Alcohol abuse and dependence criteria as predictors of a chronic course of alcohol use disorders in the general population

AIMS: To investigate whether DSM-IV abuse and dependence criteria and the ICD-10 criterion for craving differentially predict a chronic course of alcohol use disorders (AUD) in the general population. METHODS: Data were derived from the Netherlands Mental Health Survey and Incidence Study, a large representative sample of the general Dutch population with a baseline and a 1- and 3-year follow-up assessment. In the present study, a cohort of subjects with a DSM-IV AUD diagnosis at baseline was followed (n = 382). Diagnostic criteria of AUD according to DSM-IV and ICD-10 were assessed using the Composite International Diagnostic Interview (CIDI). RESULTS: In our cohort of subjects with an AUD diagnosis at baseline, the presence of all dependence criteria, except tolerance, significantly increased the risk for dependence at 1 and 3 years follow-up. Abuse criteria displayed much lower and often non-significant risks for dependence at follow-up, with the exception of the criterion 'legal problems'. The ICD-10 criterion 'craving' had the highest relative risk (RR) of all criteria for dependence at 1 year (RR = 12.4, 95% CI = 5.5-27.8) and 3 years follow-up (RR = 12.9, 95% CI = 4.4-37.7). CONCLUSION: With the exception of tolerance, all DSM-IV dependence criteria are useful in predicting the course of AUD in the general population.     

Decrease in pathology and progression of scrapie after immunisation with synthetic prion protein peptides in hamsters

Effective therapy for prion diseases is currently unavailable. Recently, vaccination was shown to be effective in mouse models of a particular neurodegenerative conditions: Alzheimer's disease (AD). Here, we report that vaccination with synthetic oligopeptides homologous to the hamster (Mesocricetus auratus) prion protein augments survival time in animals infected intraperitoneally with 263K scrapie agent. For each hamster included in the study, prion-specific serum antibodies as well as deposition of pathological prion protein (PrP(res)), glial fibrillary acidic protein (GFAP), and mRNA expression for cytokines (TNF alpha, IL-1beta, IL-10) in brain tissues were evaluated. In immunized animals, increased survival after challenge was associated with a reduction of cerebral lesion, PrP deposition and GFAP expression; in these animals, anti-prion protein peptide antibody levels were increased, and the expression of pro-inflammatory cytokines (TNF alpha and IL-1beta) was reduced. Vaccination could be an effective therapeutic approach to postpone disease onset.     

Cephalometric assessment of the mandibular growth pattern in mouth-breathing children

OBJECTIVE: At the present time, it is generally accepted that chronic mouth breathing influences craniofacial growth and development. The objective of this study was to determine the position of the jaw, its growth direction and morphology, and the facial proportions of children with two different etiological factors of mouth breathing, at different age groups. MATERIALS AND METHODS: Four groups of mouth breathing children were analyzed by cephalometry. Two groups, ages ranging from 3 to 6 and 7 to 10 years, with respiratory obstruction due to isolated adenoid hypertrophy (AH), and two groups, ages ranging from 3 to 6 and 7 to 10 years, due to adenotonsillar hypertrophy (ATH). RESULTS: No significant differences were observed between mouth breathing children caused either by AH or by ATH in any of the age groups. Only the linear Ar-Go measurement was significantly larger in children with ATH with 7 years or more. CONCLUSIONS: The results suggest that the influence of mouth breathing on mandibular growth is poorly related to the etiological factors analyzed. The single difference observed was the lower posterior facial height in children of 7 years of age or more, which was higher in those with ATH than in those with AH.     

The BAHA Softband. A new treatment for young children with bilateral congenital aural atresia

OBJECTIVE: To evaluate the validity of a bone-anchored hearing aid (BAHA) Softband (fitted unilaterally and bilaterally) in young children with bilateral congenital aural atresia. SUBJECTS: Two children with severe bilateral congenital conductive hearing loss, who had been fitted with a transcutaneous BAHA Softband at the age of 3 and 28 months, respectively. The latter child had been fitted with a conventional bone-conduction hearing aid at the age of 3 months; at 28 months, this child had received the BAHA Softband and after 5 months of unilateral application, the BAHA Softband was fitted bilaterally. Follow-up in the two children was 31 and 17 months, respectively. METHODS: Using the artificial mastoid, gain and maximum output were studied in this new transcutaneous application of the BAHA, with the BAHA Classic and the BAHA Compact as sound processor. Results were compared to those obtained with a conventional bone-conduction device (Oticon E 300 P). Aided thresholds and sound lateralization scores were assessed with double visual reinforcement audiometry (VRA). To test the validity of the BAHA Softband, the speech and language development of the children was assessed by means of age-appropriate tests (the preverbal Symbolic play test and the Dutch non-speech test for receptive and expressive language and the Dutch version of the Reynell language test). RESULTS: The electro-acoustic measurements showed minor differences in gain between the three devices. At a reduced volume setting, the mean input level at which the output levelled off was largely comparable between the BAHA Classic and the conventional device, but somewhat poorer with the BAHA Compact. Both children showed speech and language development that was in accordance with their cognitive development. CONCLUSIONS: The BAHA Softband was a valid intervention in children with congenital bilateral aural atresia who were too young for percutaneous BAHA application.     

Does neuroticism explain variations in care service use for mental health problems in the general population?

AbstractBackground Little is known about the role of personality characteristics in service utilisation for mental health problems. We investigate whether neuroticism: 1) predicts the use of primary and specialised care services for mental health problems, independently of whether a person has an emotional disorder; and 2) modifies any association between emotional disorder and service use.Methods Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) a prospective cohort study in the general population aged 18–64. Neuroticism was recorded at baseline, and emotional disorder and service use at 12-month follow-up, in a representative sample (N=7076), using the Composite International Diagnostic Interview.Results People with high neuroticism were more likely to receive care in the specialised mental health sector, and after entry to care they made more visits to the services, whether or not they had an emotional disorder. If they had an emotional disorder, their likelihood of receiving specialised mental health care showed an additional increase. Neuroticism also predicted the use of primary care for mental health problems, but greater numbers of visits were made only by clients with both high neuroticism and an emotional disorder.Conclusions It would be useful to incorporate personality characteristics into models to understand variations in service utilisation for mental health problems. The findings suggest that professionals would be wise to focus not just on their clients’ emotional problems and disorders, but also on strengthening their problem-solving abilities through approaches like cognitive behavioural therapy.     

Do different psychotic experiences differentially predict need for care in the general population?

INTRODUCTION: The pathway from subclinical psychotic experiences to need for care may depend on type of psychotic experience, level of associated distress, and previous experience of psychosis. METHOD: In a general population sample with no previous Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition , psychotic disorder (n = 4722), 83 subjects displayed at least one psychotic experience. Within the group of 83, subjects with (n = 24) and without need for care (n = 59) were compared. Presence of psychotic experiences at younger ages had been assessed at earlier interviews. RESULTS: Of 7 different psychotic experiences, only hearing voices, nonverbal hallucinations, and passivity phenomena were significantly associated with need for care. These associations were largely explained by the distress associated with the psychotic experience, but whether individuals had had psychotic experiences at earlier ages did not matter. CONCLUSIONS: Different psychotic experiences differ in the associated level of need for care and the mediating role of distress. Longer prior exposure to psychosis may not influence the pathway from subclinical to clinical.     

Resting energy expenditure: a better marker than BMI for BMD in African-American women

PURPOSE: African-American women tend to be more overweight and to have lower resting energy expenditures (REE) compared with Caucasian women. Weight is associated with bone mineral density (BMD), but the relation between BMD and REE has not been reported. METHODS: Four hundred postmenopausal African-American women aged 45-87 (yr) from San Diego, CA participated in this community-based cross-sectional study. Body composition (fat mass, lean body mass), bone mineral content (BMC) and BMD of the lumbar spine, hip (femoral neck, greater trochanter, intertrochanter), and total body were measured using dual energy x-ray absorptiometry (DXA). REE was calculated using the Harris-Benedict equation; grip strength was measured by isometric dynamometry. RESULTS: REE (r range: 0.32-0.79) showed the strongest correlation with spine, total hip, and total body BMC and BMD. In stepwise multiple linear regressions adjusted for age and grip strength, REE explained 15% of the variance in spine BMD, 33% of the variance in total hip, and 32% of the total body BMD variance. REE explained 63% of the total body BMC variance. When body weight replaced REE in the models, weight became the strongest covariate of BMC and BMD but explained 1% less of the variance in spine BMD, 5% less of the variance in total hip BMD, 4% less of the variance in total body BMD, and 3% less of the variances in spine, total hip, and total body BMC than did REE. CONCLUSION: In this cohort of African-American women, weight explained less of the BMC and BMD variance than REE. Poor energy economy may contribute to being overweight and may explain the lower rates of osteoporosis observed in African-American women.