How Does a Developmental Perspective Inform Us About the Early Natural History of Bipolar Disorder?
How does a Developmental Perspective inform us about the early Natural History of Bipolar Disorder?
Filed under: Depression Treatment
J Can Acad Child Adolesc Psychiatry. 2013 Feb; 22(1): 6-12
Duffy A, Carlson GA
The focus of this paper is to explore how a developmental perspective can advance understanding of the clinical trajectory into bipolar disorder (BD) and clarify controversies regarding the diagnosis in youth.In this selective review, we focus on findings from longitudinal studies of general population and high-risk pediatric cohorts in order to inform our understanding of the development of BD in youth. Also highlighted are related aspects of the debate about the diagnosis in young children and a discussion of the implications of the findings for advancing early detection and intervention clinical and research efforts.Evidence overwhelmingly suggests that BD typically onsets in adolescence and early adulthood, with the depressive polarity of the illness dominating the early course. Non-specific childhood antecedents have been noted in some high-risk individuals. However, in youth without a confirmed familial risk of BD, manic-like symptoms have little prognostic significance for BD and not uncommonly form part of the normative adolescent experience. Over-emphasis of symptoms and reliance on parent report alone, alongside the relative neglect of the child’s developmental stage and risk profile, contributes to the over diagnosis in young children and under recognition of BD early in the clinical course.Longitudinal population and high-risk studies over development have made major contributions to our understanding of the early natural history of BD in youth. Implications call for a different diagnostic approach to facilitate accurate identification of youth in the early clinical stages of psychiatric disorders and to differentiate between the emerging illness trajectories and transient normative symptoms in childhood and adolescence.
HubMed – depression
Cognitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment.
Filed under: Depression Treatment
Clin Interv Aging. 2013; 8: 97-102
Uemura K, Shimada H, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Suzuki T
Although much evidence supports the hypothesis that cognitive function and physical function are interrelated, it is unclear whether cognitive decline with mild cognitive impairment influences trainability of physical performance in exercise intervention. The purpose of this study was to examine the association between cognitive function at baseline and change in physical performance after exercise intervention in older adults with mild cognitive impairment.Forty-four older adults diagnosed with mild cognitive impairment based on the Peterson criteria (mean age 74.8 years) consented to and completed a 6-month twice weekly exercise intervention. The Timed Up and Go (TUG) test was used as a measure of physical performance. The Mini-Mental State Examination (MMSE), Trail Making Test Part B, Geriatric Depression Scale, baseline muscle strength of knee extension, and attendance rate of intervention, were measured as factors for predicting trainability.In the correlation analysis, the change in TUG showed modest correlations with attendance rate in the exercise program (r = -0.354, P = 0.027) and MMSE at baseline (r = -0.321, P = 0.034). A multiple regression analysis revealed that change in TUG was independently associated with attendance rate (? = -0.322, P = 0.026) and MMSE score (? = -0.295, P = 0.041), controlling for age and gender.General cognitive function was associated with improvements in physical performance after exercise intervention in subjects with mild cognitive impairment. Further research is needed to examine the effects of exercise programs designed to address cognitive obstacles in older adults with mild cognitive impairment.
HubMed – depression
Depressive symptoms and severity of acute occupational pesticide poisoning among male farmers.
Filed under: Depression Treatment
Occup Environ Med. 2013 Feb 6;
Kim J, Ko Y, Lee WJ
OBJECTIVES: Limited evidence suggests the association between severity of acute occupational pesticide poisoning and depressive symptoms in farmers. The aim of this study was to investigate the association between occupational pesticide exposure and depressive symptoms among male farmers in South Korea. METHODS: A nationwide sampling survey of male farmers was conducted in South Korea. A total of 1958 male farmers were interviewed in 2011. Severity of occupational pesticide poisoning was evaluated according to symptoms, types of treatment and number of pesticide poisonings per individual. Depressive symptoms were assessed using the Geriatric Depression Scale. A survey logistic regression model was used to estimate the multivariate OR and 95% CIs. RESULTS: Among total farmers, 10.4% (n=197) reported depressive symptoms. After controlling for potential confounders, occupational pesticide poisoning in the previous year was positively associated with the risk of depressive symptoms (OR=1.61; 95% CI 1.10 to 2.34). Cases of more severe pesticide poisoning, such as moderate- or severe-symptom cases (OR=2.81; 95% CI 1.71 to 4.63), outpatient or hospitalisation cases (OR=2.52; 95% CI 1.15 to 5.53), and multiple poisoning cases (OR=1.82; 95% CI 1.19 to 2.76) showed higher risks of depressive symptoms than did milder cases. Among the pesticides causing the poisonings, paraquat dichloride was found to be a significant predictor of depressive symptoms. No significant association was found with cumulative lifetime pesticide application and depressive symptoms. CONCLUSIONS: Our findings suggest that the risk of depression appears to be related to the severity of symptoms of poisoning, type of care received and the number of previous episodes of acute poisonings.
HubMed – depression
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