En idrottslärare behöver mer kunskaper och förståelse angående elever med ätstörningar. / A Sportteacher need more knowledge and understanding concerning students with eating disorders.

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Bipolar disorder (BD), previously known as manic depressive disorder, is associated with recurring episodes of depression and mania/hypomania. Currently, no definitive biological mechanisms have been pinpointed with regards to the origin and progression of BD, however, inflammation and oxidative stress have been shown to present in the brains of individuals with BD. Notably, other neurodegenerative disorders which also contain an inflammatory component including Alzheimer’s disease and Multiple Sclerosis display with disruption of the brain blood barrier (BBB). We thus propose a model of BD wherein BBB disruption facilitates inflammation and oxidative stress induced neural damage. This study looked to utilize amphetamine (AMPH) induced mania model and lipopolysaccharide (LPS) induced inflammatory model to represent BD like conditions in rats and to assess BBB permeability. We observed elevated locomotor data in response to AMPH administration and a trend of increased BBB permeability across regions following low dose chronic AMPH injections. In the LPS induced BBB permeability model, we did not detect any elevated serum C-reactive protein (CRP) or tumour necrosis factor alpha (TNF-α) levels but did see significantly elevated BBB permeability in the LPS group and lithium pre-treatment providing some protection against BBB permeability in one of our cohorts. These trends were further corroborated by a follow-up study and thus warrant further investigation into the mechanistic nature of BBB breakdown in this model. This may provide a breakthrough in understanding the pathophysiology of BD and the underlying mechanistic effects of lithium, paving the way for new more target therapeutic remedies to combat this debilitating disorder. / Thesis / Master of Science (MSc)

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The global burden of mental health disorders is rising with the world health organization recently having recognized major depressive disorder as the leading cause of disability worldwide. Nearly one in five Canadians are now estimated to struggle with a mental health disorder and Generalized Aanxiety Ddisorder (GAD) Mmajor Ddepressive Ddisorder (MDD) and Bbipolar Ddisorder are three of the most prevalent. Despite significant research into the disorders’ cause, the pathophysiology and underlying etiology of these diseases remains largely undiscovered. Recent research has highlighted the potential role of the gut microbiota in mental health, in particular in connection with anxiety. Our research aims to investigate this link in a cohort of GAD, MDD and bipolar patients recruited through the Anxiety Treatment and Research Centre at St. Joseph’s Healthcare in Hamilton, as well as through the University Health Nnetwork in Toronto. 71 GAD, 18 MDD, 17 euthymic MDD and 23 Bipolar patients provided fecal samples from which DNA was extracted, following which the V3 region of the 16S rRNA gene was amplified and sequenced using the Illumina Miseq platform. Sequencing data was analyzed through an in-house pipeline to construct community profiles of patients and age and sex matched healthy controls. My work involved analyzing the data to identify signature organisms that might identify putative disease associated microbial communities for further hypothesis generation about possible roles in disease. Furthermore, an extensive culturing effort was undertaken to identify and characterize some of the Bacteroides strains which were enriched in the GAD patient population. This study presents novel insights into some of the organisms that may be markers for a number of different diseases as well developing a better understanding of the Bacteroides that were correlated with anxiety. / Thesis / Master of Science (MSc) / Mental hHealth disorders including Ggeneralized Aanxiety Ddisorder (GAD), Mmajor Ddepressive Ddisorder (MDD) and Bbipolar Ddisorder (BD) affect somewhere between five and ten percent of Canadians, with the Wworld Hhealth Oorganization recently labeling MDD the leading cause of disability worldwide. Despite decades of research, on these disorders we still have a poor understanding of what factors may contribute to causing these disorders their underlying mechanisms of actionetiology. Another hallmark of many mental health conditions are increased rates of gastrointestinal symptomsor digestive distress relative to the healthy populatioindividualsn. Recently, there has been a great deal of research about how the trillions of bacteria that live in the digestive tract play a role in neuronal brain development and behaviour. This study aimed to better understand which the organisms reside iinn the digestive tract of mental health patients in hopes of better understanding how some of these organisms could be contributing to patients’ poor mental health. Additionally, through better understanding the nature of these communities, recommendations could potentially be made about therapeutic interventions to restore a healthy community.

Adherence to treatment recommendations following medical care for pediatric conditions is critically important for promoting optimal physical and psychological well-being. While it has been a focus of many studies across pediatric chronic illness populations, there is a dearth of research examining adherence following pediatric unintentional injury. Empirical evidence from studies with pediatric chronic illness samples indicates that youth experience a number of barriers to adherence to medical recommendations. Adherence is especially difficult for adolescents due to the unique challenges of this developmental period. A mixed methods research approach was utilized to gain a holistic understanding of potential psychological barriers to adherence following adolescent injury. Quantitative analyses examined the potential predictive roles of adolescent psychological [i.e., posttraumatic stress (PTSD), depression, quality of life] and relational (i.e., parent PTSD and depression) factors on adherence. Results of analyses were insignificant; thus, qualitative data was collected to deepen the understanding of barriers to adherence. Findings from qualitative data analyses suggested that a number of barriers to adherence to treatment recommendations exist, including: concern of pain medication addiction, competing activities, treatment side effects, health status, desire for autonomy, and symptoms of depression. Results of qualitative analyses also revealed the presence of additional factors that could facilitate adherence to treatment recommendations. Taking into consideration findings from both quantitative and qualitative analyses, adherence may be best conceptualized as a result of a dynamic decision-making process influenced by numerous interacting factors. This study is the first to examine barriers to adherence among adolescents following unintentional injury and provides an initial roadmap for understanding the mechanisms involved in this complex process. / Ph. D.

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Previous studies indicate that four childhood factors - trauma, neglect, separations, and parental psychopathology, are relevant to the etiology of borderline personality disorder (BPD). The present sought to tease apart the relative strength of relationship between these childhood factors and specific features of BPD in adults. Four hypotheses were tested. The first two are: childhood neglect is the best predictor of the BPD features 1) "chronic feelings of emptiness" and 2) "general anxiety and impulsiveness". The second two are: childhood trauma is the best predictor of 3) "self-destructive behaviors" and 4) "depersonalization and brief psychotic episodes". The sample consisted of sixty-six subjects with borderline, antisocial or schizotypal personality disorder or bipolar type II affective disorder. The latter three groups were used as psychiatric control groups. Subjects were obtained from outpatient mental health settings and advertisements for symptomatic volunteers. Thirty-four subjects met full DSM-III criteria for BPD. Ascertainment of the severity of eleven features of BPD was made using a semi-structured interview (BPD Scale). Childhood and parental psychopathology variables were assessed using semi-structured interviews based on subjects' recollections of childhood experiences. statistical procedures included stepwise multiple regression analyses designed to test the hypotheses and to determine the strongest predictor (s) for each of the remaining BPD features. The results supported all four hypotheses. In addition, the results indicated that childhood trauma was the best predictor of the BPD features "regressive behavior in psychiatric treatment", "anger and hostility in relationships", "overdependence in relationships" and overall severity of borderline psychopathology. Parental psychopathology added significant additional variance to the prediction of "overdependence in relationships" and the overall severity of borderline psychopathology. The findings suggest that, in a group of adults with a range of psychiatric illnesses, specific childhood factors are uniquely associated with specific elements of BPD. Additionally, the findings showed that the four childhood factors were significantly inter-correlated, suggesting that BPD is, in part, the result of multiple developmental factors. / 2999-01-01

Yes / Specialist services for dementia are seeing an increasing number of patients. We investigated whether interactional and linguistic features in the communication behaviour of patients with memory problems could help distinguish between those with problems secondary to neurological disorders (ND) and those with Functional Memory Disorder (FMD). In Part 1 of this study, a Diagnostic Scoring Aid (DSA) was developed encouraging linguists to provide quantitative ratings for 14 interactional features. An optimal cut-off differentiating ND and FMD was established by applying the DSA to 30 initial patient-doctor memory clinic encounters. In Part 2, the DSA was tested prospectively in ten additional cases analysed independently by two Conversation Analysts blinded to medical information. In part one, the median score of the DSA was +5 in ND and -5 in FMD (p<0.001). The optimal numeric DSA cut off (+1) identified patients with ND with a sensitivity of 86.7% and a specificity of 100%. In part two, DSA scores of rater one correctly predicted 10/10 and those of rater two 9/10 diagnoses. This study indicates that interactional and linguistic features can help distinguish between patients developing dementia and those with FMD and could aid the stratification of patients with memory problems. / NIHR Research for Patient Benefit (RfPB) Programme: PB-PG-0211-24079 – Using Conversation Analysis in the Differential Diagnosis of Memory Problems: a pilot study. 2013-2015