[Consensus Regarding the Definition of Persons With Severe Mental Illness and the Number of Such Persons in the Netherlands.]

[Consensus regarding the definition of persons with severe mental illness and the number of such persons in the Netherlands.]

Tijdschr Psychiatr. 2013; 55(6): 427-438
Delespaul P

Insurance companies and mental health service planners need to have information about the prevalence of severe mental illness (smi) and about the numbers of persons affected. They require these data in order to be able to develop, implement and evaluate innovative mental health care for such patients. This information lets them draw up their budgets and define their priorities.To reach a consensus regarding the number of patients with smi in the Netherlands.A consensus was reached regarding the definition of smi, and the prevalence of smi was determined on the basis of epidemiological literature and policy papers relating to mental health care in the Netherlands. When figures from the literature were inaccurate or unavailable, estimates were checked by a group of experts.The definition of smi was adjusted and amended in relation to psychiatric comorbidity. An analysis of the care-loads of all the mental health care providers yielded an estimate of 160,000 smi patients aged 18-65, including those receiving addiction care and forensic care (1.6% of the adult population). When children and adolescents (< 18 years) and the elderly (> 65 years) were included, the total number of patients came to 216,000 (1.3%). The prevalence among the population was estimated to be 281,000 (1.7%).The Consensus group is of the opinion that the consensus document estimates of the number of smi patients in the Netherlands are as accurate as they can possibly be. Of course, the document contains assumptions and extrapolations which will require further research. The figures will be confirmed or adjusted in the future as soon as new evidence becomes available. HubMed – addiction

[The nicotine receptor as target for the improvement of cognitive symptoms in schizophrenia].

Tijdschr Psychiatr. 2013; 55(6): 415-25
Quisenaerts C, Morrens M, Sabbe B

Nicotine receptor agonists are drugs that may be useful for the treatment of cognitive symptoms in schizophrenia.By studying the relevant literature we want to investigate to what extent nicotine enhances cognition in patients with schizophrenia and to find out which domains are affected. We also attempt to identify the obstacles that might impede the use, in the future, of nicotine receptor agonists. In addition, we aim to present the most likely neurobiological working mechanism of nicotine.We searched the literature using PubMed and the search terms ‘schizophrenia’, (‘nicotine’ or ‘smoking’), ‘cognition’ and ‘P50’.Attention and visuo-spatial memory seems to respond favourably to once-only stimulation by nicotine. These results are supported both by the improvement that nicotine brought about in the signal-to-noise ratio in a P50 sensory grating paradigm and by the neurobiological findings. However, the effect of chronic nicotinergic stimulation is less clear.There is some evidence that nicotine does have a mild but acute cognition-enhancing effect in patients with schizophrenia. However, nicotine is not suitable for clinical use, because it can have side effects and lead to addiction and desensitisation of the nicotine receptor. Nevertheless, nicotine receptor agonists do have the potential to enhance and stimulate cognition. HubMed – addiction

Trends in US newspaper and television coverage of tobacco.

Tob Control. 2013 Jul 17;
Nelson DE, Pederson LL, Mowery P, Bailey S, Sevilimedu V, London J, Babb S, Pechacek T

The news media plays an important role in agenda setting and framing of stories about tobacco control. The purpose of this study was to examine newspaper, newswire and television coverage of tobacco issues in the USA over a 7-year period.Analyses of 2004-2010 news media surveillance system data from the US Centers for Disease Control and Prevention’s Office on Smoking and Health, based on content analysis and quantitative methods. Information on extent of news coverage, and types of tobacco-related themes, were examined from articles in 10 newspapers and 2 major newswires, as well as transcripts from 6 national television networks.The overall extent of newspaper, newswire and television stories about tobacco, and level of coverage by specific media outlets, varied over time, especially for newspapers. Nevertheless, there was an average of 3 newspaper stories, 4 newswire stories, and 1 television tobacco-related story each day. Television stories were more likely to contain cessation/addiction or health effects/statistics themes and less likely to contain secondhand smoke or policy/regulation themes than newspaper/newswire stories. There was more variation in the choice of tobacco theme among individual newspapers/newswires than television media outlets.News coverage of tobacco in the USA was relatively constant from 2004 to 2010. Audiences were more likely to be exposed to different tobacco themes in newspapers/newswires than on television. Tracking information about tobacco news stories can be used by advocates, programs and others for planning and evaluation, and by researchers for hypothesis generation. HubMed – addiction

Different populations of subthalamic neurons encode cocaine versus sucrose reward and predict future error.

J Neurophysiol. 2013 Jul 17;
Lardeux S, Paleressompoulle D, Pernaud R, Cador M, Baunez C

The search for treatment of cocaine addiction raises the challenge to find a way to diminish motivation for the drug without decreasing it for natural rewards. Subthalamic nucleus (STN) inactivation decreases motivation for cocaine, while increasing motivation for food, suggesting that STN can dissociate different rewards. Here, we investigated how rat STN neurons respond to cues predicting cocaine or sucrose and to these rewards delivery while rats are performing a discriminative stimuli task. We show that different neuronal populations of STN neurons encode cocaine and sucrose. In addition, we also show that STN activity at the cue onset predicts future error. When changing unexpectedly the reward predicted, STN neurons show capacities of adaptation, suggesting a role in reward prediction error. Furthermore, some STN neurons show a response to executive error (i.e. ‘oops neurons’) that is specific to the missed reward. These results position the STN as a nexus where natural rewards and drugs of abuse are coded differentially and can influence the performance. Therefore, STN can be viewed as a structure where action could be taken for the treatment of cocaine addiction. HubMed – addiction

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