Solar insolation in springtime influences age of onset of bipolar I disorder.

OBJECTIVE: To confirm prior findings that the larger the maximum monthly increase in solar insolation in springtime, the younger the age of onset of bipolar disorder. METHOD: Data were collected from 5536 patients at 50 sites in 32 countries on six continents. Onset occurred at 456 locations in 57 countries. Variables included solar insolation, birth-cohort, family history, polarity of first episode and country physician density. RESULTS: There was a significant, inverse association between the maximum monthly increase in solar insolation at the onset location, and the age of onset. This effect was reduced in those without a family history of mood disorders and with a first episode of mania rather than depression. The maximum monthly increase occurred in springtime. The youngest birth-cohort had the youngest age of onset. All prior relationships were confirmed using both the entire sample, and only the youngest birth-cohort (all estimated coefficients P < 0.001). CONCLUSION: A large increase in springtime solar insolation may impact the onset of bipolar disorder, especially with a family history of mood disorders. Recent societal changes that affect light exposure (LED lighting, mobile devices backlit with LEDs) may influence adaptability to a springtime circadian challenge.

Problem drinking among patients attending primary healthcare units in Kampala, Uganda.

OBJECTIVE: Previous studies have shown that a large a number of primary health care patients have alcohol related problems and very few are detected and treated. Few studies have been done in developing countries on this topic. This study sought to determine the prevalence and detection of alcohol related problems in a Primary Health Care setting (PHC). in Kampala Uganda. METHOD: 768 consecutive PHC patients in two PHC centers in Kampala, Uganda, were screened in a two stage procedure. After being asked if they drink alcohol they were interviewed by means of the CAGE questionnaire and a quantity/frequency questionnaire. Those who scored positive on the CAGE were further diagnosed for alcohol dependence using the DSM- IV diagnostic criteria. RESULTS: Of all patients, 17.4% scored above cut-off on the CAGE, 28.5% had a high risk drinking pattern and 9.5% had alcohol dependence. Among drinkers, drinking beyond safe limit was more common among men. Males and those aged between 35 to 44 years, were more likely to be CAGE positive and to be diagnosed with alcohol dependence. Only 27 out of 366 drinkers were asked about alcohol by the PHC professional. Males and high risk drinkers were more likely to be asked. CONCLUSION: Prevalence of alcohol problems was high and detection rate of alcohol related problems was low in this Ugandan setting. Training of PHC professionals in diagnosing and treating alcohol related problems is required.