Higher rates of allergies, autoimmune diseases and low-grade inflammation markers in treatment-resistant major depression.

Only 30% of patients with major depressive disorder (MDD) reach full recovery or remission. Treatment-resistant depression (TRD) is MDD that does not respond to adequate treatment attempts with at least two antidepressants. TRD is associated more with immune activation than with treatment responsive depression. The current retrospective population-based cross-sectional study, utilizing data from a large nation-wide health maintenance organization in Israel which provides services to estimated 725,000 members, aimed to assess the clinical signs and laboratory markers of autoimmune comorbidity and low-grade inflammation, in patients with TRD. Included were participants aged 18-70 years, diagnosed twice within one year with ICD-9-CM MDD and two control groups, MDD responders (MDD-r) consisting of people with MDD and no TRD and a non-MDD group that included people with no MDD or TRD. The case (570 subjects in TRD group) to control ratio in both control groups (2850 subjects in MDD-r and 2850 subjects in non-MDD control group) was 1:5. Compared to MDD-r, the overall proportion of allergic diseases was higher among the TRD than among the MDD-r [OR 1.52 (1.19-1.94); p â€‹< â€‹0.001]. Any systemic autoimmune disease was associated with increased likelihood of MDD-r [OR 1.52 (1.04-2.24); p â€‹= â€‹0.03] or TRD [OR 2.22 (1.30-3.78); p â€‹= â€‹0.003]. Higher rates of positive (>1:80) antinuclear antibodies [33 (5.79%)] were found among the TRD than among the MDD-r [98 (3.44%); p â€‹= â€‹0.011). More allergy and autoimmune comorbidities and presence of low-grade inflammation biomarkers, were found mainly in TRD.

ADHD as a Risk Factor for Infection With Covid-19.

Background: ADHD limits the ability to comply with Covid-19 prevention recommendations. We hypothesized that ADHD constitutes a risk factor for Covid-19 infection and that pharmacotherapy may lower that risk. Methods: Study population included all subjects (N = 14,022) registered with Leumit Health Services between February 1st and April 30, 2020, who underwent at least one Covid-19 test. Data were collected from the electronic health records. Purchasing consecutively at least three ADHD-medication-prescriptions during past year was considered drug-treatment. Results: A total of 1,416 (10.1%) subjects (aged 2 months-103 years) were Covid-19-positive.They were significantly younger, and had higher rates of ADHD (adjOR 1.58 (95% CI 1.27-1.96, p < .001) than Covid-19-negative subjects. The risk for Covid-19-Positive was higher in untreated-ADHD subjects compared to non-ADHD subjects [crudeOR 1.61 (95% CI 1.36-1.89, p < .001)], while no higher risk was detected in treated ones [crudeOR 1.07 (95% CI 0.78-1.48, p = .65)]. Conclusion: Untreated ADHD seems to constitute a risk factor for Covid-19 infection while drug-treatment ameliorates this effect.

The association between sociodemographic characteristics and postpartum depression symptoms among Arab-Bedouin women in Southern Israel.

BACKGROUND: Prevalence rates of postpartum depression (PPD) are 10 to 20% among various populations. Little is known about the characteristics of PPD among populations experiencing cultural transition. This study aimed to assess PPD symptoms (PPDS) prevalence and to identify risk factors unique to Arab-Bedouin women in southern Israel. METHODS: The sample included 564 women who visited maternal and child health clinics. Sociodemographic characteristics were obtained using in-person interviews. PPDS were assessed using a validated Arabic translation of the Edinburgh Postnatal Depression Scale (EPDS). Prevalence of PPDS was estimated using the cut-off score of EPDS ≥10; a more stringent cut-off score of EPDS ≥13 was used to define women with moderate to severe PPDS. RESULTS: The prevalence of PPDS among women was 31%, of which 19.1% were assessed as having moderate to severe symptoms (EPDS ≥ 13). In a multivariate logistic regression, the variables associated with EPDS ≥10 were having an ill-infant odds ratio (OR) = 3.9, lack of husband's support (OR = 2.6), history of emotional problems (OR = 3.2), low income (OR = 1.6), low level of education (OR = 1.6), high marital conflicts (OR = 1.5), and an unplanned pregnancy (OR = 1.5). CONCLUSION: In the generally understudied population of Arab-Bedouin women living in southern Israel, we found a high prevalence of PPDS. The unique risk factors described in our research can inform health care professionals in designing interventions for early detection and prevention of PPD.

Interactive effects of memory structuring and gender in preventing posttraumatic stress symptoms.

This study retested effects of a Memory Structuring Intervention (MSI) and the moderating role of gender in relation to posttraumatic stress disorder (PTSD) symptoms. Thirty-four traffic accident victims with high pulse rates were randomly assigned to MSI or supportive listening (control) phone conversations soon after accidents. Based on converging clinical and neuroscience research, the MSI taught chronological organization, labeling emotions/sensations, and describing causality. PTSD symptoms were assessed 3 months later. No overall group differences were found. However, a group by gender interaction revealed that, for women, the MSI was associated with less PTSD symptoms than the control treatment, while the opposite pattern was seen in men. Limitations and possible explanations for these findings are discussed.

[A psychosocial view of a number of Jewish mourning rituals during normal and pathological grief].

This article describes the three stages of normal and pathological mourning, emphasizing the constellation embodied in Judaism for this process. These stages are: shock, acute mourning, working through and reconciliation. We present the important question: "How to define pathological mourning?" It is certainly not only a matter of extending beyond the accepted time limits of the mourning process, but also a question of the intensity of mourning in ones daily life, the degree of being preoccupied with it, and the degree of priority that this mourning process has in an individual's life. A number of forms of pathological mourning, during the three mentioned stages, are described, with special attention to Jewish mourning rituals, especially: The "rending of the garments" (Kriyah), the Kaddish, the Shiva, and the termination of mourning after a fixed period of time. One of the possible interpretations of these rituals is that they prevent and neutralize manifestations of aggression and violence. This is an analogue to the function of biological (genetic) rituals which according to the theory of Konrad Lorenz, also minimize the dangerous aggression between the species in nature. The religious ritual converts an aggressive behavior to a minimal and symbolic action, often re-directed, so that an originally dangerous behavior becomes a ritual with an important communicative function.