The role of ethnicity and native-country income in multiple sclerosis: the Italian multicentre study (MS-MigIT).

OBJECTIVE: Multiple sclerosis (MS) is a complex disorder in which environmental and genetic factors interact modifying disease risk and course. This multicentre, case-control study involving 18 Italian MS Centres investigated MS course by ethnicity and native-country economic status in foreign-born patients living in Italy. METHODS: We identified 457 MS patients who migrated to Italy and 893 age- and sex-matched native-born Italian patients. In our population, 1225 (93.2%) subjects were White Europeans and White Northern Americans (WENA) and 89 (6.8%) patients were from other ethnical groups (OEG); 1109 (82.1%) patients were born in a high-income (HI) Country and 241 (17.9%) in a low-middle-income (LMI) Country. Medical records and patients interviews were used to collect demographic and disease data. RESULTS: We included 1350 individuals (973 women and 377 men); mean (SD) age was 45.0 (11.7) years. At onset, 25.45% OEG patients vs 12.47% WENA (p = 0.039) had > 3 STIR spine lesions. At recruitment, the same group featured mean (SD) EDSS score of 2.85 (2.23) vs 2.64 (2.28) (p = 0.044) reached in 8.9 (9.0) vs 12.0 (9.0) years (p = 0.018) and underwent 1.10 (4.44) vs. 0.99 (0.40) annual MRI examinations (p = 0.035). At disease onset, patients from LMI countries had higher EDSS score than HI patients (2.40 (1.43) vs 1.99 (1.17); p = 0.032). DISCUSSION: Our results suggested that both ethnicity and socio-economic status of native country shape MS presentation and course and should be considered for an appropriate management of patients. To the best of our knowledge, this is the first study reporting on the impact of ethnicity in MS at an individual level and beyond an ecological population-perspective.

Estimating population genetics and forensic efficiency of the GlobalFiler PCR amplification kit in the population of Sardinia (Italy).

GlobalFiler is a new PCR amplification kit that includes 21 autosomal short tandem repeats and three sex-determining loci. In the present research, for the first time, the GlobalFiler kit was tested to analyze a sample of 500 unrelated individuals from 18 villages encompassing the entire area of Sardinia (Italy). We tested if the kit, which is a powerful tool in forensic studies, may also find application in the field of population genetics. In agreement with data from the literature on forensic parameters values, marker SE33 showed the highest degree of polymorphism, whereas TPOX was the least informative locus. Seventeen out of twenty-one autosomal markers included in the kit resulted highly polymorphic, and therefore Globalfiler turned out to be highly useful for forensic analysis in the Sardinian population. Moreover, our data suggest developing different STR databases in different populations, like Sardinians, to increase the statistical power of autosomal STR profiling. On the other hand, due to the presence of some very highly polymorphic markers, the efficiency of Globalfiler in detecting geographical variability is affected. Indeed, the differentiation previously observed between the Sardinian and Italian populations appeared greatly reduced and even the presence of genetic isolates, previously recorded when uniparental markers was not revealed.

Feeding Your Himalayan Expedition: Nutritional Signatures and Body Composition Adaptations of Trekkers and Porters.

High-altitude exposure leads to many physiological challenges, such as weight loss and dehydration. However, little attention has been posed to the role of nutrition and ethnic differences. Aiming to fulfill this gap, five Italian trekkers and seven Nepalese porters, all males, recorded their diet in diaries during a Himalayan expedition (19 days), and the average daily intake of micro and macro-nutrients were calculated. Bioimpedance analysis was performed five times during the trek; muscle ultrasound was performed before and after the expedition, only for the Italians. The Nepalese group consumed a lot of rice and only Italians consumed cheese. Water intake was slightly over 3000 g/d for both groups. Nepalese diet had a higher density of dietary fibre and lower density of riboflavin, vitamins A, K, and B12. Intake of calcium was lower than recommended levels. Body mass index, waist circumference, fat-free mass, and total body water decreased in both groups, whereas resistance (Rz) increased. Italians reactance (Xc) increased at day 9, whereas that of Nepalese occurred at days 5, 9, and 16. The cross-sectional area of the Vastus lateralis was reduced after the expedition. Specific nutritional and food-related risk factors guidance is needed for diverse expedition groups. Loss of muscle mass and balance of fluids both deserve a particular focus as concerns altitude expeditions.

Sposàrsi a Franca: tendências da nupcialidade entre imigrantes italianos no interior paulista, 1885-1930 / Sposàrsi a Franca: nuptial trends among Italian immigrants in the interior of São Paulo, 1885-1930 / Sposàrsi a Franca: tendencias de la nupcialidad entre inmigrantes italianos en el interior de São Paulo, 1885-1930

Em consonância com os estudos em Demografia Histórica e História da Família, este artigo visa a resgatar aspectos relativos à nupcialidade vivenciada pelos italianos e seus descendentes no município de Franca, interior do estado de São Paulo. A reflexão é corroborada pela historiografia recente que aponta a expansão da economia cafeeira no interior paulista como responsável por alterações no panorama demográfico por meio da atração de uma imigração internacional em massa, cujos impactos foram sentidos em diferentes espaços de ação, na família, nas relações matrimoniais, na etnicidade e integração desses grupos na sociedade brasileira entre o final do século XIX e as primeiras décadas do século XX. Combinando metodologias seriais e de microanálise para explorar os dados disponíveis nos registros de matrícula da Hospedaria de Imigrantes de São Paulo e assentos de casamento do Registro Paroquial do Arquivo da Cúria Diocesana de Franca (1885-1930), abre-se caminho para enriquecer o universo de interpretações sobre a nupcialidade nos municípios atingidos pela imigração internacional de italianos. Esse artigo examina os impactos das variáveis imigratórias nos padrões de casamento dos italianos no município e resgata aspectos da endogamia desse grupo, favorecida pelos respectivos contextos e bagagens culturais que conduziram o processo imigratório por eles vivenciado.

In line with studies in Demographic History and Family History, this article aims to rescue aspects related to nuptiality experienced by Italians and their descendants in the municipality of Franca, in the interior of the state of São Paulo. The reflection is corroborated by recent historiography research pointing to the expansion of the coffee-based economy in the interior of São Paulo as responsible for demographic changes through the attraction of mass international immigration. This affected different areas, including family, matrimonial relations, ethnicity and integration of these groups in Brazilian society at the turn of the 20th century. A combination of serial and microanalysis methodologies to explore the data available in the registration records of the São Paulo Immigrant Inn and wedding seats in the Parish Records of the Diocesan Archive of Franca (1885-1930), paves the way to expand the universe of interpretations on nuptiality in municipalities affected by Italian immigration. This article examines the impacts of immigration variables on Italians' marriage patterns in the municipality and retrieves aspects of this groups' inbreeding, favored by the respective cultural contexts and backgrounds that led to the immigration process they experienced.

En línea con los estudios en Demografía histórica e Historia familiar, este artículo tiene como objetivo rescatar aspectos relacionados con la nupcialidad vivida por los italianos y sus descendientes en el municipio de Franca, en el interior del estado de San Pablo. La reflexión es corroborada por la historiografía reciente, que apunta a la expansión de la economía cafetera en el interior del estado como responsable de cambios en el panorama demográfico mediante la atracción de la inmigración internacional masiva, cuyos impactos se sintieron en diferentes espacios de acción, en la familia, en las relaciones matrimoniales, en la etnicidad y en la integración de estos grupos en la sociedad brasileña entre fines del siglo XIX y las primeras décadas del XX. Al combinar metodologías seriadas y de microanálisis para explorar los datos disponibles en los registros de la Posada de Inmigrantes de San Pablo y en los asientos de boda del Registro Parroquial del Archivo de la Curia Diocesana de Franca (1885-1930) se abre el camino para enriquecer el universo de interpretaciones sobre nupcialidad en los municipios afectados por la inmigración internacional de italianos. Este artículo examina los impactos de las variables de inmigración en los patrones matrimoniales de los italianos en el municipio y recupera aspectos de la endogamia de este grupo, favorecida por los respectivos contextos culturales y antecedentes que llevaron al proceso de inmigración que vivieron.

Effect of Covid-19 pandemic on mental health among Albanian people residing in the country and abroad - Implications for mental care.

BACKGROUND: Coronavirus disease caused by the novel coronavirus Covid-19 is a current worldwide outbreak. The use of quarantine and isolation proved effective in containing the spread of infection. OBJECTIVES: The purpose of this cross-sectional study was to assess the mental health of Albanian people residing in the country and abroad during the quarantine period for the Covid-19 pandemic. DESIGN: This study was carried out from 25th March - 20th April 2020 through a web survey shared on social networks. The goal was to reach at least the minimum sample size for cross-sectional studies. The Patient Health Questionnaire (PHQ-9) was used to assess mental health. Chi-square (χ2) and Fisher -Exact test were used to assess the statistical significance among variables. P values ≤0.05 were considered statistically significant. RESULTS: 715 participants were included in the final analyses (78.41% females and 21.53% males). Most were residents in Albania (80.41%) and the others resided mainly in Italy (6.89%), Greece (3.51%), Germany (2.43%), Kosovo (1.62%) and the UK (1.69%). Statistical association was found between gender, country of residency and measures taken. Summary score of PHQ-9 items was 6.4662. The total score of depression classification shows that 31.82% and 12.90% of participants have respectively mild and moderate depression. Female participants showed the highest score for some items of PHQ-9, p≤0.05. CONCLUSIONS: Findings suggest that health care professionals should recognize and address mental health problems associated with Covid-19 especially in vulnerable groups. Acting in a timely and proper manner is essential in preventing these problems from becoming chronic.

Cognitive Outcomes and Relationships with Phenylalanine in Phenylketonuria: A Comparison between Italian and English Adult Samples.

We aimed to assess if the same cognitive batteries can be used cross-nationally to monitor the effect of Phenylketonuria (PKU). We assessed whether a battery, previously used with English adults with PKU (AwPKU), was also sensitive to impairments in Italian AwPKU. From our original battery, we selected a number of tasks that comprehensively assessed visual attention, visuo-motor coordination, executive functions (particularly, reasoning, planning, and monitoring), sustained attention, and verbal and visual memory and learning. When verbal stimuli/or responses were involved, stimuli were closely matched between the two languages for psycholinguistic variables. We administered the tasks to 19 Italian AwPKU and 19 Italian matched controls and compared results from with 19 English AwPKU and 19 English matched controls selected from a previously tested cohort. Participant election was blind to cognitive performance and metabolic control, but participants were closely matched for age and education. The Italian AwPKU group had slightly worse metabolic control but showed levels of performance and patterns of impairment similar to the English AwPKU group. The Italian results also showed extensive correlations between adult cognitive measures and metabolic measures across the life span, both in terms of Phenylalanine (Phe) levels and Phe fluctuations, replicating previous results in English. These results suggest that batteries with the same and/or matched tasks can be used to assess cognitive outcomes across countries allowing results to be compared and accrued. Future studies should explore potential differences in metabolic control across countries to understand what variables make metabolic control easier to achieve.

Disparities in emergency department use between Italians and migrants residing in Rome, Italy: the Rome Dynamic Longitudinal Study from 2005 to 2015.

BACKGROUND: The Emergency Department (ED) can be considered an indicator of accessibility and quality and can be influenced in period of economic downturns. In the last fifteen years, the number of migrants in Italy has doubled (from 2.4 million in 2005 to 5.2 in 2019, 4.1 and 8.7% of the total population, respectively). However, evidence about migrants' healthcare use is poor, and no studies focused on the ED utilisation rate during the Great Recession are available. This study aims to analyse trends in all-cause and cause-specific ED utilisation among migrants and Italians residing in Rome, Italy, before and after 2008. METHODS: Longitudinal study based on data from the Municipal Register of Rome linked to the Emergency Department Register from 2005 to 2015. We analysed 2,184,467 individuals, aged 25-64 in each year. We applied a Hurdle model to estimate the propensity to use the ED and to model how often individuals accessed the ED. RESULTS: Migrants were less likely to be ED users than Italians, except for Africans (RR = 1.46, 95%CI 1.40-1.52) and Latin Americans (RR = 1.04, 95%CI 1.00-1.08) who had higher all-cause utilisation rates than non-migrants. Compared to the pre-2008 period, in the post-2008 we found an increase in the likelihood of being an ED user (OR = 1.34, 95%CI 1.34-1.35), and a decrease in ED utilisation rates (RR = 0.96, 95%CI 0.96-0.97) for the whole population, with differences among migrant subgroups, regardless of cause. CONCLUSIONS: This study shows differences in the ED utilisation between migrants and Italians, and within the migrant population, during the Great Recession. The findings may reflect differentials in the health status, and barriers to access primary and secondary care among migrants. In this regard, health policies and cuts in health spending measures may have played a key role, and interventions to tackle health and access disparities should include policy measures addressing the underlying factors, adopting a Health in All Policies perspective. Further researches focusing on specific groups of migrants, and on the causes and diagnoses related to the ED utilisation, may help to explain the differences observed.

Opportunities and peer support for aggression and delinquency during adolescence in nine countries.

This study tested culture-general and culture-specific aspects of adolescent developmental processes by focusing on opportunities and peer support for aggressive and delinquent behavior, which could help account for cultural similarities and differences in problem behavior during adolescence. Adolescents from 12 cultural groups in 9 countries (China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States) provided data at ages 12, 14, and 15. Variance in opportunities and peer support for aggression and delinquency, as well as aggressive and delinquent behavior, was greater within than between cultures. Across cultural groups, opportunities and peer support for aggression and delinquency increased from early to mid-adolescence. Consistently across diverse cultural groups, opportunities and peer support for aggression and delinquency predicted subsequent aggressive and delinquent behavior, even after controlling for prior aggressive and delinquent behavior. The findings illustrate ways that international collaborative research can contribute to developmental science by embedding the study of development within cultural contexts.

Understanding adolescents' acculturation processes: New insights from the intergroup perspective.

Recent developments in the acculturation literature have emphasized the importance of adopting intergroup perspectives that provide a valuable background for investigating how acculturation orientations (i.e., maintenance of the culture of origin and the adoption of the destination culture) of adolescents from migrant families are embedded in their proximal socialization contexts. Accordingly, we sought to understand the combined effects of the perceived parents' acculturation orientations and classmates' acculturation preferences on adolescents' own acculturation orientations in two independent cultural contexts, namely North-East of Italy (Study I) and South-East of Turkey (Study II). Participants were 269 (53.2% female; Mage = 14.77) and 211 (71.1% female; Mage = 15.37) adolescents from migrant families in Italy and in Turkey, respectively. Findings indicated that adolescents' acculturation orientations were influenced by their perceptions of both parents' acculturation orientations and classmates' acculturation preferences. In addition, the effects of parents' adoption of the destination culture were stronger than the effects of classmates' preferences for adoption of the destination culture in both countries. However, the effects of parents' maintenance of the culture of origin were stronger than the effects of classmates' preferences for maintaining the culture of origin in Turkey, but not in Italy.

Parents' Concepts of the Successful School Child in Seven Western Cultures.

Although children's school success is a parental goal in most cultures, there is wide cultural variation in the qualities that parents most wish their children to develop for that purpose. A questionnaire contained forty-one child qualities was administered to 757 parents in seven cultural communities in Australia, Italy, the Netherlands, Poland, Spain, Sweden, and the United States. Exploratory factor analysis was conducted separately within each sample and results revealed both similarities and differences across the seven samples. The factor structures showed considerable similarity: four domains of characteristics (Cognitive Qualities, Social Qualities, Negative temperament, and Good Characters) were identified in each sample as strongly influencing children's success in school. However, parents differed across the seven cultural communities in the importance they attributed to these factors. The results also reveal some culturally unique patterns in parents' concepts of the successful schoolchild; the seven samples were differentiated by distinctive associations of individual qualities around the four common domains. These results offer new insights for incorporating perspectives from other cultures into our own concepts of what qualities are most important for children's success in school, and how educators can be cognizant of differing cultural perspectives represented by the families whose children are their students.

Biological history of an Italian prehistoric community and the population of the central Italy during the 1st millennium BCE.

Understanding the population of Central Italy during the 1st millennium BCE is a crucial topic in the biological history of the Mediterranean basin. This period saw the emergence of the Etruscan and Roman cultures which had a significant impact on the bio-cultural history of the region. In this study, we analyse a prehistoric population from Caracupa (Iron Age, Latium, Central Italy). The results suggest an overall good level of health for the population. Despite this, some musculoskeletal changes related to biomechanical stressors were observed, probably as the result of strenuous physical activity. The results of a Simple Matching analysis of intragroup distance distributions suggest potential model of kinship structures and lineages. This may be due to the relative geographic isolation of the Caracupa population. Furthermore, in order to investigate the wider population of Central Italy during the 1st millennium BCE, we have constructed a population pattern using genetic and phenotypic skeletal and dental traits. The comparison between Central Italy and more isolated populations indicated a divergence between the Western and Eastern sides of Central Italy. However, we do not exclude a probable common genetic substratum for all Central Italian populations during the 1st millennium BCE.

A cluster of SARS-CoV-2 infection among Italian tourists visiting India, March 2020.

BACKGROUND & OBJECTIVES: A cluster of SARS-CoV-2 infection occurred among Italian tourists visiting India. We report here the epidemiological, clinical, radiological and laboratory findings of the first cluster of SARS-CoV-2 infection among the tourists. METHODS: Information was collected on demographic details, travel and exposure history, comorbidities, timelines of events, date of symptom onset and duration of hospitalization from the 16 Italian tourists and an Indian with laboratory-confirmed SARS-CoV-2 infection. The clinical, laboratory, radiologic and treatment data was abstracted from their medical records and all tourists were followed up till their recovery or discharge or death. Throat and deep nasal swab specimens were collected on days 3, 8, 15, 18, 23 and 25 to evaluate viral clearance. RESULTS: A group of 23 Italian tourists reached New Delhi, India, on February 21, 2020 and along with three Indians visited several tourist places in Rajasthan. By March 3, 2020, 17 of the 26 (attack rate: 65.4%) had become positive for SARS-CoV-2 infection. Of these 17 patients, nine were symptomatic, while eight did not show any symptoms. Of the nine who developed symptoms, six were mild, one was severe and two were critically ill. The median duration between the day of confirmation for COVID-19 and RT-PCR negativity was 18 days (range: 12-23 days). Two patients died with a case fatality of 11.8 per cent. INTERPRETATION & CONCLUSIONS: This study reconfirms higher rates of transmission among close contacts and therefore, public health measures such as physical distancing, personal hygiene and infection control measures are necessary to prevent transmission.

Cross-cultural effects of parent warmth and control on aggression and rule-breaking from ages 8 to 13.

We investigated whether bidirectional associations between parental warmth and behavioral control and child aggression and rule-breaking behavior emerged in 12 cultural groups. Study participants included 1,298 children (M = 8.29 years, standard deviation [SD] = 0.66, 51% girls) from Shanghai, China (n = 121); Medellín, Colombia (n = 108); Naples (n = 100) and Rome (n = 103), Italy; Zarqa, Jordan (n = 114); Kisumu, Kenya (n = 100); Manila, Philippines (n = 120); Trollhättan/Vänersborg, Sweden (n = 101); Chiang Mai, Thailand (n = 120); and Durham, NC, United States (n = 111 White, n = 103 Black, n = 97 Latino) followed over 5 years (i.e., ages 8-13). Warmth and control were measured using the Parental Acceptance-Rejection/Control Questionnaire, child aggression and rule-breaking were measured using the Achenbach System of Empirically-Based Assessment. Multiple-group structural equation modeling was conducted. Associations between parent warmth and subsequent rule-breaking behavior were found to be more common across ontogeny and demonstrate greater variability across different cultures than associations between warmth and subsequent aggressive behavior. In contrast, the evocative effects of child aggressive behavior on subsequent parent warmth and behavioral control were more common, especially before age 10, than those of rule-breaking behavior. Considering the type of externalizing behavior, developmental time point, and cultural context is essential to understanding how parenting and child behavior reciprocally affect one another.

Connectedness as a protective factor in immigrant youth: results from the Health Behaviours in School-aged Children (HBSC) Italian study.

OBJECTIVES: The aim of this work was to study whether and to what extent selected connectedness variables (perceived family, peer, and school support) are protective factors against low life satisfaction and high health complaints in immigrant youth with different ethnic backgrounds, while also taking into account the effect of socioeconomic status (SES). METHODS: A representative sample of 47,799 students (15% immigrants, among whom 4980 were from non-Western countries) aged 11, 13, and 15 years were recruited from schools throughout Italy within the framework of the Italian 2013/2014 Health Behaviour in School-aged Children study. Bayesian network analyses were used to assess the association between connectedness variables, and low life satisfaction and high health complaints. RESULTS: The connectedness variables family and school support were strong protective factors against both low life satisfaction and high health complaints (99% probability of relative risk < 1 in all subgroup comparisons). This protective role was still present when subgroups with high SES were compared. Peer support also showed a protective effect, though it was weaker. CONCLUSIONS: Our results show that, among immigrant youth, perceived high support can act as a moderator on the effect of environmental stressors. In line with international guidelines, these results confirm that public health professionals should create school interventions that foster a culture of inclusiveness, promote a supportive school environment, and engage families of immigrant youth.

The destiny of Italian prisoners in Austro-Hungarian POW camps during the First World War: remembering the defeat of Caporetto 100 years on.

The living conditions of Italian prisoners during the First World War were extremely difficult. At the end of the conflict, the treatment of Italian soldiers in Austro-Hungarian POW camps and in those of the German territories was recognized as particularly harsh in comparison with that of other prisoners. The reasons may be ascribed to three main factors. The Italian prisoners paid the price of being considered traitors, since Italy was allied with the Austro-Hungarian Empire and with Germany until 1914, subsequently switching to the side of France, the United Kingdom and Russia. The Italian government and the Italian High Command considered their soldiers poorly inclined to engage in a war which became over time increasingly costly in terms of human sacrifice. The strategy pursued by the General-in-Chief Luigi Cadorna was very aggressive and showed little care for the life conditions of his troops, who were frequently thrown into the fray and exposed to potential slaughter. Due to this negative judgement on their troops' willingness to fight, the government did not help, and even hindered, the despatch of packages of food and clothes to prisoners in the Austro-Hungarian and German camps via the Red Cross. The idea of a better life in the trenches compared with that expected in the camps as prisoners was widespread. Thirdly, the maritime blockade of the Adriatic Sea over time reduced to starvation the populations of Austria, Hungary and Germany, which obviously had grave repercussions on prisoners. It was estimated that around 100,000 Italians lost their lives in POW camps; after the defeat at Caporetto, when over 250,000 prisoners were captured, the number of deaths rose. The main causes of death were: tuberculosis, pneumonia, malnutrition and typhoid fever. At the end of the war, when coming back to Italy, former POWs were interned for months in camps (located predominantly in the Emilia region) and had to face interrogation and trials to demonstrate they were not deserters and were free to go back home. In the meantime, many lost their lives due to "Spanish" flu, pneumonia and other infectious diseases. Only the mobilization both of families and public opinion forced the Italian government to close the camps at the end of the year 1919.

Identification of Italian Renaissance noble women through a bioarchaeological study of skeletal remains.

Three female skeletons, dated back to the beginning of the 15th century were recovered during an archaeological excavation in the Guinigi Chapel in Lucca (Italy). Archaeological and historical sources indicated that the remains might be those of Paolo Guinigi's wives. At the beginning of the 15th century Paolo Guinigi ruled Lucca for nearly 30 years (1400-1429), providing a long period of wealth and peace to the city. In those years of power Paolo Guinigi married four women from different countries. This study is aimed at identifying the three skeletons of Paolo's wives found in the Guinigi Chapel. The three skeletons were identified using a multidisciplinary approach, by integrating historical, archaeological, anthropological, and isotopic data. The anthropological studies evidenced the biological profile of two adult women and of one adolescent female, in agreement with the historical descriptions of three of the four wives of Paolo Guinigi. The isotopic analysis supported the identification of each individual.

Megacities, migration and an evolutionary approach to bipolar disorder: a study of Sardinian immigrants in Latin America

Objective: To determine whether people with a Sardinian genetic background who live in the megacities of South America have a higher frequency of hypomania than residents of Sardinia. Methods: A community survey of Sardinian immigrants was carried out in four Brazilian metropoles (n=218) and Buenos Aires (n=306). The results were compared with those of a study involving a similar methodology (Mood Disorder Questionnaire [MDQ] as a screening tool) conducted in seven Italian regions, including a sub-sample from Sardinia. Results: There was a higher prevalence of lifetime hypomania among Sardinians living in the Brazilian metropoles than among those living in Sardinia. This result was also consistent with Sardinian immigrants in Buenos Aires. After stratification by sex and age, the lifetime prevalence of MDQ scores ≥ 8 among Sardinians in South-American megacities and Sardinia was 8.6% vs. 2.9%, respectively (p < 0.0001). Conclusions: The higher frequency of hypomania in migrant populations appears to favor an evolutionary view in which mood disorders may be a maladaptive aspect of a genetic background with adaptive characteristics.