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Bellis M.A.,Liverpool John Moores University | Hughes K.,Liverpool John Moores University | Leckenby N.,Liverpool John Moores University | Jones L.,Liverpool John Moores University | And 8 more authors.
Bulletin of the World Health Organization

Objective To evaluate the association between adverse childhood experiences - e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration - and the health of young adults in eight eastern European countries. Methods Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10 696 respondents - 59.7% female - aged 18-25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide. Findings Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of health-harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval, CI: 1.32-2.15) - for physical inactivity - to 48.53 (95% CI: 31.98-76.65) - for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population. Conclusion Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in eastern European. Source

Mellsop G.,University of Auckland | Choi W.K.,Castle Peak Hospital | Every-Palmer S.,Central Regional Forensic Services | Green B.,Queensland Forensic Mental Health Services | And 4 more authors.
International Journal of Law and Psychiatry

Prompted by four questions, forensic mental health clinicians from Russia, China, Japan, Hong Kong, Australia and New Zealand provided information on both the legislative basis and current practice concerning the relationship between legal insanity, intoxication and drug induced psychosis in their six Pacific Rim Countries which account for nearly 20% of the world's population.Details of the survey for each contributing nation are provided. While there are significant variations in practice that have been shaped by regional legal, clinical and cultural influences there is considerable similarity in the legislation underpinning how these issues are considered. Consequently there remain similar challenges for each nation. In none of the legislative bases was the issue of drug induced psychosis specifically addressed.The authors conclude that evolving pharmaco-neuropsychiatric knowledge, societal values and patterns of substance misuse require nations to consider developments in scientific and clinical knowledge to support their interpretations of the relationship between altered mental states as a result of substance use and the legal construct of insanity. © 2016 Elsevier Ltd. Source

Strekalova T.,Maastricht University | Costa-Nunes J.P.,Maastricht University | Costa-Nunes J.P.,New University of Lisbon | Veniaminova E.,Maastricht University | And 7 more authors.
Journal of Affective Disorders

Background High cholesterol intake in mice induces hepatic lipid dystrophy and inflammation, signs of non-alcoholic fatty liver disease (NAFLD), depressive- and anxiety-like behaviors, and the up-regulation of brain and liver Toll-like receptor 4 (Tlr4). Here, we investigated whether dicholine succinate (DS), an insulin receptor sensitizer and mitochondrial complex II substrate would interact with these effects. Methods C57BL/6 J mice were given a 0.2%-cholesterol diet for 3 weeks, alone or along with oral DS administration, or a control feed. Outcomes included behavioral measures of anxiety/depression, and Tlr4 and peroxisome-proliferator-activated-receptor-gamma coactivator-1b (PPARGC1b) expression. Results 50 mg/kg DS treatment for 3 weeks partially ameliorated the cholesterol-induced anxiety- and depressive-like changes. Mice were next treated at the higher dose (180 mg/kg), either for the 3-week period of dietary intervention, or for the last two weeks. Three-week DS administration normalized behaviors in the forced swim and O-maze tests and abolished the Tlr4 up-regulation in the brain and liver. The delayed, 2-week DS treatment had similar effects on Tlr4 expression and largely rescued the above-mentioned behaviors. Suppression of PPARGC1b, a master regulator of mitochondrial biogenesis, by the high cholesterol diet, was prevented with the 3-week administration, and markedly diminished by the a 2-week administration of DS. None of treatments prevented hepatic dystrophy and triglyceride accumulation. Limitations Other conditions have to be tested to define possible limitations of reported effects of DS. Conclusions DS treatment did not alter the patho-morphological substrates of NAFLD syndrome in mice, but ameliorated its molecular and behavioral consequences, likely by activating mitochondrial functions and anti-inflammatory mechanisms. © 2016 Elsevier B.V. All rights reserved. Source

Gilenko M.V.,Serbsky National Research Center for Social and Forensic Psychiatry
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova

To identify typical clinical and pathogenetic variants of organic mental disorders (OMD), comorbid with alcohol dependence.Material and methods. A study included 302 men who underwent forensic-psychiatric examination. Clinical/ psychopathological, clinical/dynamic and statistical methods were used.Results and conclusion. Significant disorders of social adaptation, commitment of serious unlawful acts, problems of diagnosis and forensic psychiatric assessment were typical of all comorbid disorders studied. We determined two main variants of this comorbid pathology: 1) primary OMD, complicated with alcohol dependence; 2) alcohol dependence, which caused secondary OMD. These variants differ not only in the etiopathogenesis, but in the clinical design and dynamic of disorders. © 2014, Media Sphera. All rights reserved. Source

Stein D.J.,University of Cape Town | Ahokas A.,Mehilainen Clinic | Marquez M.S.,Teaching and Research in Neuroscience | Haschl C.,Prague Psychiatric Center | And 5 more authors.
Journal of Clinical Psychiatry

Background: Agomelatine was efficacious in reducing symptoms in a short-term placebo-controlled trial in generalized anxiety disorder (GAD) and in preventing relapse in a longer term placebo-controlled study. An additional short-term placebo-controlled study is required by regulatory agencies to confirm the efficacy of agomelatine in GAD. Method: This 12-week, placebo-controlled, double-blind, randomized, parallel group, international, multicenter study was designed to confirm the efficacy of agomelatine 25 50 mg/d in the treatment of patients with a primary D5M-IV- TR diagnosis of GAD. The primary outcome measure was the Hamilton Anxiety Rating Scale (HARS) total score. Assay sensitivity was evaluated by including an escitalopram (10 20 mg/d) group. Settings:The study was undertaken in 45 clinical centers in Argentina, Czech Republic, Finland, South Korea, Poland, Russia, and Slovakia from April 2010 to July 2011. Results: One hundred thirty-nine outpatients were included in the agomelatine group, 131 in the placebo group, and 142 in the escitalopram group. Agomelatine significantly reduced mean (SD) HARS total score (agomelatine-placebo difference: 4.71 [1.03], P< .0001) and had significant effects on secondary outcome measures, including psychic and somatic HARS subscales, response rate (estimate [standard error]) (agomelatine-placebo difference: 27.4% [5.9%], P <.0001), remission on the HARS (agomelatine-placebo difference: 16.8% [5.4%], P .002), Clinical Global Impressions- Severity of Illness scale (CGI-S) (P <.001), functional impairment (P< .0001), and sleep quality (P< .001). Findings were confirmed in the subset of more severely ill patients (HARS total score >25 with or without CGI S >5 at baseline). Agomelatine was well tolerated by patients, with no more adverse events than placebo. Escitalopram was similarly efficacious but was accompanied by a higher incidence of adverse events compared to placebo. Conclusions: In clinical practice, agomelatine has at least similar efficacy to that of escitalopram for the short-term treatment of GAD and is well tolerated. Trial Registration: Control led-Tria ls.com identifier: 1SRCTN03554974. © 2014 Physicians Postgraduate Press, Inc. Source

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