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.

The factorial structure of the 41-item version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Spanish population of 8 to 12 years-old

On this instrumental study we intend to analyse the factorial structure of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Spanish sample using exploratory and confirmatory factorial analysis. As a second objective we intend to develop a short form of it for rapid screening and, finally, to analyze the reliabilities of both questionnaires. The SCARED was administered to a community sample of 1,508 children aged between 8 and 12 years. The sample was randomly split using half for the exploratory analysis and the other half for the confirmatory study. Furthermore a reduced version of the SCARED was developed using the SchmidLeiman procedure. Exploratory Factor Analysis yielded a four factor structure comprised of Somatic/panic, Generalized anxiety, Separation anxiety and Social phobia factors This structure was confirmed using Confirmatory Factor Analysis. The four factors, the full scale and the short scale showed good reliabilities. The results obtained seem to indicate that the Spanish version of the SCARED has good internal consistency, and along with other recent results, has a structure of four related factors that replicates the dimensions proposed for anxiety disorders by the DSM-IV-TR

EXTRAÇÃO DE POLI(3-HIDROXIBUTIRATO), PRODUZIDO POR Cupriavidus necator, COM CARBONATO DE PROPILENO

The environmental impact of plastic waste has attracted worldwide attention. Amid the current context of increasing concern for the environment, biodegradable plastics have been widely studied as a replacement for synthetic plastics. Poly(3-hydroxybutyrate) (P(3HB)) is a biopolymer stored as an intracellular energy and reserve source in many microorganisms. Because it is an intracellular product, P(3HB) must be extracted from the cells at the end of the culture. The purpose of this study was to investigate the effect of extraction time, heating temperature, first standing time (after filtration and extraction), second standing time (after P(3HB) precipitation) and solvent amount, during the process of extracting P(3HB) from Cupriavidus necator DSM 545, using propylene carbonate as solvent. The extraction kinetic of P(3HB) with propylene carbonate from thermally treated biomass was evaluated at different temperatures. The physical properties of the P(3HB) obtained were also evaluated. In this case, P(3HB) obtained at optimal conditions of recovery (98%) and purity (99%) was used. Results showed that temperature was the most important factor in these responses for the range of values studied (110-150 ºC).

Personality and Depression

The aim of this study was to illustrate the associations of personality variables and depression. The first study population consisted of 50 patients with DSM-IV defined major depressive disorder. Subjects were randomized to receive either fluoxetine medication or short-term psychodynamic psychotherapy. The Hamilton Depression Rating Scale was completed at the baseline and in the follow-up at four months. Baseline mature defense style measured with the Defense Style Questionnaire predicted favourable outcome in the fluoxetine treatment group, whereas no associations were found in psychotherapy group. The Psychological Mindedness Scale scores were not predictive for recovery in patients receiving psychotherapy or medication. The Psychological Mindedness Scale seems not to be useful in selecting optimal treatment in major depressive disorder. Harm Avoidance measured with the Temperament and Character Inventory associated with the baseline severity of the depressive state. In the fluoxetine treatment group high Reward Dependence, high Self-Directedness and high Cooperativeness were predictive for more severe depression in the four months follow-up, whereas no associations were found in the psychotherapy treatment group. It is possible that the result reflects the differences in the placebo response. The second data were derived from the Finnish Public Sector Study. These prospective studies with four years follow-up focused on the predictive value of optimism and pessimism, first, to work disability with a diagnosis of depression lasting at least 90 days and returning to work (N= 38214) , and second, to the likelihood of initiating antidepressant medication treatment lasting at least 100 days and ending the treatment (N= 29930). Results show that low optimism associates with the elevated risk of work disability and higher likelihood of antidepressant use. High pessimism associated with higher likelihood starting at least 100 days antidepressant medication and not stopping medication during the follow up. High pessimism did not seem to predict the entering to depression related work disability, but in the case of disability period it associated with the lower likelihood of returning to work. The thesis shows that personality features play a role as a vulnerability factor, and influence the onset and course of depression. Taking these factors into account more than is currently done may increase the possibilities to enhance the treatment results in depression.

Applications of graph transformation in tools for domain-specific modeling languages

The use of domain-specific languages (DSLs) has been proposed as an approach to cost-e ectively develop families of software systems in a restricted application domain. Domain-specific languages in combination with the accumulated knowledge and experience of previous implementations, can in turn be used to generate new applications with unique sets of requirements. For this reason, DSLs are considered to be an important approach for software reuse. However, the toolset supporting a particular domain-specific language is also domain-specific and is per definition not reusable. Therefore, creating and maintaining a DSL requires additional resources that could be even larger than the savings associated with using them. As a solution, di erent tool frameworks have been proposed to simplify and reduce the cost of developments of DSLs. Developers of tool support for DSLs need to instantiate, customize or configure the framework for a particular DSL. There are di erent approaches for this. An approach is to use an application programming interface (API) and to extend the basic framework using an imperative programming language. An example of a tools which is based on this approach is Eclipse GEF. Another approach is to configure the framework using declarative languages that are independent of the underlying framework implementation. We believe this second approach can bring important benefits as this brings focus to specifying what should the tool be like instead of writing a program specifying how the tool achieves this functionality. In this thesis we explore this second approach. We use graph transformation as the basic approach to customize a domain-specific modeling (DSM) tool framework. The contributions of this thesis includes a comparison of di erent approaches for defining, representing and interchanging software modeling languages and models and a tool architecture for an open domain-specific modeling framework that e ciently integrates several model transformation components and visual editors. We also present several specific algorithms and tool components for DSM framework. These include an approach for graph query based on region operators and the star operator and an approach for reconciling models and diagrams after executing model transformation programs. We exemplify our approach with two case studies MICAS and EFCO. In these studies we show how our experimental modeling tool framework has been used to define tool environments for domain-specific languages.

Definição de áreas prioritárias ao uso público no parque estadual da Cachoeira da Fumaça - ES, utilizando geoprocessamento

O Parque Estadual da Cachoeira da Fumaça (PECF) está localizado entre os municípios de Alegre e Ibitirama, no sul do Estado do Espírito Santo, possuindo área aproximada de 162,50 hectares. Levando-se em consideração a importância ambiental do PECF para o Estado do Espírito Santo, a necessidade de proteção dos ecossistemas da Mata Atlântica e suas formações associadas, bem como o aprimoramento das técnicas de gestão, este trabalho teve por objetivo propor subsídios aos gestores, através da geração de um mapa de adequabilidade com áreas prioritárias ao uso público, utilizando análise multicritério e lógica fuzzy. Os materiais utilizados foram: Ortofoto do ES, mapa de curvas de nível obtido do Geobases e para coleta de dados em campo utilizou-se GPS diferencial. Os fatores relevantes para avaliação dos aspectos relacionados ao ecoturismo que foram utilizados para produzir os mapas de adequabilidade, seguindo uma ordem de prioridade estabelecida pelo método Analytic Hierarchy Process (AHP) foram: fator cachoeira, uso dos solos, massa de água (contendo os rios), trilhas, locais de acessos, estruturas e declividade. Após a combinação dos fatores, foi gerado o mapa de adequabilidade para uso público, com superfície de adequabilidade mostrando a aptidão e representando o zoneamento da área do PECF para o objetivo proposto. A partir do zoneamento da Unidade de Conservação foi possível mostrar as áreas com diferentes graus de aptidão ao ecoturismo de acordo com suas distâncias da cachoeira, trilhas, e da área de Mata Atlântica.

Eating disorders, weight perception, and dieting in adolescence

Background: Eating disorders are serious psychiatric disorders, which usually have their onset in adolescence. Body dissatisfaction and dieting, both common among adolescents, are recognised risk factors for eating disorders. The aim of the present study was to assess the prevalence of eating disorders in the general adolescent population, assess the risk of developing eating disorders in subgroups of dieters, and analyse longitudinal concomitants of incorrect weight perception. Method: A prospective follow-up study on 595 adolescents, aged 15 at baseline, was conducted in western Finland. The study comprised questionnaires directed at the whole study population and subsequent personal interviews with adolescents found to be screen-positive for eating disorders, at both baseline and three-year follow-up. Results: The lifetime prevalence rates for 18 year old females were 2.6 % for anorexia nervosa, 0.4 for bulimia nervosa, and 9.0 % for eating disorder not otherwise specified (EDNOS). No prevalent case of DSM-IV eating disorders was found among the male participants. Eating disorders, as well as depressive symptoms, social anxiety, and low self-esteem, was more prevalent among females who perceived themselves as being overweight, despite being normal or underweight, when compared to females with a correct weight perception. An incorrect weight perception was associated in males with social anxiety. Female adolescents dieting due to psychological distress, rather than vanity or overweight, had a fifteen-fold risk of developing an eating disorder. Conclusions: Eating disorders are common among female adolescents, and adolescents choosing to diet due to psychological distress show a markedly increased risk of developing an eating disorder. Promotion of general well-being as well as the prevention of body dissatisfaction and misdirected dieting, accompanied by early detection and proper treatment of eating disorders, is needed to reduce the incidence of and facilitate recovery in adolescents suffering from eating disorders.

Problemas conjugais e outros fatores associados a transtornos psiquiátricos do pós-parto

OBJETIVO: Estudar a associação entre transtornos mentais pós-parto e fatores demográficos e psicossociais, pré e perinatais. MÉTODOS: Todas as familias com crianças de quatro meses da Vila Jardim - Porto Alegre (RS) - nascidos entre novembro de 1998 e dezembro de 1999 foram avaliadas. Utilizou-se o Self Report Questionnaire (SRQ-20) e entrevistas clínicas semiestruturadas individuais e do casal para fundamentar uma hipótese diagnóstica segundo os critérios do da quarta edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV). Realizou-se a avaliação da relação conjugal e do relacionamento da mãe com as famílias de origem e a rede social utilizando-se a Escala de Avaliação Global do Funcionamento Relacional (GARF). RESULTADOS: Foram avaliadas 148 mães e os 116 pais que coabitavam. Segundo o SRQ, 34,4% das mães e 25,4% dos pais apresentaram suspeita de transtorno psiquiátrico. Clinicamente os percentuais foram maiores. Coabitar ou não com companheiro não esteve associado com transtorno mental materno. Na análise da totalidade do grupo de mulheres, estiveram associados: baixa renda familiar (OR=0,8; p<0,05) e a presença de transtorno materno no passado (OR=2,2; p<0,05). O estudo apenas das mulheres que coabitavam (n=116) mostrou associação exclusivamente com a má qualidade da relação conjugal (OR=7,3; p<0,05). CONCLUSÃO: Este estudo reforça a necessidade de se verificar a presença de transtorno mental materno da mãe nas consultas de pré-natal e puericultura, e introduz dados sobre o pai e, especialmente, sobre a importância da relação conjugal.

Vitrification of bovine preantral follicles with dimethylsulfoxide and sucrose plus α-tocopherol

Abstract: The objective of this study was to evaluate the vitrification of bovine preantral follicles with dimethylsulfoxide (D) and sucrose (S) plus α-tocopherol 5mmol/L (T5) or 10mmol/L (T10) and, evaluate the thawed with minimal essential medium (m) with or without sucrose (s). Ovaries of cows were collected from slaughterhouse for the experiment I (n=66) and II (n=51). In the laboratory ovarian fragments were randomly assigned either to fresh control and 8 vitrification treatments (Controle and Dm; Dms, DSm; DSms; DST5m; DST5ms; DST10m; DST10ms). Ovarian fragments were placed in vitrification solution (5 min) and immersed in liquid nitrogen (-196°C), after a week, the fragments were thawed and analyzed. In the experiments I, preantral follicles were morphologically observed for histological evaluation, (normal; degenerated and developing of stage). In the experiment II, preantral follicles were mechanically isolated from ovarian tissue and examined with trypan blue, where dead and live corresponded to stained or non-stained. The treatments DSm, DSms and DST10m were effective in preserving the morphology in situ. However, the viability of isolated preantral follicles after vitrification remained high only in treatment DST10m. Thus, DST10m preserves survival rates and morphological integrity during vitrification of bovine preantral follicles.

Power-line-communication-based data transmission concept for an LVDC electricity distribution network – Analysis and implementation

Communications play a key role in modern smart grids. New functionalities that make the grids ‘smart’ require the communication network to function properly. Data transmission between intelligent electric devices (IEDs) in the rectifier and the customer-end inverters (CEIs) used for power conversion is also required in the smart grid concept of the low-voltage direct current (LVDC) distribution network. Smart grid applications, such as smart metering, demand side management (DSM), and grid protection applied with communications are all installed in the LVDC system. Thus, besides remote connection to the databases of the grid operators, a local communication network in the LVDC network is needed. One solution applied to implement the communication medium in power distribution grids is power line communication (PLC). There are power cables in the distribution grids, and hence, they may be applied as a communication channel for the distribution-level data. This doctoral thesis proposes an IP-based high-frequency (HF) band PLC data transmission concept for the LVDC network. A general method to implement the Ethernet-based PLC concept between the public distribution rectifier and the customerend inverters in the LVDC grid is introduced. Low-voltage cables are studied as the communication channel in the frequency band of 100 kHz–30 MHz. The communication channel characteristics and the noise in the channel are described. All individual components in the channel are presented in detail, and a channel model, comprising models for each channel component is developed and verified by measurements. The channel noise is also studied by measurements. Theoretical signalto- noise ratio (SNR) and channel capacity analyses and practical data transmission tests are carried out to evaluate the applicability of the PLC concept against the requirements set by the smart grid applications in the LVDC system. The main results concerning the applicability of the PLC concept and its limitations are presented, and suggestion for future research proposed.

Potential and Challenges of Analog Reconfigurable Computation in Modern and Future CMOS

In this work, the feasibility of the floating-gate technology in analog computing platforms in a scaled down general-purpose CMOS technology is considered. When the technology is scaled down the performance of analog circuits tends to get worse because the process parameters are optimized for digital transistors and the scaling involves the reduction of supply voltages. Generally, the challenge in analog circuit design is that all salient design metrics such as power, area, bandwidth and accuracy are interrelated. Furthermore, poor flexibility, i.e. lack of reconfigurability, the reuse of IP etc., can be considered the most severe weakness of analog hardware. On this account, digital calibration schemes are often required for improved performance or yield enhancement, whereas high flexibility/reconfigurability can not be easily achieved. Here, it is discussed whether it is possible to work around these obstacles by using floating-gate transistors (FGTs), and analyze problems associated with the practical implementation. FGT technology is attractive because it is electrically programmable and also features a charge-based built-in non-volatile memory. Apart from being ideal for canceling the circuit non-idealities due to process variations, the FGTs can also be used as computational or adaptive elements in analog circuits. The nominal gate oxide thickness in the deep sub-micron (DSM) processes is too thin to support robust charge retention and consequently the FGT becomes leaky. In principle, non-leaky FGTs can be implemented in a scaled down process without any special masks by using “double”-oxide transistors intended for providing devices that operate with higher supply voltages than general purpose devices. However, in practice the technology scaling poses several challenges which are addressed in this thesis. To provide a sufficiently wide-ranging survey, six prototype chips with varying complexity were implemented in four different DSM process nodes and investigated from this perspective. The focus is on non-leaky FGTs, but the presented autozeroing floating-gate amplifier (AFGA) demonstrates that leaky FGTs may also find a use. The simplest test structures contain only a few transistors, whereas the most complex experimental chip is an implementation of a spiking neural network (SNN) which comprises thousands of active and passive devices. More precisely, it is a fully connected (256 FGT synapses) two-layer spiking neural network (SNN), where the adaptive properties of FGT are taken advantage of. A compact realization of Spike Timing Dependent Plasticity (STDP) within the SNN is one of the key contributions of this thesis. Finally, the considerations in this thesis extend beyond CMOS to emerging nanodevices. To this end, one promising emerging nanoscale circuit element - memristor - is reviewed and its applicability for analog processing is considered. Furthermore, it is discussed how the FGT technology can be used to prototype computation paradigms compatible with these emerging two-terminal nanoscale devices in a mature and widely available CMOS technology.

Hyperventilation in panic disorder patients and healthy first-degree relatives

Our aim was to observe the induction of panic attacks by a hyperventilation challenge test in panic disorder patients (DSM-IV) and their healthy first-degree relatives. We randomly selected 25 panic disorder patients, 31 healthy first-degree relatives of probands with panic disorder and 26 normal volunteers with no family history of panic disorder. All patients had no psychotropic drugs for at least one week. They were induced to hyperventilate (30 breaths/min) for 4 min and anxiety scales were applied before and after the test. A total of 44.0% (N = 11) panic disorder patients, 16.1% (N = 5) of first-degree relatives and 11.5% (N = 3) of control subjects had a panic attack after hyperventilating (chi² = 8.93, d.f. = 2, P = 0.011). In this challenge test the panic disorder patients were more sensitive to hyperventilation than first-degree relatives and normal volunteers. Although the hyperventilation test has a low sensitivity, our data suggest that there is no association between a family history of panic disorder and hyperreactivity to an acute hyperventilation challenge test. Perhaps cognitive variables should be considered to play a specific role in this association since symptoms of a panic attack and acute hyperventilation overlap.

Smoking and psychiatric disorders: a comorbidity survey

Epidemiological and clinical studies have shown a positive correlation between smoking and psychiatric disorders. To investigate the prevalence of cigarette smoking, 277 psychiatric outpatients with anxiety or depressive disorders (DSM-IV) answered a self-evaluation questionnaire about smoking behavior and were compared with a group of 68 control subjects. The diagnoses (N = 262) were: 30.2% (N = 79) major depressive disorder, 23.3% (N = 61) panic disorder, 15.6% (N = 41) social anxiety disorder, 7.3% (N = 19) other anxiety disorders, and 23.7% (N = 62) comorbidity disorders. Among them, 26.3% (N = 69) were smokers, 23.7% (N = 62) were former smokers and 50.0% (N = 131) were nonsmokers. The prevalence of nicotine dependence among the smokers was 59.0% (DSM-IV). The frequency of cigarette smoking did not show any significant difference among the five classes of diagnosis. The social anxiety disorder patients were the heaviest smokers (75.0%), with more unsuccessful attempts to stop smoking (89.0%). The frequency of former smokers was significantly higher among older subjects and nonsmokers were significantly younger (c² = 9.13, d.f. = 2, P = 0.01). Our data present some clinical implications suggesting that in our psychiatric outpatient sample with anxiety disorder, major depression and comorbidity (anxiety disorder and major depression), the frequency of cigarette smoking did not differ from the frequency found in the control group or in general population studies. Some specific features of our population (outpatients, anxiety and depressive disorders) might be responsible for these results.

Diagnostic profile of inpatients as a determinant of length of stay in a general hospital psychiatric unit

The aim of this study was to determine if the diagnostic profile of inpatients of a psychiatric unit in a general hospital influences the length of stay. The results of a retrospective survey comprising the first 16 years of operation of the Psychiatric Unit of the Ribeirão Preto General Hospital (PURP) showed that the progressive increase observed in the length of stay correlated with the increase in percentage of schizophrenia diagnosis, after the 8th year of hospital operation, and of affective disorders, after the 12th year. The length of hospitalization kept increasing until the 16th year, even though there was no change in the diagnostic profile of the patients admitted to the unit. In a prospective study encompassing the next six months, 61 inpatients were evaluated with the Structured Clinical Interview for DSM-III-R and the Brief Psychiatric Rating Scale (BPRS). The results showed that 82% of the inpatients fulfilled the diagnostic criteria for the schizophrenic or affective disorder spectrum at admission, with a discharge rate slower than for other diagnoses, although the length of hospitalization did not significantly differ among diagnostic categories. The results further demonstrated that in every diagnostic category more than 50% of the patients stayed in hospital for more than one week after reaching a BPRS score equal to 6, indicative of discharge. Overall, these data suggest that the increase in length of hospitalization may be due to a higher percentage of patients with a diagnosis of schizophrenia and affective disorder admitted to the PURP. In addition, patients with low symptomatic levels remained in hospital longer than they should have.

Is avoidant disorder part of the social phobia spectrum in a referred sample of Brazilian children and adolescents?

The diagnosis of avoidant disorder was deleted from the Diagnostic and Statistical Manual of Mental disorders - fourth edition (DSM-IV) based on a `committee decision' suggesting that avoidant disorder is part of the social phobia spectrum. The objective of the present study was to examine the nature of this clinical association in a referred sample of Brazilian children and adolescents. We assessed a referred sample of 375 youths using semi-structured diagnostic interview methodology. Demographic (age at admission to the study and sex) and clinical (level of impairment, age at onset of symptoms and pattern of comorbidity) data were assessed in subsamples of children with avoidant disorder (N = 7), social phobia (N = 26), and comorbidity between both disorders (N = 24). Although a significant difference in the male/female ratio was detected among groups (P = 0.03), none of the other clinical variables differed significantly among subjects that presented each condition separately or in combination. Most of the children with avoidant disorder fulfilled criteria for social phobia. Thus, our findings support the validity of the conceptualization of avoidant disorder as part of the social phobia spectrum in a clinical sample.