Children in Uganda: rates of behavioural deviations and psychiatric disorders in various school and clinic populations.
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Individuals potentially at risk for psychiatric disorders were identified by screening 375 college student volunteers for low platelet monoamine oxidase (MAO) activity levels. The lower and upper 10% in MAO activity were administered a personal and family history interview, psychological tests and average evoked response (AER) electroencephalographic procedures. Results indicated that low MAO males and females were socially more active, had more psychiatric contact, and had relatives who were psychiatrically more disturbed than high MAO subjects. Low MAO males had more convictions, experimented more with illegal drugs and had elevated scores on the MMPI. AER criteria further defined a high risk group of low MAO-AER augmenters which had more suicides among their relatives and higher scores on the schizophrenia scale of the MMPI.
Foster care received by 178 patients with chronic psychiatric disorders discharged from Hamilton Psychiatric Hospital in the years 1966 through 1969 was studied by technique evaluation. Residents were followed for 3 years by means of health records. The achievement of operational objectives of the program (Homes for Special Care) was compared with two types of outcome--emergency readmission to hospital and discharge to the community. Emergency readmission was associated with rural location of the foster home, inferior quality of the home operator and smaller size (i.e., fewer residents) of the home. Discharge to the community was more common among younger, female residents whose previous psychiatric hospitalization had been relatively brief. In general, prescription audit was not a fruitful way of evaluating quality of health care.
The author served as a military psychiatrist for one year. In this article, he presents material from a personally conducted examination of soldiers with psychiatric disorders. He has also collected material on two control groups of soldiers. He has also processed patient material collected by other military psychiatrists. Both patient groups are compared with the two control groups concerning various civilian background factors. The study shows that the patients differ from the controls regarding a number of negative factors in their civilian background. These factors can be seen as predisposing to the development of psychiatric disorders while in the Military. The author concludes that these factors ought to be identified at the conscription examination, which is at present inadequate from a psychiatric viewpoint. An effort should be made at conscription to construct a profile of the individual's adaptability. The possibility of the development of a psychiatric disorder could thus be better evaluated.
The author served as a military psychiatrist for one year. In this article, he presents material from a personally conducted examination of soldiers with psychiatric disorders. He has also collected material on two control groups of soldiers. He has also processed patient material collected by other military psychiatrists. Both patient groups are compared with the two control groups concerning various civilian background factors. The study shows that the patients differ from the controls regarding a number of negative factors in their civilian background. These factors can be seen as predisposing to the development of psychiatric disorders while in the Military. The author concludes that these factors ought to be identified at the conscription examination, which is a present in adequate from a psychiatric viewpoint. An effort should be made at conscription to construct a profile of the individual's adaptability. The possibility of the development of a psychiatric disorder could thus be better evaluated.
The authors point out that new findings in psychiatric genetics and psychopharmacology support the heterogeneity of psychiatric disorders. They present data on the current rates of specific psychiatric disorders, using a recently developed diagnostic technique in a survey conducted in New Haven, Conn., during 1975-1976. The survey showed that depressive disorders are the most common diagnoses.
Chronic neurotic encopresis (CNE), a childhood psychiatric disorder characterized by inappropriate fecal soiling, necessitated the formation of the following specific etiological factors: a) a neurologically immature developmental musculature, an organic condition which may complicate toilet training; b) premature or harsh toilet training; c) a family constellation in which the father is frequently absent and the mother erratic, emotionally inappropriate, and distant; d) the child's formation of a noncommunicative, passive, dependent personality. All of these factors are helpful in explaining the occurrence of CNE, which is thus seen as the result of a synergistic interaction among them. The complexity of etiological agents dictates a multifactorial rather than unicausal model of mental illness. Future research and tactics of psychotherapeutic intervention should focus on the interplay among these factors rather than attempting to single out one primary predisposing factor.
The incidence of serious psychiatric illness in 27,376 patients during pregnancy and the puerperium was one in 138 (0.7%). The puerperal-onset group comprised 64 of the 198 cases (32%) and, of these, 22% required admission to a psychiatric institution. Moreover, this group of patients had a recurrence rate of 45% in subsequent pregnancies. Clinical, ethnic and socioeconomic factors were analysed and compared with the same factors in a control group to seek significant associations that might indicate impending psychiatric disorders in obstetric patients.
Morning and evening plasma cortisol levels were checked in 123 consecutively newly admitted psychiatric patients with a variety of diagnoses. Questions asked were whether there were differences among groups with more severe illness, type of depression, alcohol abuse, or particular symptoms. Morning cortisol elevation was found in 33% of patients and was not associated with any particular diagnostic category. Evening cortisol elevation occurred in 85% of the subjects. It was significantly higher in those with unipolar depression and organic brain syndrome, also in those patients who abused alcohol regardless of diagnosis. Evening cortisol elevation was twice as common in patients with diagnoses of more severe psychiatric illness than in those with minor disorders. Further study is suggested to see if these patterns of cortisol elevation are sustained beyond the stress-of-admission period.
Recent studies have suggested that psychosocial factors play an important part in the prediction of the course of minor psychiatric disorders. Fifty-nine new psychiatric out-patients suffering from minor disorders were assessed, using standardized clinical and social interviews, and 52 were followed up after one year and the clinical assessment repeated. Social and clinical factors were equally important predictors of the number of months ill in the survey year, but social and constitutional variables were superior in the prediction of percentage change in symptoms over the year. The results of correlation, factor and multiple regression analyses suggest that the course of minor psychiatric disorder is best predicted by three sets of variables which are, in order of importance, the patient's material social circumstances, his clinical symptoms and his 'genetic risk' scores.
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Understanding the genetic and environmental contributions (and their interactions, which are likely to be complex) to the etiology of psychiatric disorders requires research designs incorporating many basic principles of genetics. Genetic variation is likely to contribute to psychiatric disorders and genetic heterogeneity is likely to exist for any single disorder, ie, completely different genetic variants may each be capable of increasing an individual's susceptibility to the disorder. Thus, it is important to define phenotypes that may more closely reflect each individual genetic variant rather than to rely solely on the psychiatric diagnosis. Research should be undertaken with the goal of testing specific hypotheses that can be excluded. Research designs can include studies of unrelated individuals, twins, separated relatives, nuclear families, or extended pedigrees. Not all hypotheses can be tested on one type of data, and appropriate analytic methods vary. Because genetic hypotheses cannot be tested on studies of unrelated individuals, it is important that data be collected on families instead of unrelated individual patients and/or controls. Studies should include traits that bridge the gap between the genotype and the diagnostic phenotype. Such studies should be multidisciplinary, and the best statistical-genetics methodology should be used for data analysis.
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The present study, fourth in the national literature about general psychiatric epidemiology, refers the experience of a social security system through the study of a sample obtained in a year of work of an important neurologic and psychiatric clinic of this system, studying relevant characteristics of 1 054 subjects in a total 7 102 acute and chronic psychiatric patients, showing a prevalence of 180 per 100 000 habitants. We found 36 different psychiatric disorders, most of them psychoneurotic in ambulatory patients and psychotic forms in hospitalized. The last ones made the 0.022% of the total sample. The biggest frecuency is made by young adults with moderate predominance of females than males. The sample is formed near the 10% by patients of 26 states of Mexican Republic. The period of major frecuency are the months of vacations of government workers, most of them of Public Education Secretary (Secretaría de Educación Pública). We comment some epidemiological articles of Mexican medical literature concerning psychiatric disorders and some socioeconomic and cultural characteristics of mental pathology in our country.
A case-history format was utilized to compare interrater agreement on childhood and adolescent psychiatric disorders, using DSM-II and DSM-III. The average interrater agreement was 57% for DSM-II and 54% for axis I (clinical psychiatric syndrome) of DSM-III. There was high agreement in both systems on cases of psychosis, conduct disorder, hyperactivity, and mental retardation, with DSM-III appearing slightly better. There was noteworthy interrater disagreement in both systems for "anxiety" disorders, complex cases, and in the subtyping of depression. Overall, the reliability of DSM-III appears to be good and is comparable with that of DSM-II and other classification systems of childhood psychiatric disorders.
The clinical overlap between major psychiatric disorders (MPDs) and Alzheimer's disease (AD) implicates complex shared etiology. Previous studies demonstrated that both diseases are genetically complex and highly heritable, suggesting that more endeavors are necessary to be made from the very bottom to understand their genetic basis. With the advance of post-genomic analysis, multi-ancestry meta-analysis allows the generalizability of the genetic architecture across different populations to uncover ancestry-specific variants, while multi-trait analysis enables the discovery of the co-colocalized risk genomic regions across diseases. Therefore, in this study, we leveraged published GWAS summary statistics from European, East Asian, Hispanic and African American populations to report schizophrenia, major depressive disorders, and Alzheimer's disease risk loci and further fine-mapping to credible sets with >95% PP inclusion of the causal variant. We distilled 2871 potential traits from publicly available and found 134 traits significantly genetically correlated with both MPDs and AD using batch LD score regression. We then prioritized the identified loci from multi-ancestry results for cross-trait colocalization analysis to assess shared genetic etiology and further nominated 2 colocalized loci across both conditions, including rs2532240 and rs6504163. In the end, we finalized our analysis by validation and functional inference of the underlying susceptibility genes as well as putative mechanisms using evidence from multiple resources, including FIVEx, Open Targets, and scQTLbase.
Child patients with mental retardation or psychiatric disorders were selected for the presence of prominent acrocentric chromosome satellites and highest or lowest IQ scores. No correlation was found between IQ scores, of which eleven were below IQ 54 and 16 above IQ 68, and the length of acrocentric short arm, satellite, stalk, or short arm material below the stalk. Conventional staining, quinacrine fluorescence, C banding and ammoniacal silver staining revealed the apparent same acrocentric short arm variation between patient and one parent in eight families studied. These findings suggest that the satellite variants were truly normal variants and not etiologically related to the developmental disorders seen in the patients.
A 32-year-old man suffered from juxtapapillary retinochoroiditis in the right eye and a psychiatric disorder. The diagnosis of toxoplasmosis was supported by the clinical ocular findings, serologic examinations, and isolation of the organism from the cerebrospinal fluid. As the retinochoroidal lesion absorbed, the psychiatric symptoms also disappeared during the course of six weeks.