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Resume Introduction Nous nous sommes propose de discuter l’eventuel caractere adaptatif des symptomes thymiques reconnus comme pathologiques attenues, dans des contextes evolutifs. Methodologie Nous nous sommes bases sur l’analyse : (1) de l’histoire de l’evolution des symptomes de la depression face a de grands changements sociaux ; (2) du profil thymique des emigrants de la Sardaigne vers differentes metropoles. Resultats et conclusions L’augmentation epidemique de la frequence des troubles de l’humeur, depuis la « maladie anglaise », laisse supposer qu’au moins les formes « legeres » auraient un avantage adaptatif. Sinon, l’expansion des troubles aurait ete autolimitee. D’un point de vue sociobiologique, deux hypotheses soutiennent notre postulat. La premiere est la selection de la societe en phase d’evolution rapide des personnes aux capacites exploratoires developpees et capables de supporter des rythmes biologiques acceleres. La deuxieme est que le changement social stimule le changement psychologique et psychopathologique. Ainsi, il serait plausible que les personnes hyperactives puissent moduler et creer le nouvel environnement. Si ce modele peut expliquer l’epidemie des troubles de l’humeur, sa verification devrait orienter les futures recherches.

Objectives The role of physical activity (PA) in the promotion of mental wellbeing and prevention of psychological disorders in population groups at increased risk for mental health conditions, such as migrant populations, has never been systematically investigated. Methods We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Pubmed, Web of Science, SportDiscus. We included randomized (RCTs), controlled clinical trials (CCT), and pre-post intervention studies, that assessed the efficacy of PA interventions in migrants, compared with any types of controls. Results We included 27 studies (4166 participants) (16 RCTs; 2 CCTs; 9 pre-post design) between 1997 and 2020. Meta-analysis showed a significant beneficial effect of PA over control conditions for general functioning (SMD -0.35, 95% CI -0.83 to −0.16; 400 participants), outcome expectancies (SMD -0.78, 95% CI -1.17 to −0.40; 118 participants), self-efficacy/coping (SMD -0.28, 95% CI -0.52 to −0.03; 269 participants), and psychological symptoms (SMD -0.48, 95% CI -0.88 to −0.08; 6 RCTs; 597 participants). Similar findings were produced by pre-post intervention studies (SMD -0.35, 95% CI -0.60 to −0.10; 7 studies; 302 participants). Conclusions Migrant populations may benefit from PA interventions to improve psychological outcomes. Uncertainty remains about the best approach to promote PA in this population, and future research should consider the complex factors that characterize the migration experience.

Background Violence exposure (direct, indirect, individual, structural) affects youth mental health. Objective We aimed to evaluate the effectiveness of psychosocial interventions in addressing the sequelae of violence exposure on youth (15–24 years old) and evaluate whether moderating factors impact intervention effectiveness. Methods We systematically searched eight databases and reference lists to retrieve any studies of psychosocial interventions addressing mental health among youth aged 15–25 exposed to violence. We assessed study risk of bias using an adapted version of the Downs and Black’s Risk of Bias Scale. Results We identified n = 3077 studies. Sixteen articles representing 14 studies met were included. The studies assessed direct and indirect individual violence exposure at least once. We pooled the data from the 14 studies and evaluated the effects. We estimated an average effect of r+ = 0.57 (RCTs: 95 % CI 0.02–1.13; observational studies: 95 % CI 0.27–86) with some heterogeneity (RCTs: I2 = 78.03, longitudinal studies: I2 = 82.93). The most effective interventions are Cognitive Behavioral Therapy, and Exposure Therapy with an exposure focus. However, due to the small number of studies we are uncertain about benefits of interventions. Conclusions No study assessed structural violence. Therefore, studies are needed to evaluate the effects of psychosocial interventions for youth exposed to direct, indirect, individual and structural violence.

The purpose was to determine if brain damage in Wilson's disease (WD) is different in comorbid bipolar spectrum disorders (BDs), comorbid major depressive disorder (MDD) or without any mood disorders.An observational study was conducted on consecutive patients from a center for WD care. The study sample was divided by psychiatric assessment into WD without any mood disorders, WD with BDs and WD with MDD negative at Mood Disorder Questionnaire (MDQ).Thirty-eight WD patients were recruited (53.2% females): 21 without mood disorders (55.2%), 9 with comorbid BDs (26.7%) and 8 with MDD without MDQ+ (21.1%). The BDs showed a higher frequency of brain damage, reaching statistically significant differences in the basal ganglia (P.001), in the overall brain (P.003) and at the limit in the white matter (P.05).In WD, comorbidity with BDs is associated with earlier evidence of brain damage, especially in the basal ganglia. The results confirm the importance of screening and early diagnosis of BDs in WD. Future follow-up studies on large samples are required to confirm if detection of BDs may be an early marker of brain damage and if a good therapeutic response in BDs may improve the prognosis of WD.

Background: The purpose is to measure the worsening of the Quality of Life (QoL) in people with Multiple Sclerosis (MS) and the concomitant role of co-morbid Major Depressive Disorder (MDD) and Bipolar Disorder (BD), the latter not yet studied even though it was found strictly associated with MS. Methods: Cases: 201 consecutive-MS-patients. Controls: 804 sex-and-age-matched subjects without MS, randomly selected from an epidemiological database study. Psychiatric diagnoses according to DSM-IV were determined by physicians using structured interview tools (ANTAS-SCID). Bipolar Spectrum Disorders were identified by Mood Disorders Questionnaire (MDQ). QoL was measured by SF-12. Results: MS was the strongest determinant in worsening the QoL in the overall sample. Both MDD and BD type-II lifetime diagnoses were significantly associated with a poorer quality of life in the total sample as in cases of MS. In MS the impairment of the QoL attributable to BD type-II was even greater than that in MDD. Limitations: The MS diagnosis was made differently in cases and controls. Although this may have produced false negatives in controls, it would have reinforced the null hypothesis (no role of MS in worsening the QoL); therefore, it does not invalidate the study. Conclusions: MDD as well BD type-II are co-determinants in worsening QoL in MS. Clinicians should consider depressive symptoms as well as the hypomanic and mixed components in MS. Additional research is required to confirm our results and further clarify the manner in which BD and the mixed symptoms of BD type-II may affect awareness of both the underlying disease and psychiatric component and finally to what extent they impact treatment adherence with the available therapies for MS. & 2014 Elsevier B.V. All rights reserved. 1. Background

Background The introduction of screening questionnaires, such as the Mood Disorder Questionnaire (MDQ), has stimulated clinical and epidemiological studies on bipolar disorders. In this work, we studied the item response pattern of the MDQ in the Italian population and compared the results with those of the validation of the MDQ in Asian studies (Chinese and Korean), analyzing similarities and differences among the populations studied. Methods The sample was made up of 2278 participants, distributed as follows: 56.6% females, 50.8% living in the north-central Italy, and 33.7% living in rural areas. The factor analysis was run on the matrix of tetrachoric correlations. The psychometric properties of the MDQ were also studied using the Rasch logistic model. Results The parallel analysis found two significant components. The first includes symptoms referring to acceleration, danger and irritability as risky behaviors, social interaction problems and mental flow. The second includes symptoms referring to self-confidence and energy. With respect to the Korean/Chinese results, the Italian sample, item 11 (“much more sex”), appears related to self-confidence and energy, while in Asia it is connected with items expressing risky behaviors and irritability. Limitations Differences in the frequency of comorbid disorders in Asian and Italian populations should be considered. The results should be confirmed and compared with those of other populations. Conclusions Cultural differences appear to be associated with a different symptomatic expression of bipolar spectrum disorders. Future research will investigate the role of gene–environment interaction in the genesis of these differences.

The aim was to determine the risk of Mood Disorders (MD), particularly Bipolar Disorders (BD), in Multiple Sclerosis (MS) using standardized psychiatric diagnostic tools.Case-control study.201 consecutive-patients with MS.804 sex- and age-matched subjects without MS, randomly selected from a database concurrently used for an epidemiological study on the MD prevalence in the community. Psychiatric diagnoses according to DSM-IV were determined by physicians using structured interview tools (ANTAS-SCID).Compared to controls, MS patients had a higher lifetime prevalence of DSM-IV Major Depressive Disorders (MDD; P0.0001), BD I (P=0.05), BD II (P0.0001) and Cyclothymia (P=0.0001). As people with MS had a higher risk of depressive and bipolar spectrum disorders, ratio MDD/bipolar spectrum disorders was lower among cases (P0.005) indicating a higher association with Bipolar Spectrum Disorders and MS.MS diagnosis was differently collected in cases and controls. Even if this might have produced false negatives in controls, it would have reinforced the null hypothesis of no increased risk for MD in MS; therefore, it does not invalidate the results of the study.This study was the first to show an association between BD and MS using standardized diagnostic tools and a case-control design. The results suggest a risk of under-diagnosis of BD (particularly type II) in MS and caution in prescribing ADs to people with depressive episodes in MS without prior excluding BD. The association between auto-immune degenerative diseases (like MS) and BD may be an interesting field for the study of the pathogenic hypothesis.

Introduction The objective was to estimate the rate of subjects who tested positive at a screening for bipolar disorders among the people insured by a French Health Company, and subsequently to measure treatment patterns. Methods Cross-sectional postal survey on the “Mutuelle Generale de l'Education Nationale” (MGEN) policyholders. A self-rated questionnaire was sent by mail to 20,099 individuals randomly selected among MGEN policyholders. Tools: questionnaire on socio-demographic variables and health-care use; Mood Disorder Questionnaire (MDQ); Composite International Diagnostic Interview Short Form Self-Administered (CIDI-SA). Results Responders were 10,288 (53%). The prevalence of MDQ positivity (MDQ+) was 3.6%. The respondents older than 65 showed the lowest frequencies. High frequencies were recorded by the people who had left work because of long term sickness and by people with invalidity. Subjects having a diagnosis of ICD-10 major depression were found to be at risk. Positive subjects had no more contacts with general practitioners than negative subjects; on the contrary they had more contacts with psychiatrists, alternative medicine professionals, psychologists, psychoanalysts, spiritual guides or welfare workers. MDQ+ subjects had a higher risk to use all kinds of psychodrugs, including antidepressants (27.7%, OR=2.7, CI95% 1.9–3.9). Discussion The prevalence of MDQ+ was similar to the surveys in the USA and Italy. The use of ADs in people with MDQ+ and MDD diagnosis needs to be taken into account when managing the public health-care system. A large rate of positive subjects reported to have used ineffective treatments for bipolar disorders. Limits Relative low response rate and observational design

Objective: To evaluate the association between celiac disease and specific anxiety and depressive disorders and to identify potential common pathogenetic links, with particular regard to thyroid function and autoimmunity. Methods: Cases included 36 adult celiac patients, 25 females and 11 males, aged 18–64 years. Controls comprised 144 healthy subjects matched by sex and age with no clinical evidence or family history of celiac disease. Diagnosis of celiac disease was made on the basis of clinical history and serological criteria. Psychiatric diagnoses were formulated using the International Composite Diagnostic Interview, according to DSM-IV criteria. Thyroid was evaluated by palpation, echography and measurement of serum-free thyroid hormones (FT4, FT3), thyroid-stimulating hormone (TSH) and antithyroid autoantibodies (anti-TPO). Results: Compared to controls, a significantly higher number of celiac patients met criteria for lifetime [15 (41.7%) versus 30 (29.8%), P

The new solid-state complex {[Hf(NEt2)2Cl2(DME)] (DME = 1,2-dimethoxyethane)}, intermediate in the synthesis of the new bis-diethylamide bis-isopropoxy hafnium (IV) complex [Hf(NEt2)2(OiPr)2], has been synthesized, isolated and characterized by NMR spectroscopy and X-ray diffraction. The crystal structure showed the metal to be hexa-coordinated with a distorted octahedral geometry. Catalytic tests for the polymerization of ethylene have been carried out using this intermediate with [(NHMe2Ph)B(C6F5)4] as cocatalyst. The obtained polymer had a high molecular weight and a high melting point, characteristic of a high density polyethylene (HDPE).

Improvement of antipsychotic-induced blepharospasm and involuntary oral-mandibulo movements was observed with the use of the anticonvulsant drug gabapentin among 14 of 16 affectively ill patients who had been exposed to maintenance neuroleptics of the conventional type. In many cases, the movement disorders of these patients had not responded to more standard measures such as clozapine. This finding permits a potential strategy for patients with treatment-emergent tardive dyskinesia, a well-known complication of extended conventional neuroleptic use. Gabapentin, whose mood stabilizing properties have been reported in several clinical reports, represents a more natural treatment in the setting of bipolar spectrum disorders.

Dear sir,As demonstrated recently, celiac disease may be consid-ered as a significant risk factor for mood disorders [1]. Astudy of 36 adult celiac patients from the Internal MedicineDepartment of the University of Cagliari (Sardinia, Italy)and 144 healthy controls from the community celiac patientsshowed significantly elevated risks for major depressivedisorders (OR=2.7), dysthymic disorders (OR=6.2), ad-justment disorders (OR=5.3) and panic disorders(OR=7.3). We hypothesised that the association may bedue to malabsorption of tryptophan leading to a decreasedcentral serotonin synthesis [2]. Other mechanisms may alsobe related to the autoimmune pathogenesis of celiac disease[1]; cytokines produced by immune reactions may exert aneffect on brain circuits related to mood regulation; severalneuroendocrine secretory systems are involved in the con-trol of immune reactions. Therefore, there may be animportant pathogenetic links between autoimmune diseaseand affective disorders [3,4].A new epidemiological study in Sardinia identifiedanother important group of affective disorders, RecurrentBrief Depression (RBD), as being very common in thecommunity with a lifetime prevalence rate of 7.6% (males5.8%, females 9.0%); RBD was especially prevalent inyoung adults aged 18 to 24 years and strongly associatedwith major depression (combined depression) [5], suicideattempts and substance abuse [6]. Comparable to doubledepression [7] combined depression is a more severe dis-order than pure major depression. RBD is therefore a rele-vant health problem as shown in previous studies [8]. Todaythere is still no large scale investigation of RBD, althoughvarious community surveys [6] and the large World HealthOrganization (WHO) study on psychiatric diseases in gen-eral medical practice showed a considerable prevalence ofRBD in all collaborative sites [9]. Consequently, new dataon RBD are of great interest.The data collected for the study on affective disordersand celiac disease [1] allowed also to diagnose RBDaccording to ICD-10 criteria [10]. We found associationbetween RBD and celiac disease, which were even stronger(OR=7.6; 95% C.I. 3.2–17.8) than those with majordepression (OR=2.7) and comparable to that of dysthymia(OR=6.2). Of the 36 celiac patients, 36.1% versus 6.9% ofthe 144 controls manifested RBD. Men and women withceliac disease showed similar rates of RBD (3/9=33.3%and 10/27=37.0%); among women the association wassignificant (OR=7.3; 95% C.I. 2.6–20.5).The high prevalence of RBD and its strong associationwith major depressive disorder, suicidality and substanceabuse meets requirements for collocation into the spectrumof mood disorders. Celiac disorder may be an importantmodel for studying association between mood disordersand contribute to the understanding of the pathogenesis ofRBD and mood disorders in general.References

Family focused therapy is one of the adjunct psychosocial interventions that have significantly produced positive results in the treatment of bipolar disorders by reducing the burden of illness through the prevention of relapses, the reduction of interepisode symptoms, encourage compliance with medication use, and decrease suicide attempts. The family focused therapy is time limited, focus on the “here and now”, as well as symptoms relief and symptom management. These approaches help build trust with family and provides for a safe support network. It is different from individual therapy because it incorporates family members, by allowing them to help treat the identified patient, especially with those who lack insight about their illness and to improve behavior and social skills. The different models of family interventions will be discussed as well as the challenges and issues with boundaries (e.g. informed consent, the rights of the client, information about disclosure and confidentiality as well as the legality of the therapy) need to be made clear in working with a therapist who is open to restructuring some parts of the therapy process, in order to meet the needs and desires of the particular family. Combining family-focused treatment with medications, provides a better outcome than just medication alone or medication and equally intensive individual therapy.