Affective disorders (AD), including depression have important epidemiological impact on elderly morbi-mortality been also associated to elevate suicide rates. However, AD impact on trends elderly mortality, morbidity and Brazilian health service cost (hospitalization and outpatient care) need to be more deeply investigated. Therefore, this study evaluated the trends of AD and suicide mortality in Brazilian elderly population (1996-2015) and in use of health services (hospitalization and outpatient care) and their costs in 2009 to 2015 period by a socio-ecological analysis using databank evaluable for Health Unic System (DATASUS, Brazil Ministry). The study was performed just in elderly subjects (> 60 years old) considering as co-variables: sex ad age. Linear, Joint point and multivariate regressions were used to detect change in the trends of AD and suicide mortality. Total AD mortality was slightly higher in women (1.2/100.000) than men (1.0/100.000). At contrary, suicide mortality rate was higher in men (13.5/100.000) than females (2.5/100.000). In both mortality causes, occurrence was age-dependent, with higher rates in oldest-old group (> 80 years). Hospitalizations by AD was also higher in older group, in both sex. However, hospitalization costs trend to decrease in the last four years. The whole of results suggests the necessity to construct specific preventive and treatment programs for elderly people, since this population presents important biological, functional, health and social specificities that are different of find in adults.

Antipsychotic drugs, such as haloperidol and risperidone, are used in long-term treatment of psychiatric patients and thus increase the risk of obesity and other metabolic dysfunctions. Available evidence suggests that these drugs have pro-inflammatory effect, which contributes to the establishment of endocrine disturbances. However, results yielded by extant studies are inconsistent. Therefore, in this work, we tested the in vitro effects of different high concentrations of haloperidol and risperidone on the activation of isolated macrophages (RAW 264.7 cell line). The results indicated that macrophages were activated by both drugs. In addition, the activation involved an increase in nitric oxide levels and apoptosis events by modulation of caspases 8 and 3 levels and a decrease of the Bcl-2/BAX gene expression ratio. Cells treated with haloperidol and risperidone also presented higher concentrations of inflammatory cytokines (IL-1β, IL-6, TNFα) and low levels of IL-6 anti-inflammatory cytokine in a dose-dependent manner. Despite the limitation of cell line studies based solely on macrophages cells, we suggest that antipsychotic drugs could potentially exacerbate inflammatory processes in peripheral tissues (blood and fat). The continued activation of macrophages could contribute to the development of obesity and other endocrine disturbances caused by the use of antipsychotic drugs.

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BackgroundOlanzapine (OLZ) is a second-generation antipsychotic drug used for treatment of schizophrenia, bipolar disorder, and other neuropsychiatric conditions. Undesirable side effects of OLZ include metabolic alterations associated with chronic oxidative-inflammation events. It is possible that lithium (Li), a mood modulator that exhibits anti-inflammatory properties may attenuate OLZ-induced oxi-inflammatory effects.MethodologyTo test this hypothesis we activated RAW 264.7 immortalized macrophages with OLZ and evaluated oxidation and inflammation at the gene and protein levels. Li and OLZ concentrations were determined using estimated plasma therapeutic concentrations.ResultsOLZ triggered a significant increase in macrophage proliferation at 72 h. Higher levels of oxidative markers and proinflammatory cytokines, such as TNF-α, IL-1β, and IL-6, with a concomitant reduction in IL-10, were observed in OLZ-exposed macrophages. Lithium (Li) exposure triggered a short and attenuated inflammatory response demonstrated by elevation of superoxide anion (SA), reactive oxygen species (ROS), IL-1β, and cellular proliferation followed by elevation of anti-inflammatory IL-10 levels. Li treatment of OLZ-supplemented macrophages was able to reverse elevation of oxidative and inflammatory markers and increase IL-10 levels.ConclusionsDespite methodological limitations related to in vitro protocols, results suggested that Li may attenuate OLZ-induced oxidative and inflammatory responses that result from metabolic side effects associated with OLZ.

Background: Oxidative stress and chronic inflammatory states triggered by a single-nucleotide polymorphism (SNP) in superoxide dismutase manganese-dependent gene (Val16Ala-SOD2) have been associated with the risk of developing several chronic, nontransmissible diseases. However, it is still not clear whether the VV-SOD2 genotype that causes higher basal superoxide anion levels has any impact on the risk for depression and self-reported psychological stress in elderly people. Methods: In the present study, we tested this hypothesis using a case-control study where depression was detected using the Geriatric Depression Scale-15 (GDS-15). A total of 612 Brazilian free-living elderly subjects with a mean age of 67.1 ± 7.1 years old (number of controls, C = 497, and depressive individuals, D = 115) were included in this study. All participants had similar social, health, and lifestyle variables, with the exception of polypharmacy (≥5 medicines daily intake), which was higher in the D group, compared to C subjects. Results: Our results showed that the VV-SOD2 genotype significantly increased the risk for depression and psychological stress in the elderly subjects, independently of sex/gender, age, and other prior diseases and health indicators (depression risk = 1.842, 1.109-3.061 95% CI, p = .018). VV-subjects also had a higher daily intake of antidepressants, anxiolytics, and anti-inflammatory drugs than A-allele subjects. 2 of 12 | da CRUZ JUNG et al. Conclusion:Our findings support the hypothesis that genetically induced oxidative superoxide-hydrogen peroxide imbalance may be involved in an increased risk for developing depression and psychological stress in free-living elderly people without other chronic nontransmissible diseases. K E Y W O R D Sdepression, elderly, psychological stress, superoxide dismutase polymorphism | 3 of 12 da CRUZ JUNG et al.

A one hypothesis to explain some vestibular peripheral disorders is their association with life style. Thus, studies with young adults are relevant.Aim: to analyze the prevalence of dynamic balance alterations in young adults and their possible association with life style variables, health and negative emotional states (since they can impact the outcome). Materials and Methods:we carried out a non-probabilistic cross-sectional, clinical-retrospective study with young adults (18-32 years of age) from a university with 751 individuals, with a mean age of 22.45± 3.32 years. Life style, health and negative emotional states (NES) variables -depression, stress and anxiety, were collected by means of an interview. The Unterberger test was used in order to check for indications of dynamic balance alterations. Individuals with altered dynamic balance (ADB) were compared to those without these alterations (controls).Results: From our sample, 642 (83.6%) had less than 45º of deviation, while 109 (14.2%) had greater than 45º deviation and were the considered with ADB. The ADB group had a greater prevalence of smoking, alcohol abuse/dependence, high blood pressure and NES.Conclusion: the study highlights the occurrence of ADB which needs to be corroborated in future studies. Braz J Otorhinolaryngol. 2010;76(3):392-8. ORIGINAL ARTICLE BJORL

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