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9 results

  • Association of postnatal severe acute malnutrition with pancreatic exocrine and endocrine function in children and adults: a systematic review

  • Farzana Ferdous, Suzanne Filteau, Nanna Buhl Schwartz, Sehlulekile Gumede-Moyo, Sharon Elizabeth Cox
  • Journal:
    British Journal of Nutrition / Volume 129 / Issue 4 / 28 February 2023
    Published online by Cambridge University Press:
    04 May 2022, pp. 576-609
    Print publication:
    28 February 2023
    • Article
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  • Severe acute malnutrition may lead both concurrently and subsequently to malabsorption and impaired glucose metabolism from pancreatic dysfunction. We conducted a systematic review to investigate the associations of current and prior postnatal wasting malnutrition with pancreatic endocrine and exocrine functions in humans. We searched PubMed, Google Scholar, Web of Science and reference lists of retrieved articles, limited to articles in English published before 1 February 2022. We included sixty-eight articles, mostly cross-sectional or cohort studies from twenty-nine countries including 592 530 participants, of which 325 998 were from a single study. Many were small clinical studies from decades ago and rated poor quality. Exocrine pancreas function, indicated by duodenal fluid or serum enzymes, or faecal elastase, was generally impaired in malnutrition. Insulin production was usually low in malnourished children and adults. Glucose disappearance during oral and intravenous glucose tolerance tests was variable. Upon treatment of malnutrition, most abnormalities improved but frequently not to control levels. Famine survivors studied decades later showed ongoing impaired glucose tolerance with some evidence of sex differences. The similar findings from anorexia nervosa, famine survivors and poverty- or infection-associated malnutrition in low- and middle-income countries (LMIC) lend credence to results being due to malnutrition itself. Research using large, well-documented cohorts and considering sexes separately, is needed to improve prevention and treatment of exocrine and endocrine pancreas abnormalities in LMIC with a high burden of malnutrition and diabetes.

  • 6 - Biological Approaches to Psychiatric Disorders: A Sociological Approach

  • from Part I - Theoretical Perspectives on Mental Health and Illness: Introduction to Part I
    • By Sharon Schwartz, Professor of Epidemiology, Columbia University, Mailman School of Public Health, Cheryl Corcoran, Assistant Professor of Psychiatry, Columbia University; Research Scientist, New York State Psychiatric Institute
  • Edited by Teresa L. Scheid, University of North Carolina, Charlotte, Eric R. Wright, Georgia State University
  • Book:
    A Handbook for the Study of Mental Health
    Published online:
    28 May 2018
    Print publication:
    08 June 2017, pp 98-125

  • Summary

    The biological understanding of mental illness views it as a disease of the brain. The biological revolution in psychiatry was sparked by evidence for a genetic component to psychiatric disorders and pharmaceutical advances in drug therapies, which added to understanding of the chemistry of the brain and neuronal communication (neurochemistry). Furthermore, advances in neuroscience or neuroanatomy (which combines the findings from several scientific disciplines) have furthered our understanding of the relationship between the structure of the brain and human behavior. Schwartz and Corcoran provide an overview of what biological psychiatrists know about the brain and its function and dysfunction (neuroanatomy), neurochemistry, and genetics. Psychiatric medications affect the level of neurotransmitters, and hence correct dysfunctions in the neuronal communications systems. Schizophrenia has been hypothesized to result from an excess of dopamine, and the symptoms of schizophrenia are often reduced with the administration of medications which block specific dopamine receptors. Yet this evidence does not demonstrate that the cause of schizophrenia is a chemical imbalance as not all people respond to medications. The medications only affect some of the symptoms of schizophrenia, and studies report inconsistent responses. Contradictory findings and gaps also exist in knowledge of the role played by neurotransmitter dysfunctions in depression. While the evidence for a genetic link to schizophrenia and depression is compelling, Schwartz and Corcoran describe a variety of methodological problems which make heritability estimates questionable.

    Furthermore, the specific mode of transmission and interactions among genetic and environmental factors need further examination. The biological revolution has pointed to the complexity of understanding mental illness. Schwartz and Corcoran conclude by outlining what role sociologists can play in researching the factors which affect the etiology and course of mental disorder, and in using the information gained by biological psychiatrists to further understanding of the relationship between social and biological factors. The student will want to read this chapter carefully and identify what information they thought was incontrovertible (i.e., schizophrenia is caused by a particular gene) has in fact not been verified.

    Introduction

    That recent decades have witnessed a biological revolution in psychiatry is undeniable. A presidential proclamation branded the 1990s “The Decade of the Brain.” President Obama announced the BRAIN (Brain Research through Advancing Innovative Neurotechnologies) initiative in 2013 to promote an understanding of the brain functions underlying health and disease (http://braininitiative.nih.gov/about.htm).

  • 4 - Biological Theories of Psychiatric Disorders: A Sociological Approach

  • from Part I - Approaches to Mental Health and Illness: Conflicting Definitions and Emphases
  • Edited by Teresa L. Scheid, University of North Carolina, Charlotte, Tony N. Brown, Vanderbilt University, Tennessee
  • Book:
    A Handbook for the Study of Mental Health
    Published online:
    05 June 2012
    Print publication:
    16 November 2009, pp 64-88

  • Summary

    This chapter focuses on three areas: brain structure and function (neuroanatomy), brain activity (functional brain imaging), and gene effects (genetics). Information from each area is beginning to be integrated, with the goal of understanding biological disease processes. The chapter focuses on the neurons because it is their functioning that is largely the basis of theories of psychiatric disorders at the level of analysis, with the recognition that the glial cells that support the neurons may also be relevant. Researchers have used several methods to test the hypothesis that psychiatric disorders reflect dysfunctions in neuronal communication systems. Researchers have also examined postmortem brain tissue to see changes in the shapes of neurons and their connections. Sociological analyses of the social construction of psychiatric disorders are also important; particularly at this juncture when the number of disorders officially recognized in psychiatry is growing at an unprecedented rate.

  • PTSD Symptoms and Comorbid Mental Disorders in Israeli War Veterans

  • Andrew E. Skodol, Sharon Schwartz, Bruce P. Dohrenwend, Itzhak Levav, Patrick E. Shrout, Marian Reiff
  • Journal:
    The British Journal of Psychiatry / Volume 169 / Issue 6 / December 1996
    Published online by Cambridge University Press:
    02 January 2018, pp. 717-725
    Print publication:
    December 1996
  • Background

    The purpose of this study was to investigate patterns of mental disorders comorbid with PTSD symptoms in young Israeli men exposed to combat.

    Method

    Six hundred and seventeen subjects were selected via a general population sample and evaluated in a two-phase case-identification procedure, culminating in a modified SADS–L interview, administered by psychiatrists.

    Results

    Major depressive disorder (OR=3.2), substance use disorders (OR=1.9) and personality disorders (OR=3.0) occurred more frequently in men reporting symptoms of PTSD than in men who had been under fire who did not report symptoms. With the possible exception of personality disorders, comorbid disorders did not constitute risk factors for PTSD. Comorbid PTSD and RDC disorders were associated with increased help-seeking.

    Conclusions

    The results suggest similar rates and types of PTSD comorbidity in Israeli war veterans as in veterans in the US assessed in general population studies, and are consistent with shared risk factors for PTSD and comorbid disorders.