Financial difficulties in bipolar disorder part 2: psychological correlates and a proposed psychological model.

OBJECTIVES: A number of psychological variables have been shown to be prominent in bipolar disorder. However, no research has looked at the relationship between financial difficulties and psychological factors in bipolar disorder. AIMS: This study aims to look at the relationship between financial difficulties and psychological factors in bipolar disorder. METHOD: Fifty-four participants with diagnosis of bipolar disorder in an adult secondary care NHS mental health service completed the questionnaire pack which included measures examining financial variables including difficulty paying bills and perceived financial wellbeing. Questionnaires measured self-esteem, impulsivity, mindfulness and dysfunctional attitudes. RESULTS: Financial difficulties cross-sectionally were related to a number of psychological variables such as mindfulness and impulsivity. Over time, the strongest effects were for compulsive spending which was increased over time by higher dependency and achievement cognitions, lower mindfulness and lower self-esteem. Poor perceived financial wellness lower self-esteem over time. A psychological model incorporating these and related findings is presented. CONCLUSION: Psychological factors appear to be related to financial difficulties in bipolar disorder. Future research is needed to confirm the model presented here and develop interventions.

Financial difficulties in bipolar disorder part 1: longitudinal relationships with mental health.

BACKGROUND: There has been little research on whether finances affect mental health in bipolar disorder. AIMS: This study aimed to examine the relationship between finances and mental health in bipolar disorder across two time points. METHODS: Fifty-four participants with bipolar disorder in a National Health Service community mental health service completed questionnaires examining financial difficulties, compulsive buying and perceived financial well-being. Questionnaires also measured alcohol dependence, stress, depression, anxiety, past and current manic symptoms. RESULTS: Partial correlations showed correlations over time: depression, anxiety and stress predicted later compulsive buying. Compulsive buying also predicted later anxiety. Lower perceived financial wellness increased anxiety and stress over time. Being on benefits was associated with higher depression and going without items such as clothes was linked to higher depression, stress, anxiety and past hypomanic symptoms. CONCLUSIONS: Financial difficulties are related to mental health in bipolar disorder. Poor mental health leads to compulsive buying, whereas worry about finances increases anxiety and stress, with a vicious cycle for anxiety.

2-Aminoimidazoles inhibitors of TGF-beta receptor 1.

The 4-(5-fluoro-6-methyl-pyridin-2-yl)-5-quinoxalin-6-yl-1H-imidazol-2-ylamine 3 is a potent and selective inhibitor of TGF-betaR1. Substitution of the amino group of 3 typically led to a slight decrease in the affinity for the receptor and in TGF-beta-inducted PAI-luciferase reporter activity. However, 2-acetamidoimidazoles were identified as attractive candidates for further optimization as a result of their significant activity combined to their superior pharmacokinetic profile.

Recession, debt and mental health: challenges and solutions.

Background During the economic downturn, the link between recession and health has featured in many countries' media, political, and medical debate. This paper focuses on the previously neglected relationship between personal debt and mental health.Aims Using the UK as a case study, this paper considers the public health challenges presented by debt to mental health. We then propose solutions identified in workshops held during the UK Government's Foresight Review of Mental Capital and Wellbeing.Results Within their respective sectors, health professionals should receive basic 'debt first aid' training, whilst all UK financial sector codes of practice should - as a minimum - recognise the existence of customers with mental health problems. Further longitudinal research is also needed to 'unpack' the relationship between debt and mental health. Across sectors, a lack of co-ordinated activity across health, money advice, and creditor organisations remains a weakness. A renewed emphasis on co-ordinated 'debt care pathways' and better communication between local health and advice services is needed.Discussion The relationship between debt and mental health presents a contemporary public health challenge. Solutions exist, but will require action and investment at a time of competition for funds.

Rapid assessment and response studies of injection drug use: knowledge gain, capacity building, and intervention development in a multisite study.

OBJECTIVES: We evaluated the World Health Organization's rapid assessment and response (RAR) method of assessing injection drug use and its associated health problems, focusing on knowledge gain, capacity building, and whether RAR leads to the development of interventions reducing the health effects of injection drug use. METHODS: Data were derived from RAR studies conducted in Beijing, China; Bogotá, Colombia; Greater Rosario, Argentina; Hanoi, Vietnam; Kharkiv, Ukraine; Minsk, Belarus; Nairobi, Kenya; Penang, Malaysia; St. Petersburg, Russia; and Tehran, Iran. RESULTS: Substantial gains in knowledge and response capacity were reported at all of the study sites. Before RAR initiation, prevention and intervention programs had been absent or inadequate at most of the sites. The RARs resulted in many new or modified interventions; 7 sites reported 24 health-related interventions that were subsequently developed and influenced by the RARs. CONCLUSIONS: RARs, which require relatively little external funding, appear to be effective in linking assessment to development of appropriate interventions. The present results add to the evidence that rapid assessment is an important public health tool.

Rapid assessment: an international review of diffusion, practice and outcomes in the substance use field.

'Rapid assessment' (RA) methods have the potential to generate important public health information. This potential is now the subject of debate within the substance use field. Despite this, much remains unknown about the application and outcomes of RAs on substance use, a situation compounded by the absence of published studies. Consequently, we undertook a retrospective review of the use of RA in the substance use field drawing on three methods: literature review (n=300 published and unpublished documents); survey of RA practitioners/commissioners (n=1200 contacts); in-depth expert consultation (n=10 interviews). Study findings indicated: (i) earliest identified RAs were conducted in 1993, with 83 identified studies conducted by 2001; (ii) RAs have been conducted in 70 countries, with seven out of 10 assessments undertaken between 1998 and 2001; (iii) RAs were reported as taking 9-486 days (69 weeks) to complete; and (iv) important outcomes can follow RA on substance use--one in two studies were followed by medical or non-medical interventions, workshops, training, policy change, community participation, network building, or other outcomes (45/83; 54%), whilst more than one in four RAs were followed by medical and non-medical interventions, or policy impact and change (25/83; 30%). In conclusion, we argue that to fully realise the potential of RA in the substance use field, investment has to be made in RA's evidence and knowledge base: in short, a culture of learning, reflection and discussion has to be introduced into a methodology currently premised on rapidity and pragmatism.