BACKGROUND: Affective disorders probably have a multifactorial aetiology, both biological and psychosocial factors may be of importance at onset as well as at relapses. The aim of the study was to investigate how the age of onset of bipolar and unipolar disorder relates to family history of affective disorder, early parental separation and life events. A second purpose of this study was to analyze the importance of life events preceding the first and subsequent episodes of affective disorder. METHODS: The case records of 282 patients (161 females/121 males; mean age 56) were investigated. They all had a DSM-IV based diagnosis of either bipolar I/II (67%) or unipolar (33%) disorder. Variables, such as family history, early parental loss and life events according to Paykel life events scale, were examined. RESULTS: We found a significantly lower age of onset in bipolar patients with a family history of affective disorder (28.9 vs. 33.9 years). Bipolar patients with preceding life events had a higher age of onset (33.1 vs. 28.3 years). Moreover, bipolar patients with heredity, had less life events at onset. For the bipolar, as well as the unipolar group, life stressors more frequently preceded the first episode of affective disorder than the subsequent episodes. Limitations: The major limitation of this study is the retrospective approach, with e.g. difficulties to decide whether a life event plays a role in aetiology of affective disorder or is its consequence. CONCLUSIONS: Bipolar patients with high constitutional vulnerability have an earlier age of onset and need less stress factors to become ill. Better knowledge about the stress- and the vulnerability-factors in affective disorder might contribute to development of individually tailored therapeutic strategies in future.
Optically stimulated luminescence (OSL) has been used for estimation of the accumulated doses in quartz inclusions obtained from two fired bricks, extracted in July 2004 from a building located in the forested surroundings of the recreational area Novie Bobovichi, the Bryansk Region, Russia. The area was significantly contaminated by Chernobyl fallout with initial (137)Cs ground deposition level of approximately 1.1 MBq m(-2). The accumulated OSL doses in sections of the bricks varied from 141 to 207 mGy, of which between 76 and 146 mGy are attributable to Chernobyl fallout. Using the OSL depth-dose profiles obtained from the exposed bricks and the results from a gamma-ray-survey of the area, the Chernobyl-related cumulative gamma-ray dose for a point detector located in free air at a height of 1m above the ground in the study area was estimated to be ca. 240 mGy for the time period starting on 27 April 1986 and ending on 31 July 2004. This result is in good agreement with the result of deterministic modelling of the cumulative gamma-ray dose in free air above undisturbed ground from the Chernobyl source in the Bryansk Region. Over the same time period, the external Chernobyl-related dose via forest pathway for the most exposed individuals (e.g., forest workers) is estimated to be approximately 39 mSv. Prognosis for the external exposure from 1986 to 2056 is presented and compared with the predictions given by other investigators of the region.
The aim of this study was to register and compare clinical oral mucosal lesions and gingival recessions associated with the use of two different smokeless tobacco products, loose snuff and portion-bag packed snuff. Selected for the study were 252 men (mean age 36.3 yr) of whom 184 (mean age 36.0 yr) used exclusively loose snuff and 68 (mean age 36.9 yr) exclusively portion-bag snuff. Oral mucosal lesions were registered according to a four-grade clinical scale. There was a significantly larger proportion of less pronounced lesions, Degrees 1 and 2, among the users of portion-bag snuff compared with the users of loose snuff. This was also valid when differences in consumption data were considered. Smokeless tobacco-associated gingival recessions were found in 42 (23.5%) subjects among the users of loose snuff and in 2 (2.9%) subjects among the users of portion-bag snuff. The results of this study support previous preliminary assessments that clinical changes of the oral mucosa and the gingival margin are less pronounced among those who use portion-bag snuff than among those who use loose snuff.
From a total material of 184 Swedish users of loose packed moist snuff and 68 users of portion-bag packed moist snuff, cases were selected from subgroups based on a four-point clinical grading scale. The selected material for the study comprised 70 cases (ten from each clinical grade group, no Degree 4 lesion was found among portion-bag users). Features recognized in biopsies from these cases together with findings in previous studies correlated well with the use of a four-point scale for the grading of clinical changes, especially in the context of discriminating lesions for which special efforts should be undertaken to make the patient stop or change the snuff dipping habit and for selecting patients in whom regular clinical follow-up including a biopsy should be carried out. In this article is also discussed the labeling of the clinical oral mucosal changes seen at the site where a quid of snuff is regularly placed. The conceptual use of "snuff dippers' lesions" is recommended instead of e.g. snuff-induced leukoplakia.
We investigated the mode of inheritance of cluster headache in 370 families. The probands were from a neurological clinic in Jutland and two departments of neurology in Copenhagen County, Denmark. The criteria of the International Headache Society were used. The patterns of segregation of cluster headache were assessed by complex segregation analysis performed with the computer program POINTER. Of the 370 probands with cluster headache, 25 had 36 relatives with cluster headache. The segregation analysis suggests that cluster headache has an autosomal dominant gene (p
The Internet can reach a large number of people at a low cost and offers the opportunity for 2-way communication. The present study was designed to evaluate the effects of applied relaxation and problem solving in the treatment of recurrent headache when implemented via the Internet and E-mail. A group of 102 headache sufferers were randomized to 2 conditions: a 6-week treatment condition or a waiting-list control. The dropout was proportionately large (56%), and at the end of the study there were 20 participants in the treatment condition and 25 participants in the control condition. Results showed statistically significant reductions in headache for the treated participants. In 50% of these, the reduction was clinically significant. The Internet has the potential to serve as a complement in the treatment of recurrent headache and deserves further study.
BACKGROUND: The Burn Specific Health Scale (BSHS) is an outcome scale designed specifically for burn patients. The scale has been abbreviated (BSHS-A) and revised (BSHS-R). We used a factor analytic approach to further improve the scale for clinical use. METHODS: Two hundred forty-eight of 350 former patients (70.9%) treated at the Uppsala Burn Unit between 1980 and 1995 responded to 94 questions from previous versions of the BSHS. RESULTS: Principal components factor analyses were used to derive an instrument with 40 items called the Burn Specific Health Scale-Brief (BSHS-B), resulting in nine well-defined domains with intercorrelations ranging from 0.11 to 0.56, and Chronbach's factor alphas ranging from 0.75 to 0.93. The domains describe function with respect to Heat Sensitivity, Affect, Hand Function, Treatment Regimens, Work, Sexuality, Interpersonal Relationships, Simple Abilities, and Body Image. CONCLUSION: The BSHS-B is a valid but shorter alternative to the previously described BSHS-A. Important domains of postburn distress are captured better in the BSHS-B than in the BSHS-R.
"The purpose of this paper is to introduce an updated system of annual indexes of divorce risks and to use the system to display trends in divorce risks for Swedish women over the years since 1971. Divorce-risk trends turn out to have been quite different for women at different parities. Trends for women in their first marriage (the majority) are also somewhat different from trends in later marriages. After a spurt in divorces at parity 0 connected with a divorce reform in 1974, divorce risks have been quite stable for women at this parity, but they have increased steadily among married mothers, mostly as an effect of an increasing prevalence of premarital childbearing. Our indexes are produced by an indirect standardization of register data with respect to women's age at marriage, duration of marriage, and order of marriage. We also recommend standardization with respect to an indicator of premarital childbearing, which is particularly important in a population with extensive nonmarital cohabitation." (SUMMARY IN FRE)
To explore whether the prevalence and severity of retinopathy differ in diabetes cohorts diagnosed through screening as compared with conventional health care.
A total of 257 diabetes patients, 151 detected through screening and 106 through conventional clinical care, were included. Retinopathy was evaluated by fundus photography. The modified Airlie House adaptation of the Early Treatment Retinopathy Study protocol was used to grade the photographs. Averages of clinically collected fasting blood glucose (FBG), blood pressure and body mass index values were compiled from diabetes diagnosis until the eye examination. Blood chemistry, smoking habits and peripheral neuropathy were assessed at the time of the eye examination.
Among the screening-detected patients, 22% had retinopathy as compared to 51% among those clinically detected (p