7.11.2005

Childhood adversities as risk factors for adult mental disorders

Pirkola, S; Isometsa, E; Aro, H; Kestila, L; Hamalainen, J; Veijola, J; Kiviruusu, O; Lonnqvist, J

SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 40 (10): 769-777 OCT 2005

Background: The sex- specific role of stressful or traumatic childhood experiences and adverse circumstances in developing adulthood mental disorders is complex and still in need of comprehensive research.

Methods: Within the Health 2000 project in Finland, a representative sample of 4,076 subjects aged 30 - 64 years were investigated to examine associations between a set of retrospectively self- reported adverse environmental factors during childhood ( 0 - 16 years) and mental disorders diagnosed in the past 12 months by the Munich Composite International Diagnostic Interview.

Results: Of the 60% of adults reporting at least one childhood adversity, 17% had a current ( past 12 months) mental disorder, compared to 10% of the non- reporters. A moderate dose - response relationship between the total number of adversities and current disorders was observed. Paternal mental health problems associated particularly strongly with male depressive disorders ( OR 4.46), and maternal mental health problems with female depressive disorders ( OR 3.20). Although seldom reported, maternal alcohol problems associated with alcohol use disorders in both sexes. Being bullied at school and childhood family discord predicted a variety of adulthood disorders in both sexes. All these four adversity items were more typical for depressive disorders with an earlier onset. Among females, more adversities were associated with mental disorders and their statistical significance was greater than among males.

Conclusions: There are marked sex differences and several diagnosis- related patterns in the associations between reported childhood experiences and environmental circumstances and adulthood mental disorders. The impact of adversities is probably composed of a wide range of factors from direct causal associations to complex, interacting environmental effects. Variations in the reported associations reflect the differing genetic and environmental transmission mechanisms of mental disorders.

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Prevalence and diagnosis of schizophrenia based on register, case record and interview data in an isolated Finnish birth cohort born 1940-1969

Arajarvi, R; Suvisaari, J; Suokas, J; Schreck, M; Haukka, J; Hintikka, J; Partonen, T; Lonnqvist, J

SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 40 (10): 808-816 OCT 2005

Introduction: Schizophrenia occurs worldwide but the prevalence varies markedly. In Finland, schizophrenia is most prevalent in the northeastern region. Our aims were to reassess the register-, case record- and interview- based lifetime prevalence in a genetically homogeneous birth cohort from an isolate population with earlier reported high prevalence of schizophrenia and a chromosome linkage to chromosome 1q.

Methods: We identified all patients with a diagnosis of schizophrenia [ International Classification of Diseases ( ICD)- 8, ICD- 9 or ICD- 10 codes], born 1940 - 1969 in the isolate ( n= 282) and alive ( n= 237) in 1998 using the Hospital Discharge, Disability Pension and Free Medicine Registers. The corresponding birth cohort of 14,817 persons and 12,368 alive in 1998 was identified from the National Population Register. We validated 69% of the register diagnosis by making DSM- IV consensus diagnoses, and interviewed 131 ( 55%) of the 237 patients with SCID- I and SCID- II.

Results: The register- based lifetime prevalence was 1.5% for schizophrenia and 1.9% for schizophrenia spectrum psychotic disorders: in birth cohorts born 1945 to 1959, the latter prevalence was especially high 2.4%). Of those with a register diagnosis of schizophrenia spectrum psychotic disorder, 69% or 63% also received a record- based consensus diagnosis or SCID interview diagnosis of schizophrenia, and the prevalence was 0.9 - 1.3 and 0.7 - 1.2%, respectively, when we reassessed most of the register- based cases. The cumulative incidence of schizophrenia spectrum psychotic disorders in the total birth cohort was 1.9%.

Conclusion: In this isolate, the register, DSM- IV consensus and SCID interview- based lifetime prevalence of schizophrenia was internationally high. For genetic research work, the register diagnosis should be reassessed using either structured interview or the best estimate consensus diagnosis.

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Dietary Westernisation: conceptualisation and measurement in Mauritius

Uusitalo, U; Sobal, J; Moothoosamy, L; Chitson, P; Shaw, J; Zimmet, P; Tuomilehto, J

PUBLIC HEALTH NUTRITION, 8 (6): 608-619 SEP 2005

Objectives: The aims of the study were to provide information that will contribute to conceptualising what is called 'dietary Westernisation', and to provide an example of measuring it on an individual level.

Design: Food consumption frequency and demographic data on adults in Mauritius were examined in 1988, 1992 and 1998. In 1992, a 24-hour recall was also included. The cross-sectional samples consisted of 1115 (age 25-74 years) Mauritians in 1987/88, 1917 (age 30-74 years) in 1992 and 2239 (age 20-74 years) in 1998. Principal components analysis was carried out on daily consumption frequencies of 10 indicator foods (white rice, white bakery bread, pulses, processed meat, poultry, fresh/frozen fish, butter, margarine, whole milk and skimmed/low-fat milk). Correlations between dietary patterns and selected food consumption frequencies were examined in each survey year.

Results: Four dietary patterns were identified as being related to dietary Westernisation. The Traditional dietary pattern was characterised by higher consumption frequencies of Indian breads, salted/smoked fish and sugar-sweetened tea. The Western dietary pattern was characterised by higher consumption frequencies of cakes/pastries, meat and many Western fast foods like burgers, but, surprisingly, also by brown bread, breakfast cereals and salad. The Bread/butter dietary pattern predominantly described more frequent consumption of bread compared with rice. The Margarine/milk dietary pattern was inconsistently related with staple foods. Younger, educated and wealthier Mauritians appeared to adopt Western dietary patterns earlier.

Conclusions: This study suggests that relatively few indicator foods are needed for measuring dietary Westernisation. Dietary Westernisation in a non-Western country may also include shifts towards voluntary consumption of healthier foods.

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Completed suicide among subjects receiving psychotherapy

Pallaskorpi, SK; Isometsa, ET; Henriksson, MM; Suominen, KH; Lonnqvist, JK

PSYCHOTHERAPY AND PSYCHOSOMATICS, 74 (6): 388-391 2005

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Urocortin 1 expression in five pairs of rat lines selectively bred for differences in alcohol drinking

Turek, VF; Tsivkovskaia, NO; Hyytia, P; Harding, S; Le, AD; Ryabinin, AE

PSYCHOPHARMACOLOGY, 181 (3): 511-517 SEP 2005

Rationale: There is accumulating evidence that the neuropeptide urocortin 1 (Ucn 1) is involved in alcohol consumption. Thus far, however, most studies have been performed in mice. Objectives: The purpose of the present study was to characterize Ucn1 expression in rats selectively bred for either high or low alcohol intake. Methods: Brains from naive male rats of five pairs of independently selected lines (iP/iNP, AA/ANA, HARF/LARF, HAD1/LAD1, and HAD2/LAD2) were analyzed by immunohistochemistry. Results: Significant differences were found between iP/iNP, HARF/LARF, and HAD2/LAD2 in number of Ucn1-containing cells in the Edinger-Westphal (EW) nucleus (the main source of Ucn1 in the brain), whereas no significant differences were found between HAD1/LAD1 and AA/ANA. Similarly, significant differences in the optical density of Ucn1 immunoreactivity in EW were found between iP/iNP, HARF/LARF, and HAD2/LAD2, whereas no differences on this measure were found between HAD1/LAD1 and AA/ANA. In the lateral septum (LS, the main projection area of Ucn1-containing neurons in the rat), significant differences were found only between AA/ANA and HAD2/LAD2; however, a meta-analysis indicated that across all five lines, preferring animals bad a significantly greater number of Ucn1-positive fibers than nonpreferring animals. Conclusions: These results provide evidence that, in rats, Ucn1 may be involved in regulation of alcohol intake, and that this regulation may occur through the Ucn1 projections to LS.

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Trajectories of growth among children who have coronary events as adults

Barker, DJP; Osmond, C; Forsen, TJ; Kajantie, E; Eriksson, JG

NEW ENGLAND JOURNAL OF MEDICINE, 353 (17): 1802-1809 OCT 27 2005

Background: Low birth weight is a risk factor for coronary heart disease. It is uncertain how postnatal growth affects disease risk.

Methods: We studied 8760 people born in Helsinki from 1934 through 1944. Childhood growth had been recorded. A total of 357 men and 87 women had been admitted to the hospital with coronary heart disease or had died from the disease. Coronary risk factors were measured in a subset of 2003 people.

Results: The mean body size of children who had coronary events as adults was below average at birth. At two years of age the children were thin; subsequently, their body-mass index (BMI) increased relative to that of other children and had reached average values by 11 years of age. In simultaneous regressions, the hazard ratios associated with a 1 SD increase in BMI were 0.76 (95 percent confidence interval, 0.66 to 0.87; P<0.001) at 2 years and 1.14 (95 percent confidence interval, 1.00 to 1.31; P=0.05) at 11 years among the boys. The corresponding figures for the girls were 0.62 (95 percent confidence interval, 0.46 to 0.82; P=0.001) and 1.35 (95 percent confidence interval, 1.02 to 1.78; P=0.04). Low BMI at 2 years of age and increased BMI from 2 to 11 years of age were also associated with raised fasting insulin concentrations (P<0.001 for both).

Conclusions: On average, adults who had a coronary event had been small at birth and thin at two years of age and thereafter put on weight rapidly. This pattern of growth during childhood was associated with insulin resistance in later life. The risk of coronary events was more strongly related to the tempo of childhood gain in BMI than to the BMI attained at any particular age.

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Self-employment and risk aversion - evidence from psychological test data

Ekelund, J; Johansson, E; Jarvelin, MR; Lichtermann, D

LABOUR ECONOMICS, 12 (5): 649-659 OCT 2005

This paper investigates the effect of risk aversion on an individual's probability of being self-employed by using psychometric data from a large, population-based cohort of Finns born in 1966. We found that our measure of risk aversion,. a facet of a basic temperament dimension, ham avoidance, has a significant negative effect on self-employment status. Since this measure is directly derived from a highly valid biosocial theory of normal personality variation (Arch. Gen. Psychiatry 44 (1987) 573) whose scalable dimensions manifest well before adulthood and remain stabile over lifetime, we argue that risk aversion is a psychological factor causative of the choice to become self-employed. (c) 2004 Elsevier B.V. All rights reserved.

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Severe acute respiratory syndrome coronavirus fails to activate cytokine-mediated innate immune responses in cultured human monocyte-derived dendritic cells

Ziegler, T; Matikainen, S; Ronkko, E; Osterlund, P; Sillanpaa, M; Siren, J; Fagerlund, R; Immonen, M; Melen, K; Julkunen, L

JOURNAL OF VIROLOGY, 79 (21): 13800-13805 NOV 2005

Activation of host innate immune responses was studied in severe acute respiratory syndrome coronavirus (SCV)-infected human A549 lung epithelial cells, macrophages, and dendritic cells (DCs). In all cell types, SCV-specific subgenomic mRNAs were seen, whereas no expression of SCV proteins was found. No induction of cytokine genes (alpha interferon [IFN-alpha], IFN-beta, interleukin-28A/B [IL-28A/B], IL-29, tumor necrosis factor alpha, CCL5, or CXCL10) or IFN-alpha/beta-induced MxA gene was seen in SCV-infected A549 cells, macrophages, or DCs. SCV also failed to induce DC maturation (CD86 expression) or enhance major histocompatibility complex class II expression. Our data strongly suggest that SCV fails to activate host cell cytokine gene expression in human macrophages and DCs.

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Distribution and determinants of serum high-sensitive C-reactive protein in a population of young adults. The Cardiovascular Risk in Young Finns Study

Raitakari, M; Mansikkaniemi, K; Marniemi, J; Viikari, JSA; Raitakari, OT

JOURNAL OF INTERNAL MEDICINE, 258 (5): 428-434 NOV 2005

Objectives: Elevated C-reactive protein (CRP) is a suggested risk marker for cardiovascular disease. We aimed at investigating the distribution and determinants of CRP levels in young adults.

Design: Population-based study.

Subjects: A total of 2120 participants aged 24-39 years.

Main outcome measures: Distribution of CRP, and the relationship between CRP and risk factors.

Results: CRP concentration (mean ± SD) was 1.43 ± 3.26 mg L-1 in men, 1.36 ± 2.36 mg L-1 in women who did not use oral contraceptives (OC) and 3.69 ± 6.01 mg L-1 in women who used OCs. In total, 8.8% of men, 10.3% of non-OC user women and 35.3% of OC user women had CRP concentration > 3 mg L-1 (recommended cut-off point of high risk for cardiovascular disease). In univariate analysis, CRP was associated with obesity indices and physical activity amongst both sexes. In men, the multivariate correlates of CRP included waist circumference (P < 0.0001), smoking (< 0.0001) and HDL cholesterol (P = 0.024) (inverse association). These three variables explained 21.9% (model R-2) of the total variation in CRP, waist circumference having the greatest influence (partial R-2 = 19.6%). In women, the multivariate correlates of CRP included OC use (P < 0.0001), body mass index (BMI) (P < 0.0001), triglycerides (< 0.0001) and physical activity (P = 0.025) (inverse association). These four variables explained 38.2% (model R-2) of the total variation in CRP, with OC use (partial R-2 = 18.4%) and BMI (partial R-2 = 18.0%) having the greatest influence.

Conclusions: The determinants of CRP level include obesity and smoking in men, and obesity, OC use and physical activity in women. About one in three of healthy women who use OCs have CRP concentration exceeding 3 mg L-1.

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Conjugate pneumococcal vaccine in HIV-infected Ugandans and the effect of past receipt of polysaccharide vaccine

Miiro, G; Kayhty, H; Watera, C; Tolmie, H; Whitworth, JAG; Gilks, CF; French, N

JOURNAL OF INFECTIOUS DISEASES, 192 (10): 1801-1805 NOV 15 2005

We investigated the immunogenicity of a 7-valent conjugate pneumococcal vaccine (CPV) in human immunodeficiency virus - infected Ugandan adults and measured the effect of past pneumococcal polysaccharide vaccine (PPV) receipt given as part of a controlled trial. Two doses of CPV, 4 weeks apart, were given to 54 past PPV recipients and 55 past placebo recipients (84% female; median CD4 cell count, 251 cells/mu L [range, 1 - 936 cells/mu L]). Postvaccination anticapsular immunoglobulin G (IgG) concentrations were directly correlated with CD4 cell count (P < .01 for all serotypes). There were significant increases in anticapsular IgG concentrations for all serotypes after the first dose (P < .01) and for all serotypes except 14 and 9V after the second dose. Past receipt of PPV did not affect vaccine response.

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Suicide prevention strategies - A systematic review

Mann, JJ; Apter, A; Bertolote, J; Beautrais, A; Currier, D; Haas, A; Hegerl, U; Lonnqvist, J; Malone, K; Marusic, A; Mehlum, L; Patton, G; Phillips, M; Rutz, W; Rihmer, Z; Schmidtke, A; Shaffer, D; Silverman, M; Takahashi, Y; Varnik, A; Wasserman, D; Yip, P; Hendin, H

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 294 (16): 2064-2074 OCT 26 2005

Context: In 2002, an estimated 877000 lives were lost worldwide through suicide. Some developed nations have implemented national suicide prevention plans. Although these plans generally propose multiple interventions, their effectiveness is rarely evaluated.

Objectives: To examine evidence for the effectiveness of specific suicide-preventive interventions and to make recommendations for future prevention programs and research.

Data Sources and Study Selection: Relevant publications were identified via electronic searches of MEDLINE, the Cochrane Library, and PsychINFO databases using multiple search terms related to suicide prevention. Studies, published between 1966 and June 2005, included those that evaluated preventative interventions in major domains; education and awareness for the general public and for professionals; screening tools for at-risk individuals; treatment of psychiatric disorders; restricting access to lethal means; and responsible media reporting of suicide.

Data Extraction: Data were extracted on primary outcomes of interest: suicidal behavior (completion, attempt, ideation), intermediary or secondary outcomes (treatment seeking, identification of at-risk individuals, antidepressant prescription/use rates, referrals), or both. Experts from 15 countries reviewed all studies. Included articles were those that reported on completed and attempted suicide and suicidal ideation; or, where applicable, intermediate outcomes, including help-seeking behavior, identification of at-risk individuals, entry into treatment, and antidepressant prescription rates. We included 3 major types of studies for which the research question was clearly defined: systematic reviews and meta-analyses (n=10); quantitative studies, either randomized controlled trials (n = 18) or cohort studies (n =24); and ecological, or population-based studies (n=41). Heterogeneity of study populations and methodology did not permit formal meta-analysis; thus, a narrative synthesis is presented.

Data Synthesis: Education of physicians and restricting access to lethal means were found to prevent suicide. Other methods including public education, screening programs, and media education need more testing.

Conclusions: Physician education in depression recognition and treatment and restricting access to lethal methods reduce suicide rates. Other interventions need more evidence of efficacy. Ascertaining which components of suicide prevention programs are effective in reducing rates of suicide and suicide attempt is essential in order to optimize use of limited resources.

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Transcriptional downregulation of the lactase (LCT) gene during childhood

Rasinpera, H; Kuokkanen, M; Kolho, KL; Lindahl, H; Enattah, NS; Savilahti, E; Orpana, A; Jarvela, I

GUT, 54 (11): 1660-1661 NOV 2005

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Three cases of cardiac complications associated with Campylobacter jejuni infection and review of the literature

Hannu, T; Mattila, L; Rautelin, H; Siitonen, A; Leirisalo-Repo, M

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 24 (9): 619-622 SEP 2005

Presented here are three cases of acute cardiac disease (myocarditis, myopericarditis, and acute atrial fibrillation) associated with Campylobacter jejuni infection, followed by a review of the corresponding literature. Since Campylobacter jejuni is the most common cause of human bacterial enteritis in developed countries, these cases emphasize the importance of keeping cardiac complications in mind when treating patients with acute gastroenteritis due to this pathogen.

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Apparent temperature and first coronary event in Rome and Helsinki

Picciotto, S; Stafoggia, M; Forastiere, F; Lanki, T; Pekkanen, J; Perucci, CA

EPIDEMIOLOGY, 16 (5): S49-S49 SEP 2005

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Airgene - Air pollution and inflammatory response in myocardial infarction survivors: Gene-environment interaction in a high risk group

Peters, A; Antoniades, C; Bellander, T; Chrysohoou, C; Forastiere, F; Henneberger, A; Illig, T; Jacquemin, B; Koenig, W; Lanki, T; Ljungman, P; Picciotto, S; Rueckerl, R; Salomaa, V; Sunyer, J

EPIDEMIOLOGY, 16 (5): S66-S67 SEP 2005

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Mortality in Kuwait due to pm from oil fires after the Gulf War: Combining expert elicitation assessments

Tuomisto, JT; Wilson, A; Cooke, RM; Tainio, M; Evans, JS

EPIDEMIOLOGY, 16 (5): S74-S75 SEP 2005

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Daily variation in size-fractionated particulate air pollution and cardiovascular and respiratory mortality

Pekkanen, J; Tiittanen, P; Aalto, P; Kulmala, M

EPIDEMIOLOGY, 16 (5): S76-S76 SEP 2005

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Cancer risk in fisherman families: A retrospective cohort study in Finland

Verkasalo, PK; Turunen, A; Pukkala, E; Kiviranta, H; Vartianen, T

EPIDEMIOLOGY, 16 (5): S76-S76 SEP 2005

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Continuously measured personal PM2.5 and heart rate variability in subjects with coronary heart disease

Lanki, T; Timonen, KL; de Hartog, JJ; Peters, A; Tarkiainen, T; Pekkanen, J

EPIDEMIOLOGY, 16 (5): S86-S86 SEP 2005

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Sleep duration and breast cancer: A prospective cohort study

Verkasalo, PK; Lillberg, K; Stevens, RG; Hublin, C; Partinen, M; Koskenvuo, M; Kaprio, J

EPIDEMIOLOGY, 16 (5): S115-S115 SEP 2005

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What risk assessment can tell us about the mortality impacts of the Kuwaiti oil fires

Evans, JS; Wilson, A; Tuomisto, JT; Tainio, M; Cooke, RM

EPIDEMIOLOGY, 16 (5): S137-S138 SEP 2005

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Binge drinking in midlife and dementia risk

Jarvenpaa, T; Rinne, JO; Koskenvuo, M; Raiha, I; Kaprio, J

EPIDEMIOLOGY, 16 (6): 766-771 NOV 2005

Background: Studies examining the long-term effects of alcohol consumption on cognitive functioning have produced conflicting results. Our goal was to determine whether a long follow-up period combined with information about drinking patterns, in addition to total alcohol consumption, would provide new insights about the relationship of alcohol use with dementia risk.

Methods: A population-based cohort of 554 Finnish twins, who had provided data on alcohol consumption in questionnaires in 1975 and 198 1, was followed for 25 years. Subjects were age 65 years or older at the time of dementia assessment in 1999-2001. Dementia risk was analyzed with respect to varying patterns of alcohol use by log-linear modeling, adjusted for age, sex, and education.

Results: By the end of follow-up, 103 participants had developed dementia. Binge drinking (ie, alcohol exceeding the amount of 5 bottles of beer or a bottle of wine on I occasion at least monthly), as reported in 1975, was associated with a relative risk of 3.2 (95% confidence interval = 1.2-8.6) for dementia. Passing out at least twice as a result of excessive alcohol use during the previous year, as reported in 1981, was associated with a relative risk of 10.5 (2.4-46) for dementia in drinkers.

Conclusions: Binge drinking in midlife is associated with an increased risk of dementia.

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Effect of the Pro12Ala polymorphism of the PPAR gamma 2 gene on serum adiponectin changes

Mousavinasab, F; Tahtinen, T; Jokelainen, J; Koskela, P; Vanhala, M; Oikarinen, J; Keinanen-Kiukaanniemi, S; Laakso, M

ENDOCRINE, 27 (3): 307-309 AUG 2005

The Pro12Ala polymorphism of the peroxisome proliferator-activated receptor gamma 2 (PPAR gamma 2) gene and adiponectin, a protein secreted from adipose tissue, have been associated with insulin sensitivity. The present study demonstrates that in Finnish servicemen who were on a high-caloric diet for 6 mo only subjects with the Ala 12 allele of PPAR gamma 2 had a significant increase in adiponectin levels with weight loss induced by heavy exercise. This study demonstrates an interaction of genetic and environmental factors in the regulation of serum adiponectin concentrations.

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Somatic and psychological characteristics of noise-sensitive adults in Finland

Heinonen-Guzejev, M; Vuorinen, HS; Mussalo-Rauhamaa, H; Heikkila, K; Koskenvuo, M; Kaprio, J

ARCHIVES OF ENVIRONMENTAL HEALTH, 59 (8): 410-417 AUG 2004

The authors examined the relationship of noise sensitivity with health status and psychological factors in individuals < 70 yr of age in Finland. Subjects (n = 1,355) were selected from a 1988 case-control study, based on the Finnish Twin Cohort, that assessed noise sensitivity, lifetime noise exposure, and hypertension. Other health status and psychological factors were obtained from a questionnaire that had been administered to the same individuals in 1981. Statistical analysis showed that noise sensitivity was associated significantly with hypertension, emphysema, use of psychotropic drugs (i.e., sleeping pills, tranquilizers, and pain relievers), stress, smoking, and hostility, even after adjustment for lifetime noise exposure. These results indicate that noise sensitivity has both psychological and somatogenic components.

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The calculated genetic barrier for drug resistance mutations in six different non-B subtypes and two CRFs in a large European dataset is largely similar to subtype B

van de Vijver, DAMC; Wensing, AMJ; Angarano, G; Asjo, B; Balotta, C; Boeri, E; Camacho, R; Chaix, MI; Costagliola, D; de Coul, EO; de Luca, A; Maljkovic, I; de Mendoza, C; Derdelinckx, I; Grossman, Z; Hamouda, O; Hatzakis, A; Grossman, Z; Hamouda, O; Hatzakis, A; Hoepelman, IM; Hemmer, R; Horban, A; Korn, K; Kucherer, C; Leitner, T; Loveday, C; MacRae, E; Meyer, L; Nielsen, C; Ormaasen, V; Perrin, L; Paraskevis, D; Puchhammer-Stockl, E; Ruiz, L; Salminen, M; Schmit, JCC; Schneider, F; Schuurman, R; Soriano, V; Stanczak, G; Stanojevic, M; Vandamme, AM; Van Laethem, K; Violin, M; Wilbe, K; Yerly, S; Zazzi, M; Boucher, CAB

Group Author: SPREAD Programme

ANTIVIRAL THERAPY, 9 (4): U74-U75 AUG 2004

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Updated European recommendations for the clinical use of HIV drug resistance testing

Vandamme, AM; Sonnerborg, A; Ait-Khaled, M; Albert, J; Asjo, B; Bacheler, L; Banhegyi, D; Boucher, C; Brun-Vezinet, F; Camacho, R; Clevenbergh, P; Clumeck, N; Dedes, N; De Luca, A; Doerr, HW; Faudon, JL; Gatti, G; Gerstoft, J; Hall, WW; Hatzakis, A; Hellmann, N; Horban, A; Lundgren, JD; Kempf, D; Miller, M; Miller, V; Myers, TW; Nielsen, C; Opravil, M; Palmisano, L; Perno, CF; Phillips, A; Pillay, D; Pumarola, T; Ruiz, L; Salminen, M; Schapiro, J; Schmidt, B; Schmit, JC; Schuurman, R; Shulse, E; Soriano, V; Staszewski, S; Vella, S; Youle, M; Ziermann, R; Perrin, L

ANTIVIRAL THERAPY, 9 (6): 829-848 DEC 2004

In most European countries, HIV drug resistance testing has become a routine clinical tool. However, its practical implementation in a clinical context is demanding. The European HIV Drug Resistance Panel was established to make recommendations to clinicians and virologists on this topic and to propose quality control measures. The panel recommends resistance testing for the following indications: i) drug-naive patients with acute or recent infection; ii) therapy failure, including suboptimal treatment response, when treatment change is considered; iii) pregnant HIV-1-infected women and paediatric patients with detectable viral load when treatment initiation or change is considered; and iv) genotype source patient when post-exposure prophylaxis is considered. In addition, for drug-naive patients with chronic infection in whom treatment is to be started, the panel suggests that resistance testing should be strongly considered and recommends testing the earliest sample for drug resistance if suspicion of resistance is high or prevalence of resistance in this population exceeds 10%. The panel does not favour genotyping over phenotype, however it is anticipated that genotyping will be used more often because of its greater accessibility, lower cost and faster turnaround time. For the interpretation of resistance data, clinically validated systems should be used to the greatest extent possible. It is mandatory that laboratories performing HIV resistance tests take regular part in quality assurance programs. Similarly, it is necessary that HIV clinicians and virologists take part in continuous education and meet regularly to discuss problematic clinical cases. Indeed, resistance test results should be used in the context of all other clinically relevant information for predicting therapy response. The panel also encourages the timely collection of epidemiological information to estimate the impact of transmission of resistant HIV and the prevalence of HIV-1 non-B subtypes in the different European countries.

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Differences in the frequency of minor substitutions between HIV-1 subtypes and their potential impact on the genetic barrier for resistance to protease inhibitors

van de Vijver, DAMC; Wensing, AMJ; Angarano, G; Asjo, B; Balotta, C; Boeri, E; Camacho, R; Chaix, ML; Costagliola, D; de Coul, ELMO; de Luca, A; Maljkovic, I; de Mendoza, C; Derdelinckx, I; Grossman, Z; Hamouda, O; Hatzakis, A; Hoepelman, IM; Hemmer, R; Horban, A; Korn, K; Kucherer, C; Leitner, T; Loveday, C; MacRae, E; Meyer, L; Nielsen, C; Ormaasen, V; Perrin, L; Paraskevis, D; Puchhammer-Stockl, E; Ruiz, L; Salminen, M; Schmit, JCC; Schneider, F; Schuurman, R; Soriano, V; Stanczak, G; Stanojevic, M; Vandamme, AM; Van Laethem, K; Violin, M; Wilbe, K; Yerly, S; Zazzi, M; Boucher, CAB

Group Author: SPREAD Programme

ANTIVIRAL THERAPY, 10 (4): S145-S145 132 2005

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Premorbid intellectual functioning in bipolar disorder and schizophrenia: Results from a cohort study of male conscripts

Tiihonen, J; Haukka, J; Henriksson, M; Cannon, M; Kieseppa, T; Laaksonen, I; Sinivuo, J; Lonnqvist, J

AMERICAN JOURNAL OF PSYCHIATRY, 162 (10): 1904-1910 OCT 2005

Objective: Premorbid intellectual impairment has been described in schizophrenia, but little is known about premorbid intellectual functioning in bipolar disorder or other psychoses. In this study, premorbid intellectual ability was investigated in individuals with bipolar disorder, schizophrenia, or other psychoses.

Method: Results on verbal, arithmetic, and visuospatial reasoning tests were obtained for 195,019 apparently healthy male subjects conscripted into the Finnish Defense Forces during 1982-1987 (mean age, 19.9 years). Linkage with the Finnish Hospital Discharge Register (mean follow-up time, 7.1 years) identified conscripts later diagnosed with bipolar disorder (N=100), schizophrenia (N=621), or other psychoses (N=527).

Results: Poor performance on the visuospatial reasoning test at age 20 was associated with higher risks for all three disorders. The odds ratios indicating the difference in risk of illness between the lowest and highest of nine performance categories were 34.65 (95% confidence interval [CI], 4.05-296.44) for bipolar disorder, 13.76 (95% CI=5.49-34.47) for schizophrenia, and 4.28 (95% CI=2.09-8.77) for other psychoses. In contrast, the higher the score for arithmetic reasoning, the greater the risk of bipolar disorder; a high score was associated with a more than 12-fold greater risk. Verbal test performance was not associated with higher risk for psychiatric disorder..

Conclusions: These results indicate that premorbid visuospatial reasoning is impaired in bipolar disorder and schizophrenia and, to a smaller extent, in other psychoses. This suggests that a subtle neurodevelopmental aberration is involved in the etiology of bipolar disorder and schizophrenia. High arithmetic test performance may be associated with greater risk for bipolar disorder.

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Linkage findings from COGA and NAG: Independent studies suggest a gene on chromosome 2p with pleiotropic effects on multiple psychiatric phenotypes

Dick, D; Dunn, G; Bierut, L; Goate, A; Rice, J; Wang, J; Hinrichs, A; Foroud, T; Hesselbrock, V; Madden, P; Agrawal, A; Pergadia, M; Saccone, S; Heath, A

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 15-16 SEP 5 2005

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Genes behind complex disease in a simple population: Schizophrenia susceptibility genes in Finland

Paunio, T; Partonen, T; Lonnqvist, J; Peltonen, L

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 26-26 SEP 5 2005

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Role of allelic variants of dopamine receptor genes in personality traits: A Finnish population-based birth cohort study

Nyman, ES; Loukola, A; Varilo, T; Ekelund, J; Joukamaa, M; Freimer, N; Jarvelin, M; Peltonen, L

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 51-51 SEP 5 2005

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Genome-wide scan for autism in an extended pedigree from a regional subisolate in Finland

Ylisaukko-oja, T; Varilo, T; Kilpinen, H; Alen, R; Vanhala, R; Kempas, E; Elmohandness, M; von Wendt, L; Jarvela, I; Peltonen, L

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 72-72 SEP 5 2005

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Association analysis of candidate genes on 16p12 in Finnish bipolar disorder families

Palo, OM; Silander, K; Ekholm, JM; Kieseppa, T; Partonen, T; Lonnqvist, J; Paunio, T; Peltonen, L

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 79-80 SEP 5 2005

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Candidate gene study of bipolar family sample: SNP variation in COMT, NRG1 and DTNBP1 genes

Soronen, P; Palo, OM; Kieseppa, T; Ellonen, P; Ekholm, J; Peltonen, JO; Turunen, J; Pietilainen, O; Lonnqvist, J; Peltonen, L; Partonen, T; Paunio, T

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 92-92 SEP 5 2005

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Association analysis of three schizophrenia candidate genes in Finnish family sample: AKT1, dysbindin and neuregulin 1

Turunen, JA; Peltonen, J; Hennah, W; Pietilainen, O; Loukola, A; Paunio, T; Ekelund, J; Varilo, T; Silander, K; Partonen, T; Lonnqvist, J; Peltonen, L

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 94-94 SEP 5 2005

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Clustering of phenotypic features in familial schizophrenia

Paunio, T; Tuulio-Henriksson, A; Heino, J; Ruotsalainen, L; Koivisto, M; Partonen, T; Schreck, M; Mannila, H; Peltonen, L; Lonnqvist, J

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 112-113 SEP 5 2005

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Two biologically interacting genes, DISC1 and NDE1, associate with schizophrenia and visual working memory functions

Hennah, W; Tuulio-Henriksson, A; Paunio, T; Ekelund, J; Kilpinen, H; Palo, OM; Silander, K; Partonen, T; Lonnqvist, J; Peltonen, L

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 123-123 SEP 5 2005

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Testing for association of regional candidate genes on 7q22 in Finnish schizophrenia families

Peltonen, JO; Loukola, A; Silander, K; Paunio, T; Ekelund, J; Varilo, T; Heikkila, K; Partonen, T; Lonnqvist, J; Peltonen, L

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 132-132 SEP 5 2005

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Candidate gene study on chromosome 1q32 in Finnish schizophrenia families

Pylkko, E; Kestila, M; Varilo, T; Silander, K; Loukola, A; Hennah, W; Partonen, T; Paunio, T; Lonnqvist, J; Peltonen, L

AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS, 138B (1): 133-133 SEP 5 2005

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Use of laboratory markers and the audit questionnaire by primary care physicians to detect alcohol abuse by patients

Aalto, M; Seppa, K

ALCOHOL AND ALCOHOLISM, 40 (6): 520-523 NOV-DEC 2005

Aims: To evaluate how often laboratory markers [Mean corpuscular volume (MCV), Gamma-glutamyl transferase, Aspartate aminotransferase, Alanine aminotransferase, or Carbohydrate-deficient transferrin (CDT)] and the Alcohol Use Disorders Identification Test (AUDIT) are used to detect alcohol abuse in primary health care.

Methods: Cross-sectional self-administered questionnaire survey to all 3193 primary health care physicians in Finland. Response rate was (65.7%). Results: CDT was used at least occasionally by 43.4% of the physicians. Corresponding figures were 53.4% for conventional alcohol laboratory markers (MCV, transaminases) and 67.0% for AUDIT. Almost all the respondents used some laboratory marker to detect alcohol abuse. The use of brief alcohol intervention was associated with the greater likelihood that a physician uses different methods to detect alcohol abuse. The data also indicates that gender, age, and having a specialist licence influence activity in using different methods.

Conclusions: Considering the ambivalences in relation to alcohol issues in health care, the use of CDT and AUDIT are reasonably frequent. This may indicate that tools to facilitate the work may also help in adapting new activities.

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