Risicofactoren van psychotische symptomen en hun causaliteit: een overzicht

Author(s):  
J.W. MEIRLAEN

Risk factors of psychotic symptoms and their causality: an overview. Psychotic symptoms exist on a continuum in both clinical and non-clinical populations. The purpose of this review article is to provide a concise overview of the most studied risk factors ensuring a person moves along the continuum and exhibits more psychotic symptoms. A possible causal relationship is evaluated for every risk factor using the Bradford Hill criteria for causation. This literature study could show a strong association, dose-response relationship and temporal relationship between cannabis use and psychotic symptoms on the one hand and amphetamine use and psychotic symptoms on the other. Furthermore, a few biologically plausible mechanisms could be withheld, whereby a causal relationship seems likely in both cases. Regarding sleep problems, childhood victimization, urbanicity and demographic factors, there was sufficient scientific evidence in the literary study for this article to withhold an association with psychotic symptoms.

Foods ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 383
Author(s):  
Agnieszka Micek ◽  
Justyna Godos ◽  
Achille Cernigliaro ◽  
Raffaele Ivan Cincione ◽  
Silvio Buscemi ◽  
...  

Polyphenol-rich beverage consumption is not univocally accepted as a risk modulator for cardio-metabolic risk factors, despite mechanistic and epidemiological evidence suggesting otherwise. The aim of this study was to assess whether an association between polyphenol-rich beverage consumption and metabolic status could be observed in a Mediterranean cohort with relatively low intake of tea, coffee, red and white wine, beer, and fresh citrus juice. Demographic and dietary characteristics of 2044 adults living in southern Italy were analyzed. Multivariate logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of the association between polyphenol-rich and alcoholic beverage consumption and metabolic status adjusted for potential confounding factors. Specific polyphenol-rich beverages were associated, to a various extent, with metabolic outcomes. Individuals with a higher total polyphenol-rich beverages had higher polyphenols intake and were less likely to have hypertension, type-2 diabetes, and dyslipidemia (OR = 0.57, 95% CI: 0.44–0.73; OR = 0.41, 95% CI: 0.26–0.66; and OR = 0.41, 95% CI: 0.29–0.57, respectively). However, when adjusted for potential confounding factors, only the association with hypertension remained significant (OR = 0.69, 95% CI: 0.50–0.94). Current scientific evidence suggests that such beverages may play a role on cardio-metabolic risk factors, especially when consumed within the context of a dietary pattern characterized by an intake of a plurality of them. However, these associations might be mediated by an overall healthier lifestyle.


2021 ◽  
pp. 004947552110052
Author(s):  
Sandeep Moola ◽  
Deepti Beri ◽  
Abdul Salam ◽  
Jagnoor Jagnoor ◽  
Arun Teja ◽  
...  

Leptospirosis is a zoonotic disease of public health importance in India. A country-level evidence gap map was developed to identify gaps on epidemiology of leptospirosis. It is the first such on leptospirosis globally and on any single disease condition in India. The steps for development of evidence gap map were development of a framework to map evidence, retrieval of evidence, data extraction parameters and mapping of available evidence in evidence gap map framework. The prevalence evidence gap map consisted of 157 studies (102 in humans, 55 in animals, and 12 in both). The evidence gap map on risk factors had 120 studies (102 in humans, 11 in animals and 7 in both). There were inter-state differences in availability of research and disparity between animal and human research. Research on high-risk groups was limited and studies did not use the One Health approach to identify epidemiology, which can help understand the issue more comprehensively. The study demonstrates the potential of evidence gap maps to inform research priorities.


2021 ◽  
Vol 8 (1) ◽  
pp. e000759
Author(s):  
Daniel Higbee ◽  
Raquel Granell ◽  
Esther Walton ◽  
Roxanna Korologou-Linden ◽  
George Davey Smith ◽  
...  

RationaleLarge retrospective case-control studies have reported an association between chronic obstructive pulmonary disease (COPD), reduced lung function and an increased risk of Alzheimer’s disease. However, it remains unclear if these diseases are causally linked, or due to shared risk factors. Conventional observational epidemiology suffers from unmeasured confounding and reverse causation. Additional analyses addressing causality are required.ObjectivesTo examine a causal relationship between COPD, lung function and Alzheimer’s disease.MethodsUsing two-sample Mendelian randomisation, we used single nucleotide polymorphisms (SNPs) identified in a genome wide association study (GWAS) for lung function as instrumental variables (exposure). Additionally, we used SNPs discovered in a GWAS for COPD in those with moderate to very severe obstruction. The effect of these SNPs on Alzheimer’s disease (outcome) was taken from a GWAS based on a sample of 24 807 patients and 55 058 controls.ResultsWe found minimal evidence for an effect of either lung function (OR: 1.02 per SD; 95% CI 0.91 to 1.13; p value 0.68) or liability for COPD on Alzheimer’s disease (OR: 0.97 per SD; 95% CI 0.92 to 1.03; p value 0.40).ConclusionNeither reduced lung function nor liability COPD are likely to be causally associated with an increased risk of Alzheimer’s, any observed association is likely due to unmeasured confounding. Scientific attention and health prevention policy may be better focused on overlapping risk factors, rather than attempts to reduce risk of Alzheimer’s disease by targeting impaired lung function or COPD directly.


2012 ◽  
Vol 3 (4) ◽  
pp. 210-217 ◽  
Author(s):  
Anne K. Nitter ◽  
Are H. Pripp ◽  
Karin Ø. Forseth

AbstractIntroductionChronic musculoskeletal pain represents a significant health problem among adults in Norway. The prevalence of chronic pain can be up to 50% in both genders. However, the prevalence of chronic widespread pain is significantly higher in females than in males. Chronic widespread pain is seen as the end of a continuum of pain. There is rather sparse knowledge about the incidence of pain in initially pain free individuals and the course of self-reported pain over time. Moreover, little is known about risk factors for incidence of chronic pain or prognostic factors for the course of self-reported pain. We believe that such knowledge may contribute to develop strategies for treatment at an early stadium of the pain condition and thereby reduce the prevalence of chronic pain included chronic widespread pain.Aims of the studyThe aims of this study were threefold: (1) to calculate the incidence of self-reported musculoskeletal pain in a female cohort, (2) to describe the course of pain and (3) to investigate whether or not health complaints and sleep problems are predictive factors for onset of pain or prognostic factors for the course of pain.MethodsThis is a prospective population-based study of all women between 20 and 50 years who were registered in Arendal, Norway, in 1989 (N = 2498 individuals). A questionnaire about chronic pain (pain >3 months duration in muscles, joints, back or the whole body), modulating factors for pain, sleep problems and seven non-specific health complaints was mailed to all traceable women, in 1990 (N =2498), 1995 (n = 2435) and 2007 (n = 2261). Of these, 1338 responded on all three occasions. Outcome measures were presence and extent of chronic pain.ResultsThe prevalence of chronic pain was 57% in 1990 and 61% in 2007. From 1990 to 2007, 53% of the subjects changed pain category. The incidence of chronic pain in initially pain free individuals during follow-up was 44%, whereas the recovery rate was 25%. Impaired sleep quality predicted onset of chronic pain. There was a linear association between the number of health complaints and the incidence of chronic pain in initially pain free individuals. Equivalent results were found for persistence of pain and worsening of pain.ConclusionThe prevalence of chronic pain was rather stable throughout the follow-up period, but the prevalence of chronic widespread pain increased. Individual changes in pain extent occurred frequently. The presence of sleep disturbances and number of health complaints predicted onset, persistence and worsening of pain.ImplicationsSleep problems must be thoroughly addressed as a possible risk factor for onset or worsening of pain. Elimination of sleep problems in an early phase is an interesting approach in treating chronic pain. More research is needed to illuminate the possible pathogenetic relations between pain, non-specific health complaints, sleep problems and also depression.


Heart ◽  
2021 ◽  
pp. heartjnl-2021-319129
Author(s):  
Marios Rossides ◽  
Susanna Kullberg ◽  
Johan Grunewald ◽  
Anders Eklund ◽  
Daniela Di Giuseppe ◽  
...  

ObjectivesPrevious studies showed a strong association between sarcoidosis and heart failure (HF) but did not consider risk stratification or risk factors to identify useful aetiological insights. We estimated overall and stratified HRs and identified risk factors for HF in sarcoidosis.MethodsSarcoidosis cases were identified from the Swedish National Patient Register (NPR; ≥2 International Classification of Diseases-coded visits, 2003–2013) and matched to general population comparators. They were followed for HF in the NPR. Treated were cases who were dispensed ≥1 immunosuppressant ±3 months from the first sarcoidosis visit (2006–2013). Using Cox models, we estimated HRs adjusted for demographics and comorbidity and identified independent risk factors of HF together with their attributable fractions (AFs).ResultsDuring follow-up, 204 of 8574 sarcoidosis cases and 721 of 84 192 comparators were diagnosed with HF (rate 2.2 vs 0.7/1000 person-years, respectively). The HR associated with sarcoidosis was 2.43 (95% CI 2.06 to 2.86) and did not vary by age, sex or treatment status. It was higher during the first 2 years after diagnosis (HR 3.7 vs 1.9) and in individuals without a history of ischaemic heart disease (IHD; HR 2.7 vs 1.7). Diabetes, atrial fibrillation and other arrhythmias were the strongest independent clinical predictors of HF (HR 2.5 each, 2-year AF 20%, 16% and 12%, respectively).ConclusionsAlthough low, the HF rate was more than twofold increased in sarcoidosis compared with the general population, particularly right after diagnosis. IHD history cannot solely explain these risks, whereas ventricular arrhythmias indicating cardiac sarcoidosis appear to be a strong predictor of HF in sarcoidosis.


2018 ◽  
Vol 183 (9-10) ◽  
pp. e532-e538 ◽  
Author(s):  
Eric B Elbogen ◽  
H Ryan Wagner ◽  
Mira Brancu ◽  
Nathan A Kimbrel ◽  
Jennifer C Naylor ◽  
...  

Abstract Introduction In response to a strong focus on suicide prevention for all veterans, the Department of Veterans Affairs (VA) recently revised policy to provide emergency mental healthcare for veterans who received Other Than Honorable (OTH) discharges from the military. This current study takes a preliminary step toward identifying demographic, historic, military, clinical, and social characteristics of veterans with OTH discharges. Materials and Methods N = 1,172 Iraq/Afghanistan-era veterans were evaluated between 2005 and 2016 in the multi-site VA Mid-Atlantic Mental Illness, Research, Education and Clinical Center (MIRECC) Study of Post-Deployment Mental Health (PDMH Study). Results Veterans with OTH discharges constituted 2.7% of our sample, approximating the estimated rate in the overall U.S. veteran population. Compared to veterans discharged under honorable conditions, veterans with OTH discharges were more likely to be younger and have greater odds of reporting family history of drug abuse and depression. Further, veterans with OTH discharges reported a lower level of social support and were more likely to be single, endorse more sleep problems, score higher on measures of drug misuse, have a history of incarceration, and meet diagnostic criteria for major depressive disorder. A subsequent matching analysis provided further evidence of the association between OTH discharge and two risk factors: drug misuse and incarceration. Conclusion These findings elucidate potential factors associated with veterans with OTH discharges, particularly substance abuse and criminal justice involvement. Results also indicate higher incidence of risk factors that often accompany suicidal ideation and should be a highlighted component of healthcare delivery to this vulnerable cohort of veterans.


2015 ◽  
Vol 41 (1) ◽  
pp. 77-89 ◽  
Author(s):  
Laíse Soares Oliveira Resende ◽  
Edson Theodoro dos Santos-Neto

This review sought to identify the available scientific evidence on risk factors associated with adverse reactions to antituberculosis drugs. We performed a systematic review of studies published in the 1965-2012 period and indexed in the MEDLINE and LILACS databases. A total of 1,389 articles were initially selected. After reading their abstracts, we selected 85 studies. Of those 85 studies, 16 were included in the review. Risk factors for adverse reactions to antituberculosis drugs included age > 60 years, treatment regimens, alcoholism, anemia, and HIV co-infection, as well as sodium, iron, and albumin deficiency. Protective factors against hepatic adverse effects of antituberculosis drugs included being male (combined OR = 0.38; 95% CI: 0.20-0.72) and showing a rapid/intermediate N-acetyltransferase 2 acetylator phenotype (combined OR = 0.41; 95% CI: 0.18-0.90). There is evidence to support the need for management of adverse reactions to antituberculosis drugs at public health care facilities.


2021 ◽  
pp. 1-11
Author(s):  
Andrea A. Jones ◽  
Kristina M. Gicas ◽  
Sara Mostafavi ◽  
Melissa L. Woodward ◽  
Olga Leonova ◽  
...  

Abstract Background People living in precarious housing or homelessness have higher than expected rates of psychotic disorders, persistent psychotic symptoms, and premature mortality. Psychotic symptoms can be modeled as a complex dynamic system, allowing assessment of roles for risk factors in symptom development, persistence, and contribution to premature mortality. Method The severity of delusions, conceptual disorganization, hallucinations, suspiciousness, and unusual thought content was rated monthly over 5 years in a community sample of precariously housed/homeless adults (n = 375) in Vancouver, Canada. Multilevel vector auto-regression analysis was used to construct temporal, contemporaneous, and between-person symptom networks. Network measures were compared between participants with (n = 219) or without (n = 156) history of psychotic disorder using bootstrap and permutation analyses. Relationships between network connectivity and risk factors including homelessness, trauma, and substance dependence were estimated by multiple linear regression. The contribution of network measures to premature mortality was estimated by Cox proportional hazard models. Results Delusions and unusual thought content were central symptoms in the multilevel network. Each psychotic symptom was positively reinforcing over time, an effect most pronounced in participants with a history of psychotic disorder. Global connectivity was similar between those with and without such a history. Greater connectivity between symptoms was associated with methamphetamine dependence and past trauma exposure. Auto-regressive connectivity was associated with premature mortality in participants under age 55. Conclusions Past and current experiences contribute to the severity and dynamic relationships between psychotic symptoms. Interrupting the self-perpetuating severity of psychotic symptoms in a vulnerable group of people could contribute to reducing premature mortality.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
LAURA EVENSEN ◽  
Nan Liu ◽  
Yijun Wang ◽  
Bernadette Boden-Albala

Objective: To describe the relationship between sleep problems, measured by the Medical Outcomes Sleep scale (MOS) at baseline, in ischemic stroke and TIA (IS/TIA) patients and the likelihood of having a recurrent event, leading to vascular death. Background: Among IS/TIA patients, there is increased risk for recurrent vascular events, including stroke, MI and vascular death. While history of stroke is a major predictor of recurrent events, there may be unidentified factors in play. Sleep quality may predict recurrent vascular events, but little is known about the relationship between sleep and recurrent events in IS/TIA patients. Methods: The Stroke Warning Information and Faster Treatment (SWIFT) Study is an NINDS SPOTRIAS funded randomized trial to study the effect of culturally appropriate, interactive education on stroke knowledge and time to arrival after IS/TIA. Sleep problems and recurrent event information were collected among consentable IS/TIA patients. Cox proportional hazards models were used to describe relationships between sleep and recurrent vascular events in IS/TIA patients. The MOS, a 12 item sleep assessment, measures 6 dimensions of sleep: initiation, maintenance, quantity, adequacy, somnolence and respiratory impairment. Results: Over 5 years, the SWIFT study cohort of 1198 [77% IS; 23% TIA] patients were prospectively enrolled. This cohort was 50% female; 50% Hispanic, 31% White and 18% Black, with a mean NIHSS of 3.2 [SD ±3.8]. 750 subjects completed the MOS scale at baseline. In a multivariate analysis, after adjusting for demographics and vascular risk factors: gender, age, race ethnicity, NIHSS, stroke history, qualifying event type, hypertension, diabetes, smoking and family stroke history, longer sleep initiation is associated with combined outcome of IS/TIA, MI and vascular death [p=0.1, HR=1.09]. Significant predictors of vascular death included: trouble falling asleep (initiation) [p=0.05, HR=1.15]; not ‘getting enough sleep to feel rested’ and not ‘getting the amount of sleep you need’ (adequacy) [p=0.06, HR=1.18 and p=0.03, HR=1.18, respectively]; shortness of breath or headache upon waking (respiratory impairment) [p=0.003, HR=1.33]; restless sleep [p=0.07, HR=1.15] and waking at night with trouble resuming sleep [p=0.004, HR=1.23] (maintenance); daytime drowsiness [p=0.05, HR=1.18] and trouble staying awake [p=0.01, HR=1.25] (somnolence); and taking naps (quantity) [p=0.03, HR=1.22]. Conclusions: Sleep problems represent diverse, modifiable risk factors for secondary vascular events, particularly vascular death. Exploring sleep dimensions may yield crucial information for reduction of secondary vascular events in IS/TIA patients. Further investigation is needed to fully understand the effects of sleep on secondary vascular event incidence.


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