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UK Biobank is a well-characterised cohort of over 500 000 participants including genetics, environmental data and imaging. An online mental health questionnaire was designed for UK Biobank participants to expand its potential.
Describe the development, implementation and results of this questionnaire.
An expert working group designed the questionnaire, using established measures where possible, and consulting a patient group. Operational criteria were agreed for defining likely disorder and risk states, including lifetime depression, mania/hypomania, generalised anxiety disorder, unusual experiences and self-harm, and current post-traumatic stress and hazardous/harmful alcohol use.
A total of 157 366 completed online questionnaires were available by August 2017. Participants were aged 45–82 (53% were ≥65 years) and 57% women. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status. Lifetime depression was a common finding, with 24% (37 434) of participants meeting criteria and current hazardous/harmful alcohol use criteria were met by 21% (32 602), whereas other criteria were met by less than 8% of the participants. There was extensive comorbidity among the syndromes. Mental disorders were associated with a high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.
The UK Biobank questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed because of selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.
UK Biobank is a well-characterised cohort of over 500 000 participants that offers unique opportunities to investigate multiple diseases and risk factors.
An online mental health questionnaire completed by UK Biobank participants was expected to expand the potential for research into mental disorders.
An expert working group designed the questionnaire, using established measures where possible, and consulting with a patient group regarding acceptability. Case definitions were defined using operational criteria for lifetime depression, mania, anxiety disorder, psychotic-like experiences and self-harm, as well as current post-traumatic stress and alcohol use disorders.
157 366 completed online questionnaires were available by August 2017. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status than the general population across a range of indicators. Thirty-five per cent (55 750) of participants had at least one defined syndrome, of which lifetime depression was the most common at 24% (37 434). There was extensive comorbidity among the syndromes. Mental disorders were associated with high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.
The questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed owing to selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.
Declaration of interest
G.B. received grants from the National Institute for Health Research during the study; and support from Illumina Ltd. and the European Commission outside the submitted work. B.C. received grants from the Scottish Executive Chief Scientist Office and from The Dr Mortimer and Theresa Sackler Foundation during the study. C.S. received grants from the Medical Research Council and Wellcome Trust during the study, and is the Chief Scientist for UK Biobank. M.H. received grants from the Innovative Medicines Initiative via the RADAR-CNS programme and personal fees as an expert witness outside the submitted work.
Previous studies have suggested that antidepressant treatment of depression may potentiate dopamine transmission through increased sensitivity of postsynaptic D2 receptors.
D2 receptor function was assessed in 24 patients with major depression before and 16 patients after 16 weeks of treatment with cognitive behavioural therapy (CBT) using a challenge with a selective D2 antagonist, sulpiride. Four hundred milligrams of sulpiride was administered orally on two test days and response was measured by the change in prolactin levels and changes in self-rating scale measures of mood, anxiety and pleasure.
The prolactin response to sulpiride (as measured by the maximum prolactin level) was significantly increased after CBT (z = −2.792, p = 0.005). Sulpiride resulted in an improvement on mood ratings on both test days, but after CBT, this effect was significantly diminished as measured by the Profile of Mood States score (t = −2.27, p = 0.038).
After 16 weeks of CBT, we detected an enhanced prolactin response to sulpiride, suggesting an increased sensitivity of D2 receptor functioning.
This paper reviews recent work examining two topics of economic research vital for invasive species policy—integration and valuation. Integration requires bioeconomic models that blend invasive biology with economic circumstances and the feedback loops between the two systems. Valuation requires nonmarket valuation associated with human and environmental damages posed by invasive species. We argue for a second-level of integration in invasive species economics—valuation based on integration models. Policy prescriptions based on integration models need valuation work; valuation surveys need integration models—the two are complements. Valuation could be enhanced with integration in mind; integration could be made better with valuation in mind. An example from blending the two research areas is presented and its merits demonstrated.
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