Rudy Bowen

Expression of brain-derived neurotrophic factor mRNA in rat hippocampus after treatment with antipsychotic drugs.

Typical and atypical antipsychotic drugs, though both effective, act on different neurotransmitter receptors and are dissimilar in some clinical effects and side effects. The typical antipsychotic drug haloperidol has been shown to cause a decrease in the expression of brain‐derived neurotrophic factor (BDNF), which plays an important role in neuronal cell survival, differentiation, and neuronal connectivity. However, it is still unknown whether atypical antipsychotic drugs similarly regulate BDNF expression. We examined the effects of chronic (28 days) administration of typical and atypical antipsychotic drugs on BDNF mRNA expression in the rat hippocampus using in situ hybridization. Quantitative analysis revealed that the typical antipsychotic drug haloperidol (1 mg/kg) down‐regulated BDNF mRNA expression in both CA1 (P < 0.05) and dentate gyrus (P < 0.01) regions compared with vehicle control. In contrast, the atypical antipsychotic agents clozapine (10 mg/kg) and olanzapine (2.7 mg/kg) up‐regulated BDNF mRNA expression in CA1, CA3, and dentate gyrus regions of the rat hippocampus compared with their respective controls (P < 0.01). These findings demonstrate that the typical and atypical antipsychotic drugs differentially regulate BDNF mRNA expression in rat hippocampus.

How spiritual values and worship attendance relate to psychiatric disorders in the Canadian population.

Objective: Research into risk and protective factors for psychiatric disorders may help reduce the burden of these conditions. Spirituality and religion are 2 such factors, but research remains limited. Using a representative national sample of respondents, this study examines the relation between worship frequency and the importance of spiritual values and DSM-IV psychiatric and substance use disorders. Method: In 2002, the Canadian Community Health Survey obtained data from about 37 000 individuals aged 15 years or older. While controlling for demographic characteristics, we determined odds ratios for lifetime, 1-year, and past psychiatric disorders, with worship frequency and spiritual values as predictors. Results: Higher worship frequency was associated with lower odds of psychiatric disorders. In contrast, those who considered higher spiritual values important (in a search for meaning, in giving strength, and in understanding lifes difficulties) had higher odds of most psychiatric disorders. Conclusion: This study confirms an association between higher worship frequency and lower odds of depression and it expands that finding to other psychiatric disorders. The association between spiritual values and mood, anxiety, and addictive disorders is complex and may reflect the use of spirituality to reframe life difficulties, including mental disorders.

The association between spiritual and religious involvement and depressive symptoms in a Canadian population.

Data from a large epidemiologic survey were examined to determine the relationship of religious practice (worship service attendance), spiritual and religious self-perception, and importance (salience) to depressive symptoms. Data were obtained from 70,884 respondents older than 15 years from the Canadian National Population Health Survey (Wave II, 1996–1997). Logistic regression was used to examine the relationship of the religious/spiritual variables to depressive symptoms while controlling for demographic, social, and health variables. More frequent worship service attendees had significantly fewer depressive symptoms. In contrast, those who stated spiritual values or faith were important or perceived themselves to be spiritual/religious had higher levels of depressive symptoms, even after controlling for potential mediating and confounding factors. It is evident that spirituality/religion has an important effect on depressive symptoms, but this study underscores the complexity of this relationship. Longitudinal studies are needed to help elucidate mechanisms and the order and direction of effects.

Nature of anxiety comorbid with attention deficit hyperactivity disorder in children from a pediatric primary care setting.

The clinical characteristics of children with comorbid anxiety and attention deficit hyperactivity disorder (ADHD were examined. A sample of children from a pediatric primary care practice was assessed for anxiety disorders and ADHD. We defined four groups of children: (1) anxiety disorders only with no ADHD (n=54); (2) ADHD-only with no anxiety disorder (n=15); (3) neither ADHD nor an anxiety disorder (n=107); and (4) comorbid ADHD and anxiety disorder (n=14). Approximately 50% of children with ADHD had a comorbid anxiety disorder, and approximately 20% of children with an anxiety disorder had comorbid ADHD. The presence of comorbid ADHD and anxiety was associated with more attentional problems, school fears, and mood disorders and lower levels of social competence compared to children who had either ADHD-only or anxiety-only. Children with comorbid anxiety disorders and ADHD have more severe symptoms and are more impaired than children with either condition alone. Interventions need to be tailored to address the complexity of these comorbid conditions and their associated sequelae.

Canadian Psychiatric Inpatient Religious Commitment: An Association With Mental Health

Background: Research indicates that religion may have a positive effect on coping and possibly enhance clinical outcomes. This study aims to de ter mine the level of religious interest of psychiatric in patients and to assess whether religious commitment has an impact on selected outcome variables. Methods: There were 88 consecutive adult patients (50% men) who were admitted to a Canadian tertiary care psychiatry in patient unit and were in ter viewed about their religious beliefs and practices. Patients with a Beck Depression score of 12 or more were included for out come analysis. Results: A total of 59% believed in a God who re wards and punishes, 27% had a high frequency of worship at ten dance, and 35% prayed once or more daily. More frequent worship at tenders had less severe depressive symptoms, shorter cur rent length of stay, higher sat is faction with life, and lower rates of cur rent and life time al cohol abuse (P < 0.05), when com pared with those with less frequent or no worship at ten dance. In contrast, private spirituality was as sociated with lower depressive symptoms and cur rent al co hol use only (P < 0.05), and prayer frequency had no significant as sociations. Discussion: This study indicates that certain religious practices may protect against se verity of symptoms, hospital use, and enhance life sat is faction among psychiatric in patients. This is the first known Canadian study that examines religious commitment among psychiatric in patients.

Patterns of depression and treatment in pregnant and postpartum women.

Objective: To determine the course of depression and the effects of treatment during pregnancy and into the postpartum period. Method: This is a longitudinal study of a community sample of 649 pregnant women who were assessed in early pregnancy (17.4 ± 4.9 weeks), late pregnancy (30.6 ± 2.7 weeks), and postpartum (4.2 ± 2.1 weeks) with the Edinburgh Postnatal Depression Scale (EPDS). Women who scored 12 or more on the EPDS were encouraged to seek assessment and treatment. We used generalized estimating equation modelling to determine the predicted mean depression scores, taking age, ethnicity, history of depression, and previous and present treatment status into account. Results: The unadjusted prevalence of depression (EPDS ≥ 12) was 14.1% (n = 91) in early pregnancy, 10.4% (n = 62) in late pregnancy, and 8.1% (n = 48) postpartum. Twelve per cent of women were engaged in treatment. The predicted mean EPDS score decreased over the course of the pregnancy into the postpartum period, most significantly when women were engaged in counselling or taking psychotropic medication. Counselling was the more common method of treatment during pregnancy and medication in the postpartum period. Women who were depressed and untreated were more likely to be younger, more stressed, have less support, have a history of depression, and use alcohol. Conclusions: We confirm that depressive symptoms improve over the course of the pregnancy into the postpartum period, particularly for women who receive treatment. Our study is unique as it takes the history of depression, present and past treatment status, and the longitudinal nature of the data into account.

Valproic acid enhances axonal regeneration and recovery of motor function after sciatic nerve axotomy in adult rats

It has recently been demonstrated that valproic acid (VPA) robustly promotes neurite outgrowth, activates the extracellular signal regulated kinase pathway, and increases growth cone-associated protein 43 and bcl-2 levels in cultured human neuroblastoma SH-SY5Y cells. We hypothesized that VPA could also enhance peripheral nerve regeneration in adult animals. To test this hypothesis, we examined the effects of VPA (300 mg/kg daily for 16 weeks) on sciatic axonal regeneration following single or conditional axotomies in rats. The results showed that in VPA-treated rats there was a significant increase in the total numbers of regenerated myelinated nerve fibers and reinnervated muscle fibers in comparison with those rats not treated with VPA. As measured by sciatic function index and toe spread index, the motor function of the reinnervated hind limbs of rats receiving single axotomy without VPA treatment significantly improved at week 8 and reached plateau levels at about week 11, whereas the motor function of the reinnervated hind limbs of rats receiving single axotomy plus VPA and rats receiving conditional axotomy with or without VPA treatment significantly improved at week 4 and reached plateau levels at about week 8; there was no significant difference of the motor function among the three later groups. The results demonstrated that VPA is able to enhance sciatic nerve regeneration and recovery of motor function in adult rats, suggesting the potential clinical application of VPA for the treatment of peripheral nerve injury in humans.

Chronic pain and fatigue: Associations with religion and spirituality.

BACKGROUND Conditions with chronic, non-life-threatening pain and fatigue remain a challenge to treat, and are associated with high health care use. Understanding psychological and psychosocial contributing and coping factors, and working with patients to modify them, is one goal of management. An individuals spirituality and/or religion may be one such factor that can influence the experience of chronic pain or fatigue. METHODS The Canadian Community Health Survey (2002) obtained data from 37,000 individuals 15 years of age or older. From these data, four conditions with chronic pain and fatigue were analyzed together -- fibromyalgia, back pain, migraine headaches and chronic fatigue syndrome. Additional data from the survey were used to determine how religion and spirituality affect psychological well-being, as well as the use of various coping methods. RESULTS Religious persons were less likely to have chronic pain and fatigue, while those who were spiritual but not affiliated with regular worship attendance were more likely to have those conditions. Individuals with chronic pain and fatigue were more likely to use prayer and seek spiritual support as a coping method than the general population. Furthermore, chronic pain and fatigue sufferers who were both religious and spiritual were more likely to have better psychological well-being and use positive coping strategies. INTERPRETATION Consideration of an individuals spirituality and/or religion, and how it may be used in coping may be an additional component to the overall management of chronic pain and fatigue.

Mood swings in patients with anxiety disorders compared with normal controls

BACKGROUND About 70-80% of patients with anxiety syndromes suffer from depression. Mood variability including hypomania, cyclothymia and hyperthymia have been described in 40-50% of patients with depression. There is an emerging literature that such variability could also characterize anxiety disorders. The aim of this study was to visually document and quantify mood variability in patients with anxiety disorders. METHODS Twenty patients with anxiety disorders and 22 normal control subjects completed two visual analogue scales (VAS) on depressed mood and high mood, twice per day for 14 days. The Beck Depression Inventory and the Altman Self-Rating Mood Scale were used for concurrent validity. RESULTS On the VAS, patients showed higher levels of depressed and high moods, and greater mood variability than the controls. Variability of depressed and high moods was highly correlated. LIMITATIONS This was a relatively small sample from a single center. Patients were selected by convenience and were under treatment. The control subjects were not interviewed. CONCLUSIONS Subsyndromal mood variability in patients with anxiety disorders can be visually depicted and quantified. The mood variability of patients with anxiety disorders who also complain of mood swings is greater than the mood fluctuations described by normal subjects.

Mood Swings in Patients with Panic Disorder

Depression is frequently found in patients with panic disorder. It is known that patients suffering from panic disorder and depression have more severe symptoms of anxiety and avoidance and respond less well to treatment with antidepressants. The General Behaviour Inventory, an instrument that identifies subjects with subsyndromal and syndromal recurrent mood disorders was completed by 108 patients in a panic disorder program. Thirty-four percent (n = 37) were classified as suffering from a mood disorder. Of the mood disordered patients, 25 of 37(68%) (23% of the total) were classified as suffering from bipolar or cyclothymic mood disorder.