© 2009 The Royal College of Psychiatrists
Highlights of this issue
Impact of cannabis on risk of psychosis and suicide
Two papers in the Journal this week focus on the potential impact of cannabis use on mental health outcomes. Di Forti et al (pp. 488–491) examined the risk of psychosis associated with use of high-potency cannabis. They found that individuals presenting with a first episode of psychosis were no more likely than local population controls to have ever taken cannabis but the former were more likely to have taken high-potency cannabis. Price et al (pp. 492–497) utilised data from a longitudinal study of men conscripted for military service in Sweden and found that although cannabis use was associated with an elevated risk of suicide, adjustment for markers of psychological and behavioural problems eliminated the association.
Stress sensitivity and job burnout
Daily-life stress sensitivity was found to be associated with depressive symptoms and major depressive disorder in women participating in a longitudinal twin study described by Wichers et al (pp. 498–503). The effect was strongest among those with high genetic liability and without exposure to negative life events. In a survey of community mental health staff working in the Veneto region of Italy, Lasalvia et al (pp. 537–544) found that nearly two-thirds of psychiatric staff reported high levels of job distress. Burnout, suffered by one in five staff members, was predicted by higher frequency of face-to-face interaction with service users, length of tenure, weakness of work group cohesion, and perceived unfairness.
Depression in Sri Lanka and Latin America
In the first large population-based twin study of depression conducted in a low-income country (Sri Lanka), Ball et al (pp. 504–509) found that the strength of genetic influence on depression in women was similar to that obtained from samples in higher-income countries. For men the results were less clear but the authors found some evidence to suggest that environmental influences might be greater. In a population-based study of people aged over 65 years set in Peru, Mexico and Venezuela, Guerra et al (pp. 510–515) found that the prevalence of late-life depression was similar to that seen in Europe, with little variation seen between study centres. Most individuals with depression had never received any treatment.
Occurrence of depression – population prevalence and primary care incidence
Inspired by the epidemiologist Rose and his emphasis on understanding determinants of ‘sick populations’ not just ‘sick individuals’, Veerman et al (pp. 516–519) used population data to develop and test models for predicting prevalence of depression. They found that mean Beck Depression Inventory score predicted the prevalence of depression and concluded that depression rates depend on the characteristics of both individuals and populations. Using data from 298 UK general practices, Rait et al (pp. 520–524) found that the incidence of GP-recorded depression fell between 1996 and 2006 while the incidence of depressive symptom recording rose. Depression and depressive symptoms were both more commonly recorded for women and in more deprived areas.
Cognitive functioning and quality of vascular care for those with psychosis
In a meta-analytic study of cognitive functioning, Bora et al (pp. 475–482) found that differences in cognitive performance between individuals with schizophrenia, schizoaffective disorder and affective psychoses were small and largely driven by a subgroup of individuals with schizophrenia who were more likely to be male, have severe negative symptoms and younger age at onset. In a universal healthcare setting, Kisely et al (pp. 545–550) found that individuals with psychosis received poorer levels of vascular care. Despite higher mortality rates, they were less likely to receive guideline-consistent treatment for both ischaemic heart disease events and stroke.
Typology of bipolar 1 episodes and the link between autism and intellectual disability
In a prospective study of individuals with bipolar 1 disorder followed for up to 25 years for the occurrence of mood episodes, Solomon et al (pp. 525–530) found that almost one-third of episodes could be classified as major depression, one-fifth as mania and one-quarter as cycling. The authors call for a revision of diagnostic classification systems to add a category for cycling episodes given their frequency. In a population-based twin study, Hoekstra et al (pp. 531–536) found a modest association between extreme autistic traits and intellectual disability, underpinned by only a modest genetic correlation. The authors conclude that extreme autistic traits are substantially genetically independent of the vulnerability to impaired intellectual functioning.
Related articles in BJP:
- Cognitive functioning in schizophrenia, schizoaffective disorder and affective psychoses: meta-analytic study
- Emre Bora, Murat Yucel, and Christos Pantelis
BJP 2009 195: 475-482.[Abstract] [Full Text] - High-potency cannabis and the risk of psychosis
- Marta Di Forti, Craig Morgan, Paola Dazzan, Carmine Pariante, Valeria Mondelli, Tiago Reis Marques, Rowena Handley, Sonija Luzi, Manuela Russo, Alessandra Paparelli, Alexander Butt, Simona A. Stilo, Ben Wiffen, John Powell, and Robin M. Murray
BJP 2009 195: 488-491.[Abstract] [Full Text] - Cannabis and suicide: longitudinal study
- Ceri Price, Tomas Hemmingsson, Glyn Lewis, Stanley Zammit, and Peter Allebeck
BJP 2009 195: 492-497.[Abstract] [Full Text] - Transition from stress sensitivity to a depressive state: longitudinal twin study
- Marieke Wichers, Nicole Geschwind, Nele Jacobs, Gunter Kenis, Frenk Peeters, Catherine Derom, Evert Thiery, Philippe Delespaul, and Jim van Os
BJP 2009 195: 498-503.[Abstract] [Full Text] - Genetic and environmental contributions to depression in Sri Lanka
- Harriet A. Ball, Athula Sumathipala, Sisira H. Siribaddana, Yulia Kovas, Nick Glozier, Peter McGuffin, and Matthew Hotopf
BJP 2009 195: 504-509.[Abstract] [Full Text] - Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study
- Mariella Guerra, Cleusa P. Ferri, Ana Luisa Sosa, Aquiles Salas, Ciro Gaona, Victor Gonzales, Gabriela Rojas de la Torre, and Martin Prince
BJP 2009 195: 510-515.[Abstract] [Full Text] - Population prevalence of depression and mean Beck Depression Inventory score
- J. L. Veerman, C. Dowrick, J. L. Ayuso-Mateos, G. Dunn, and J. J. Barendregt
BJP 2009 195: 516-519.[Abstract] [Full Text] - Recent trends in the incidence of recorded depression in primary care
- Greta Rait, Kate Walters, Mark Griffin, Marta Buszewicz, Irene Petersen, and Irwin Nazareth
BJP 2009 195: 520-524.[Abstract] [Full Text] - Empirical typology of bipolar I mood episodes
- David A. Solomon, Andrew C. Leon, Jean Endicott, William H. Coryell, Chunshan Li, Jess G. Fiedorowicz, and Martin B. Keller
BJP 2009 195: 525-530.[Abstract] [Full Text] - Association between extreme autistic traits and intellectual disability: insights from a general population twin study
- R. A. Hoekstra, F. Happé, S. Baron-Cohen, and A. Ronald
BJP 2009 195: 531-536.[Abstract] [Full Text] - Influence of perceived organisational factors on job burnout: survey of community mental health staff
- Antonio Lasalvia, Chiara Bonetto, Mariaelena Bertani, Sarah Bissoli, Doriana Cristofalo, Giovanna Marrella, Enrico Ceccato, Carla Cremonese, Moreno De Rossi, Lorenza Lazzarotto, Vanna Marangon, Idana Morandin, Maria Zucchetto, Michele Tansella, and Mirella Ruggeri
BJP 2009 195: 537-544.[Abstract] [Full Text] - Treatment of ischaemic heart disease and stroke in individuals with psychosis under universal healthcare
- Stephen Kisely, Leslie Anne Campbell, and Yan Wang
BJP 2009 195: 545-550.[Abstract] [Full Text]
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