Conflict of interest statement

Conflicts of Interest: None declared.