ABSTRACT
Background: About 30% of patients treated with second generation antipsychotics (SGA) experience weight gain. Although there is evidence that the FTO gene is associated with obesity its role in antipsychotic induced weight gain is not so clear. Methods: A genetic association study was carried out to identify the association between FTO rs9939609 and antipsychotic induced weight gain. Sample consisted of 180 cases and 120 controls. Cases were patients diagnosed with schizophrenia or schizoaffective disorder, treated with second-generation antipsychotics for a minimum of 3 months, and had gained at least 10% of body weight. Controls were patients with schizophrenia treated with second-generation antipsychotics for a minimum of 3 months but had not gained ≥10% of body weight. Genomic DNA was extracted from whole blood. Polymerase chain reaction of the samples was done. Real-time quantitative PCR (qPCR) was carried out using BIO-RAD CFX96 Touch TM PCR detection system. Results: Females were significantly more among cases (58.3%) than controls (35%). Cases (52.4%) were significantly more likely to be overweight or obese than controls (13.8%). Genotype distribution was in Hardy-Weinberg equilibrium (p=0.43). Cochran-Armitage trend test was not significant. Risk of antipsychotic induced weight gain in the AA genotype [OR 1.69 (95% CI 0.74-3.86)] and AT genotype [OR 1.1 (95% CI 0.67-1.79)] were not significantly higher than the TT genotype. Recessive model showed that AA/AT genotypes were at significantly higher risk of being obese/overweight [OR 1.84 (95% CI 1.05-3.2)]. Conclusions: There was no significant association between FTO rs9939609 and antipsychotic induced weight gain. AA/AT genotypes had significantly higher risk of overweight/obesity.
Subject(s)
Alpha-Ketoglutarate-Dependent Dioxygenase FTO/drug effects , Antipsychotic Agents/adverse effects , Overweight/genetics , Schizophrenia/drug therapy , Weight Gain/genetics , Adult , Case-Control Studies , Female , Genotype , Humans , Male , Middle Aged , Obesity/chemically induced , Obesity/genetics , Overweight/chemically induced , Polymerase Chain Reaction , Polymorphism, Single Nucleotide , Risk Factors , Schizophrenia/genetics , Sri LankaABSTRACT
OBJECTIVES: To translate and validate the Sinhala version of the Centre for Epidemiological Studies Depression scale (CES-D) for diagnosing depression in out-patients. DESIGN: A combined qualitative and quantitative approach was used for the translation of the CES-D. Sample size was calculated to detect a targeted sensitivity and specificity of 85%. The sample consisted of 75 participants diagnosed with major depressive disorder according to DSM IV criteria and 75 gender matched controls. Criterion validity was assessed using receiver operating charact-eristic (ROC) analysis. The Structured Clinical Interview for DSM-IV (SCID-II) conducted by a psychiatrist was used as the gold standard. RESULTS: Mean age of the sample was 33 years. There were 91 females (60.7%). There was significant difference in the mean CES-D scores between cases (13.94) and controls (6.58) [t=14.50, df=148, p<0.001]. A score of ≥ 16 gave a sensitivity of 84% and specificity of 92%. A score of ≥ 21 gave a sensitivity of 73.3% and specificity of 96%. The Cronbach's alpha was 0.93. The four items that were reverse coded had poor correlation with total scores. The average correlation coefficient for the reverse-scored items was 0.35 and for the rest of the items 0.63. Principal component analysis with oblique rotation identified four factors. Factor 1 corresponds to the "depressed affect" and "somatic complaints" in the original model proposed by Radloff. Factor 2 corresponds to the interpersonal concerns. Factors 3 and 4 loaded the reversed coded items. CONCLUSIONS: The Sinhala version of the CES-D is a valid and reliable instrument for diagnosing major depressive disorder.
Subject(s)
Depressive Disorder/diagnosis , Outpatients/psychology , Translations , Adult , Case-Control Studies , Depressive Disorder/psychology , Female , Humans , Male , ROC Curve , Sensitivity and Specificity , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To carry out time series analyses of hospital admissions for poisoning between 1995-2008 in all districts in Sri Lanka to identify trends and geographical variations in the substances used in poisoning. METHODS: Data of hospital admissions from 1995-2008 due to poisoning were obtained from the Annual Health Bulletins published by the Ministry of Health. Data were converted to annual rates per 100,000 population. Time trends in the rates of suicide and self-poisoning were calculated using univariate time series analysis. RESULTS: All districts except Kilinochchi and Mullaitivu showed an increase in the rates of admissions due to poisoning with drugs, medicaments and biological substances. Colombo, Hambantota, Kalutara and Anuradhapura showed an exponential increase. Hambantota, Monaragala, Nuwara Eliya and Colombo show an increase in the rate of admissions after pesticide poisoning. All other districts showed a linear decrease. Admissions due to all types of poisoning showed a negative trend in Anuradhapura, Polonnaruwa, Ampara, Matale and Batticoloa districts. Other districts show a positive trend in the rate of admissions for all types of poisoning. CONCLUSIONS: Results should be viewed with caution because they are based on analysis of secondary data. Although the rate of suicides has reduced since 1995, admissions due to self poisoning have increased in almost all districts. While pesticide poisoning is becoming less, there is a gradual shift to the use of drugs and medicaments in self poisoning. Poisoning with drugs, medicaments and biological substances are increasing both in urban and rural areas.
