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Research round-up
Insight
Research round-up
Alfred Pasieka/Science Photo Library
SSRIs, statins, and depression
For more on SSRIs, statins, and depression see Am J Psychiatry 2016; published online May 3. http://dx.doi.org/10.1176/appi. ajp.2016.15040463 For more on adult ADHD see JAMA Psychiatry 2016; published online May 18. http://dx.doi. org/10.1001/ jamapsychiatry.2016.0383 For more on workaholism and mental health see PLoS One 2016; 11: e0152978 For more on smoking in pregnancy and offspring schizophrenia see Am J Psychiatry 2016; published online May 24. http://dx.doi. org/10.1176/appi. ajp.2016.15060800 For more on hyperthermia for depression see JAMA Psychiatry 2016; published online May 12. http://dx.doi.org/10.1001/ jamapsychiatry.2016.1031 For more on neurodevelopment of anxiety see Biol Psychiatry 2016; published online May 9. http://dx.doi.org/10.1016/j. biopsych.2016.04.021
606
Investigators of a Danish nationwide cohort study have used linked registry data (1997–2012) to examine the antidepressant effects of SSRIs in combination with a statin. Researchers included 872 216 participants using SSRIs, comprising 642 058 personyears of follow-up; 113 108 (13%) participants were also using statins. Analysis suggested a lower risk for hospital psychiatric contacts in the cohort who had concomitantly used a statin in addition to an SSRI than in SSRI users without additional statin use (adjusted hazard ratio [HR] 0·75, 95% CI 0·69–0·82). The risk for psychiatric hospital contacts for depression was likewise lower in the combination group than in the group given SSRI treatment alone (adjusted HR 0·64, 95% CI 0·55–0·75).
Adult ADHD: a late-onset syndrome? The concept of adult attention deficit hyperactivity disorder (ADHD) existing as a separate entity to childhood ADHD is the focus of new research. In the study, researchers analysed data for 5249 individuals included in the Brazilian 1993 Pelotas Birth Cohort Study who were followed up to the age of 18 years or 19 years. When assessed at age 11 years, the prevalence of childhood ADHD was 9% (occurring in 393 of 4426 individuals). Of the 492 (12%) of 4039 individuals with ADHD at the assessment at age 18–19 years, 60 (12%) also had the diagnosis at the 11 year assessment. After exclusion of comorbidities, the prevalence of young adult ADHD was 6% (256 of 4039 individuals) in the cohort, 11% (n=29) of whom also had a diagnosis of ADHD in childhood.
and psychiatric symptoms. Using an online survey, researchers assessed workaholism and psychiatric symptoms in 16 426 respondents who worked full time or part time. The mean age of participants was 37·3 years (SD 11·4) and 10 487 (64%) were women. 1287 (8%) participants were classified as workaholics according to the Bergen Work Addiction Scale. Clinical levels of ADHD were higher in workaholics than in non-workaholics (33% vs 13%; logistic regression analysis adjusted odds ratio [OR] 2·26, 95% CI 1·96–2·60), as were rates of obsessive-compulsive disorder (26% vs 9%; 2·21, 1·88–2·58), anxiety (34% vs 12%; 2·42, 2·09–2·81), and depression (9% vs 3%; 1·56, 1·21–1·99; p<0·001 for all comparisons). In adjusted logistic regression analyses, workaholism was associated with female sex (OR 1·77, 95% CI 1·53–2·04) and inversely associated with age (0·97, 0·96–0·97).
clinical trial. Researchers randomly allocated participants with major depressive disorder to a single session of whole-body hyperthermia (core body temperature increased to 38·5°C; n=17) or sham intervention (n=17). At 6 week follow-up, the active intervention group had lower scores on the Hamilton Depression Rating Scale compared with the sham intervention group (12·40 [SD 5·45] vs 17·21 [4·78]; difference −4·27, 95% CI −7·94 to −0·61; p = 0·02); differences between the groups were evident at 1 week follow-up (14·80 [5·40] vs 20·86 [3·33]; −6·53, 95% CI −9·90 to −3·16; p <0·001). Although sweating and nausea occurred more frequently in the whole-body hyperthermia group, overall, there were no significant differences in adverse events between the two groups, and no occurrences of serious adverse events.
Neurodevelopment of anxiety Smoking in pregnancy and offspring schizophrenia With data from a Finnish national birth cohort, researchers have investigated the relation between nicotine exposure prenatally and the risk of subsequent schizophrenia in offspring. In the case-control study, researchers used registry information for livebirths from 1983 to 1998 followed to 2009. 977 cases of schizophrenia occurred during followup and were matched to 977 controls for the study. Information on prenatal nicotine exposure was assessed using cotinine levels from archived maternal serum samples. In adjusted analysis, increasing log-transformed maternal cotinine was associated with a greater risk of schizophrenia in offspring (odds ratio 3·41, 95% CI 1·86–6·24).
Workaholism and mental health
Hyperthermia for depression
Results from a Norwegian crosssectional study highlight the associations between workaholism
The effect of whole-body hyperthermia on symptoms of depression has been investigated in a small single-centre
Insight into the possible sex differences in neurodevelopment and the association with anxiety symptoms is provided by results from a study by Kaczkurkin and colleagues. Researchers analysed cerebral imaging data for young people included in a crosssectional study. No sex differences in trait anxiety were apparent in the early-pubertal (n=139) or midpubertal (n=277) cohorts; however, in the post-pubertal cohort (n=452), greater trait anxiety was present in females than in males (p=0·13). Trait anxiety was accompanied by increased cerebral blood flow in various regions, including the insula (p<0·001), fusiform gyrus (p=0·003), and the left amygdala (p<0.001). Further analysis suggested that increased blood flow in the left amygdala might partly account for some of the postpubertal sex differences in trait anxiety (p=0·022).
Seema Kang www.thelancet.com/psychiatry Vol 3 July 2016
Research round-up
Alfred Pasieka/Science Photo Library
SSRIs, statins, and depression
For more on SSRIs, statins, and depression see Am J Psychiatry 2016; published online May 3. http://dx.doi.org/10.1176/appi. ajp.2016.15040463 For more on adult ADHD see JAMA Psychiatry 2016; published online May 18. http://dx.doi. org/10.1001/ jamapsychiatry.2016.0383 For more on workaholism and mental health see PLoS One 2016; 11: e0152978 For more on smoking in pregnancy and offspring schizophrenia see Am J Psychiatry 2016; published online May 24. http://dx.doi. org/10.1176/appi. ajp.2016.15060800 For more on hyperthermia for depression see JAMA Psychiatry 2016; published online May 12. http://dx.doi.org/10.1001/ jamapsychiatry.2016.1031 For more on neurodevelopment of anxiety see Biol Psychiatry 2016; published online May 9. http://dx.doi.org/10.1016/j. biopsych.2016.04.021
606
Investigators of a Danish nationwide cohort study have used linked registry data (1997–2012) to examine the antidepressant effects of SSRIs in combination with a statin. Researchers included 872 216 participants using SSRIs, comprising 642 058 personyears of follow-up; 113 108 (13%) participants were also using statins. Analysis suggested a lower risk for hospital psychiatric contacts in the cohort who had concomitantly used a statin in addition to an SSRI than in SSRI users without additional statin use (adjusted hazard ratio [HR] 0·75, 95% CI 0·69–0·82). The risk for psychiatric hospital contacts for depression was likewise lower in the combination group than in the group given SSRI treatment alone (adjusted HR 0·64, 95% CI 0·55–0·75).
Adult ADHD: a late-onset syndrome? The concept of adult attention deficit hyperactivity disorder (ADHD) existing as a separate entity to childhood ADHD is the focus of new research. In the study, researchers analysed data for 5249 individuals included in the Brazilian 1993 Pelotas Birth Cohort Study who were followed up to the age of 18 years or 19 years. When assessed at age 11 years, the prevalence of childhood ADHD was 9% (occurring in 393 of 4426 individuals). Of the 492 (12%) of 4039 individuals with ADHD at the assessment at age 18–19 years, 60 (12%) also had the diagnosis at the 11 year assessment. After exclusion of comorbidities, the prevalence of young adult ADHD was 6% (256 of 4039 individuals) in the cohort, 11% (n=29) of whom also had a diagnosis of ADHD in childhood.
and psychiatric symptoms. Using an online survey, researchers assessed workaholism and psychiatric symptoms in 16 426 respondents who worked full time or part time. The mean age of participants was 37·3 years (SD 11·4) and 10 487 (64%) were women. 1287 (8%) participants were classified as workaholics according to the Bergen Work Addiction Scale. Clinical levels of ADHD were higher in workaholics than in non-workaholics (33% vs 13%; logistic regression analysis adjusted odds ratio [OR] 2·26, 95% CI 1·96–2·60), as were rates of obsessive-compulsive disorder (26% vs 9%; 2·21, 1·88–2·58), anxiety (34% vs 12%; 2·42, 2·09–2·81), and depression (9% vs 3%; 1·56, 1·21–1·99; p<0·001 for all comparisons). In adjusted logistic regression analyses, workaholism was associated with female sex (OR 1·77, 95% CI 1·53–2·04) and inversely associated with age (0·97, 0·96–0·97).
clinical trial. Researchers randomly allocated participants with major depressive disorder to a single session of whole-body hyperthermia (core body temperature increased to 38·5°C; n=17) or sham intervention (n=17). At 6 week follow-up, the active intervention group had lower scores on the Hamilton Depression Rating Scale compared with the sham intervention group (12·40 [SD 5·45] vs 17·21 [4·78]; difference −4·27, 95% CI −7·94 to −0·61; p = 0·02); differences between the groups were evident at 1 week follow-up (14·80 [5·40] vs 20·86 [3·33]; −6·53, 95% CI −9·90 to −3·16; p <0·001). Although sweating and nausea occurred more frequently in the whole-body hyperthermia group, overall, there were no significant differences in adverse events between the two groups, and no occurrences of serious adverse events.
Neurodevelopment of anxiety Smoking in pregnancy and offspring schizophrenia With data from a Finnish national birth cohort, researchers have investigated the relation between nicotine exposure prenatally and the risk of subsequent schizophrenia in offspring. In the case-control study, researchers used registry information for livebirths from 1983 to 1998 followed to 2009. 977 cases of schizophrenia occurred during followup and were matched to 977 controls for the study. Information on prenatal nicotine exposure was assessed using cotinine levels from archived maternal serum samples. In adjusted analysis, increasing log-transformed maternal cotinine was associated with a greater risk of schizophrenia in offspring (odds ratio 3·41, 95% CI 1·86–6·24).
Workaholism and mental health
Hyperthermia for depression
Results from a Norwegian crosssectional study highlight the associations between workaholism
The effect of whole-body hyperthermia on symptoms of depression has been investigated in a small single-centre
Insight into the possible sex differences in neurodevelopment and the association with anxiety symptoms is provided by results from a study by Kaczkurkin and colleagues. Researchers analysed cerebral imaging data for young people included in a crosssectional study. No sex differences in trait anxiety were apparent in the early-pubertal (n=139) or midpubertal (n=277) cohorts; however, in the post-pubertal cohort (n=452), greater trait anxiety was present in females than in males (p=0·13). Trait anxiety was accompanied by increased cerebral blood flow in various regions, including the insula (p<0·001), fusiform gyrus (p=0·003), and the left amygdala (p<0.001). Further analysis suggested that increased blood flow in the left amygdala might partly account for some of the postpubertal sex differences in trait anxiety (p=0·022).
Seema Kang www.thelancet.com/psychiatry Vol 3 July 2016