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Conflicts between humans and bears have occurred since prehistory. Through time, the catalogue of human–bear conflicts (HBC) has been changing depending on the values and needs of human societies and their interactions with bears. Even today, conflict situations vary among the eight species of bears and geographically across these species’ ranges. This results in a broad range of interactions between bears and humans that may be considered as conflicts, including: (1) predation of domestic or semiwild animals, including bees, hunting dogs, and pet animals; (2) damage due to foraging on cultivated berries, fruits, agricultural products, and the tree bark in forest plantations; (3) economic loss due to destruction of beehives, fences, silos, houses, and other human property; (4) bear attacks on humans causing mild or fatal trauma; (5) bluff charges, bear intrusions into residential areas; and (6) vehicle collisions with bears and traffic accidents. In this chapter we aim to outline the principal types of HBC and geographical differences in the occurrence of conflicts and the coexistence between people and bears.
The transgenic Liberty Link® (LL) soybean is tolerant to glufosinate, conferred by the enzyme phosphinothricin acetyltransferase (PAT), which is encoded by the pat gene from Streptomyces viridochromogenes. Because symptoms of injury can be observed in soybean [Glycine max (L.) Merr.] plants in some situations, this study evaluated the effects of rates of glufosinate on agronomic performance; quality of LL soybean seeds; and the ammonia, glufosinate, and N-acetyl-l-glufosinate concentration (NAG) in soybeans with and without the pat gene after application of increasing glufosinate rates. Field and greenhouse experiments were conducted; the first evaluated the selectivity of glufosinate in LL soybeans, and the second evaluated the metabolic changes in soybeans with (LL) and without (RR2) the pat gene, after application of glufosinate. For fieldwork, application of glufosinate at rates up to four times the maximum recommended caused initial injury symptoms (up to 38.5%) in LL soybean plants. However, no negative effect was found on seed quality and agronomic performance of LL plants, including yield. This shows the selectivity of glufosinate promoted by pat gene insertion for application in POST (V4), in LL soybean. For the greenhouse experiment, it was concluded that the LL soybean plants presented high glufosinate metabolism, lower ammonia concentration, and no reduction in dry matter, in comparison with RR2 soybean, after application of high rates of glufosinate.
Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear.
We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed.
This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model.
A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R = −0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure.
Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.
Resistance to antipsychotic treatment affects up to 30% of patients with schizophrenia. Although the time course of development of treatment-resistant schizophrenia (TRS) varies from patient to patient, the reasons for these variations remain unknown. Growing evidence suggests brain dysconnectivity as a significant feature of schizophrenia. In this study, we compared fractional anisotropy (FA) of brain white matter between TRS and non–treatment-resistant schizophrenia (non-TRS) patients. Our central hypothesis was that TRS is associated with reduced FA values.
TRS was defined as the persistence of moderate to severe symptoms after adequate treatment with at least two antipsychotics from different classes. Diffusion-tensor brain MRI obtained images from 34 TRS participants and 51 non-TRS. Whole-brain analysis of FA and axial, radial, and mean diffusivity were performed using Tract-Based Spatial Statistics (TBSS) and FMRIB’s Software Library (FSL), yielding a contrast between TRS and non-TRS patients, corrected for multiple comparisons using family-wise error (FWE) < 0.05.
We found a significant reduction in FA in the splenium of corpus callosum (CC) in TRS when compared to non-TRS. The antipsychotic dose did not relate to the splenium CC.
Our results suggest that the focal abnormality of CC may be a potential biomarker of TRS.
In 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America.
We searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela.
The number of psychiatric beds decreased in 15 out of 17 Latin American countries (median −35%) since 1991. Our findings indicate the total removal of 69 415 psychiatric beds. The prison population increased in all countries (median +181%). Panel data regression analyses showed a significant inverse relationship −2.70 (95% CI −4.28 to −1.11; p = 0.002) indicating that prison populations increased more when and where more psychiatric beds were removed. This relationship held up when introducing per capita income and income inequality as covariates −2.37 (95% CI −3.95 to −0.8; p = 0.006).
Important numbers of psychiatric beds have been removed in Latin America. Removals of psychiatric beds were related to increasing incarceration rates. Minimum numbers of psychiatric beds need to be defined and addressed in national policies.
Failure to adjust doses may contribute to adverse events. We evaluated the effectiveness of providing the estimated glomerular filtration rate on appropriateness of dosing for antimicrobials. The approach increased appropriateness of dosing from 33.9% to 41.4% (P < .001). Nudging prescription behavior can boost strategies for adequate antimicrobial prescription.
The co-infection between visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) has increased in several countries in the world. The current serological tests are not suitable since they present low sensitivity to detect the most of VL/HIV cases, and a more precise diagnosis should be performed. In this context, in the present study, an immunoproteomics approach was performed using Leishmania infantum antigenic extracts and VL, HIV and VL/HIV patients sera, besides healthy subjects samples; aiming to identify antigenic markers for these clinical conditions. Results showed that 43 spots were recognized by antibodies in VL and VL/HIV sera, and 26 proteins were identified by mass spectrometry. Between them, β-tubulin was expressed, purified and tested in ELISA experiments as a proof of concept for validation of our immunoproteomics findings and results showed high sensitivity and specificity values to detect VL and VL/HIV patients. In conclusion, the identified proteins in the present work could be considered as candidates for future studies aiming to improvement of the diagnosis of VL and VL/HIV co-infection.
Cognitive deficits are a core feature of psychotic disorders. Both in adult and adolescent populations, studies have shown that patients with psychosis have poorer cognitive functioning than controls. The cognitive domains that seem to be affected are mainly attention, working memory, learning and memory, and executive function. However, with regard to the trajectory of cognitive function throughout the illness, there is still a dearth of prospective data in patients who develop psychosis during adolescence. In this article, neuropsychological functioning was assessed in a sample of 24 first episodes of early onset psychosis (EOP) and 29 healthy adolescents at baseline and after a two-year follow-up. Patients with EOP showed lower scores than controls in overall cognitive functioning and in all specific domains assessed (attention, working memory, executive function, and learning and memory) both at baseline and the two-year follow-up. When changes in cognitive functioning over two years were assessed, patients and controls showed significant improvement in almost all cognitive domains. However, this improvement disappeared in the patient group after controlling for improvement in symptomatology. Our findings support a neurodevelopmental pathological process in this sample of adolescents with psychosis.
Interdigital 2D:4D ratio has been considered as an indicator of prenatal exposure to androgens, entailing then a smaller ratio more androgenisation. Although it has been related to systemizing and empathy dimensions in the general population, it has never been studied in parents of people with Autism Spectrum Disorders (ASDs).
Objectives and aims
To analyse the relationship between the 2D:4D ratio and these psychological variables in this population.
The sample was composed by parents of both genders of people with (n = 46) or without (n = 42) ASDs. The ratio was calculated as the mean of 3 measurements of each hand evaluated by 3 different researchers. Psychological dimensions were evaluated by means of the Systemizing and Empathy Quotients (SQ and EQ, respectively).
Parents of ASDs persons showed lower scores in the EQ than controls, being these differences replicated only in men. No differences between groups for the 2D:4D ratio were found. Nevertheless, regression analyses indicated that in parents of ASDs a higher 2D:4D left ratio predicted a higher EQ. This result was also observed in men but not in women. In any case, the model was not significant in the control group.
Parents of ASDs persons showed lower EQ than controls, being this quotient predicted by the left 2D:4D ratio only in the former. When analysing in each gender, these results are only obtained in men. Among other parameters, the D2:D4 ratio (especially the left hand one) could be considered a valid indicator of the ASDs parent's idiosyncrasy.
Corticobasal degeneration is a rare neurodegenerative disorder affecting both cortex and basal ganglia with clinical and underlying pathological heterogeneity. Although motor features of CBD were emphasized in earlier descriptions psychiatric symptoms, including cognitive impairment and mood disorders, have been consistently reported during the course of the disease. Clinical diagnosis of CBD is challenging and can be difficult to differentiate from other neuropsychiatric disorders with overlapping features. This can lead to significant underdiagnosis of CBD particularly during its early stages.
We report a case of a 48 year-old female patient presenting with insidious orofacial dystonia co-occurring with depression which remained controlled for five years. Later, while experiencing major psycho-social stress factors, she presented with a rapidly progressive clinical syndrome compatible with the diagnosis of cortico-basal degeneration with severe motor, cognitive and behavioural symptoms, including alien limb phenomenon, nonfluent aphasia and personality changes. Neuropsychological assessment revealed significant frontal lobe dysfunction and SPECT imaging showed asymetrical fronto-parietal hypoperfusion.
This case illustrates the difficulties in the clinical diagnosis of CBD both in early and late stages due to its clinical overlap with mood and movement disorders as well as with Fronto-Temporal Dementia. At the same time, it highlights the influence of psycho-social stress factors in the manifestation of degenerative disorders.
Caregiving of offspring with a chronic illness is a highly stressful vital experience. Previous studies with parents of schizophrenic persons revealed that these situations increase health complaints (González-Bono et al., 2009), with the duration of caring being a relevant variable (Contell-Montaña et al., 2010). The higher age of the caregivers of schizophrenia can contribute to this health unbalance, but little is known in younger samples.
To test whether middle-aged caregivers (parents of autistic persons) present higher health disturbances than controls and to investigate the moderating role of duration of caring
Health complaints and resting levels of immunoglobulin A (IgA) were measured in a sample of 38 middle-aged caregivers of autistic offspring (24 mothers/14 fathers) and 35 parents of healthy persons (17 women/18 men) of similar characteristics.
Caregivers report more immunological, muscular, genital-urinary and general health complaints than controls. Additionally, the scores of all scales and total score of Goldberg Health Questionnaire were higher in caregivers than in non caregivers. No significant differences were found in IgA levels. Among caregivers, fewer years of caring were associated with more anxiety and lower IgA levels.
Chronic stress of caregiving of autistic offspring is associated with more health complaints. The number of years after unequivocal diagnosis of autism has a moderating effect on immunological disturbances and anxiety in care givers. Further research is needed to clarify whether the interventions focused on anxiety can influence the low antibodies levels and decrease future health complaints.
Analysing reactivity to laboratory stressor in lab is a valid model for understanding how people act in real-life situations. Electrodermal activity is a good index of emotionality, which has not been analysed in caregivers of persons with Autism Spectrum Disorders (ASDs).
Objectives and aims
This work aims to compare the response of electrodermal activity to mental stress between caregivers of ASDs people and controls, as the former could show a different response due to their particular situation characterised by a state of continuous alert.
Parents of both genders of people with (n = 44) or without (n = 42) ASDs carried out a set of different mental tasks. Skin Conductance Level (SCL) was continuously registered before, during, and after the tasks. Skin Conductance Responses (SCR) were obtained from SCL levels using Acqknowledge software.
For SCL, a significant effect of “gender” and of “period x group” and “period x group x gender” interactions was observed. SCL was higher in men than in women and in controls when compared to caregivers. Controls presented more SCL Reactivity than caregivers, being these results were replicated in men (who also showed worse recovery in controls) but not in women. In caregivers, men showed lower SCR Reactivity than women.
Caregivers of ASDs showed a lower electrodermal reactivity to mental stress than controls, and this effect was stronger in men. These results could reflect a lower reactivity to stressful situations in caregivers and, consequently, a loss of the adaptative potential of the stress response in this population.
Caregivers of relatives with chronic diseases has shown lower rest levels of immunoglobulin A than non-caregivers (Gallagher et al., 2008). In response to mental stress, IgA levels used to be increased in healthy population (Okamura et al. 2010). Scarce studies have been focused on immunological effects of caregiving in response to stress, and the results are controversial. To our knowledge, there are no studies stressing this field in chronically stressed populations such as caregivers of autistic offspring.
Objectives and aims
Evaluate whether caregivers present different psychosocial and immunological responses to acute stress than non-caregivers, as well as what is the role of gender in these responses.
38 caregivers of persons with autism and 35 non-caregivers were exposed to a psychosocial laboratory stress. IgA levels were measured before, during and after a set of several mental tasks, while the state of mood was evaluated before and after the stressors.
Caregivers showed blunted IgA response to stress in men and women compared with non-caregivers, although the response pattern was different for each gender. Moreover, caregivers presented worse mood (depression, anger, fatigue, vigor and total score) than non-caregivers. Moreover, psychological effects of stress are inversely associated with levels of IgA, fundamentally during the task.
Caregiving reduces IgA secretion in response to psychosocial stress, although differently in men and women. Further studies are necessary to explore other neuroendocrine factors, together with mood, that could be involved in this buffered response.
Cognitive impairment has been consistently described in adult-onset psychosis. A few studies have reported that cognitive impairment is present in early-onset schizophrenia. However, studies on other psychoses are lacking and little is known about the potential specificity of cognitive impairment patterns among the differential sub-diagnoses.
1) To examine the nature and extent of cognitive impairment in first-episode early-onset psychosis (EOP) and 2) To search for differential cognitive impairment profiles among the diagnosis subgroups.
This study describes the basal neuropsychological results of the child and adolescent first-episode psychosis study (CAFEPS), a spanish multicenter longitudinal study. One hundred first-episode patients with EOP and 98 healthy controls underwent a comprehensive neuropsychological assessment. Three diagnostic categories were established: schizophrenia spectrum disorders (n=45), affective psychosis (n=28), and psychosis not otherwise specified (n=28). Baseline diagnoses were confirmed at a 6-month follow-up visit.
Performance of patients was between 0.88 and 2 standard deviations below that of controls in all cognitive domains: attention (p<0.001), working memory (p<0.001), executive functioning (p<0.001), and memory (p<0.001). The three diagnostic subgroups did not differ from one another in terms of impaired/preserved cognitive functions and degree of impairment.
The pattern and degree of cognitive impairment in first-episode EOP patients is similar to that reported in first-episode adult-onset patients. Our results failed to identify significant differences among diagnostic subgroups at the onset of the illness. The longitudinal design of the present study will allow for identification of potential differences in the course of cognitive impairment.
Relatively few studies have assessed the prevalence, correlates, and independent impact on quality of life (QoL) of trichotillomania (TTM) in large samples.
Consecutive participants (N = 7639) were recruited from a cross-sectional web-based study. Sociodemographic data were collected and several validated self-reported mental health measures were completed (Minnesota Impulsive Disorders Interview, Hypomania checklist, Fagerström Test for Nicotine Dependence, Alcohol Use Disorders Identification Test, Early Trauma Inventory Self Report–Short Form, and the Symptom Checklist-90–Revised Inventory). Health-related QoL was assessed with the World Health Organization QoL abbreviated scale (WHOQOL-Bref). Multivariable models adjusted associations to potential confounders.
The sample was predominantly composed of young females (71.3%; mean age: 27.2 ± 7.9 years). The prevalence of probable TTM was 1.4% (95% confidence intervals [CI]: 1.2-1.7), and was more common among females. Participants with probable TTM had a greater likelihood of having co-occurring probable depression (adjusted odds ratio [ORadj] = 1.744; 95% CI: 1.187-2.560), tobacco (ORadj = 2.250; 95% CI: 1.191-4.250), and alcohol (ORadj = 1.751; 95% CI: 1.169-2.621) use disorders. Probable TTM was also independently associated with suicidal ideation (ORadj = 1.917; 95% CI: 1.224-3.003) and exposure to childhood sexual abuse (ORadj = 1.221; 95% CI: 1.098-1.358). In addition, a positive screen for TTM had more impaired physical and mental QoL.
TTM was associated with a positive screen for several psychiatric comorbidities as well as impaired physical and psychological QoL. Efforts towards the recognition and treatment of TTM across psycho-dermatology services are warranted.
We present the case report of a 46-year-old woman who experienced obsessive-compulsive symptoms for over twenty years, with multiple relapses, severe depressive symptoms and many hospitalizations in the psychiatric Inpatient Unit. Treatment with different SSRIs, tricyclic antidepressants, atypical antipsychotics and even electroconvulsive therapy were administered with poor results.
After her last hospitalization a Cognitive-Behavioral Therapy, including exposure and response prevention and cognitive therapy, is initiated combined with medication, improving depressive symptoms, the ritual behaviors and levels of anxiety.
Modern treatments for Obsessive-Compulsive Disorder (OCD) have radically changed how the disorder is viewed. While in the past OCD was regarded as chronic and untreatable, a diagnosis of OCD may now be regarded with hope. Cognitive and behavior therapy and antidepressant medications are currently used to treat the disorder. They can be used to control the symptoms and enable people with OCD to restore normal function in their lives.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Bupropion is a dual antidepressant, a norepinephrine and dopamine reuptake inhibitor. Its main use is in affective disorders as major depression. Antidepressants have been commonly associated with sexual side effects in the libido, sexual arousal, orgasm and erectile function. Bupropion has negative influence in sexual function, even it could increase the libido. Due to this, it could be a good option in patients with active sexual life and affective disorder.
A 58-year-old female with a long history of depression disorder for 5 years. History of lots of side effects with different treatments, sexual dysfunction with serotonin-antidepressants. Treated with bupropion SR 150 mg/day and alprazolam, she suffered a relapse. The bupropion was increased to 300 mg/day. Three days later she appeared in the consultation room, presented a sense of pre-orgasmic of 72 hours of evolution, high increased libido, tiredness, muscle tension and insomnia. This sense did not improve after the sexual act. It had never happened previously. The side effect improved when the bupropion was reduced to 150 mg/day and disappeared with its withdrawal.
The case made a relationship between the increased of bupropion's dose and the appearance of unusual sexual side effects (increased of libido and pre-orgasmic sense). Not only bupropion is one of the antidepressants that do not cause sexual dysfunction, if not it was reported in some trials that could be a treatment against this dysfunction due to its prosexual effects. The mechanism is unknown but could be related with norepinephrine or dopamine transmission.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Over 50% of adult disability claimants fail some form of SVT. While some over report psychological, affective symptoms, others may report incredible cognitive symptoms. We examined effects of different types of response bias on free recall and self-reported depression.
Participants and methods This is a single site cross-sectional study using a convenience sample (n = 224) of disability claimants in the Netherlands. The Green Word Memory Test (GWMT) was administered to all subjects. The Amsterdam Short Term Memory Test (AKTG), the Structured Inventory of Malingered. Symptomatology (SIMS), and the beck depression inventory (BDI-II) were administered in subsamples. Participant classification according to GWMT and SIMS outcomes resulted in four groups, G+/S+, G+/S−, G−/S+ and G−/S−.
Average age of the participants was 46.3 years (SD 9.9), 41.5% were female, and 43% were higher educated. GWMT was positive in 48.2% of all subjects, and 27.6% scored positive on both GWMT and SIMS. Analysis of variance of GWMT Free recall and Beck depression scores showed significant group differences [F(3, 123) = 33.21, P = .000] and [F(3, 106) = 25.17, P = .000] respectively.
Non credible test performance was prevalent in this Dutch study of disability claimants. Insufficient effort and over reporting of psychological symptoms are associated with different score profiles on regular tests and self-rating scales.
Disclosure of interest
The author receives funding for his work as a neuropsychologist in an expertise setting.
Mental disorders can have a major impact on brain development. Peripheral blood concentrations of brain-derived neurotrophic factor (BDNF) are lower in adult psychiatric disorders. Serum BDNF concentrations and BDNF genotype have been associated with cortical maturation in children and adolescents. In 2 large independent samples, this study tests associations between serum BDNF concentrations, brain structure, and psychopathology, and the effects of BDNF genotype on BDNF serum concentrations in late childhood and early adolescence.
Children and adolescents (7-14 years old) from 2 cities (n = 267 in Porto Alegre; n = 273 in São Paulo) were evaluated as part of the Brazilian high-risk cohort (HRC) study. Serum BDNF concentrations were quantified by sandwich ELISA. Genotyping was conducted from blood or saliva samples using the SNParray Infinium HumanCore Array BeadChip. Subcortical volumes and cortical thickness were quantified using FreeSurfer. The Development and Well-Being Behavior Assessment was used to identify the presence of a psychiatric disorder.
Serum BDNF concentrations were not associated with subcortical volumes or with cortical thickness. Serum BDNF concentration did not differ between participants with and without mental disorders, or between Val homozygotes and Met carriers.
No evidence was found to support serum BDNF concentrations as a useful marker of developmental differences in brain and behavior in early life. Negative findings were replicated in 2 of the largest independent samples investigated to date.