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Biomedical subjects

R Harrington

Publications and source records attributed to R Harrington.

At least 19 recordsLinked to original sources
PubMed2002

Can maternal depression increase infant risk of illness and growth impairment in developing countries?

Despite relative improvement in living conditions and availability of modern healthcare, infant mortality rates continue to be very high in many developing countries. High rates of depression have also been reported in women in these countries. The continuous care and attention of children is a demanding task, and poor physical or mental health in mothers might be expected to have adverse consequences on their children's health, nutrition and psychological well-being. Review of published literature reveals very little research in developing countries on the association between poor mental health in mothers and the subsequent physical well-being of their children. We hypothesize that the level of care provided by mothers with depression may put their infants at higher risk of infection and impaired growth, compared with infants of mothers without depression. We outline approaches to test such a hypothesis in a developing country, and discuss its implications.

Adult↗
PubMed2001

Susceptibility genes for a trait measure of attention deficit hyperactivity disorder: a pilot study in a non-clinical sample of twins.

Attention deficit hyperactivity disorder (ADHD) is a highly heritable disorder, and molecular genetic studies are underway, with most researchers focusing on identifying susceptibility genes in clinical samples with ADHD. An alternative approach is to search for quantitative trait loci underlying the trait measure of ADHD in non-clinical samples. Positive findings of association of the dopamine transporter DAT1 480 bp allele (allele 10) and the DRD4 7 repeat allele with clinical ADHD have been previously reported. In this pilot study, we examined these polymorphisms in a selected population-based sample of twins (50 high scoring pairs, 42 low scoring pairs). There was a trend for an increase in the frequency of the dopamine receptor DRD4 7 repeat allele in the high-scoring concordant monozygotic twins (odds ratio=1.4). Although this result was not statistically significant, the frequency of the 7 repeat allele was similar to that reported for our clinic sample of ADHD patients drawn from the same geographical area. There was a non-significant trend for an increased frequency of the DAT1 allele 10 (odds ratio=1.3). These results suggest that a molecular genetic study based on a questionnaire-derived measure of ADHD in a non-clinical sample is feasible and the results appear to be comparable with those from studies of clinical cases. However, sample size and power are key issues to consider when using this approach.

Adolescent↗
PubMed2001

Examining for association between candidate gene polymorphisms in the dopamine pathway and attention-deficit hyperactivity disorder: a family-based study.

Attention-deficit hyperactivity disorder (ADHD) is a highly heritable childhood-onset psychiatric condition characterized by developmentally inappropriate inattention, hyperactivity, and impulsiveness. The pathophysiology of ADHD is currently unknown. However, the therapeutic effects of stimulant medication together with findings from animal and neuroimaging studies as well as from several molecular genetic studies of the dopamine receptor D4 gene and dopamine transporter gene have implicated involvement of the dopaminergic system. To test the dopaminergic hypothesis further, we have looked for association between ADHD and alleles of seven dopamine-related candidate genes using a family-based association approach in a sample of 150 children diagnosed with ADHD. We tested polymorphisms in genes encoding three dopamine receptors (DRD3, DRD4, and DRD5) and four dopamine-relevant enzymes: tyrosine hydroxylase [tyrosine hydroxylase (TH)], dopamine beta hydroxylase (DbetaH), catechol-O-methyltransferase (COMT), and monoamine oxidase A (MAOA). We were unable to detect a significant association with any of the polymorphisms genotyped, although there was a trend for preferential transmission of the DRD5 148 bp marker allele and the MAOA 122 bp marker allele. We conclude that none of the alleles we have tested makes a major contribution to ADHD, although much larger samples are required to exclude small effects.

Adolescent↗
PubMed2001

Adolescents' bereavement experiences. Prevalence, association with depressive symptoms, and use of services.

The present study set out to estimate the prevalence of bereavement experiences in adolescents, the association between these experiences and depressive symptoms and the attitudes of bereaved young people to professional interventions. The study was based on 1746 adolescents aged between 11 and 16 years from two secondary schools in Northern England. Questionnaire measures of bereavement experiences and depressive symptoms were completed by the adolescents in the classroom. One thousand three hundred and fifty-five (77.6%) reported that at least one of their first-or second-degree relatives or close friends had died. These losses were associated with increased levels of depressive symptoms in comparison with the loss of other relatives or pets. The impact of the loss of someone close depended to an important extent on the young person's perception of how the loss had changed their lives. Most adolescents did not feel the need for professional services. Those who did use these services had higher levels of depressive symptoms, suggesting that service use was likely to have been appropriate.

Adolescent↗
PubMed2001

The effect of natural enemies on the spread of barley yellow dwarf virus (BYDV) by Rhopalosiphum padi (Hemiptera: Aphididae).

The effects of two natural aphid enemies, adult Coccinella septempunctata Linneaus, a predator, and Aphidius rhopalosiphi de Stefani Perez, a parasitoid, on spread of barley yellow dwarf virus (BYDV) transmitted by the bird cherry-oat aphid, Rhopalosiphum padi (Linnaeus) were studied under laboratory conditions. Predators or parasitoids were introduced to trays of durum wheat seedlings and the patterns of virus infection were observed after two, seven and 14 days of exposure. More plants were infected with BYDV in control trays without A. rhopalosiphi than in trays with the parasitoid present, both seven and 14 days after the introduction of parasitoids. Patterns of virus infection were found to be similar over time in trays with a parasitoid present and in control trays. More plants were infected in trays with C. septempunctata present than in control trays, both two and seven days after the introduction of the coccinellid. The spread of virus infections progressed differently over time for the two treatments (predator and parasitoid), differences between treatments being most marked after two days and seven days, when more plants exposed to predators but fewer exposed to parasitoids were infected with BYDV compared to their respective controls. However, by the 14th day 88% of all plants were infected and there was no significant difference between the two treatments. The role of natural enemies in spread of BYDV is discussed.

Animals↗
PubMed2001

The relationship between life satisfaction, self-consciousness, and the Myers-Briggs type inventory dimensions.

The study was an investigation of the relationship between psychological well-being, life satisfaction, self-consciousness, and the four Myers-Briggs Type Indicator dimensions (MBTI; I. B. Myers & M. H. McCaulley, 1985). The participants were 97 college students (79 women and 18 men whose mean age was 31.4 years). All the students were administered four instruments, the Psychological Well-Being Inventory (C. D. Ryff, 1989), the Satisfaction With Life Scale (E. Diener, R. A. Emmons, R. J. Larsen, & S. Griffin, 1985), the Self-Consciousness Scale-Revised (M. F. Scheier & C. S. Carver, 1985), and the MBTI (Form G Self-Scoring). MANOVAs revealed significant differences on three of the four dimensions of the MBTI with extraverts showing higher psychological well-being and life satisfaction and lower self-consciousness than introverts. Intuition types scored higher in psychological well-being and lower in self-consciousness than Sensing types. Judging types scored higher in psychological well-being than Perceiving types. Correlational analyses showed that most dimensions of psychological well-being were negatively related to self-consciousness. The relationship between life satisfaction and personality variables is discussed.

Adult↗
PubMed2001

Depression, suicide and deliberate self-harm in adolescence.

The past decade has seen important advances in research into the epidemiology, aetiology and treatment of depression and suicidal behaviour in the young. We are beginning to understand how risk factors combine to precipitate and maintain these problems. There is rarely a linear relationship between causes and outcomes. Rather, the cause is usually a combination of predisposing constitutional factors arising from genetic endowment or earlier experience and precipitating stressful events. These aetiological factors act through biochemical, psychological and social processes to produce the outcome. Progress has also been in the development of a range of effective treatments, such as 'here and now' psychological treatments and antidepressants. All depressed or suicidal young people require careful assessment. Some will require a brief intervention only. Others, however, will require more intensive and lengthy forms of treatment.

Adolescent↗
PubMed2001

The treatment of child and adolescent mental health problems in primary care: a systematic review.

BACKGROUND: There is significant potential to increase the accessibility and effectiveness of child and adolescent mental health services through the involvement of primary care professionals and the delivery of interventions in the primary care setting. However, little is known about the actual clinical and cost-effectiveness of such service delivery. OBJECTIVE: The aim of the study was to review systematically the evidence concerning the effectiveness of interventions for child and adolescent mental health problems in primary care, and interventions designed to improve the skills of primary care staff. METHODS: Searches were made of The Cochrane Clinical Trials Register, MEDLINE, PSYCINFO, EMBASE and CINAHL, together with correspondence with subject experts and authors of studies, and checking of references in identified papers. RESULTS AND CONCLUSIONS: There was some preliminary evidence that treatments by specialist staff working in primary care were effective, although the quality of included studies was variable and no data were available on the cost-effectiveness of interventions. Equally, some educational interventions show potential for increasing the skills and confidence of primary care staff, but controlled evaluations were rare and few studies reported actual changes in professional behaviour or patient health outcomes. A significant programme of research is required if the potential for child and adolescent mental health services in primary care is to be realized in an effective and efficient way.

Adolescent↗
PubMed2001

Randomized trial of group therapy for repeated deliberate self-harm in adolescents.

OBJECTIVE: To compare group therapy with routine care in adolescents who had deliberately harmed themselves on at least two occasions within a year. METHOD: Single-blind pilot study with two randomized parallel groups that took place in Manchester, England. Sixty-three adolescents aged 12 through 16 years were randomly assigned to group therapy and routine care or routine care alone. Outcome data on suicide attempts were obtained without knowledge of treatment allocation on all randomized cases (62/63 by direct interview) on average 29 weeks later. The primary outcomes were depression and suicidal behavior. RESULTS: In intention-to-treat analyses, adolescents who had group therapy were less likely to be "repeaters" at the end of the study (i.e., to have repeated deliberate self-harm on two or more further occasions) than adolescents who had routine care (2/32 versus 10/31; odds ratio 6.3), but the confidence intervals for this ratio were wide (95% confidence interval 1.4 to 28.7). They were also less likely to use routine care, had better school attendance, and had a lower rate of behavioral disorder than adolescents given routine care alone. The interventions did not differ, however, in their effects on depression or global outcome. CONCLUSIONS: Group therapy shows promise as a treatment for adolescents who repeatedly harm themselves, but larger studies are required to assess more accurately the efficacy of this intervention.

Adolescent↗
PubMed2001

The Maudsley long-term follow-up of child and adolescent depression. 1. Psychiatric outcomes in adulthood.

BACKGROUND: Strong links exist between juvenile and adult depression but comorbid conduct disorder in childhood may mitigate this continuity. AIMS: To test the impact of comorbid conduct disorder on psychiatric adult outcomes. METHOD: A group of 149 subjects assessed at the Maudsley Hospital in the period 1970-1983 and meeting DSM-IV criteria for major depressive disorder with (n=53) or without (n=96) conduct disorder were interviewed 20 years later. Data were collected on the lifetime history of psychiatric disorders. RESULTS: Adult depressive recurrence was high for major depression (62.4%) and any depression (75.2%), and survival analyses showed no difference between the two groups. The group with conduct disorders had higher rates of drug misuse and dependence, alcoholism and antisocial personality disorders. CONCLUSIONS: Adolescent depression carries an elevated risk of adult depression irrespective of comorbidity. Comorbid conduct disorder in childhood is associated with raised rates of other psychiatric outcomes.

Adolescent↗
PubMed2001

The Maudsley long-term follow-up of child and adolescent depression. 2. Suicidality, criminality and social dysfunction in adulthood.

BACKGROUND: Strong links exist between juvenile and adult depression, but comorbid conduct disorder may be associated with worse adult social difficulties. AIMS: To test the impact of comorbid conduct disorder on social adjustment and dysfunction, suicidality and criminality of adults who had had depression as youths. METHOD: Subjects (n=149) assessed at the Maudsley Hospital in 1970-1983 and meeting DSM-IV criteria for major depressive disorder with (CD-MDD; n=53) or without (MDD; n=96) conduct disorder were interviewed 20 years later. Data were collected on lifetime psychiatric disorders and adult social/personality functioning. Death certificates and criminal records were obtained. RESULTS: The suicide risk was 2.45%, and 44.3% of the sample had attempted suicide once in their lives. Compared with the MDD group, the CD-MDD group had higher rates of suicidal behaviours and criminal offences, and exhibited more pervasive social dysfunction. CONCLUSIONS: Adolescent depression is associated with raised risks of adult suicidality and with persistent interpersonal difficulties. Youths with CD-MDD show more severe and pervasive social dysfunction.

Adolescent↗
PubMed2001

Examining the comorbidity of ADHD-related behaviours and conduct problems using a twin study design.

BACKGROUND: Although attention-deficit hyperactivity disorder (ADHD) and conduct disorder (CD) frequently co-occur, the underlying mechanisms for this comorbidity are not well understood. AIMS: To examine whether ADHD and conduct problems share common risk factors and whether ADHD+CD is a more heritable variant of ADHD. METHOD: Questionnaires were sent to 2846 families. Parent-rated data were obtained for 2082 twin pairs and analysed using bivariate genetic analysis and a liability threshold model approach. RESULTS: The overlap of ADHD and conduct problems was explained by common genetic and non-shared environmental factors influencing both categories. Nevertheless, the two categories appeared to be partly distinct in that additional environmental factors influenced conduct problems. It appeared that ADHD+CD was a genetically more severe variant of ADHD. CONCLUSIONS: Conduct problems and ADHD share a common genetic aetiology; ADHD+CD appears to be a more severe subtype in terms of genetic loading as well as clinical severity.

Adolescent↗
PubMed2001

Feeding behaviour of the aphid Rhopalosiphum padi (Hemiptera: Aphididae) on nitrogen and water-stressed barley (Hordeum vulgare) seedlings.

Electrical penetration graphs (EPGs) were used to examine the probing behaviour of adult apterous Rhopalosiphum padi (Linnaeus) on barley seedlings grown under conditions of nitrogen or water stress. Aphids took significantly longer to reach and ingest from sieve elements of nitrogen-deficient seedlings than from nitrogen-sufficient seedlings but there were no such differences between water-stressed or well-watered seedlings. On both nitrogen and water-stressed seedlings the average length of each individual period of salivation into the sieve element was significantly greater compared with their respective unstressed controls.

Animals↗
PubMed2000

Randomised comparison of the effectiveness and costs of community and hospital based mental health services for children with behavioural disorders.

OBJECTIVE: To test the hypothesis that a community based intervention by secondary child and adolescent mental health services would be significantly more effective and less costly than a hospital based intervention. DESIGN: Open study with two randomised parallel groups. SETTING: Two health districts in the north of England. PARTICIPANTS: Parents of 3 to 10 year old children with behavioural disorder who had been referred to child and adolescent mental health services. INTERVENTION: Parental education groups. MAIN OUTCOME MEASURES: Parents' and teachers' reports of the child's behaviour, parental depression, parental criticism of the child, impact of the child's behaviour on the family. RESULTS: 141 subjects were randomised to community (n=72) or hospital (n=69) treatment. Primary outcome data were obtained on 115 (82%) cases a year later. Intention to treat analyses showed no significant differences between the community and hospital based groups on any of the outcome measures, or on costs. Parental depression was common and predicted the child's outcome. CONCLUSIONS: Location of child mental health services may be less important than the range of services that they provide, which should include effective treatment for parents' mental health problems.

Child↗
PubMed2000

Deliberate self-poisoning in adolescence: why does a brief family intervention work in some cases and not others?

In a randomized trial of a brief family intervention with adolescents who had deliberately poisoned themselves, we have previously reported that, within the group of patients who did not have major depression, the family intervention was significantly superior to routine care in reducing suicidal thinking. The present paper examined whether efficacy was related to changes in family functioning or other possible mediating variables. Potential mediators included family functioning, hopelessness, depression, adolescent problem-solving and compliance with treatment. The efficacy of the family intervention in reducing suicidal ideation within the non-depressed sub-group was probably not mediated by changes in these variables. The implications of this finding are discussed.

Adolescent↗
PubMed2000

Direct detection of infectious HIV-1 in blood using a centrifugation-indicator cell assay.

Plasma HIV RNA is a useful surrogate marker for predicting HIV-1 disease progression in infected individuals but provides no information regarding the infectious viral titer. Traditional assays of infectious HIV-1 are, however, time consuming, insensitive, use non-standardized reagents and are subject to selection bias introduced by prolonged cultivation. In this pilot study infectious HIV-1 was detected directly in patient plasma using the indicator line HeLa-CD4-CCR5-LTR/beta-gal in a centrifugation-culture method. Replication competent HIV-1 was identified within 2 days of tissue culture inoculation in six (26%) of 23 plasma specimens. The capability of a new cell line, MT4-CCR5-tat, to amplify plasma HIV-1 was also tested. HIV was cultivated from ten (71%) of 14 specimens using MT4-CCR5-tat cells before titering the virus with the indicator cell assay. Using these stable cell lines in refined versions of this assay it may be feasible to develop rapid, simple methods for titering infectious plasma HIV-1 and for testing the susceptibility of the virus to antiretroviral drugs.

Blood↗