Background The study estimated service coverage for severe mental disorders (psychosis, bipolar disorder and moderate-severe depression), globally and regionally, using data collected from the Mental Health Atlas 2017. Methods Service coverage was defined as the proportion of people with a disorder contacting a mental health service among those estimated to have the disorder during a 12-month period. We drew upon 12-month service utilisation data from the Mental Health Atlas 2017. Expected prevalent cases of individual disorders were estimated using the disorder-specific prevalence rate estimates of the Global Burden of Disease Study 2016 and total population sizes. Methods for assessing the validity of country-reported service utilisation data were developed and applied. Outcomes From 177 countries, 50 countries provided reliable service coverage estimates for psychosis, along with 56 countries for bipolar disorder, and 65 countries for depression. The mean service coverage for psychosis was lowest in low- [10.9% (95% confidence interval (CI) 3.3–30.4)] and lower middle-income countries [21.5% (95% CI 11.9–35.7)] and highest in high-income countries [59.5% (95% CI 42.9–74.1)]. Service coverage for bipolar disorder ranged between 3.1% (95% CI 0.8–11.5) and 10.4% (95% CI 6.7–15.8). Mean service coverage for moderate-severe depression ranged between 2.9% (95% CI 1.3–6.3) for low-income countries and 31.1% (95% CI 18.3–47.6) for high-income countries. Interpretation The reporting method utilised by the Mental Health Atlas appears to be reliable for psychosis but not for depression. This method of estimating service coverage provides progress in tracking an important indicator for mental health; however, it highlights that considerable work is needed to further develop global mental health information systems.
Cubane was recently validated as a phenyl ring (bio)isostere, but highly strained caged carbocyclic systems lack π character, which is often critical for mediating key biological interactions. This electronic property restriction associated with cubane has been addressed herein with cyclooctatetraene (COT), using known pharmaceutical and agrochemical compounds as templates. COT either outperformed or matched cubane in multiple cases suggesting that versatile complementarity exists between the two systems for enhanced bioactive molecule discovery.
Epidemiological and rodent studies suggest an association between vitamin D deficiency and brain disorders. To date, many mechanisms have been proposed to explain the role of vitamin D on brain function. However, no causal relationship between vitamin D deficiency and a specific brain disorder has been established. It is plausible that exposure to an additional insult alters the vulnerability of the brain to vitamin D deficiency. To our knowledge, a limited number of rodent studies have combined the second-hit insult (e.g. inflammation) with adult vitamin D (AVD) deficiency to examine brain outcomes. This review summarized the impact of multiple second-hit exposures on AVD-deficient animal models. AVD deficiency has been shown to impair hippocampal-dependent cognition in several experimental models, suggesting that the hippocampus could be a critical region in measuring the impact of a combined exposure. We suggest that AVD deficiency, coupled with an additional insult, could impair hippocampal-dependent cognition in a range of brain disorders and provide possible avenues for future research.
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