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BackgroundDepression is associated with socioeconomic disadvantage. However, whether and how depression exerts a causal effect on employment remains unclear. We used Mendelian randomisation (MR) to investigate whether depression affects employment and related outcomes in the UK Biobank dataset.MethodsWe selected 227 242 working-age participants (40–64 in men, 40–59 years for women) of white British ethnicity/ancestry with suitable genetic data in the UK Biobank study. We used 30 independent genetic variants associated with depression as instruments. We conducted observational and two-sample MR analyses. Outcomes were employment status (employed vs not, and employed vs sickness/disability, unemployment, retirement or caring for home/family); weekly hours worked (among employed); Townsend Deprivation Index; highest educational attainment; and household income.ResultsPeople who had experienced depression had higher odds of non-employment, sickness/disability, unemployment, caring for home/family and early retirement. Depression was associated with reduced weekly hours worked, lower household income and lower educational attainment, and increased deprivation. MR analyses suggested depression liability caused increased non-employment (OR 1.16, 95% CI 1.06 to 1.26) and sickness/disability (OR 1.56, 95% CI 1.34 to 1.82), but was not causal for caring for home/family, early retirement or unemployment. There was little evidence from MR that depression affected weekly hours worked, educational attainment, household income or deprivation.ConclusionsDepression liability appears to cause increased non-employment, particularly by increasing disability. There was little evidence of depression affecting early retirement, hours worked or household income, but power was low. Effective treatment of depression might have important economic benefits to individuals and society.

BackgroundThere are concerns that COVID-19 mitigation measures, including the ‘lockdown’, may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the initial phase of the COVID-19 lockdown and differences across population subgroups.MethodsRepeated cross-sectional and longitudinal analysis of the UK Household Longitudinal Study, including representative samples of over 27,000 adults (aged 18+) interviewed in four survey waves between 2015 and 2020. A total of 9748 adults had complete data for longitudinal analyses. Outcomes included psychological distress (General Health Questionnaire-12), loneliness, current cigarette smoking, use of e-cigarettes and alcohol consumption. Cross-sectional prevalence estimates were calculated and multilevel Poisson regression assessed associations between time period and the outcomes of interest, as well as differential associations by age, gender, education level and ethnicity.ResultsPsychological distress increased 1 month into lockdown with the prevalence rising from 19.4% (95% CI 18.7% to 20.1%) in 2017–2019 to 30.6% (95% CI 29.1% to 32.3%) in April 2020 (RR=1.3, 95% CI 1.2 to 1.4). Groups most adversely affected included women, young adults, people from an Asian background and those who were degree educated. Loneliness remained stable overall (RR=0.9, 95% CI 0.6 to 1.5). Smoking declined (RR=0.9, 95% CI=0.8,1.0) and the proportion of people drinking four or more times per week increased (RR=1.4, 95% CI 1.3 to 1.5), as did binge drinking (RR=1.5, 95% CI 1.3 to 1.7).ConclusionsPsychological distress increased 1 month into lockdown, particularly among women and young adults. Smoking declined, but adverse alcohol use generally increased. Effective measures are required to mitigate negative impacts on health.

High-purity germanium (HPGe) gamma cameras are an emerging technology for molecular breast imaging (MBI) due to their 2-D lateral spatial resolution, depth-of-interaction (DOI) estimation, and superb energy resolution. In this simulation study, we investigate the potential imaging performance of an opposing view dual-head HPGe breast imaging system using a synthetic-projection technique, which utilizes DOI data with varying degrees of overlap in an ordered-subset estimation-maximization reconstruction algorithm to create 3-D images from which new 2-D projections are then created. The radiation transport simulator Monte Carlo N-particle was employed to generate projections from 10-mm thick HPGe detectors using tungsten parallel-hole collimators with short and wide holes. Simulations modeling 140-keV emissions from various contrast-detail and breast-torso phantoms were conducted. Synthetic projections were generated along with conjugatecounting images from collected HPGe projections. Tumor contrast, signal-to-noise ratio (SNR), and hot-spot detection measurements were used to compare images. Results show that the synthetic projections could resolve more low-contrast tumors compared to single-camera projections and conjugate-counting methods. MBI simulations also showed increased contrast and SNR in synthetic projections compared to individual projections. In conclusion, the HPGe imaging system employing a synthetic-projection technique may offer advantages over individual dual-camera projections or conjugate-counting methods in terms of contrast, SNR, and tumor detectability.

Attention deficit hyperactivity disorder ADHD is a discrete clinical syndromecharacterized by the triad of inattention, hyperactivity, and impulsivity in the context of marked impairments. Molecular genetic studies have been successful in identifying genetic variants associated with ADHD, particularly with DSMIV inattentive and combined subtypes. Quantitative trait locus QTL approaches to linkage and association mapping have yet to be widely used in ADHD research, although twin studies investigating individual differences suggest that genetic liability for ADHD is continuously distributed throughout the population, underscoring the applicability of quantitative dimensional approaches. To investigate the appropriateness of QTL approaches, we tested the familial association between 894 probands with a research diagnosis of DSMIV ADHD combined type and continuous trait measures among 1,135 of their siblings unselected for phenotype. The sibling recurrence rate for ADHD combined subtype was 12.7, yielding a sibling recurrence risk ratio λsib of 9.0. Estimated sibling correlations around 0.2–0.3 are similar to those estimated from the analysis of fraternal twins in population twin samples. We further show that there are no threshold effects on the sibling risk for ADHD among the ADHD probands; and that both affected and unaffected siblings contributed to the association with ADHD trait scores. In conclusion, these data confirm the main requirement for QTL mapping of ADHD by demonstrating that narrowly defined DSMIV combined type probands show familial association with dimensional ADHD symptom scores amongst their siblings. © 2008 WileyLiss, Inc.

This paper reports the results of monitoring all admissions from a prescribed geographical area to an acute psychiatric in-patient unit for a six month period. Members of the hospital social work department assessed all admissions and selected approximately one-half of these for high social work input Demographic data for the whole subject group is examined and compared to the high input group. The case review system outlined by Goldberg and Fruin (1976) is used to describe the clients social problems on admission, as well as the social work task, in terms of practical services and other social worker activities. These findings are compared to those of Goldberg et al. (1977) who examined the social work task in an area office social services department intake team. Despite differences in demographic profiles of the two groups and consequently differing social problems, the social work task in both settings was found to be similar. In both studies 53% of clients were offered some practical (although different service) and the most common social work activities were found to be assessment, information and advice, and mobilizing resources.

A person's health might influence their ability to attend and concentrate at school, obtain, maintain, and be productive in employment, and maintain wellbeing and an active social life. We aimed to better understand the causal effects of health on social and socioeconomic outcomes, to help establish the broader benefits of investing in effective health policy, thereby strengthening the case for cross-governmental action to improve health and its wider determinants at the population level.