Somatosensory amplification, found in anxiety, depression and hypochondriasis, refers to the perception of normal somatic and visceral stimuli as being intense and disturbing. There is also some evidence that dysfunctional parental rearing styles associate with increased risk of suffering from somatic diseases and mental disorders in adulthood.

To measure somatosensory amplification in healthy adults and assess the type of parenting they received.

To verify whether a dysfunctional parenting style, as remembered and assessed by healthy adults, is linked to increased somatosensory amplification in adult life. Given that previous evidence suggested that depression and anxiety are also linked to increased somatosensory amplification, present study also controls for those symptoms in estimating the relationship between somatosensory amplification and parenting styles.

Two-hundred and thirty subjects were randomly selected from the general Greek population and asked to complete the Hospital Anxiety and Depression Scale (HADS), the Measurement Of Parenting Style (MOPS), the Remembered Relationship with Parents (RRP) and the Somatosensory Amplification Scale (SSA).

Our results showed that higher HADS scores as well as higher MOPS and RRP scores, indicative of anxiety, depression and perceived dysfunctional parenting respectively, predict a more intense somatosensory amplification. A multivariate regression model showed that increased somatosensory amplification associates best with an overcontrolling parenting style along with more anxiety, lower somatic health and lower educational status.

Our results show that a parenting style perceived as overcontrolling may result later, in adult life, in a more intense somatosensory amplification.

The term endophenotype was first used by Gottesman to describe a trait that may be intermediate on the chain of causality from genes to diseases. An endophenotype may be neuropathological, neurocognitive, emotional, neuro-physiological or neurobiological in nature. There is dearth of studies about the use of neurocognive dysfunction as endophenotype marker of BPAD, particularly from developing countries.

We aimed to evaluate neurocognitive dysfunctions as endophenotype markers of bipolar affective disorder (BPAD) in first degree relative of BPAD patients. We hypothesized that first degree relative of BPAD patients differ significantly in regard to neurocognitive dysfunction from matched controls.

A cross sectional study was carried out. Sample was drawn from first degree relatives (FDR) of patients of BPAD and controls. After assessment of neurocognitive function first degree relatives of BPAD were compared with controls on measures of attention, verbal working memory, auditory verbal memory, Visuo spatial working memory, visual attention and executive functions.

Results indicated that, first degree relatives of BPAD scored poorly on measures of neurocognition then controls. On conducting comparison over composite neurocognitive score 'we found that cognitive index in combination better discriminate the first degree relatives of BPAD from controls.

Neurocognitive dysfunction on measures of attention, verbal episodic memory, auditory verbal working memory, visuospatial working memory and executive functions significantly differentiated first degree relatives of BPAD patients from controls.

Whether burnout is anything other than a (job-related) depressive syndrome is unclear. A growing body of research suggests that the overlap of burnout with depression has been largely underestimated.

The aim of this longitudinal study was to examine whether burnout at baseline helped predict depression at follow-up when depression at baseline was controlled for.

A total of 627 French teachers took part in the two waves of this study, launched in 2012. About three of four participants were female and mean age at time 1 (T1) was 41. Depression was assessed with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). Using the PHQ-9, the severity of depressive symptoms can be graded and provisional diagnoses of major depressive disorders can be established. Burnout was measured with the Maslach Burnout Inventory. Participants completed the follow-up on an average 21 months after completing the initial survey.

Hierarchical multiple regression analysis showed that a model involving T1 burnout and depression as predictors did not explain more variance in depression at follow-up than a model involving T1 depression as the only predictor. Binary logistic regression analyses indicated that T1 burnout no longer predicted cases of major depression at follow-up when T1 depression was included in the tested model. All these results were obtained controlling for gender, age, and length of employment.

This study confirms that burnout overlaps with depression. Assessing burnout in addition to depression may not be as useful as assumed in the past.

Because randomized clinical trials in bipolar disorder include restricted study populations, the possibilities for generalizing to real-world bipolar patients are limited. Naturalistic long-term data can add valuable information about the diversity of treatment, outcome and risk factors in bipolar disorder.

After discharge from a psychiatric community hospital, 300 consecutively admitted ICD-10 bipolar I (n=158) and II (n=142) patients were followed-up naturalistically during for 4 years. Patients were assessed as to time to relapse, relapse in relation to index episode, prophylactic effects of prescribed medication, and risk factors for relapses such as prescribing attitudes, medication adherence, life events and alcohol use disorders.

204 (68%) of 300 patients relapsed within 4 years, with a mean of 208 days (SD=356.2) until the next affective episode. Relapses correlated in a statistically significant manner with the index episode. Using a Kaplan survival analysis, only lithium delayed time to the next affective relapse in a statistically significant way. Survival was reduced in a statistically significant manner when prophylactic medication was replaced by the psychiatrist or stopped by the patient. In a sub-analysis of this cohort life events (n=222) and alcohol use disorders (n=284) were associated with more depressive episodes in bipolar I patients.

Even though lithium seems more protective than other commonly used drugs, bipolar patients still suffer from a high relapse rate. Bad adherence, life events and alcohol use disorders are hereby major risk factors. The results urge for further and more holistic treatment approaches in bipolar disorder.

Negative impact of long-term lithium treatment on kidney and thyroid functions makes the important problem of such therapy. While kidney functions deteriorate in time-dependent manner after ten years of lithium therapy it is unclear whether a significant association exists between thyroid dysfunction and duration of lithium administration.

The aim was to compare thyroid hormones and antibodies in bipolar patients receiving lithium for 10-19 years with those receiving for 20 years or more.

The cross-sectional study was performed on 66 patients (21 male, 45 female) with bipolar mood disorder, receiving lithium for 10-44 (20+9) years. Thyroid stimulating hormone (TSH), free thyroxine (fT3) and free triiodothyronine (fT4) as well as thyroid peroxidase (TPO), thyroglobulin (TG) and TSH receptor (TSH-R) antibodies were measured.

Features of hypothyroidism were found in 10 (22%) female patients but not in male patients. A significant percentage of patients had abnormally high anti-TPO, and anti-TG antibodies (45% and 65%, respectively). There were no differences in thyroid function between 38 patients receiving lithium for 10-19 years and 28 patients taking the drug for 20 years or more.

The results confirm greater susceptibility of female bipolar patients for lithium-induced hypothyroidism. High anti-TPO and anti-TG antibodies suggest a possibility of autoimmune disturbance in these subjects. However, in contrast to lithium effect on kidney function, our results do not show an association between duration of long-term lithium therapy and thyroid dysfunction.

Data was analyzed from 271 patients with MS according IDF criteria, (aged 30 – 60 years). Current D and A were confirmed according to the criteria of ICD-10. All patients passed through: MMSE, HADS, HARS, HAM-A tests. GL and plasma indicators of lipid spectrum were assessed using NCEP criteria.

Subjects were divided into 2 groups, group A – with D and/or A (139) and group B -without affective disorders (132). Using Mann-Whitney test significant connection between changes in levels of indicators of lipid spectrum, the GL and affective disorders in group A were obtained. Subjects with D and A and mild cognitive impairment (MCI) had higher level of VLDL and LDL-C in comparison with only MCI subjects.

There is link between affective disorders and components of MS. Increased level of LDL and VLDL provokes comorbidity of MCI, depression and anxiety.

There has been increasing interest in the association between childhood trauma and psychosis. Proposals for potential mechanisms involved include affective dysregulation and appraisals of threat, yet few large-scale clinical studies exist in affective psychosis.

We hypothesise that within bipolar disorder (BD), childhood events will show a significant association with psychosis, and in particular with symptoms driven by dysregulation of mood or with a persecutory content.

2019 participants were recruited as part of our programme of research into the genetic and non-genetic determinants of BD (www.bdrn.org). Data on lifetime ever presence of psychosis and specific psychotic symptoms were determined by detailed structured interview with case note review. Childhood events were recorded after self-report questionnaire and case note information.

There was no relationship between childhood events, or childhood abuse, and psychosis per se. Childhood events were not associated with increased risk of persecutory or other delusions. Significant associations were found between childhood abuse and auditory hallucinations, strongest between sexual abuse and mood congruent or abusive voices. These relationships remain significant after controlling for lifetime ever cannabis misuse.

Within affective disorder, the relationship between childhood events and psychosis appears to be relatively symptom-specific. It is possible that the pathways leading to psychotic symptoms differ, with delusions and non-hallucinatory symptoms being influenced less by childhood or early environmental experience.

1. Upthegrove R, Chard C, Jones, L, Gordon –Smith K, Forty L, Jones I and Craddock N. Adverse Childhood Events and Psychosis in Bipolar Affective Disorder. BJPsych In press BJP/2014/152611

Children exposed to adverse psychosocial experiences, or early parental loss, are at an increased risk for later depression. Preclinical data indicate that epigenetic regulation of gene expression mediates the effects of early life stress (ELS) on adult behavior and health. In addition to stress-responsive systems (glucocorticoids), the expression of neurotrophic factors in the brain may be regulated epigenetically in the context of ELS contributing to mental health, or systemic disease at adulthood.

In order to investigate epigenetic changes in target genes involved in the long-term effects of early adversity on psychopathology, we have set up an animal model (rat) of prenatal stress.

show that ELS leads to a long-term down-regulation in the expression of target genes, such as the receptor for glucocorticoids and Brain derived neurotrophic factor (BDNF), thus mimicking adult conditions characterizing increased risk for psychopathology. Behavioral and neuroendocrine changes accompanying these differences in gene expression suggest increased stress responsivity, as well as impaired social behavior. Chronic treatment with the antipsychotic lurasidone during adolescence was able to counteract the changes in BDNF expression produced by ELS, preventing the down-regulation of long 3’-UTR BDNF levels that occurred from late adolescence into young adulthood. Furthermore, interaction with a non-stressed rat conspecific ameliorated behavioural dysfunction.

data indicate potential therapeutic targets to counteract prenatal stress and suggest that the perinatal environment can act as a potential buffer for stressful conditions occurring around birth. Support: ERA net-NEURON 'Poseidon” and Fondazione Cariplo 2012.

To assess the risk of first-time seizures in association with exposure to antidepressants in patients with depressive disorders.

We conducted a retrospective follow-up study with a nested case-control analysis using data from the U.K.-based Clinical Practice Research Datalink. We estimated incidence rates (IRs) with 95% confidence intervals (CIs) of seizures in depressed patients who used no antidepressant treatment or who used selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), or ‘other antidepressants’. To better adjust for potential confounding, we estimated odds ratios (ORs) of antidepressant drug use among cases with seizures and matched controls in a nested case-control analysis.

Of 151,005 depressed patients, 619 had an incident seizure during follow-up. IRs per 10,000 person-years were 9.33 (95% CI, 6.19-12.46) in non-users of antidepressants, 12.44 (95% CI, 10.67-14.21) in SSRI users, 15.44 (95% CI, 8.99-21.89) in SNRI users, 8.33 (95% CI, 4.68-11.98) in TCA users, and 5.05 (95% CI, 4.49-5.62) in past users of antidepressants. Across single antidepressants, the highest IR per 10,000 person-years (17.06 [95% CI, 7.41-26.72]) was observed in mirtazapine users. In the case-control analysis we observed the highest risks of seizure in male users of other antidepressants (OR 3.90, 95% CI 1.85-8.26), and in female users of SNRIs (2.70, 95% CI 1.33-5.48) compared with non-use.

With the exception of TCAs, antidepressant use in depressed patients was associated with an increased risk of seizures compared to non-use. Risk estimates differed across antidepressants and depended on timing of therapy, dose, and sex.

This cross-sectional study was aimed to investigate the factors associated with bipolar disorder in pregnant female, including sociodemographic parameters, social support, social conflict, suicidal idea and sleep.

A total of 84 pregnant female were recruited. They filled out self-completing questionnaires on sociodemographic factors, obstetric history, depressive symptoms and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale (EPDS). Bipolarity was assessed using the Korean version of the Mood Disorder Questionnaire (K-MDQ).

Nineteen participants (22.6%) had positive K-MDQ scores, suggesting the present of bipolarity. Positive EPDS group had twenty subjects (25%) who had depressive symptoms. The diathesis of bipolar disorder was associated with marital dissatisfaction, social conflict, depression and sleep. The multiple logistic regression analysis revealed that the only poor sleep was a risk of bipolarity.

Pregnant female with bipolarity were more depressed and sleep problems than those without bipolarity. The results showed that the most important factor of influencing bipolarity was sleep.