Suicidal and self-harm behaviour associated with adolescent attention deficit hyperactivity disorder-A study in the Northern Finland Birth Cohort 1986

Background: Suicidal behaviour, i.e. suicidal ideation and suicidal acts, as well as self-harm behaviour, are relatively common among adolescents. Depression and/or female gender seem to be risk factors for suicidal behaviour. However, the role of attention deficit hyperactivity disorder (ADHD) in these behaviours is still unclear. Aim: To study the effect of ADHD on suicidal or self-harm behaviour in adolescents from a general population sample. Methods: The sample was derived from a population-based Northern Finland Birth Cohort 1986 (n = 9432). Based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version (Kiddie-SADS-PL) interview performed in a subpopulation (n = 457), the associations between suicidal behaviour and deliberate self-harm (DSH) and the diagnosis of ADHD were studied. Results: Compared with adolescents without ADHD (n = 169), those with ADHD (n = 104) had more suicidal ideation (57% vs. 28%, P < 0.001) and DSH (69% vs. 32%, P < 0.001). In binary logistic models, the effect of ADHD on suicidal ideation remained strong (OR = 6.1) after controlling for several other predictors. Other contributing factors in suicidal behaviour included female gender, childhood emotional and behavioural problems, concurrent depression and anxiety, and, specifically in DSH, behavioural disorder, substance abuse and strains in family relations. Discussion and clinical implications: ADHD is a risk factor for suicidal ideation and DSH. These findings in a general population sample speak for a need to target mental health interventions at children and adolescents with relevant symptoms of ADHD.     

Histamine in Cerebrospinal Fluid of Children with Febrile Convulsions

Summary: Febrile convulsions (FC) are frequent acute neurologic disturbances of childhood. The cellular and neurochemical mechanisms causing FC are unclear. Among other mechanisms, the CNS histamine (HA) has been suggested to participate in seizure control and thermoregulation. We evaluated the possible role of HA in regulation of FC by measuring HA and tele-methylhis- tamine (t–MH) concentrations in the cerebrospinal fluid (CSF) of children with FC. The study group consisted of 35 children treated for acute FC in the hospital. The control groups consisted of (a) feverish children without seizures ( n =23), (b) convulsive children without fever ( n =7), and (c) children with neither fever nor convulsions ( n =21). HA was assayed by high-performance liquid chromatography (HPLC) with fluorescence detection, and t-MH was measured by gas chromatography-mass spectrometry. CSF HA concentration in the group of febrile Convulsions occur rather frequently in connection with febrile children without seizures was significantly higher (0.69 ± 0.16 pmol/ml, mean k SE) than in children with FC (0.36 ± 0.07 pmol/ml, p <0.05, analysis of variance, ANOVA). HA concentration was 0.37 ± 0.18 pmoVml in the group of nonfebrile convulsive children and 0.36 k 0.08 pmol/ml in the nonfebrile nonconvulsive group. No statistical differences in t–MH were detected between groups. The increased susceptibility to seizures during fever may be connected to the lack of increase in CSF HA in the FC group. The data support the hypothesis that the central histaminergic neuron system may be involved in inhibition of seizures associated with febrile illnesses in childhood.     

Evaluating the usefulness of training in psychogeriatrics

A training programme in psychogeriatrics was run for 51 primary health care doctors, nurses and social workers split into two groups for training in two formats. One group was a patient-case group and the other a lecture group. The participants were interviewed 2–4 months after the course and the material analysed by the phenomenographic method. The main result of the training for both groups, from the trainees' point of view, was an enhanced experience of psychogeriatric work and a more creative application of preexisting professional knowledge. No differences in outcome were detected between the groups. Problems in achieving effective training and training evaluation are discussed.     

Neurotransmitters in the nervous system of Macoma balthica (Bivalvia)

The distribution of histamine-, octopamine-, gamma-aminobutyric acid- (GABA) and taurine-like immunoreactivity in the bivalve mollusc Macoma balthica was studied immunocytochemically with antisera produced in rabbits. Histamine levels in the ganglia and whole animals were also measured by high-performance liquid chromatography using a postcolumn derivatization method. Immunoreactivity for these substances, except for taurine, is found in the central nervous system of this species. The most extensive neuronal system is revealed with the antiserum against histamine. All the main ganglia contain histamine-immunoreactive cell bodies, and a dense network of nerve fibers is seen in the ganglia and nerve roots. Histamine-immunoreactive nerve fibers project to the mantle edge, lips and oesophagus. The basal part of the inhalant siphon is rich in histamine-immunoreactive fibers. Unlike histamine, octopamine- and GABA-like immunoreactivities are restricted to the central nervous system. Taurine-like immunoreactivity is not found in the nervous system of this species. In the nervous system, histamine-immunoreactive cell bodies and fibers are more numerous than those that are octopamine- and GABA-immunoreactive. The distribution of these substance in the ganglia is different. GABA-immunoreactive cells are typically smaller than most of the histamine- and octopamine-immunoreactive cells. Most GABA- and octopamine-immunoreactive cells and fibers are located in the pedal ganglion. Histamine is distributed more evenly in the ganglia and nerve roots. The biochemical measurements of histamine correlate well with the immunohistochemical findings and confirm the predominant location of the amine in the nervous tissue. These results suggest that histamine is more widespread than some other putative transmitters, and support the concept that histamine may have an important role in many physiological processes in molluscs. © 1993 Wiley-Liss, Inc.     

Attitudes of health care professionals towards care of the elderly

The effect of a short psychogeriatrics training course for primary health care physicians, nurses and social workers on their attitudes towards care of the elderly was explored using the Snape Attitude Scale before and after the training. Participants' attitudes were not altered significantly. The most positive attitudes were found in a reference group formed by nurses specializing in psychiatry. The groups regarded physicians as having the least interest in geriatric care while social workers were felt to have the greatest willingness to care for the elderly.     

Endogenous Histamine in Cultured Bovine Adrenal Chromaffin Cells

Histamine releases catecholamines and opioids in primary cultured bovine adrenal medullary (BAM) chromaffin cells. We have studied whether histamine is synthesized and localized in BAM cells, and whether it can be released upon activation with secretagogues. In BAM cells histamine is immunohistochemically co-localized with tyrosine hydroxylase in 45 ± 8% of all cells. Only histamine immunoreactivity was observed in 8 ± 2% of all BAM cells. No mast-cell-like cells were observed in our system. Histamine can be released from BAM cells by high potassium (56 mM K⁺) in a calcium-dependent manner. Compound 48/80 did not release histamine from BAM cells but nicotine caused a dose-dependent liberation of the amine. Cultured BAM cells have histidine decarboxylase activity which is inhibited by α-fluoromethylhistidine. These results indicate that endogenous histamine is synthesized, stored and released in BAM chromaffin cells in vitro.