Mood and anxiety disorders across the adult lifespan: a European perspective.

BACKGROUND: The World Mental Health Survey Initiative (WMHSI) has advanced our understanding of mental disorders by providing data suitable for analysis across many countries. However, these data have not yet been fully explored from a cross-national lifespan perspective. In particular, there is a shortage of research on the relationship between mood and anxiety disorders and age across countries. In this study we used multigroup methods to model the distribution of 12-month DSM-IV/CIDI mood and anxiety disorders across the adult lifespan in relation to determinants of mental health in 10 European Union (EU) countries. METHOD: Logistic regression was used to model the odds of any mood or any anxiety disorder as a function of age, gender, marital status, urbanicity and employment using a multigroup approach (n = 35500). This allowed for the testing of specific lifespan hypotheses across participating countries. RESULTS: No simple geographical pattern exists with which to describe the relationship between 12-month prevalence of mood and anxiety disorders and age. Of the adults sampled, very few aged ≥ 80 years met DSM-IV diagnostic criteria for these disorders. The associations between these disorders and key sociodemographic variables were relatively homogeneous across countries after adjusting for age. CONCLUSIONS: Further research is required to confirm that there are indeed stages in the lifespan where the reported prevalence of mental disorders is low, such as among younger adults in the East and older adults in the West. This project illustrates the difficulties in conducting research among different age groups simultaneously.

Parental psychopathology and the risk of suicidal behavior in their offspring: results from the World Mental Health surveys.

Previous research suggests that parental psychopathology predicts suicidal behavior among offspring; however, the more fine-grained associations between specific parental disorders and distinct stages of the pathway to suicide are not well understood. We set out to test the hypothesis that parental disorders associated with negative mood would predict offspring suicide ideation, whereas disorders characterized by impulsive aggression (for example, antisocial personality) and anxiety/agitation (for example, panic disorder) would predict which offspring act on their suicide ideation and make a suicide attempt. Data were collected during face-to-face interviews conducted on nationally representative samples (N=55 299; age 18+) from 21 countries around the world. We tested the associations between a range of parental disorders and the onset and persistence over time (that is, time since most recent episode controlling for age of onset and time since onset) of subsequent suicidal behavior (suicide ideation, plans and attempts) among offspring. Analyses tested bivariate and multivariate associations between each parental disorder and distinct forms of suicidal behavior. Results revealed that each parental disorder examined increased the risk of suicide ideation among offspring, parental generalized anxiety and depression emerged as the only predictors of the onset and persistence (respectively) of suicide plans among offspring with ideation, whereas parental antisocial personality and anxiety disorders emerged as the only predictors of the onset and persistence of suicide attempts among ideators. A dose-response relation between parental disorders and respondent risk of suicide ideation and attempt was also found. Parental death by suicide was a particularly strong predictor of persistence of suicide attempts among offspring. These associations remained significant after controlling for comorbidity of parental disorders and for the presence of mental disorders among offspring. These findings should inform future explorations of the mechanisms of intergenerational transmission of suicidal behavior.

Induction of apoptosis by electrotransfer of positively charged proteins as Cytochrome C and Histone H1 into cells.

Cytochrome C (Cyt. C) is a mitochondrial protein inducing apoptosis when it is accumulated in the cytosol by a currently unknown mechanism, but regulated by the bcl-2 family of proteins. The linker Histone H1 is another basic protein with highly conservative structure, composition, and equal molecular weight, not changed during the evolution. An attempt was made to understand better the apoptotic processes by electroloading of leukemic cells, such as K562, HL-60, and SKW3, and human lymphocytes with positively charged proteins, such as Cyt. C, Histone H1, and methylated BSA albumin (mBSA). The triggering apoptotic processes followed by MTT test, FACS analysis, and DNA fragmentation after the electrotransfer of these proteins into the cells were observed. Histone H1 and mBSA induce the release of Cyt. C from rat liver mitochondria. Cytochrome C release was higher when mitochondria were in "high-energy" state. It is supposed that release of Cyt. C from mitochondria is due to the mechanical rupture of the outer mitochondrial membrane, rich in negatively charged groups, predominately due to cardiolipin. The reason for the morphological rupture of the outer mitochondial membrane could be the rigidification and segregation of the membrane and the destroyed membrane asymmetries of both monolayers in the presence of positively charged proteins at higher linear charges such as Histone H1. We suggested that Histone H1, at a given moment of activated signaling for apoptosis, could be not transported to the nucleus and could lead to the release of Cyt. C from the mitochondria in the cytoplasm. It is temping to speculate that Histone H1 has other physiological extranuclear functions involved in apoptosis.

Membrane electropermeabilization effects of frequency and membrane surface order on liposome leakage.

Liposomes containing fluorescence marker were exposed to an alternating electric field of 80 V peak to peak square electric waves at different frequencies 0.01, 1, and 100 kHz to perturb the liposome permeation. The efflux of fluorescence dye after application of the electric field was measured by recording the fluorescence emission due to the complex formation reaction between the fluorescence dye and calcium ions in the bulk medium solution. Two independent sets of experiments were conducted: 1) calcium ions were present during electropulsation; and 2) they were added after electric field application. Two parameters, fluorescence emission intensity and increment of temperature of the solution in the chamber, were studied. The effect of membrane surface order on the fluorescence dye leakage from the liposomes was studied by addition of urea at threshold concentration before the liposomes sealed. The data demonstrate the existence of frequency dependency window at 1 kHz. Furthermore, the data were interpreted according to the theory of interactions of electromagnetic fields with highly polarized and deformed materials such as liposome particles. The urea caused an enhancement of the fluorescence dye leakage at frequency of 100 kHz. This effect could be explained as a decrease of the membrane binding rigidity due to the disordering effect of urea on the membrane lipid surface. Our conclusion is that the frequency and the membrane surface order are additional parameters that influence the processes of membrane electropermeabilization.

Electrical stability of erythrocytes in the presence of divalent cations.

Erythrocytes suspended in a medium of low ionic strength lyse under the effect of an exponential electrical pulse. The percentage of haemolysed cells decreases several-fold in the presence of divalent cations. The protective action of the ions studied increases in the following order: Ca++, Mg++, Zn++. It is assumed that divalent ions bind to the negative charges of the lipid and protein molecules and reduce their electrostatic repulsion, which results in stabilization of the membranes.

Are the stainless steel electrodes inert?

The electrodes used for electroporation, electrofusion, and electrotransfection, as well as in electrochemotherapy should not interact with the object and release electrolysis products. We studied how far the stainless steel electrodes fulfil these requirements. The results showed that in the case of the exponential electric pulses with amplitude of 3 kV cm(-1) and time constant of 0.5 ms, the stainless steel electrodes released ferrous ions to a concentration of several micromoles per liter. We determined experimentally the dependence of the amount of the released ferrous ions on the pulse parameters and on the ionic strength of the medium. It was shown that the released ferrous ions should not be ignored. They could be of importance for the bleomycin electrochemotherapy.

Pyronin G as a fluorescent probe for quantitative determination of the membrane potential of mitochondria.

Added to mitochondrial suspension, pyronin G changes the intensity of its fluorescence depending on the membrane potential (energy state) of the mitochondria. The mechanism of this effect is studied and a dependence is obtained between the membrane potential and the fluorescence intensity. This permits quantitative determination of the membrane potential by the changes in the fluorescence of the suspension. A method is proposed for measuring the membrane potential of vesicles in the -120 to -220 mV interval.

Markers of tumour angiogenesis and tumour cells in bone marrow in gastric cancer patients.

AIMS: Vascular endothelial growth factors VEGF-A, VEGF-C and VEGF-D are considered to be potentially angiogenetic and lymphangiogenetic. "Minimal residual disease" is responsible for cancer progression and recurrence. In this study, we investigated the relation between expressions of VEGF-A, VEGF-C and VEGF-D in gastric cancer tissue and the presence of tumour cells in bone marrow. METHODS: A total of 50 resected primary gastric adenocarcinomas, 44 non-cancerous gastric mucosa and 36 lymph node metastases were analyzed by immunohistochemistry for VEGF-A, VEGF-C and VEGF-D. The specimens used were drawn from a previous study cohort, where the presence of ITC in bone marrow was confirmed with immunohistochemical assay with cytokeratin (CK)-18. RESULTS: The levels of expression of VEGF-A, VEGF-C and VEGF-D were highest in tumour (p < 0.001), and the level in lymph node metastases was significantly higher (p < 0.01) than in mucosa. The expression of VEGF-A was correlated significantly with venous tumour invasion (p < 0.05) and the presence of tumour cells in bone marrow (p < 0.05). Tumours expressing high levels of VEGF-D showed significantly advanced stages of tumour infiltration (p < 0.05) and lymph node metastasis (p < 0.01). CONCLUSIONS: VEGF-A is a significant marker for the presence of tumour cells in the bone marrow of gastric cancer patients. Our results confirm VEGF-D as a predictor for the lymphatic spread of tumour cells. Therefore, the route of metastatic spread of gastric cancer could be determined, at least in part, by the profile of VEGF family members expressed in the primary tumour of gastric cancer patients.

Mental health reforms in Eastern Europe.

OBJECTIVE: To describe the background in general culture, public and professional discourse against which mental health care reform initiatives in Eastern Europe need to be seen. METHOD: An account of some key aspects of sociopolitical and cultural transition in Eastern European countries is given, and core results of a research project on attitudes and needs assessment in psychiatry in six Eastern European countries are reported. RESULTS: In post-totalitarian cultures mental health reforms impinge on imagination in ways which are not easy to predict. Some of the reasons for this are traced to the psychiatric practices under the system of total control, e.g. dispensary care, political abuse, reification of classificatory terms. Data on a study of attitudes suggest that institutions had replaced community life in those parts of Europe. CONCLUSION: It is predicted that with time trust in the capacity of community to contain mental illness will be regained.

Pax Iliev: law, life and care in transition.

The presentation proceeds from a clinical case of domestic violence, its management in terms of professional roles and institutional involvement and the analysis of the dynamic mental processes. It is argued that regimes of total control abolish legal systems and leave a void behind. In the course of transition to civil society, rule by intimidation and threat at a local community level is the rule. Suffering and trauma are intense and health systems necessarily become involved. A pattern of decontextualizing depression may be common and revealing of institutional defence mechanisms at work. Continuous affirmation of procedures of good practice, e.g. supervision, gives a chance for the preservation of institutional sanity and professional ethics.

Pyronin--a fluorescent indicator of membrane potential of the mitochondria. Mechanism of action.

The effect of the functional state of isolated mitochondria on the fluorescence of pyronin added to the suspension is studied. It is shown experimentally that the intensity of fluorescence changes parallel to the degree of energization of the mitochondria. The magnitude and the sign of the fluorescent changes depend on the pyronin/mitochondria ratio and the length of the wave of excitating light. Model experiments show that the effects observed are probably due to the electrophoretic redistribution of pyronin between the medium, the mitochondrial membrane and the matrix, induced by the membrane potential of the mitochondria. It is assumed that pyronin acts as vector fluorescent indicator, similar to anilinonapthalenesulphonate.

Multiple perspectives on the evaluation of outcome in eastern Europe.

OBJECTIVE: The objective of the paper is to explore the capacity of mental health systems of Eastern Europe to engage in genuine mental health reforms. METHODS: Proceeding from assumptions introduced by the School of Group Relations the propensity of organisations to abandon declared primary tasks under ideological, political and other context-related influences is adopted. The mental health scene of Eastern Europe is discussed from this perspective. RESULTS: Change and progress are found to be impeded by rules prohibiting curiosity and challenge of routine practices. CONCLUSIONS: The emergence of networks of reform minded professionals in Eastern Europe is found to be a healthy sign. A major task ahead is the substitution of defunct structures of mental health (services, research, training) with new ones. The challenge of the inherited establishment is inevitable. The role of collaborative works with the West is of utmost importance.

[Hypothalamo-hypophyseal-thyroid axis in recruits and soldiers with male hypogonadism]. / Izsledvane na khipotalamo-khipofizo-tireoidnata os pri bolni s muzhki khipogonadizum nabornitsi i voinitsi.

The functional state of hypothalamus-hypophyseal-thyroid axis was investigated in 157 recruits and soldiers, aged from 17 to 26 with different forms of male hypogonadism: system of Kleinferter, male Turner, primary hypogonadism with recognized and unrecognized etiology, cryptorchism, anorchia, secondary hypogonadism and late puberty. Serum base level of TSH, T3, T4 were radioimmunologically determined as well as T3 binding with serum proteins. Single intravenous stimulation was performed with 200 mkg TRH and with 100 mkg LH-RH to groups of patients with various forms of male hypogonadism. Furthermore, the level of protein conjugated iodine (PCI) in serum was determined as well as J131 absorption by the thyroid gland and metabolism. Serum level of TSH, in male hypogonadism, was elevated with Kleifelter system and late puberty. Base level of T3 was reduced, of T4 -- elevated insecondary hypogonadism. T3 binding with serum proteins on all forms of the disease was within the norm. With the single venous TRH stimulation, the separate patients showed various responses to TSH. But in all cases, a tendency to elevation in the first several minutes after the stimulation was observed with a further stronger or poorer tendency to returning to the norm. In one patient with secondary hypogonadism an interrupted elevation of TSH was observed. The stimulation with thyrotropin-releasing hormone (TRH) gave no significant deviation in the level of T3 and T4 both in healthy subjects and patients. Single intravenous stimulation with luteinizing hormone-releasing hormone (LH-RH) induced no significant changes in the level of thyroid stimulating hormone (TSH), T3, T4 and T3 binding with serum proteins in healthy subjects and patients. Base values of PCI in male hypogonadism were with normal ranges, J131 absorption by the thyroid gland and metabolism showing a tendency to lower values.

[Insulin secretion into the serum in various forms of male hypogonadism in recruits and soldiers]. / Izsledvane sekretsiiata na insulina v seruma pri bolni s razlichni formi muzhki khipogonadizum nabornitsi i voinitsi.

Significant elevation of insulin was established with the radioimmunological determination of base insulin level in the serum, at 8 o'clock a.m. before meals in 76 patients with various forms of male hypogonadism, recruits and soldiers (Klinefelter syndrome--20, male Turner--2, primary hypogonadism with other known or unknown etiology--12, cryptorchism--14, anorchia--3, secondary hypogonadism--19, puberty tardia--6). The hyperinsulinemia established is associated with hypercortisolemia, observed in those patients.

[Hypothalamo-hypophyseal-adrenal and hypothalamo-hypophyseal-gonadal interactions in young persons with different forms of male hypogonadism]. / Khipotalamo-khipofizo-nadbubrechni i khipotalamo-khipofizo-gonadni vzaimodeistviia pri mladezhi s razlichni formi muzhki khipogonadizum.

The study includes 115 men, 17 to 26 years of age, suffering from various forms of male hypogonadism: Klinefelter's syndrome--40 patients, male Turner's syndrome--2 patients, primary hypogonadism with other etiology--14 patients, cryptorchism--12 patients, anorchidism--8 patients, secondary hypogonadism--26 patients and late puberty--13 patients. A raised hydrocortisone plasma level was found. In the anorchidism cases the basic testosterone level was the lowest one combined with the highest basic hydrocortisone level. The 24 hour rhythm of hydrocortisone secretion in Klinefelter's syndrome is regular but the hour values are higher. In cases of primary hypogonadism with other etiology, cryptorchism and secondary hypogonadism the 24 hour rhythm is disturbed and the hydrocortisone values are higher.

The sequential contractions of the rumen associated with eructation in sheep.

1. The orderly sequential movements of the reticulum and the rumen were studied in conscious sheep by electromyography using enamelled stainless-steel wires implanted in various regions of the stomach wall and by recording mechanical changes within the various parts of the organ. Electrical activity of the rumen and/or pressure changes were related to eructation when the animals were at rest, feeding or ruminating.2. Secondary contractions of the rumen were found to originate in the ventral blind sac immediately following a primary contraction or independently. The wave of contraction originating in the ventral blind sac was seen to pass in a circular manner to the dorsal blind sac, the dorsal sac, the ventral sac and finally once more to the ventral blind sac. Eructation occurs at the end of the contraction of the dorsal sac. In each case, the time required to initiate the secondary cycle depended on the strength of contraction of the ventral blind sac.3. Sustained gaseous distension elicited numerous secondary contractions of the rumen concurrent with a lower frequency of reticular contractions. Although some secondary contractions were incomplete, all began with contraction of the ventral blind sac and were associated with eructation.4. Chemical stimulation of the rumen by fatty acids at pH 5.5-5.9 increased the ratio of secondary to primary contractions of the rumen to a varying extent depending on their initial rate.5. It was concluded that the seemingly random occurrence of a secondary cycle of the rumen was dependent on the activity of the ventral blind sac and its pattern could be altered by both mechanical and chemical stimulation.

Effect of crataemon on the respiration of isolated mitochondria.

Crataemon is a drug containing the total mixture of flavonoids isolated from the leaves of Crataegus minogina. Crataemon causes activation and inhibition of the respiration of isolated liver and heart mitochondria, with different time and dose dependence and with different sensitivity to EDTA. The activating effect develops immediately, it is caused by small doses of crataemon, it is lacking in uncoupled mitochondria and completely abolished by EDTA. The inhibitory effect develops immediately or after the activation phase, it is caused by higher doses and the degree and the latency period depend on the dose. This effect is due to the action of crataemon on the flavoprotein-cytochrome c section of the electron transport chain. The inhibitory effect is partly abolished by EDTA. These effects are explained by the presence of at least two crataemon components: EDTA-sensitive and EDTA-insensitive. The EDTA-sensitive component is determined as a zinc-flavonoid complex. In small doses it uncouples oxidative phosphorylation, while large doses inhibit the electron transport between flavoprotein and cytochrome c. The EDTA-insensitive component causes only inhibition of the electron transport in the same part of the chain and manifests its effect in the higher doses.