Depressive spectrum disorders in cancer: prevalence, risk factors and screening for depression: a critical review.

BACKGROUND: Although depression and mood-related disorders are common in persons with cancer, these conditions remain frequently overlooked in clinical practice. Negative consequences of depressive disorder spectrum have been reported (e.g. suicidal ideation, increase physical complications and somatic symptoms, negative influence on prognosis), indicating the need for routine screening, assessment and management. METHODS: A search of the major databases (Medline, Embase, PsycLIT, PsycINFO, and the Cochrane Library) was conducted on the reviews and meta-analyses available in order to summarize relevant data concerning depressive disorders spectrum in terms of prevalence, risk factors, and screening and assessment among patients with cancer across the trajectory of the disease. RESULTS: The data show a prevalence of depression and depressive disorders between 5% and 60% according to the different diagnostic criteria, the tools used in the studies (e.g. semi-structured psychiatric interview and psychometric questionnaires), as well as the stage and type of cancer. Furthermore, despite the significant health care resources devoted to cancer care and the importance of addressing depressive symptoms, assessment and management of depressive spectrum disorders in cancer patients remains suboptimal. CONCLUSIONS: Routine screening and adequate assessment of depressive spectrum disorders is necessary in patients with cancer in order to effectively manage the multifaceted and complex consequences on cancer care.

Recent population decline and selection shape diversity of taxol-related genes.

Taxanes are defensive metabolites produced by Taxus species (yews) and used in anticancer therapies. Despite their medical interest, patterns of natural diversity in taxane-related genes are unknown. We examined variation at five main genes of Taxus baccata in the Iberian Peninsula, a region where unique yew genetic resources are endangered. We looked at several gene features and applied complementary neutrality tests, including diversity/divergence tests, tests solely based on site frequency spectrum (SFS) and Zeng's compound tests. To account for specific demography, microsatellite data were used to infer historical changes in population size based on an Approximate Bayesian Computation (ABC) approach. Polymorphism-divergence tests pointed to positive selection for genes TBT and TAT and balancing selection for DBAT. In addition, neutrality tests based on SFS found that while a recent reduction in population size may explain most statistics' values, selection may still be in action in genes TBT and DBAT, at least in some populations. Molecular signatures on taxol genes suggest the action of frequent selective waves with different direction or intensity, possibly related to varying adaptive pressures produced by the host-enemy co-evolution on defence-related genes. Such natural selection processes may have produced taxane variants still undiscovered.

Cuticular hydrocarbons discriminate cryptic Macrolophus species (Hemiptera: Miridae).

Macrolophus pygmaeus is commercially employed in the biological control of greenhouse and field vegetable pests. It is morphologically undistinguishable from the cryptic species M. melanotoma, and this interferes with the evaluation of the biological control activity of M. pygmaeus. We analysed the potential of cuticular hydrocarbon composition as a method to discriminate the two Macrolophus species. A third species, M. costalis, which is different from the other two species by having a dark spot at the tip of the scutellum, served as a control. Sex, diet and species, all had significant effects in the cuticular hydrocarbon profiles, but the variability associated to sex or diet was smaller than among species. Discriminant quadratic analysis of cuticular hydrocarbons confirmed the results of previous molecular genetic studies and showed, using cross-validation methods, that M. pygmaeus can be discriminated from M. costalis and M. melanotoma with prediction errors of 6.75% and 0%, respectively. Therefore, cuticular hydrocarbons can be used to separate M. pygmaeus from M. melanotoma reliably.

Parent and teacher ratings of temperamental disposition to social anxiety: the BIS 3-6.

Behavioral inhibition (BI) discourages children from interacting, predisposing them to isolation, social anxiety, and depression. We have created the Behavioral Inhibition Scale for Children Aged 3 to 6 (BIS 3-6) to detect this trait early. Parents and teachers of 365 preschoolers completed different versions of the BIS 3-6 and provided measures of psychopathology. Both versions are structured into 1 factor that explains over 40% of total variability and displays excellent internal consistency (α = .95). The moderate correlations with measures of internalizing symptoms (r = .50) and nonexistent correlations with externalizing measures suggest adequate convergent and discriminant validity. A new scoring system is proposed.

Who should report abnormal behavior at preschool age? The case of behavioral inhibition.

Children who are behaviorally "inhibited"-a condition at the extreme of the behavioral inhibition dimension-experience distress in uncertain social situations. Although parents and teachers are in the best position to detect this condition, they rarely agree. This study aims to analyze the agreement between parents and teachers and to examine the relations between ratings made by parents and teachers and assessments made by clinicians and researchers. Parents, teachers and clinicians rated the behavioral inhibition of 365 preschoolers. Seventy-three randomly selected participants were observed using an adaptation of the Behavioral Inhibition Paradigm. Parent-teacher correlations on 34 items and different clusters were, on average, r = .3. The degree of convergence between observational measures and ratings by parents and teachers was moderate-low and did not improve when considering only subsamples from the ends of the distributions. Discriminant analysis suggests that both parents and teachers tend to have a moderate-low ability to detect "inhibited" children.

Spatial genetic structure of Taxus baccata L. in the western Mediterranean Basin: past and present limits to gene movement over a broad geographic scale.

English yew (Taxus baccata L., Taxaceae), a Tertiary relict, provides a seminal example of a widespread albeit locally endangered (often close to extinction) tree species. In order to gain detailed insights into the evolutionary dynamics of the species on a broad geographical scale, over 1000 trees from 91 populations of English yew in the western Mediterranean were analyzed using seven nuclear microsatellite markers. Our results revealed contrasting patterns of genetic structure at different spatial scales: genetic variation was highly structured at the local scale, while only a low proportion of the observed variation was attributed to regional differences. We also found a geographic gradient of decreasing diversity and increasing population divergence from northwest (central Europe and northern Iberian Peninsula) to southeast (Mediterranean Iberia and North Africa). The patterns revealed in this study probably reflect the combined effects of Quaternary climatic changes and recent impact of human activities, and potentially also more ancient events dating back to the Tertiary. Both climatic and anthropogenic factors seem to have conducted to a long history of population isolation, which may have contributed significantly to enhance population divergence through restricted gene flow and genetic drift.

Bacterial community responses during a possible CO2 leaking from sub-seabed storage in marine polluted sediments.

Carbon capture and storage (CCS) is a viable option to reduce high concentrations of CO2 and mitigate their negative effects. This option has associated risks such as possible CO2 leakage from the storage sites. So far, negative effects deriving from a CO2 release have been reported for benthic macrofauna in both polluted and nonpolluted sediments. However, bacterial communities has no considered. In this work, risk assessment was carried out in order to evaluate the possible effects in a contaminated area considering bacterial responses (total number of cells, respiring activity, changes in the bacterial community composition and diversity). Four microcosms were placed into an integrated CO2 injection system with a non-pressurized chamber to simulate four different pH treatments (pH control 7.8, 7, 6.5 and 6). Results showed an impact on bacterial communities because of the CO2 treatment. Changes in respiring activity, community composition groups and diversity were found. This study highlights the use of respiring bacteria activity not only as bioindicator for environmental risk assessment and monitoring purposes but also as a bioindicador during a CO2 leakage event or CO2 enrichment process among all the responses studied.

Psychiatric side effects of interferon therapy: prevalence, proposed mechanisms, and future directions.

The increasing use of interferon (IFN) in treating a variety of disorders including, malignant melanoma and hepatitis C, has resulted in the identification and increasing concern about the psychiatric side effects that can result from treatment. These effects can occur either shortly after beginning IFN therapy or later as a result of continued treatment. Studies have reported the incidence of later side effects, which include symptoms of depression, anxiety, and occasional suicidal ideation, to be from 0% to 70%. Case studies have demonstrated that pharmacologic interventions are beneficial in reducing iatrogenic psychiatric symptoms while allowing patients to maintain IFN therapy. The present article provides an overview of the psychiatric effects of IFN therapy, the proposed mechanisms of these side effects, and case studies that provide mechanistic support. In addition, limitations of the current literature are provided with suggestions for treating physicians and a discussion of possible future research directions.

Psychosocial characteristics of individuals with non-stage IV melanoma.

PURPOSE: Melanoma is the fastest growing solid tumor among men and women and accounts for 79% of skin cancer-related deaths. Research has identified that distress is frequently associated with a diagnosis of cancer and may slow treatment-seeking and recovery, increasing morbidity and even mortality through faster disease course. Given that the 5-year survival rates for individuals with melanoma are determined primarily by the depth and extent of spread, distress that interferes with seeking treatment has the potential to be life-threatening. PATIENTS AND METHODS: The current study was designed to identify levels of distress present in individuals seeking treatment at a large, Midwestern, multidisciplinary melanoma clinic. It also focused on determining the quality of life, level of anxiety, and coping strategies used by individuals with melanoma before treatment. Given that the course of treatment and outcome for patients with stage IV disease is vastly different from that of patients with stages I to III disease, they were excluded from the study. RESULTS: Results indicated that most individuals who are presenting to a melanoma clinic do not report a clinically significant level of distress. However, there is some variability in this, with 29% of patients reporting moderate to high levels of distress. Moreover, analyses suggest that distressed individuals are more likely to use maladaptive coping strategies, such as escape-avoidance coping, and to have poorer quality of life. CONCLUSION: Although most individuals do not present with significant levels of distress, a significant minority are distressed and rely more heavily on coping strategies that do not benefit them. Such individuals would likely benefit most from psychological intervention.

Placenta-specific expression of the rat growth hormone-releasing hormone gene promoter in transgenic mice.

GH-releasing hormone (GHRH) is a hypothalamic peptide that plays a critical role in controlling the synthesis and secretion of GH in the anterior pituitary. Along with many other hypothalamic hormones, GHRH is also expressed in the placenta, although its physiological role in this tissue has not yet been determined. The placental prepro-GHRH is identical to that found in the hypothalamus. However, the placental and hypothalamic GHRH messenger RNAs differ in the region corresponding to the untranslated exon 1. A combined mechanism involving the use of tissue-specific promoters and the differential splicing of exon 1 generates the mature GHRH messenger RNAs in placenta and hypothalamus. As a first step toward the localization of the regulatory elements involved in the placenta-specific expression of the GHRH gene, we have generated transgenic mice containing constructs in which potential regulatory sequences of the rat GHRH gene were fused to the chloramphenicol acetyltransferase (CAT) reporter gene. Construct GHRH-CAT1, which contains 7.5 kilobases of flanking sequences upstream to the placental transcription start site, did not promote CAT expression in the transgenic animals. In contrast, construct GHRH-CAT2, which differs from construct GHRH-CAT1 in having additional sequences located downstream to placental exon 1, exhibited high levels of CAT expression in brain and placenta. Our results show that the sequences included in construct GHRH-CAT2 contain the cis-acting regulatory elements necessary to direct developmentally regulated and cell type-specific expression of the CAT gene in the placenta. Unexpectedly, the expression of the transgene in the brain was detected in glial cells of different areas, but not in the hypothalamus.

Possible discrimination in recruitment of psychiatry residents?

OBJECTIVE: The authors sought to determine whether there is a selection bias against international medical graduate applicants for U.S. residency training positions in psychiatry. METHOD: Identical requests for a program application were sent by two resident applicants--one international medical graduate and one graduate of a U.S. medical school--to 193 residency training programs, and the rate and character of responses were compared. RESULTS: The response rate to requests for an application form was significantly higher for the U.S. medical school graduate (159 responses) than the international medical graduate (87 responses). The quality of responses was also different in some cases. CONCLUSIONS: Some residency programs in psychiatry are attempting to limit the influx of international medical graduate applicants at the very first level: the request for an application form. The reasons for this practice are not known, but discrimination could be a possible explanation.

Differential splicing of the growth hormone-releasing hormone gene in rat placenta generates a novel pre-proGHRH mRNA that encodes a different C-terminal flanking peptide.

We have isolated and characterized a novel rat placental pre-proGHRH mRNA (pre-proGHRH-2 mRNA). This mRNA is generated by an alternative splicing process which results in the presence of an additional exon of 156 bp (designated exon 4.5) located between exons 4 and 5 of the previously reported hypothalamic and placental pre-proGHRH mRNA (pre-proGHRH-1 mRNA). Since the sequences encoding mature GHRH are included within exons 3 and 4, the processing of pre-proGHRH-2 would not affect the synthesis of mature GHRH but would generate a C-terminal peptide (designated GCTP-2) different from that previously reported in the hypothalamus and placenta (GCTP-1). The putative GCTP-2 has 64 amino acids, and the first 18 N-terminal residues are identical to those present in GCTP-1 (30 amino acids long). Pre-proGHRH-2 mRNA has not been detected in the hypothalamus.

Assessment of psychological distress in prospective bone marrow transplant patients.

Patient psychological distress is associated with many aspects of the bone marrow transplantation (BMT) process and has been linked with poor treatment outcomes. We assessed psychological distress in potential BMT candidates, and compared patient and nurse coordinator ratings of emotional distress at the time of initial BMT consultation. Fifty patients self-reported psychological distress using both the NCCN Distress Thermometer (DT) and the Hospital Anxiety and Depression Scale (HADS). Coordinators rated patient emotional distress using the DT and Coordinator Rating Scales that measure anxiety and depression. Fifty and 51% of patients self-reported clinically significant levels of emotional distress and anxiety, respectively, but only 20% self-reported clinically significant levels of depression. There was good correlation between ratings using the brief DT and the more comprehensive HADS. There was significant but only moderate agreement between patient and coordinator ratings of emotional distress and anxiety, with coordinators underestimating the number of patients with high levels of emotional distress. In addition, coordinator ratings of patient emotional distress primarily reflected anxiety, whereas anxiety and depression together only minimally accounted for patient self-reports of psychological distress. These findings suggest that: (1) the DT can be a useful screening device; (2) approximately half of patients at the time of initial consultation for BMT already experience significant levels of psychological distress; and (3) coordinators observe emotional distress primarily as anxiety, but patients experience psychological distress as something more than anxiety and depression.

Neurocognitive, behavioural and neurodevelopmental correlates of schizotypy clusters in adolescents from the general population.

INTRODUCTION: Studies on the neurocognitive correlates of schizotypy dimensions have found inconsistent results. This might stem from the fact that correlational methods, in contrast to cluster analysis, do not account for the possibility that a subject presents high scores on more than one dimension simultaneously. We aimed to establish clusters of normal adolescents based on schizotypy dimensions and compare them on neurocognitive, behavioural, and neurodevelopmental markers. METHODS: Two hundred seventy normal adolescents from the general population (mean age 13.4, SD=0.72) attending obligatory education were evaluated. RESULTS: A K-means iterative cluster analysis was performed with the Perceptual Aberration, Revised Social Anhedonia and Physical Anhedonia Scales. A forced four-cluster model yielded the following clusters: 'negative schizotypy', 'high or mixed schizotypy', 'positive schizotypy', and 'normal scorers'. Comparisons with ANOVAs showed that 'high schizotypes' performed poorly on neurocognition (Wechsler Intelligence Scales for Children-Revised (WISC-R) and Verbal Fluency (FAS)) and obtained the highest teacher ratings (TRF) of behavioural problems. 'Negative schizotypes' had the worst WCST results and more dermatoglyphic abnormalities. Both clusters had more neurological soft signs than 'normal scorers' and 'positive schizotypes'. CONCLUSIONS: Our results with community adolescents found the same cluster structure than the previous cluster analytic studies conducted in adult college subjects. Furthermore, we showed differences among them on neurocognitive and malneurodevelopment markers consistent with the adult literature on schizotypy.

Residue levels of ethoxyquin, imazalil, and iprodione in pears under cold-storage conditions.

A gas chromatographic method is presented for the simultaneous determination of the antiscald ethoxyquin and the fungicides imazalil and iprodione in peel and pulp of Blanquilla pears. Fruits were cold-stored in commercial chambers in normal atmosphere and in controlled atmosphere with low oxygen content (oxygen and carbon dioxide were held at 2.5% and 1.5%, respectively). The method uses gas-liquid chromatography (GLC) with an alkaline flame ionization detector (detector of N-P, NPD) and allows the detection of the mentioned compounds to minimum levels of 0.08-0.12 mg/kg in fresh fruit. With this system the evolution of residues in fruit was monitored throughout the period of cold storage. In the surveys carried out the residue levels of these compounds were found to be below the limits allowed by the legislation of European Union. For the three studied products residues in pulp are lower and disappear more quickly than in peel.

Medication backup: attitudes and practices of psychiatrists and residents.

Twelve residents and 12 attending psychiatrists in the adult division of a university-based department of psychiatry responded to a 20-item questionnaire about medication backup, or the provision of psychotropic medications for a patient treated in psychotherapy by another clinician. The attending psychiatrists and residents did not differ significantly in their attitudes about and practices of medication backup. Results of this preliminary study indicated that about half of both groups saw between one and five patients a month for this purpose. All except one respondent believed that medication backup may have a detrimental effect on treatment.

Contact between psychotherapists and psychiatric residents who provide medication backup.

OBJECTIVE: Psychiatric residents frequently prescribe medication for patients who are in psychotherapy with another clinician. This study examined the extent and characteristics of communication between psychiatric residents and psychotherapists who treated patients in a university outpatient clinic. METHODS: Thirteen psychiatric residents who prescribed medications for 83 patients seen by other clinicians for therapy were surveyed about whether and how often during a five-month period they had contact with the therapist, who initiated the contact, and whether it took place with the patient's consent. Patients' charts were reviewed to determine if contacts were documented. RESULTS: The psychiatric residents indicated they had contact with the therapist in 44 of 83 cases (53 percent). Contact was initiated by the prescribing psychiatrist in 47.7 percent of the cases and by the therapist in 43.2 percent of the cases. The charts of only seven patients (8.4 percent) included written documentation of contact. CONCLUSIONS: Several steps are necessary to optimize communication between treating clinicians and documentation of such communication. They include initial contact to discuss the treatment contract and clarify each clinician's responsibilities, formal written consent from the patient, regular contacts between clinicians to discuss the patient's progress, and collaboration between clinicians on the patient's treatment plan.