Focus: Addiction: Relapse Prevention and the Five Rules of Recovery

There are four main ideas in relapse prevention. First, relapse is a gradual process with distinct stages. The goal of treatment is to help individuals recognize the early stages, in which the chances of success are greatest. Second, recovery is a process of personal growth with developmental milestones. Each stage of recovery has its own risks of relapse. Third, the main tools of relapse prevention are cognitive therapy and mind-body relaxation, which are used to develop healthy coping skills. Fourth, most relapses can be explained in terms of a few basic rules. Educating clients in these rules can help them focus on what is important: 1) change your life (recovery involves creating a new life where it is easier to not use); 2) be completely honest; 3) ask for help; 4) practice self-care; and 5) don’t bend the rules.     

Prevalence and trends of common mental disorders from 2007-2009 to 2019-2022: results from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS), including comparison of prevalence rates before vs. during the COVID-19 pandemic

Up-to-date information on the prevalence and trends of common mental disorders is relevant to health care policy and planning, owing to the high burden associated with these disorders. In the first wave of the third Netherlands Mental Health Survey and Incidence Study (NEMESIS-3), a nationally representative sample was interviewed face-to-face from November 2019 to March 2022 (6,194 subjects; 1,576 interviewed before and 4,618 during the COVID-19 pandemic; age range: 18-75 years). A slightly modified version of the Composite International Diagnostic Interview 3.0 was used to assess DSM-IV and DSM-5 diagnoses. Trends in 12-month prevalence rates of DSM-IV mental disorders were examined by comparing these rates between NEMESIS-3 and NEMESIS-2 (6,646 subjects; age range: 18-64 years; interviewed from November 2007 to July 2009). Lifetime DSM-5 prevalence estimates in NEMESIS-3 were 28.6% for anxiety disorders, 27.6% for mood disorders, 16.7% for substance use disorders, and 3.6% for attention-deficit/hyperactivity disorder. Over the last 12 months, prevalence rates were 15.2%, 9.8%, 7.1%, and 3.2%, respectively. No differences in 12-month prevalence rates before vs. during the COVID-19 pandemic were found (26.7% pre-pandemic vs. 25.7% during the pandemic), even after controlling for differences in socio-demographic characteristics of the respondents interviewed in these two periods. This was the case for all four disorder categories. From 2007-2009 to 2019-2022, the 12-month prevalence rate of any DSM-IV disorder significantly increased from 17.4% to 26.1%. A stronger increase in prevalence was found for students, younger adults (18-34 years) and city dwellers. These data suggest that the prevalence of mental disorders has increased in the past decade, but this is not explained by the COVID-19 pandemic. The already high mental disorder risk of young adults has particularly further increased in recent years.     

高苯丙氨酸血症大鼠脑内单胺类递质的研究

以3d龄Sprague-Dawley大鼠腹腔注射苯丙氨酸(Phe)诱导高苯丙氨酸血症,荧光法测定大脑皮层及其突触体中去甲肾上腺素(NE)、多巴胺(DA)和5-羟色胺(5-HT)含量;Y型电迷宫法测其学习记忆能力.结果显示:高苯丙氨酸血症大鼠大脑皮层NE、DA及5-HT含量降低38.6%～67.4%,突触体中NE、DA和5-HT含量降低51.9%～70.2%,学习记忆能力明显低于对照组.结果提示,苯酮尿症智力障碍可能与大脑皮层及其突触体中某些单胺类递质含量降低相关.     

The brain as a source of relapsing Trypanosoma brucei infection in mice after chemotherapy.

During the aparasitaemic period following chemotherapy of all three strains of T. brucei infections in mice, successful transmission as shown by subsequent parasitaemia, was regularly achieved following the inoculation of homogenates of brain tissue into recipient mice. Transmission with blood obtained at the same time was consistently negative and in the case of T. brucei TREU 667, homogenates of other organs were non-infective. The implications of this central nervous system involvement are discussed with particular reference to its use as a model for relapsing infections after therapy in man.     

A Turkish family with Nance-Horan syndrome due to a novel mutation

Nance-Horan Syndrome (NHS) is a rare X-linked syndrome characterized by congenital cataract which leads to profound vision loss, characteristic dysmorphic features and specific dental anomalies. Microcornea, microphthalmia and mild or moderate mental retardation may accompany these features. Heterozygous females often manifest similarly but with less severe features than affected males. We describe two brothers who have the NHS phenotype and their carrier mother who had microcornea but not cataract. We identified a previously unreported frameshift mutation (c.558insA) in exon 1 of the NHS gene in these patients and their mother which is predicted to result in the incorporation of 11 aberrant amino acids prior to a stop codon (p.E186Efs11X). We also discussed genotype–phenotype correlation according to relevant literature.     

Neural Correlates of Body Integrity Dysphoria

1. Download : Download high-res image (130KB)
2. Download : Download full-size image

     

城市绿地对居民身心福祉的影响

城市绿地是人工与自然耦合的城市景观之一,是改善居民居住环境重要组成部分,更是提高居民身心健康的有效途径。以杭州主城区为研究对象,通过GIS技术对城市绿地遥感图像进行解译得到杭州主城区绿地空间布局图,同时,以人口密度为阻力要素,基于交通路网的500m网络距离可达范围内绿地数量和面积作为分类标准。通过对45个高、中、低不同档次的居民区进行问卷调查得到665份居民感知数据并进行统计整理。利用结构方程模型进行以绿地数量及游玩时间为标准的组间分析,区别不同组别的差异及其原因,分析城市绿地数量、面积,居民认知、动机,绿地吸引力等与居民身心健康福祉及满意度之间的关系。结果显示:城市绿地数量、居民游玩绿地次数时间等与居民福祉有显著的正向关系;居民对绿地作用的认知、去往绿地的动机进一步影响居民身心健康福祉;城市绿地的自身引力会激发居民去往绿地的积极性,从而增加去往绿地频次。另外,不同社会属性的个体对绿地需求不同,所产生的福祉效应及满意度也会有所差异。从增加居民区周围的街头绿地及邻里公园数量、提升绿地吸引力、提升居民对城市绿地作用的认知3个方面对城市绿地今后的发展规划提出建议。     

Unique gene alterations are induced in FACS‐purified Fos‐positive neurons activated during cue‐induced relapse to heroin seeking

Cue‐induced heroin seeking after prolonged withdrawal is associated with neuronal activation and altered gene expression in prefrontal cortex (PFC). However, these previous studies assessed gene expression in all neurons regardless of their activity state during heroin seeking. Using Fos as a marker of neural activity, we describe distinct molecular alterations induced in activated versus non‐activated neurons during cue‐induced heroin seeking after prolonged withdrawal. We trained rats to self‐administer heroin for 10 days (6 h/day) and assessed cue‐induced heroin seeking in extinction tests after 14 or 30 days. We used fluorescent‐activated cell sorting (FACS) to purify Fos‐positive and Fos‐negative neurons from PFC 90 min after extinction testing. Flow cytometry showed that Fos‐immunoreactivity was increased in less than 10% of sparsely distributed PFC neurons. mRNA levels of the immediate early genes fosB, arc, egr1, and egr2, as well as npy and map2k6, were increased in Fos‐positive, but not Fos‐negative, neurons. In support of these findings, double‐label immunohistochemistry indicated substantial coexpression of neuropeptide Y (NPY)‐ and Arc‐immunoreactivity in Fos‐positive neurons. Our data indicate that cue‐induced relapse to heroin seeking after prolonged withdrawal induces unique molecular alterations within activated PFC neurons that are distinct from those observed in the surrounding majority of non‐activated neurons.     

Multiplex ligation-dependant probe amplification study of children with idiopathic mental retardation in South India

BACKGROUND:

Mental retardation (MR) is a heterogeneous dysfunction of the central nervous system exhibiting complex phenotypes and has an estimated prevalence of 1-3% in the general population. However, in about 50% of the children diagnosed with any form of intellectual disability or developmental delay the cause goes undetected contributing to idiopathic intellectual disability.

MATERIALS AND METHODS:

A total of 122 children with developmental delay/MR were studied to identify the microscopic and submicroscopic chromosome rearrangements by using the conventional cytogenetics and multiplex ligation dependent probe amplification (MLPA) analysis using SALSA MLPA kits from Microbiology Research Centre Holland [MRC] Holland.

RESULTS:

All the recruited children were selected for this study, after thorough clinical assessment and metaphases prepared were analyzed by using automated karyotyping system. None was found to have chromosomal abnormality; MLPA analysis was carried out in all subjects and identified in 11 (9%) patients.

CONCLUSION:

Karyotype analysis in combination with MLPA assays for submicroscopic micro-deletions may be recommended for children with idiopathic MR.     

Modelling diseases with relapse and nonlinear incidence of infection: a multi-group epidemic model

In this paper, we introduce a basic reproduction number for a multi-group SIR model with general relapse distribution and nonlinear incidence rate. We find that basic reproduction number plays the role of a key threshold in establishing the global dynamics of the model. By means of appropriate Lyapunov functionals, a subtle grouping technique in estimating the derivatives of Lyapunov functionals guided by graph-theoretical approach and LaSalle invariance principle, it is proven that if it is less than or equal to one, the disease-free equilibrium is globally stable and the disease dies out; whereas if it is larger than one, some sufficient condition is obtained in ensuring that there is a unique endemic equilibrium which is globally stable and thus the disease persists in the population. Furthermore, our results suggest that general relapse distribution are not the reason of sustained oscillations. Biologically, our model might be realistic for sexually transmitted diseases, such as Herpes, Condyloma acuminatum, etc.