Cancer mortality in Common Mental Disorders: A 10-year retrospective cohort study.

PURPOSE: Individuals with Common Mental Disorders (CMDs) may have a higher cancer mortality. The purpose of this study was to examine cancer-related mortality among patients with CMDs and verify which cancer types are predominantly involved. METHODS: We used the Regional Mental Health Registry of the Emilia-Romagna region, in Northern Italy to identify patients aged ≥ 18 years who received an ICD 9-CM diagnosis of CMDs (i.e., depressive and neurotic disorders) over a 10 year period (2008-2017). Information on cause of death was retrieved from the Regional Cause of Death Registry. Comparisons were made with data from the regional population without CMDs. RESULTS: Among 101,487 patients suffering from CMDs (55.7% depression; 44.3% neurotic disorders), 3,087 (37.8%) died from neoplasms. The total standardized mortality ratio (SMR) was 1.82 (95% CI 1.78-1.86) while the SMR for all neoplasms was 2.08 (95% CI 2.01-2.16). Individuals of both genders, with both depressive and neurotic disorders had a higher risk of death from almost all cancers compared with the regional population. CONCLUSION: Patients with CMDs have considerably higher cancer mortality risk than the general population. Higher mortality was observed for a broad range of cancers associated with different aetiologies. It is imperative to promote cancer awareness, prevention and treatment for people with CMDs.

Personality change in the Nottingham Study of Neurotic Disorder: 30-Year cohort study.

BACKGROUND: Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and depressive disorders involved in a randomised controlled trial initiated in 1983 had full personality status assessed at baseline. We repeated assessment of personality status on three subsequent occasions over 30 years. METHODS: Personality status was recorded using methods derived from the Personality Assessment Schedule, which has algorithms for allocating Diagnostic and Statistical Manual of Mental Disorders (DSM) and the 11th International Classification of Diseases (ICD-11) categories. The category and severity of personality diagnosis were recorded at baseline in the randomised patients with DSM-III anxiety and depressive diagnoses. The same methods of assessing personality status was repeated at 2, 12 and 30 years after baseline. RESULTS: Using the ICD-11 system, 47% of patients, mainly those with no personality disturbance at baseline, retained their personality status; of the others 16.8% improved and 20.4% worsened to more severe disorder. In DSM-III diagnosed patients, those diagnosed as Cluster A and Cluster C increased in frequency (from 14% to 40%, p < 0.001, and 21.5% to 36%, p < 0.001, respectively) over follow-up, while those with Cluster B showed little change in frequency (22% to 18%, p = 0.197). CONCLUSION: In this population of patients with common mental disorders, personality status showed many changes over time, inconsistent with the view that personality disorder is a persistent or stable condition. The increase in diagnoses within the Cluster A and C groups suggests personality disorder generally increases in frequency as people age.

Distinguishing between neurosis and psychosis: discourses on neurosis in colonial Korea.

This article analyses the origins and formation of medical and social discourses on neurosis in colonial Korea. With the introduction of Western medicine after the Opening of Korea in 1876, neurasthenia and hysteria began to be understood as neurotic diseases, and their importance was further highlighted during the colonial period of 1910-45. The article also addresses the role of neuropsychiatry in forming discourses on neurosis. In medical communities during the colonial period, the main source of these discourses gradually shifted from internal medicine to neuropsychiatry. In particular, Korean neuropsychiatrists distinguished between neurosis and psychosis as a way to reinforce their authority. Neuropsychiatrists tried to explain the temperamental and environmental factors of neurosis from a psychoanalytic standpoint.

Peripandemic psychiatric emergencies: impact of the COVID-19 pandemic on patients according to diagnostic subgroup.

On March 11th, 2020, the outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic. Governments took drastic measures in an effort to reduce transmission rates and virus-associated morbidity. This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting during the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the COVID-19 pandemic with an increase in repeat visits within 1 month (30.2 vs. 20.4%, pBA = 0.001). Fewer patients with affective disorders utilized the PED (15.2 vs. 22.2%, pBA = 0.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4 vs. 26.8%, pBA = 0.004), while patients with schizophrenia more commonly had persecutory delusions (68.7 vs. 43.5%, pBA = 0.023) and visual hallucinations (18.6 vs. 3.3%, pBA = 0.011). Presentation rate of patients with neurotic, stress-related, and somatoform disorders increased. These patients were more likely to be male (48.6 vs. 28.9%, pBA = 0.060) and without previous psychiatric treatment (55.7 vs. 36.8%, pBA = 0.089). Patients with personality/behavioral disorders were more often inhabitants of psychiatric residencies (43.5 vs. 10.8%, pBA = 0.008). 20.1% of patients stated an association between psychological well-being and COVID-19. Most often patients suffered from the consequences pertaining to social measures or changes within the medical care system. By understanding how patients react to such a crisis situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.

Social contacts, friends and satisfaction with friendships in patients with psychotic, mood and neurotic disorders 1 year after hospitalisation: data from five European countries.

BACKGROUND: People with severe mental illness often struggle with social relationships, but differences among diagnostic groups are unclear. We assessed and compared objective and subjective social relationship indicators among patients with psychotic, mood and neurotic disorders one year after hospitalisation in five European countries (Belgium, Germany, Italy, Poland and United Kingdom). METHODS: The number of social contacts, including family members and friends during the previous week (Social Network Schedule), and satisfaction with the number and quality of friendships (Manchester Short Assessment of Quality of Life Quality) were assessed by face-to-face interview. Linear regression models were used to analyse associations with diagnostic groups. RESULTS: Participants (n = 2155) reported on average 2.79 ± 2.37 social contacts overall in the previous week, among whom, a mean of 1.65 ± 1.83 (59.2 ± 38.7%) were friends. Satisfaction with friendships was moderate (mean 4.62, SD 1.77). In the univariable model, patients with psychotic disorders reported having less social contact with friends than those with either mood (p < 0.05) or neurotic disorders (p < 0.001), but this difference disappeared when adjusting for socioeconomic and clinical variables (ß = - 0.106, 95% CI - 0.273 to 0.061, p = 0.215). Satisfaction with friendships was similar across diagnostic groups in both univariable (ß = - 0.066, 95% CI - 0.222 to 0.090, p = 0.408) and multivariable models (ß = 0.067, 95% CI - 0.096 to 0.229, p = 0.421). The two indicators showed a weak correlation in the total sample (total social contacts, rs = 0.266; p < 0.001; friends, rs = 0.326, p < 0.001). CONCLUSION: While objective and subjective social relationship indicators appear to be weakly correlated concepts, there is no variation in either indicator across diagnostic groups when confounders are taken into account among patients with severe mental illness. Interventions specifically targeting social relationships are needed, but they do not necessitate diagnosis-specific adaptations.

Unbridled! Thoughts on times of self-begetting and violence.

Mind is multi-levelled displaying an eons-long prehistory, while as Freud well knew civilization is new and frail: in biological evolution Thanatos long antecedes Eros. Complex intraspecies interchanges in higher animals proceeding by analogic communication give a firm place to Freudian Dingvorstellungen. Self-recognition and reflective thought come exceedingly late, in apes, requiring affectionate baby-mother mirroring. Deriving from inquiry on ego-dystonic neuroses, psychoanalysis must in the Age of Media deal with ego-syntonic pathologies sporting a demise of self-observation and self-reflection: borderline, autistic and autistoid disturbances. The 'epidemy of autism' offers fertile ground for very early psychoanalytic intervention, here briefly illustrated clinically. But on the other side, adolescent and post-adolescent disturbances cover a range going from autistoid retraction to more and more defiant if not violent protagonistic self-begettings, often propelled by overriding feelings of victimhood: filio-parental violence is the offshoot. Postmodernist ideologies accompany and fuel such trends.

NEUROTIC CONDITIONS: PROBLEM, DIAGNOSIS, CORRECTION BY COGNITIVE-BEHAVIOR THERAPY.

OBJECTIVE: The aim: To identify the relationship between neurotic states and hardiness as an indicator of mental health, to explore the possibility of using the cognitive-behavior therapy techniques to correct neurotic states in young people. PATIENTS AND METHODS: Materials and methods: The methods "Clinical questionnaire for the detection and evaluation of neurotic conditions" (K. Yakhin, D. Mendelevich) and "Hardiness Survey" (S. Muddi, adapted by D. Leontev, O. Rasskazova) were used for diagnosis. Wilcoxon test was used to determine changes in the manifestations of neurotic states in the conditions "before" and "after" the application of cognitive-behavior therapy techniques. Correlation analysis was used also to distinguish the relationship between neurotic states, hardiness and its components. RESULTS: Results: It has been identified that various neurotic states are differently related to hardiness as an indicator of mental and social health. The level of anxiety and obsessivephobic disorders has inverse negative relationship with general level of hardiness (r = -0.31 and r = -0.34), but the level of asthenia has a positive connection with this indicator (r = 0.49). The level of neurotic anxiety is inversely related with the level of personal involvement in life (r = -0.27). The effectiveness of CBT techniques (psycho-education, distancing, cognitive reassessment) for the correction of neurotic states, namely: anxiety (p <0.01) and hysterical reaction type (p <0.01) was proved. CONCLUSION: Conclusions: Neurotic states are correlated with level of hardiness (an indicator of mental and social health) and personal involvement in life. The correction of neurotic states can be effectively carried out by means of CBT.

Contribution of autobiographic memory impairment to subjective memory complaints in focal epilepsy.

"My memory is terrible!" is a common refrain among people with epilepsy, but such complaints are not reliably linked to poor performances on standard tests of memory. Negative affect like depression and anxiety are the most robust predictor of these complaints; however, neither do they entirely account for the phenomenon. The contribution of autobiographic memory impairment to subjective memory complaints in focal epilepsy has not been well-explored despite autobiographic memory impairments being common in patients with epilepsy, and the face validity of relating day-to-day memory failings to such a personally relevant form of memory. The current study sought to clarify whether autobiographic memory dysfunction contributes to subjective complaints in epilepsy, above and beyond negative affect, objective memory impairment, and epileptological factors in a large sample of patients with drug-resistant focal epilepsy relative to healthy controls (N = 135). Patients were stratified into groups with mesial temporal (MT; n = 40) versus nonmesial temporal (NMT; n = 46) foci. Compared to controls (n = 46), both patient groups reported more bitter subjective memory complaints (p < 0.001, large effect size), demonstrated poorer episodic (p = 0.001, large effect size) and semantic autobiographical recall (p = 0.004, medium effect size), and had higher levels of depressive symptomatology (p = 0.011, medium effect size), and trait neuroticism (p = 0.015, medium effect size). Contrary to expectations, multiple regression analyses revealed that autobiographic memory function was not an independent predictor of subjective memory complaints in either group with epilepsy. In people with epilepsy with MT foci, objective verbal memory dysfunction, neuroticism, and female gender predicted memory complaints (R2 = 0.70, p = 0.015), whereas only neuroticism predicted memory complaints in people with epilepsy with NMT foci (R2 = 0.21, p = 0.001). Although patients' poor recall of their autobiographical memories did not contribute to their concerns about their day-to-day memory function, the findings indicate that the location of the epileptogenic focus can provide clues as to the underlying contributors to subjective memory complaints in focal epilepsy. Important clinical implications to stem from these findings include the need for clinicians to adopt a patient-tailored, multifactorial lens when managing memory complaints in people with epilepsy, taking into account both psychological and cognitive factors.

Repression: A Critical Assessment and Update of Freud's 1915 Paper.

The concept of repression has been relegated to the periphery in current psychoanalytic theorizing. This is in part due to a reflexive and ill-informed avoidance of Freudian metapsychology, and in part due to preoccupation with 'primitive' and 'deeper' states of mind, a perspective that presumes that repression operates exclusively in 'higher level' or 'neurotic' forms of psychopathology. A careful scrutiny of psychoanalytic theory and clinical practice does not uphold such compartmentalization. Repression is ubiquitous in mental life. It contributes to normality (e.g., onset of latency), undergirds the 'psychopathology of everyday life' (e.g., parapraxes), exists alongside splitting in severe character disorders (e.g., borderline patients "forgetting" their appointments) and, by permitting a modified return of exiled mental contents, gives birth to neurotic symptoms as well as creative imagination. Taking Freud's seminal discourse on repression (in: Repression. Standard Edition, vol 14. Hogarth, London, pp 141-158 1915a) as its starting point, this paper elucidates the complex, nuanced, and pervasive nature of this defense. It deconstructs Freud's unitary concept of repression into four implicit binaries and updates his proposals in the light of contemporary psychoanalytic theory. The paper offers clear guidelines for clinical applications of these ideas.

COMORBIDITY OF NON-PSYCHOTIC MENTAL DISORDERS AND NEUROLOGIC SYMPTOMS AMONG YOUNG PEOPLE.

OBJECTIVE: The aim: to determine occurrence and structure of non-psychotic mental disorders associated with chronic pain among young people. PATIENTS AND METHODS: Materials and methods: The results of examination of 1235 students were analyzed. The following methods were applied: clinical, clinical-psychopathological, clinical-epidemiological, clinical-anamnestic, experimental-psychological and statistical. RESULTS: Results: Students with neurotic disorders associated with stress and somatoform disorders were found to prevail in the main group (F40-48.1) 187 (58,99%), affective mood disorders were on the second position (F30-34.1) - 79 (24,92%) individuals, followed by disorders of a mature personality and behavior of adults (F60-60.7) diagnosed in 31 (9,78%) students, and at last, behavioral syndromes associated with physiological disorders and physical factors (F50-51.4) - 20 (6,30%) respectively. Chronic pain syndrome was diagnosed in 113 (35,65%) students with NMD including 43 (38,05%) men and 70 (61,95%) women. The majority of young people (86 individuals - 76,11%) observed severe pain, and 27 (23,89%) of them - moderate pain. A clear correlation was found between a depressive episode and CPS (γ<0,02). CONCLUSION: Conclusions: The findings obtained should be considered in development of screening systems concerning diagnostics, prevention of nonpsychotic mental disorders associated with chronic pain syndrome.

The psychological research of the dominant configuration models of marital relationships of a women with neurotic disorders.

OBJECTIVE: The aim: To study the psychological peculiarities of relationships in families of women with neurotic disorders. PATIENTS AND METHODS: Materials and methods: 30 women who received treatment in the neurotic unit of the A.F. Maltsev Poltava Regional Clinical Psychiatric Hospital and 30 mentally healthy women have been examined. In the research the authors used a complex of interrelated and complementary general scientific and specific methods based on the systematic approach. RESULTS: Results: There was a tendency for following types of marital interactions: dependent - 58% of couples, intermediate - 35% of couples. The emotionally-metaphorical type of interpreting life events is inherent for 89% of women with neurotic disorders. Studying the types of relationships with a husbands demonstrated that women with neurotic disorders perform 'the role of victim' - 30% (1,7689) and 'the role of 'burden'' - 40% (1,7689) in their relationships. CONCLUSION: Conclusions: The types of relationships with a partner of women with neurotic disorders are partly determined by the specifics of early parenting experiences.

[EMOTIONAL EXHAUST AS A FACTOR OF THE ORIGIN AND DEVELOPMENT OF NEUROTIC CONDITIONS OF MEDICAL WORKERS].

The purpose of the study is to determine the specifics of neurotization of medical workers with emotional exhaust. Out of 6,830 medical workers surveyed, 1,012 were selected with severe emotional exhaust in order to further determine their specificity of neurotization. Used: Maslach Burnout Inventory questionnaire (MBI), modification of Maslach Burnout Inventory questionnaire (mod MBI), burnout questionnaire (BQ), neurotic level diagnosis technique (NLDT), clinical questionnaire for identifying and evaluating neurotic conditions (CQIENC), symptomatic questionnaire (SQ). Mathematical and statistical processing included descriptive statistics, C. Pearson's correlation criterion, and Cheddock's table for determining the tightness (strength) of correlation (weak - <0.3, moderate - 0.3-0.5, noticeable - 0.5-0.7, high - 0.7-0.9, very high - >0.9). Medical professionals with a higher than average level with a tendency to a high level of emotional exhaust (51.64) and emotional burnout (270.14) are dominated by stress (109.17), experience of traumatic circumstances (28.65), dissatisfaction with oneself (26.05), driving into a cell (29.10), anxiety and depression (25.37), which determine above the average level of anxiety ( 4.35, high connection 0.80), asthenia (4.20, high connection 0.74), anxiety, tension (51.57, high connection 0.76), neurotic disorders (40.28, high 0.74), hypochondriacal disorders (29.04, high connection 0.74), psychasthenic disorders (37.53, 0.76 high connection). The specifics of neurotization of medical workers with emotional exhaust affects, first of all, the emotional-volitional sphere, which gives grounds to recommend medical workers a systematic diagnosis and prevention of emotional exhaust as a component of professional deformations of medical workers.

Modeling prior information of common genetic variants improves gene discovery for neuroticism.

Neuroticism reflects emotional instability, and is related to various mental and physical health issues. However, the majority of genetic variants associated with neuroticism remain unclear. Inconsistent genetic variants identified by different genome-wide association studies (GWAS) may be attributable to low statistical power. We proposed a novel framework to improve the power for gene discovery by incorporating prior information of single nucleotide polymorphisms (SNPs) and combining two relevant existing tools, relative enrichment score (RES) and conditional false discovery rate (FDR). Here, SNP's conditional FDR was estimated given its RES based on SNP prior information including linkage disequilibrium (LD)-weighted genic annotation scores, total LD scores and heterozygosity. A known significant locus in chromosome 8p was excluded before estimating FDR due to long-range LD structure. Only one significant LD-independent SNP was detected by analyses of unconditional FDR and traditional GWAS in the discovery sample (N = 59 225), and notably four additional SNPs by conditional FDR. Three of the five SNPs, all identified by conditional FDR, were replicated (P < 0.05) in an independent sample (N = 170 911). These three SNPs are located in intronic regions of CADM2, LINGO2 and EP300 which have been reported to be associated with autism, Parkinson's disease and schizophrenia, respectively. Our approach using a combination of RES and conditional FDR improved power of traditional GWAS for gene discovery providing a useful framework for the analysis of GWAS summary statistics by utilizing SNP prior information, and helping to elucidate the links between neuroticism and complex diseases from a genetic perspective.

Shared and specific genetic risk factors for lifetime major depression, depressive symptoms and neuroticism in three population-based twin samples.

BACKGROUND: Vulnerability to depression can be measured in different ways. We here examine how genetic risk factors are inter-related for lifetime major depression (MD), self-report current depressive symptoms and the personality trait Neuroticism. METHOD: We obtained data from three population-based adult twin samples (Virginia n = 4672, Australia #1 n = 3598 and Australia #2 n = 1878) to which we fitted a common factor model where risk for 'broadly defined depression' was indexed by (i) lifetime MD assessed at personal interview, (ii) depressive symptoms, and (iii) neuroticism. We examined the proportion of genetic risk for MD deriving from the common factor v. specific to MD in each sample and then analyzed them jointly. Structural equation modeling was conducted in Mx. RESULTS: The best fit models in all samples included additive genetic and unique environmental effects. The proportion of genetic effects unique to lifetime MD and not shared with the broad depression common factor in the three samples were estimated as 77, 61, and 65%, respectively. A cross-sample mega-analysis model fit well and estimated that 65% of the genetic risk for MD was unique. CONCLUSION: A large proportion of genetic risk factors for lifetime MD was not, in the samples studied, captured by a common factor for broadly defined depression utilizing MD and self-report measures of current depressive symptoms and Neuroticism. The genetic substrate for MD may reflect neurobiological processes underlying the episodic nature of its cognitive, motor and neurovegetative manifestations, which are not well indexed by current depressive symptom and neuroticism.

Association between ambient PM2.5 and emergency department visits for psychiatric emergency diseases.

BACKGROUND: Whether or not short-term exposure to particulate matter <2.5 µm in diameter (PM2.5) increases the risk of psychiatric emergency diseases is unclear. METHODS: The study was performed in a metropolis from January 2015 to December 2016. The exposure was PM2.5, and the confounders were weather (temperature and humidity) and other pollutants (PM10, SO2, CO, O3, and NO2). The outcomes were emergency department (ED) visits with psychiatric disease codes (F00-F99 in ICD10 codes). General additive models were used for the statistical analysis to calculate the adjusted relative risks (ARRs) and 95% confidence intervals (95% CIs) for the daily number of ED visits with a lag of 1 to 3 days following a 10 µg/m3 increase in PM2.5. RESULTS: During the study period, a total of 67,561 ED visits for psychiatric diseases were identified and tested for association with PM2.5. Daily ED visits for all psychiatric diseases were not associated with PM2.5 in the model that was not adjusted for other pollutants. The ARR (95% CI) in the model adjusted for SO2 was 1.011 (1.002-1.021) by 10 µg/m3 of PM2.5 on Lag 1 for all psychiatric diseases (F00-F99). The ARR (95% CI) in the model adjusted for O3 was 1.015 (1.003-1.029) by 10 µg/m3 of PM2.5 on Lag 1 for F40-F49 (Neurotic, stress-related and somatoform disorders). CONCLUSION: An increase in PM2.5 showed a significant association with an increase in ED visits for all psychiatric diseases (F00-F99) and for neurotic, stress-related and somatoform disorders (F40-F49) on lag day 1.

An evaluation of the relationship between violence exposure status and personality characteristics among infertile women.

In this descriptive study, our aim was to examine the relationship between violence exposure status and personality characteristics among infertile women. The researchers collected data from 315 infertile women at an in vitro fertilization unit of the Woman and Child Disease Training and Research Hospital in Istanbul, Turkey. An introductory information form, the Eysenck Personality Questionnaire Revised-Abbreviated Form (EPQR-A), and the Infertile Women's Exposure to Violence Determination Scale (IWEVDS) were used as data collection tools. When the relationship between the IWEVDS and EPQR-A subdimension scores of the infertile women were examined, a positive relationship was found between the being-forced-into-traditional-practices subdimension of the IWEVDS and the neuroticism subdimension of the EPQR-A. In addition, a weak negative relationship was found between the being-forced-into-traditional-practices subdimension of the IWEVDS and the lying subdimension of the EPQR-A.

Dynamics of the prevalence of affective and neurotic disorders on the example of the Poltava region for 2014-2018.

OBJECTIVE: Introduction: Recently, the situation regarding the mental health of the world population has a tendency to deteriorate and is one of the most serious problems, which faced all countries of the world and in particular the European region (ER), since at one or another period of life problems of mental health arise at least in every fourth person of the ER, and Ukraine is no exception. ATO in Ukraine was started in 2014. We investigated the level of hospitalized mental morbidity in the residents of the city of Poltava since 2014. The aim: To study hospitalized mental morbidity of the population of the Poltava region since 2014. PATIENTS AND METHODS: Materials and methods: Studied the incidence and prevalence of depressive disorders in Poltava and Poltava regions according to the new WHO classification. ICD-11. According to the report form 10 "Report on the Disease of Persons with Mental Disorders and Behavior", the following classes of depression were studied: F30-39 Mood Disorders (Affective Disorders, F40-48 - Neurotic and Somatic Disorders, F43.0 - Severe Stress and Compliance). RESULTS: Review: Affective disorders are a set of psychiatric disorders, also called mood disorders. The main types of affective disorders are depression, bipolar disorder, and anxiety disorder. Symptoms vary by individual and can range from mild to severe. CONCLUSION: Conclusions: The rate of growth of morbidity of affective disorder has decreased, compared with 2014, by -14% and neurotic disorders has increased 3,2%.

Risk of Neuropsychiatric Adverse Effects of Lipid-Lowering Drugs: A Mendelian Randomization Study.

Background: Recent studies have highlighted the possible risk of neuropsychiatric adverse effects during treatment with lipid-lowering medications. However, there are still controversies that require a novel genetic-based approach to verify whether the impact of lipid-lowering drug treatment results in neuropsychiatric troubles including insomnia, depression, and neuroticism. Thus, we applied Mendelian randomization to assess any potential neuropsychiatric adverse effects of conventional lipid-lowering drugs such as statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and ezetimibe. Methods: A 2-sample Mendelian randomization study was conducted based on summary statistics from genome-wide association studies for lipids, insomnia, depression, and neuroticism. Single-nucleotide polymorphisms located in or near drug target genes of HMGCR, PCSK9, and NPC1L1 were used as proxies for statins, PCSK9 inhibitors, and ezetimibe therapy, respectively. To assess the validity of the genetic risk score, their associations with coronary artery disease were used as a positive control. Results: The Mendelian randomization analysis showed a statistically significant (P <.004) increased risk of depression after correcting for multiple testing with both statins (odds ratio=1.15, 95% CI: 1.04-1.19) and PCSK9 inhibitor treatment (odds ratio =1.19, 95%CI: 1.1-1.29). The risk of neuroticism was slightly reduced with statin therapy (odds ratio=0.9, 95%CI: 0.83-0.97). No significant adverse effects were associated with ezetimibe treatment. As expected, the 3 medications significantly reduced the risk of coronary artery disease. Conclusion: Using a genetic-based approach, this study showed an increased risk of depression during statin and PCSK9 inhibitor therapy while their association with insomnia risk was not significant.

Cardiovascular fitness in late adolescent males and later risk of serious non-affective mental disorders: a prospective, population-based study.

BACKGROUND: Cardiovascular fitness in late adolescence is associated with future risk of depression. Relationships with other mental disorders need elucidation. This study investigated whether fitness in late adolescence is associated with future risk of serious non-affective mental disorders. Further, we examined how having an affected brother might impact the relationship. METHOD: Prospective, population-based cohort study of 1 109 786 Swedish male conscripts with no history of mental illness, who underwent conscription examinations at age 18 between 1968 and 2005. Cardiovascular fitness was objectively measured at conscription using a bicycle ergometer test. During the follow-up (3-42 years), incident cases of serious non-affective mental disorders (schizophrenia and schizophrenia-like disorders, other psychotic disorders and neurotic, stress-related and somatoform disorders) were identified through the Swedish National Hospital Discharge Register. Cox proportional hazards models were used to assess the influence of cardiovascular fitness at conscription and risk of serious non-affective mental disorders later in life. RESULTS: Low fitness was associated with increased risk for schizophrenia and schizophrenia-like disorders [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.29-1.61], other psychotic disorders (HR 1.41, 95% CI 1.27-1.56), and neurotic or stress-related and somatoform disorders (HR 1.45, 95% CI 1.37-1.54). Relationships persisted in models that included illness in brothers. CONCLUSIONS: Lower fitness in late adolescent males is associated with increased risk of serious non-affective mental disorders in adulthood.

Occupational class and the changing patterns of hospitalization for affective and neurotic disorders: a nationwide register-based study of the Finnish working-age population, 1976-2010.

PURPOSE: This study aimed to examine the long-term changes and socioeconomic disparities in hospitalization for affective and neurotic disorders among the Finnish working-age population from 1976 to 2010. METHODS: Register-based study, consisting of a 5-year follow-up of 3,223,624 Finnish working-age (18-64-year old) individuals in seven consecutive cohorts. We calculated the hazard ratios of psychiatric hospitalization for different occupational classes using Cox regression models. RESULTS: The risk of hospitalization for affective and neurotic disorders increased in all occupational classes after the economic recession in the 1990s, and then decreased in the 2000s. Before the 2000s, the risk was the highest among manual workers. In the 2000s the disparities between upper-level non-manual employees and other occupational classes increased. Hospitalization rates remained high among female manual workers and non-manual lower-level employees. CONCLUSIONS: This study revealed important similarities and differences between occupational classes in terms of long-term changes in hospitalization for affective and neurotic disorders. The results suggest that the labor market changes and healthcare reforms during the 1990s and 2000s in Finland have been more beneficial for higher than for lower occupational classes.