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Recamier-Carballo S.,CINVESTAV | Estrada-Camarena E.,National Institute of Psychiatry | Reyes R.,CINVESTAV | Fernandez-Guasti A.,CINVESTAV
Behavioural Brain Research | Year: 2012

The antidepressant effect of estrogens combined with antidepressants is controversial: some preclinical data showed that estrogens facilitate the effect of antidepressants in the forced swimming test (FST) in young adult rats, while others failed to find such effect in middle-aged rats in the chronic mild stress (CMS) model. In clinics similar differences were reported and may be due to the compounds, the depression model or type of depression, the experimental design, and the age of the subjects or the women's menopause stage. The objective of this study was to analyze the antidepressant-like effect of the combination of 17β-estradiol (E2) and fluoxetine (FLX) in young adults (2-4 months) and middle-aged (12-14 months) ovariectomized (OVX) rats in two experimental models: FST and CMS. E2 (5 and 10μg/rat) and FLX (2.5 and 10mg/kg) per se dose-dependently reduced immobility in both age groups and, in young adults both compounds increased swimming, whereas in middle-aged rats they increased swimming and climbing. Analysis of the antidepressant-like effect of the combination of suboptimal doses of FLX (1.25mg/kg) and E2 (2.5μg/rat) showed a decrease in immobility and an increase in swimming in both age groups. In the CMS, chronic E2 (2.5μg/rat) with FLX (1.25mg/kg) augmented relative sucrose intake, but middle-aged rats responded 2 weeks earlier than young adults. These results show that the antidepressant-like effect of the combination of E2 and FLX in young adult and middle-aged female rats is evidenced in the two animal models of depression: FST and CMS. © 2012 Elsevier B.V. Source


Scott K.M.,University of Otago | Von Korff M.,Group Health Research Institute | Angermeyer M.C.,Center for Public Mental Health | Benjet C.,National Institute of Psychiatry | And 8 more authors.
Archives of General Psychiatry | Year: 2011

Context: The physical health consequences of childhood psychosocial adversities may be as substantial as the mental health consequences, but whether this is the case remains unclear because much prior research has involved unrepresentative samples and a selective focus on particular adversities or physical outcomes. The association between early-onset mental disorders and subsequent poor physical health in adulthood has not been investigated. Objective: To investigate whether childhood adversities and early-onset mental disorders are independently associated with increased risk of a range of adult-onset chronic physical conditions in culturally diverse samples spanning the full adult age range. Design: Cross-sectional community surveys of adults in 10 countries. Setting: General population. Participants: Adults (ie, aged ≥18 years; N=18 303), with diagnostic assessment and determination of age at onset of DSM-IV mental disorders, assessment of childhood familial adversities, and age of diagnosis or onset of chronic physical conditions. Main Outcome Measures: Risk (ie, hazard ratios) of adult-onset (ie, at age >20 years) heart disease, asthma, diabetes mellitus, arthritis, chronic spinal pain, and chronic headache as a function of specific childhood adversities and early-onset (ie, at age >21 years) DSM-IV depressive and anxiety disorders, with mutual adjustment. Results: A history of 3 or more childhood adversities was independently associated with onset of all 6 physical conditions (hazard ratios, 1.44 to 2.19). Controlling for current mental disorder made little difference to these associations. Early-onset mental disorders were independently associated with onset of 5 physical conditions (hazard ratios, 1.43 to 1.66). Conclusions: These results are consistent with the hypothesis that childhood adversities and early-onset mental disorders have independent, broad-spectrum effects that increase the risk of diverse chronic physical conditions in later life. They require confirmation in a prospectively designed study. The long course of these associations has theoretical and research implications. ©2011 American Medical Association. All rights reserved. Source


Merikangas K.R.,National Health Research Institute | Jin R.,Harvard University | He J.-P.,National Health Research Institute | Kessler R.C.,Harvard University | And 12 more authors.
Archives of General Psychiatry | Year: 2011

Context: There is limited information on the prevalence and correlates of bipolar spectrum disorder in international population-based studies using common methods. Objectives: To describe the prevalence, impact, patterns of comorbidity, and patterns of service utilization for bipolar spectrum disorder (BPS) in the World Health Organization World Mental Health Survey Initiative. Design, Setting, and Participants: Crosssectional, face-to-face, household surveys of 61 392 community adults in 11 countries in the Americas, Europe, and Asia assessed with the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, version 3.0, a fully structured, lay-administered psychiatric diagnostic interview. Main Outcome Measures: Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) disorders, severity, and treatment. Results: The aggregate lifetime prevalences were 0.6% for bipolar type I disorder (BP-I), 0.4% for BP-II, 1.4% for subthreshold BP, and 2.4% for BPS. Twelve-month prevalences were 0.4% for BP-I, 0.3% for BP-II, 0.8% for subthreshold BP, and 1.5% for BPS. Severity of both manic and depressive symptoms as well as suicidal behavior increased monotonically from subthreshold BP to BP-I. By contrast, role impairment was similar across BP subtypes. Symptom severity was greater for depressive episodes than manic episodes, with approximately 74.0% of respondents with depression and 50.9% of respondents with mania reporting severe role impairment. Three-quarters of those with BPS met criteria for at least 1 other disorder, with anxiety disorders (particularly panic attacks) being the most common comorbid condition. Less than half of those with lifetime BPS received mental health treatment, particularly in low-income countries, where only 25.2% reported contact with the mental health system. Conclusions: Despite cross-site variation in the prevalence rates of BPS, the severity, impact, and patterns of comorbidity were remarkably similar internationally. The uniform increases in clinical correlates, suicidal behavior, and comorbidity across each diagnostic category provide evidence for the validity of the concept of BPS. Treatment needs for BPS are often unmet, particularly in low-income countries. ©2011 American Medical Association. All rights reserved. Source


Borges G.,National Institute of Psychiatry | Loera C.R.,Metropolitan Autonomous University
Current Opinion in Psychiatry | Year: 2010

Purpose of review To present a summary of estimates of the risk of suicidal behaviour (ideation, plan and attempt) among those with substance use disorders in the general population and risk estimates for those with acute alcohol and drug consumption (intoxication) immediately prior to a suicide attempt. Recent findings In Mexico and elsewhere studies have emerged on the risk of suicidal behaviour among those with substance use disorders that are not affected by treatment selection bias or by psychiatric comorbidity. In developed and developing groups of nations, alcohol use disorders were associated with increased odds ratio (OR) of ideation (range 2.0-2.5) and attempt (2.6-3.7), whereas drug use disorders were associated with increased risk of ideation (2.3-3.0) and attempt (2.0-4.0). Follow-up studies of general population samples reported an OR for drug use disorders from 1.9 to 3.7 for ideation, and an OR of 3.0 for attempt. Alcohol dependence increased suicide ideation with an OR of 1.5. Those drinking alcohol prior to the suicide attempt had ORs in the range of 6.2-9.6. This increase may have a dose-response relationship. We found no studies providing risk estimates for drug use prior to a suicide attempt. Summary Current evidence points to a causal role of alcohol and drug use disorders exerting a distal effect on suicidal behaviour. Evidence for the proximal role of alcohol and drug use, as triggers of suicidal behaviour, are still very limited in number, analytical techniques and scope of substances other than alcohol. © 2010 Wolters Kluwer Health π Lippincott Williams & Wilkins 0951-7367. Source


Breslau J.,University of California at Davis | Borges G.,National Institute of Psychiatry | Tancredi D.,University of California at Davis | Saito N.,University of California at Davis | And 5 more authors.
Archives of General Psychiatry | Year: 2011

Context: Migration is suspected to increase risk for depressive and anxiety disorders. Objective: To test the hypothesized increase in risk for depressive and anxiety disorders after arrival in the United States among Mexican migrants. Design:Wecombined data from surveys conducted separately in Mexico and the United States that used the same diagnostic interview. Discrete time survival models were specified to estimate the relative odds of first onset of depressive disorders (major depressive episode and dysthymia) and anxiety disorders (generalized anxiety disorder, social phobia, panic disorder, and posttraumatic stress disorder) among migrants after their arrival in the United States compared with nonmigrant Mexicans who have a migrant in their immediate family. Setting: Population surveys in the United States and Mexico. Participants: Two thousand five hundred nineteen nonmigrant family members of migrants in Mexico and 554 Mexican migrants in the United States. Main Outcome Measures: First onset of any depressive or anxiety disorder. Results: After arrival in the United States, migrants had a significantly higher risk for first onset of any depressive or anxiety disorder than did nonmigrant family members of migrants in Mexico (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). Associations between migration and disorder varied across birth cohorts. Elevated risk among migrants relative to nonmigrants was restricted to the 2 younger cohorts (those aged 18-25 or 26-35 years at interview). In the most recent birth cohort, the association between migration and first onset of any depressive or anxiety disorder was particularly strong (odds ratio, 3.89; 95% confidence interval, 2.74-5.53). Conclusions: This is, to our knowledge, the first study to compare risk for first onset of psychiatric disorder betweenrepresentativesamplesof migrants in the United States and nonmigrants in Mexico. The findings are consistent with the hypothesized adverse effect of migration from Mexico to the United States on the mental health of migrants, but only among migrants in recent birth cohorts. ©2011 American Medical Association. All rights reserved. Source

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