Goldbergappel5451

BACKGROUND This prospective investigation examined relations between dietary trans fatty acid intake of women at midlife in baseline and prevalence of depressive symptoms 5 years later. METHODS Women enrolled in the Study of Women's Health Across the Nation (SWAN) had measures of CES-D depression scores 5 years later and trans fatty acid intake at baseline. Logistic regression models were used to study prospective associations between trans fatty acid intake and depressive symptoms. RESULTS In overall 2376 women, baseline trans fatty acid intake did not predict depressive symptoms (p = 0.139) in model 1 adjusting for total caloric intake. However, after additional adjustment for age, race/ethnicity, education, financial strain, physical activity, BMI, menopausal status, VMS, chronic stress and use of antidepressant in model 2, baseline trans fatty acid intake predicted depressive symptoms 5 years later. This association remained statistically significant when additional controlling for SHBG, testosterone and estradiol in fully adjusted model 3. The fully adjusted OR of depressive symptoms was 1.637 (1.087-2.467) in quartile 4 (the highest) versus quartile 1 (the lowest) of the trans fatty acid intake. Sensitivity analyses performed in women with baseline CES-D score less then 16 showed that this association remained statistically significant. LIMITATIONS Assessment of depression and trans fatty acid intake was based on a self-report scale. CONCLUSIONS Trans fatty acid intake is a predictor for depressive symptoms 5 years later in midlife women independent health and psychosocial profiles. This underlines the importance of targeting trans fatty acid in the prevention of major depression in midlife women. V.BACKGROUND Borderline personality disorder (BPD) affects 1-5% of the population and is characterized by a complex symptomatology and selective functional impairments. Although brain imaging studies have contributed to better characterizing the pathophysiological mechanisms underlying BPD, the white matter (WM) deficits associated with this disorder are still unclear. Therefore, the present review aims at providing an overview of the findings emerged from the available diffusion tensor imaging (DTI) studies on BPD. METHODS From a bibliographic research in PubMed until May 2019, we collected 12 studies that fulfilled our inclusion criteria, including a total sample of 291 BPD subjects and 293 healthy controls. RESULTS Overall, the DTI studies reviewed showed impairments in selective WM tracts that are part of the prefronto-limbic system, including frontal WM (short and long tracts), anterior cingulate cortex, corpus callosum, corona radiata, hippocampal fornix and thalamic radiation, in BPD patients compared to healthy controls. LIMITATIONS Few DTI studies with heterogeneous findings. CONCLUSIONS Overall these results reported that BPD is characterized by selective structural connectivity alterations in prefronto-limbic structures, further supporting the neurobiological model of BPD that suggests the presence of an abnormal modulation of frontal regions over limbic structures. Finally, the results also highlighted that the disrupted WM integrity in selective brain regions may also explain key-aspects of BPD symptomatology, including emotional dysregulation, ambivalence, contradictory behaviors and cognitive dysfunctions. V.OBJECTIVE Rates of pediatric bipolar disorders have increased and some are concerned about diagnostic accuracy. Disruptive mood dysregulation disorder (DMDD) was added to the DSM-5 in 2013. Azacitidine purchase The purpose of this study was to assess diagnostic trends of bipolar disorders and DMDD and to identify predictors of receiving the DMDD diagnosis since implementation of DSM-5. METHOD Kentucky Medicaid claims from 2012-2017 for children under 18 years (N = 814,919; 2012 n = 473,389; 2013 n = 470,918; 2014 n = 499,094; 2015 n = 517,199; 2016 n = 529,048; 2017 n = 535,814) were used. Logistic regression was used to identify predictors of a diagnosis of DMDD in 2015-2017 for a sub-sample (n = 5,071). RESULTS The use of DMDD rose after 2013 and mood disorder NOS decreased steadily through 2017. This decrease was seen when there was a diagnosis of bipolar and oppositional defiant disorder (ODD) combined with mood disorder NOS. A diagnosis of only mood disorder NOS in 2012 did not predict DMDD in 2015-2017, but the same diagnosis in 2013 was predictive (OR 2.14, p = 0.049). The reverse is true for a diagnosis of only ADHD in 2013, which did not predict DMDD in later years, but its presence in 2012 was predictive (OR 1.36, p = 0.010). CONCLUSIONS DMDD increased after 2013, and this was associated with a diagnosis of mood disorder NOS, ADHD, as well as with bipolar disorders comorbid with ODD. Given the complexity of comorbid diagnoses, DMDD may be more accurate in classifying some children. Administrative claims data have limitations, which are discussed; and the data represent only children living in Kentucky. V.BACKGROUND Lithium at therapeutic doses has protective effects against suicide in clinical practice. This meta-analysis aimed to investigate the relationship between lithium concentration in drinking water and suicide mortality in the general population. METHODS A systematic search was conducted in Web of Knowledge, PubMed, ScienceDirect, and Scopus to find papers reporting the crude relationship between drinking water lithium and suicide incidence in the general population until June 2019. The pooled effect measure was expressed as odds ratio (OR) and 95% confidence interval (CI) using the random-effects model. RESULTS We retrieved 308 English original articles, of which 13 ecologic studies with a total sample size of 939 regions and one cohort study with a sample size of 3,740,113 people were eligible for the meta-analysis. A significant relationship was found between the lithium concentration in drinking water and reduced suicide mortality (OR= 0.42; 95% CI 0.27-0.67; p-value less then 0.01). Ten studies reported gender-specific responses to lithium, with the pooled estimates as follows OR= 0.54; 95% CI 0.35-0.84; p-value less then 0.01 for men, OR= 0.70; 95% CI 0.48-1.01; p-value =0.057 for women, and OR= 0.63; 95% CI 0.47-0.83; p-value less then 0.01 for total. LIMITATIONS The study was limited to the assessment of the crude relationship between lithium exposure and suicide rate without considering the role of confounders. CONCLUSIONS Lithium in drinking water is dose-dependently associated with reduced suicide mortality at least in ecological studies. However, we need well-designed clinical trials to confirm the protective effect of drinking water lithium intake against suicide.