The salience and symbolism of numbers across cultural beliefs and practice.

Numbers are ubiquitous to modern existence and have evolved with humanity over millenia. They structure, record and quantify human behaviour, spiritual belief systems and the evolution of innovation across all spheres of life. Furthermore, cultural identities and interpersonal expression often have numerical components to them for instance rites of passage, population demography and fiscal measures. The salience of numbers in both historical and contemporary cultural life arguably plays a role in individual psyches and the experience of distress or wellness. This paper illustrates the cultural relativism of numbers through superstition and foreboding to auspiciousness in different societies. As a short hand for the quantification of multiple phenomena in low literacy to high technology populations, rural and urban societies as well as traditional and evolving societies, numbers have and will continue to be core to all cultures as they have from prehistoric to contemporary times.

Vitamin D and depression: A case series.

INTRODUCTION: Over two-thirds of Canadians are deficient in vitamin D. Clinical overlap can compound diagnosis of depression in vitamin D deficient individuals. Citing high costs, the Ministry of Health has restricted routine vitamin D screening and hence is not feasible. OBJECTIVES: The current case series is an attempt to recognise the clinical overlap between depression and vitamin D deficiency in order to avoid unnecessary antidepressant prescriptions and to demonstrate the role of collaborative care in such patients. METHOD: After appropriate ethics approval 62 patients from an outpatient clinic were screened for the diagnosis of treatment resistant depression. Those who had predominant somatic complaints were further screened for organic factors and those with inadequate vitamin D levels were referred to family physicians for supplementation with vitamin D. RESULTS: More than 50% were detected deficient in vitamin D after our evaluation. They showed subjective improvement with vitamin D supplements. No modification of antidepressants was needed. CONCLUSION: Vitamin D deficiency should be suspected in depressed patients with prominent somatic symptoms and their treatment resistance should be reconsidered to avoid unnecessary exposure to mood stabilisers. Collaborating with primary care is advocated. LIMITATION: Co-prescription of an antidepressant is a confounder in our case series, and we propose more organised studies with objective rating scales.