Global Epidemiology of Mental Disorders: What Are We Missing?

Background

Population-based studies provide the understanding of health-need required for effective public health policy and service-planning. Mental disorders are an important but, until recently, neglected agenda in global health. This paper reviews the coverage and limitations in global epidemiological data for mental disorders and suggests strategies to strengthen the data.

Methods

Systematic reviews were conducted for population-based epidemiological studies in mental disorders to inform new estimates for the global burden of disease study. Estimates of population coverage were calculated, adjusted for study parameters (age, gender and sampling frames) to quantify regional coverage.

Results

Of the 77,000 data sources identified, fewer than 1% could be used for deriving national estimates of prevalence, incidence, remission, and mortality in mental disorders. The two major limitations were (1) highly variable regional coverage, and (2) important methodological issues that prevented synthesis across studies, including the use of varying case definitions, the selection of samples not allowing generalization, lack of standardized indicators, and incomplete reporting. North America and Australasia had the most complete prevalence data for mental disorders while coverage was highly variable across Europe, Latin America, and Asia Pacific, and poor in other regions of Asia and Africa. Nationally-representative data for incidence, remission, and mortality were sparse across most of the world.

Discussion

Recent calls to action for global mental health were predicated on the high prevalence and disability of mental disorders. However, the global picture of disorders is inadequate for planning. Global data coverage is not commensurate with other important health problems, and for most of the world''s population, mental disorders are invisible and remain a low priority.     

Surgical Stress Abrogates Pre-Existing Protective T Cell Mediated Anti-Tumor Immunity Leading to Postoperative Cancer Recurrence

Anti-tumor CD8⁺ T cells are a key determinant for overall survival in patients following surgical resection for solid malignancies. Using a mouse model of cancer vaccination (adenovirus expressing melanoma tumor-associated antigen (TAA)—dopachrome tautomerase (AdDCT) and resection resulting in major surgical stress (abdominal nephrectomy), we demonstrate that surgical stress results in a reduction in the number of CD8⁺ T cell that produce cytokines (IFNγ, TNFα, Granzyme B) in response to TAA. This effect is secondary to both reduced proliferation and impaired T cell function following antigen binding. In a prophylactic model, surgical stress completely abrogates tumor protection conferred by vaccination in the immediate postoperative period. In a clinically relevant surgical resection model, vaccinated mice undergoing a positive margin resection with surgical stress had decreased survival compared to mice with positive margin resection alone. Preoperative immunotherapy with IFNα significantly extends survival in surgically stressed mice. Importantly, myeloid derived suppressor cell (MDSC) population numbers and functional impairment of TAA-specific CD8⁺ T cell were altered in surgically stressed mice. Our observations suggest that cancer progression may result from surgery-induced suppression of tumor-specific CD8⁺ T cells. Preoperative immunotherapies aimed at targeting the prometastatic effects of cancer surgery will reduce recurrence and improve survival in cancer surgery patients.     

An astigmatid defence volatile against a phytoseiid mite

Numerous semiochemicals have been isolated from several species of astigmatid mites with various identified or unidentified functions. Alarm pheromonal activity is widespread with neryl formate and neral, being the most common compounds eliciting alarm response in conspecifics. The cosmopolitan astigmatid mite Suidasia medanensis (= S. pontifica) Oudemans (Acari: Suidasidae) has been reported to use neral as an alarm pheromone, but neral can also act as an allomone towards predators of oribatid mites. Suidasia medanensis can be utilised as a factitious prey for mass‐rearing of the phytoseiid predatory mite Amblyseius (= Typhlodromips) swirskii (Athias‐Henriot) (Acari: Phytoseiidae), which is used for biological control of insect and mite pests in protected crops. This study investigated the potential defence properties of the S. medanensis volatiles against A. swirskii, comparing the repellency to pollen‐reared (naïve) vs. S. medanensis‐reared (experienced) predators using a synthetic blend of the isomers neral and geranial (1:1) as a model compound. In a repellency bioassay, the synthetic blend elicited a significant repellence to A. swirskii with no difference between naïve and experienced predators. During capture success studies, S. medanensis under repeated attack could release sufficient quantities of the defence volatile to deter 1–5 attacks from A. swirskii, whereas hexane‐treated S. medanensis artificially depleted of volatiles were significantly more vulnerable to an attack. This is the first report of an astigmatid defence volatile with repellent activity to a phytoseiid mite and the starting point to understanding semiochemical interactions in any current or novel factitious predator‐prey mass‐rearing system.     

Circulating RNAs as predictive markers for the progression of type 2 diabetes

Type 2 Diabetes Mellitus (T2DM) is the most prevalent form of diabetes in the USA, thus, the identification of biomarkers that could be used to predict the progression from prediabetes to T2DM would be greatly beneficial. Recently, circulating RNA including microRNAs (miRNAs) present in various body fluids have emerged as potential biomarkers for various health conditions, including T2DM. Whereas studies that examine the changes of miRNA spectra between healthy controls and T2DM individuals have been reported, the goal of this study is to conduct a baseline comparison of prediabetic individuals who either progress to T2DM, or remain prediabetic. Using an advanced small RNA sequencing library construction method that improves the detection of miRNA species, we identified 57 miRNAs that showed significant concentration differences between progressors (progress from prediabetes to T2DM) and non‐progressors. Among them, 26 have been previously reported to be associated with T2DM in either body fluids or tissue samples. Some of the miRNAs identified were also affected by obesity. Furthermore, we identified miRNA panels that are able to discriminate progressors from non‐progressors. These results suggest that upon further validation these miRNAs may be useful to predict the risk of conversion to T2DM from prediabetes.     

A curated gene list for expanding the horizons of pigmentation biology

Over the past century, studies of human pigmentary disorders along with mouse and zebrafish models have shed light on the many cellular functions associated with visible pigment phenotypes. This has led to numerous genes annotated with the ontology term “pigmentation” in independent human, mouse, and zebrafish databases. Comparisons among these datasets revealed that each is individually incomplete in documenting all genes involved in integument‐based pigmentation phenotypes. Additionally, each database contained inherent species‐specific biases in data annotation, and the term “pigmentation” did not solely reflect integument pigmentation phenotypes. This review presents a comprehensive, cross‐species list of 650 genes involved in pigmentation phenotypes that was compiled with extensive manual curation of genes annotated in OMIM, MGI, ZFIN, and GO. The resulting cross‐species list of genes both intrinsic and extrinsic to integument pigment cells provides a valuable tool that can be used to expand our knowledge of complex, pigmentation‐associated pathways.     

Turbidity Structures the Controls of Ecosystem Metabolism and Associated Metabolic Process Domains Along a 75-km Segment of a Semiarid Stream

Ecosystems - Stream ecosystem metabolism contributes to global carbon cycling, yet predicting metabolism across ecosystems remains elusive. Even within stream segments, spatial variation in...     

Low‐coverage reduced representation sequencing reveals subtle within‐island genetic structure in Aldabra giant tortoises

Aldabrachelys gigantea (Aldabra giant tortoise) is one of only two giant tortoise species left in the world and survives as a single wild population of over 100,000 individuals on Aldabra Atoll, Seychelles. Despite this large current population size, the species faces an uncertain future because of its extremely restricted distribution range and high vulnerability to the projected consequences of climate change. Captive‐bred A. gigantea are increasingly used in rewilding programs across the region, where they are introduced to replace extinct giant tortoises in an attempt to functionally resurrect degraded island ecosystems. However, there has been little consideration of the current levels of genetic variation and differentiation within and among the islands on Aldabra. As previous microsatellite studies were inconclusive, we combined low‐coverage and double‐digest restriction‐associated DNA (ddRAD) sequencing to analyze samples from 33 tortoises (11 from each main island). Using 5426 variant sites within the tortoise genome, we detected patterns of within‐island population structure, but no differentiation between the islands. These unexpected results highlight the importance of using genome‐wide genetic markers to capture higher‐resolution genetic structure to inform future management plans, even in a seemingly panmictic population. We show that low‐coverage ddRAD sequencing provides an affordable alternative approach to conservation genomic projects of non‐model species with large genomes.     

Abundance and accessibility of forage for reindeer in forests of Northern Sweden: Impacts of landscape and winter climate regime

The survival of reindeer during winter, their period of greatest food stress, depends largely on the abundance and accessibility of forage in their pastures. In Northern Sweden, realized availability of forage is notably affected by snow conditions and the impacts of forestry. While these factors have been examined in isolation, their combined effect has, to the best of our knowledge to date, not been researched. In this study, vegetation surveys and analysis of snow conditions were undertaken in forest stands at various stages of recovery from clear‐cutting. The variation in abundance and growth of understory species edible by reindeer, such as lichen, was noted as forests matured. The barrier effect of ice lenses in the snow was also measured in these stands. Lichen biomass was significantly affected by a combination of stand maturity, understory vegetation height, and lichen height. Soil disturbance from the processes of felling and competition in the vegetation communities recovering from this disturbance were identified as key drivers of change in lichen biomass. Overall, clear‐cut forests had some of the greatest prevalence of ice lenses in the snow column, and forage availability at these sites was up to 61% less than in mature stands over 58 years in age. It is suggested that alternative silviculture methods are investigated for use in this reindeer herding region, as frequent clear‐cutting and consequent reduction in the average forest stand age and maturity class may be detrimental to reindeer grazing, reducing both abundance of forage, and access to it during winter.