Gender differences in characteristics and outcomes of smokers diagnosed with psychosis participating in a smoking cessation intervention

While research has identified gender differences in characteristics and outcomes of smokers in the general population, no studies have examined this among smokers with psychosis. This study aimed to explore gender differences among 298 smokers with psychosis (schizophrenia, schizoaffective and bipolar affective disorder) participating in a smoking intervention study. Results revealed a general lack of gender differences on a range of variables for smokers with psychosis including reasons for smoking/quitting, readiness and motivation to quit, use of nicotine replacement therapy, and smoking outcomes including point prevalence or continuous abstinence, and there were no significant predictors of smoking reduction status according to gender at any of the follow-up time-points. The current study did find that female smokers with psychosis were significantly more likely than males to report that they smoked to prevent weight gain. Furthermore, the females reported significantly more reasons for quitting smoking and were more likely to be driven by extrinsic motivators to quit such as immediate reinforcement and social influence, compared to the male smokers with psychosis. Clinical implications include specifically focussing on weight issues and enhancing intrinsic motivation to quit smoking for female smokers with psychosis; and strengthening reasons for quitting among males with psychosis.     

Reward sensitivity and anger in euthymic bipolar disorder

According to the hypersensitive behavioral approach system (BAS) model of bipolar disorder (BP), hypersensitivity of the BAS is a trait that should be present even in the euthymic state. This would be expected to result in increased anger and reward sensitivity, both of which are related to the approach system. This study examined these predictions through the use of tasks that assess different aspects of the BAS: reward sensitivity, anger and impulsivity. These characteristics were assessed using the probabilistic classification task (PCT), ultimatum game (UG) and single key impulsivity paradigm (SKIP), respectively. Participants were euthymic adult bipolar disorder patients (BP; N=40) and healthy controls (HC; N=41). In the UG, all participants showed the standard pattern of rejecting overtly unfair offers and accepting clearly fair offers; however, BPs rejected more of the moderately unfair offers than did HCs. BP and HC participants did not differ on their ability to learn, but did show different patterns of learning from reward and punishment. Learning for reward and punishment were negatively correlated in the BP group, suggesting that individuals could learn well either from reward or punishment, but not both. No correlation was found between these forms of learning in the HC group. BP patients show signs of their disorder even in the euthymic state, as seen by the dysbalance between reward and punishment learning and their residual anger in the UG.     

The Role of Muscarinic Receptors in the Pathophysiology of Mood Disorders: A Potential Novel Treatment?

The central cholinergic system has been implicated in the pathophysiology of mood disorders. An imbalance in central cholinergic neurotransmitter activity has been proposed to contribute to the manic and depressive episodes typical of these disorders. Neuropharmacological studies into the effects of cholinergic agonists and antagonists on mood state have provided considerable support for this hypothesis. Furthermore, recent clinical studies have shown that the pan-CHRM antagonist, scopolamine, produces rapid-acting antidepressant effects in individuals with either major depressive disorder (MDD) or bipolar disorder (BPD), such as bipolar depression, contrasting the delayed therapeutic response of conventional mood stabilisers and antidepressants. This review presents recent data from neuroimaging, post-mortem and genetic studies supporting the involvement of muscarinic cholinergic receptors (CHRMs), particularly CHRM2, in the pathophysiology of MDD and BPD. Thus, novel drugs that selectively target CHRMs with negligible effects in the peripheral nervous system might produce more rapid and robust clinical improvement in patients with BPD and MDD.     

Interatrial septal tachycardias following atrial fibrillation ablation or cardiac surgery: Electrophysiological features and ablation outcomes

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Interatrial septal tachycardia (IAS-AT) represented 9% of organized atrial tachycardia (AT) following atrial fibrillation (AF) ablation or cardiac surgery referred for radiofrequency catheter ablation (RFCA). The majority (93%) were targeted from the superior interatrial septum (IAS) limbus and the remaining 7% from the inferior limbus (left). Multiple interatrial septal connections at the level of the superior (red dotted lines) and inferior limbus (red circle) (right) may provide the anatomic substrate for IAS-AT. BB = Bachmann bundle; ICV = inferior vena cava; LA = left atrium; LAA = left atrial appendage; LS = left superior pulmonary vein; RA = right atrium; RAA = right atrial appendage; RI = right inferior pulmonary vein; RS = right superior pulmonary vein; SCV = superior vena cava; SP = septopulmonary bundle. (Anatomic image reproduced with permission from Ho and Sanchez-Quintana.¹⁵)

     

超声引导经皮双极射频消融治疗良性甲状腺结节的局部疗效观察

正甲状腺良性结节通常无需处理,但随着结节增大可能影响美观或有压迫不适感,此时多需要治疗。射频消融(radiofrequency ablation,RFA)作为一种微创治疗方式,目前临床已广泛用于甲状腺结节的治疗~([1])。本组旨在对行超声引导经皮双极RFA治疗的良性甲状腺结节的局部疗效进行分析。     

喹硫平治疗双相情感障碍患者临床疗效分析及对IL-1、IL-1O、TNF-α炎症因子水平的影响

目的:探讨喹硫平治疗双相抑郁患者临床疗效分析及对白介素-1(IL-1)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)炎症因子水平的影响.方法:将106例双相抑郁患者纳入研究对象,随机分为对照组和观察组各53例.对照组采用碳酸锂治疗,观察组采用喹硫平治疗.结果:观察组治疗后IL-1、TNF-α较治疗前均明显降低,IL-10较治疗前均明显升高,差异具有统计学意义(P＜0.05);观察组治疗血清白蛋白、总胆红素较治疗前均明显升高,差异具有统计学意义(P＜0.05);观察组治疗后HAMD评分低于治疗前及对照组治疗后,差异具有统计学意义(P＜0.05).结论:喹硫平治疗双相抑郁患者效果明显,可明显降低IL-1、TNF-α水平,提高IL-10水平,具有重要临床意义.     

Preliminary evidence of disparities in physical activity among adolescents with bipolar disorder

Physical activity can potentially mitigate the symptomatic burden and cardiovascular risk associated with bipolar disorder (BD). Studies have found that adults with BD are less physically active than controls. However, no previous study has examined this topic among adolescents with BD. This study compares physical activity among adolescents with BD vs. healthy controls without major psychiatric disorders, and examines characteristics associated with physical activity among adolescents with BD. Subjects were 86 adolescents with a diagnosis of BD via gold-standard psychiatric interviews, and 50 controls. The Quick Weight, Activity & Excess Screener (WAVE) was used to assess physical activity. Between-group analyses examined for differences in achieving recommended benchmarks for three types of physical activity: working out, “working in” (incidental physical activity), and screen time. Exploratory within-group analyses were based on a median split (high vs. low) of the total physical activity scores among BD adolescents. Adolescents with BD were significantly less likely to report working out regularly (6%) as compared to controls (22%; χ² = 7.98, p = 0.005). There were no significant between-group differences in working in or screen time. BD adolescents with low levels of physical activity were less likely to have a family history of substance use disorder (p = 0.03). Adolescents with BD are less likely than their peers to achieve the recommended benchmark for regular working out. Future studies are warranted to determine what factors explain this difference, and to identify strategies for optimizing physical activity among adolescents with BD.