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Fulltext Epigenetics, mental health and transgenerational epigenetic effects

Lake, H., Pridmore, S.

Malaysian Journal of Psychiatry, 2014;23(1):89-100.
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Objective: to review the field of epigenetics, and present basic and recent material that may be of interest to clinical psychiatrists. We include basic molecular mechanism, a consideration of findings related to mental disorders, evidence of sustained effects, and the evidence for and implications of transgenerational epigenetic modifications. Method: we examined all the available papers for the last five years identified by PubMed using the words ‘epigenetics’ and ‘epigenetics psychiatry’, and the available leading specialized textbooks. Results: we report on molecular mechanisms including DNA and histone modifications, and non-coding RNAs. While some modifications are short-lived, others are life-long. Depression, suicide, schizophrenia, PTSD, borderline personality disorder and drug addiction are among the conditions for which epigenetic involvement has been proposed. Transgenerational epigenetics enables the environmental experience of one generation to be non-genetically inherited by subsequent generations. This has been molecularly demonstrated in laboratory animals and epidemically suggested in humans. Conclusions: epigenetics provides a new way of understanding human behavior and points to potential therapies for mental disorders. Should it transpire that transgenerational epigenetic modifications apply with force in humans as they do to laboratory animals, this will emphasize the need for cultural shift, safe societies with ample opportunities.
Medicalisation of suicide

Pridmore S

Malays J Med Sci, 2011 Oct;18(4):78-83.
PMID: 22589676

Medicalisation is the misclassification of non-medical problems as medical problems. A common form of medicalisation is the misclassification of normal distress as a mental disorder (usually a mood disorder). Suicide is medicalised when it is considered a medical diagnosis per se, when it is considered to be secondary to a mental disorder when no mental disorder is present, and when no mental disorder is present but the management of suicidal behaviour associated with distress is believed to be the sole responsibility of mental health professionals. In the West, psychological autopsies have led to the belief that all or almost all suicide is the result of mental disorder. However, there are reservations about the scientific status of such studies. The actions of psychological autopsy researchers, coroners/magistrates, police, policy writers, and grieving relatives all contribute. Medicalisation of suicide has the potential to distort research findings, and caution is recommended.
Cutting: rare in Kelantan (Malaysia)

Pridmore S, Yaacob MJ

Aust N Z J Psychiatry, 2008 Oct;42(10):909.
PMID: 18788133
Suicide and the publicly exposed pedophile

Walter G, Pridmore S

Malays J Med Sci, 2012 Oct;19(4):50-6.
PMID: 23613648

BACKGROUND: Current clinical wisdom is that the vast majority of those who complete suicide suffer from a mental disorder. Uncritical adherence to this belief may limit our understanding and restrict the full range of prevention activities. We aimed to examine the public record for accounts of suicide by men who had been, or were about to be, investigated or apprehended for "sex only" child sex offences, with a view to presenting a collection of case histories, and identifying examples of suicide in the apparent absence of mental disorder other than pedophilia.
METHODS: The public record (hard and electronic copy) was examined.
RESULTS: Twenty case histories were identified of men with no apparent mental disorder (other than pedophilia) who completed suicide shortly after exposure or threatened public exposure and/or early or potential legal punishment.
CONCLUSION: This evidence strongly suggests that exposure or threatened public exposure of pedophilia and/or early or potential legal punishment creates a predicament, which may lead to completed suicide.
Fulltext Second Courses of Transcranial Magnetic Stimulation (TMS) in Major Depressive Episodes for Initial Responders and Non-Responders

Pridmore S, Erger S, May T

Malays J Med Sci, 2019 May;26(3):102-109.
PMID: 31303854 DOI: 10.21315/mjms2019.26.3.8

Background: Transcranial Magnetic Stimulation (TMS) is effective in major depressive episodes (MDE). However, MDE may follow a chronic, relapsing course, and some individuals may not satisfactorily respond to a first course of TMS.
Objective: To investigate the outcome of second courses of TMS.
Method: A naturalistic investigation-we prospectively studied 30 MDE in-patients and routinely collected information, including pre- and post-treatment with Six-item Hamilton Depression Rating Scale (HAMD6), a six-item Visual Analogue Scale (VAS6) and the Clinical Global Impression-Severity (CGI-S). Two categories of patients were considered: i) those who had remitted with a first course, but relapsed, and ii) those who had not remitted with the first course.
Results: Thirty individuals received a second TMS course. The mean time to the second course was 27.5 weeks. Based on the HAMD6, 26 (87%) achieved remission after the first course, and 22 (73%) achieved remission after the second course. Furthermore, based on the HAMD6 results, of the four patients who did not achieve remission with a first course, three (75%) did so with a second course.
Conclusion: In MDE, a second course of TMS is likely to help those who remitted to a first course and then relapsed, as well as those who did not achieve remission with a first course.
Fulltext Suicide: What the General Public and the Individual Should Know

Pridmore S, Money TT, Pridmore W

Malays J Med Sci, 2018 Mar;25(2):15-19.
PMID: 30918451 DOI: 10.21315/mjms2018.25.2.2

Background: The predominant, current western view is that all suicide is the result of mental disorder. This view is much too narrow and does not admit extensive information regarding the social, economic, and forensic factors (among many others) which may contribute to completed suicide. A consequence of this narrow view is that prevention strategies mainly focus on the detection and treatment of mental disorder. A preferred approach is to place greater emphasis on public health approaches to suicide prevention.
Objective: To develop and suggest a body of information which may be useful in a public health approach to suicide.
Conclusion: It is suggested that the following be available to the general public: i) suicide is a fact of life which should be minimised, ii) suicide has many different triggers, iii) most people who take their lives are able to make decisions, and iv) increased public discussion and understanding of suicide is desirable. Five pieces of information that may be useful to those contemplating suicide include: i) don't murder the part of you that wants to live, ii) suicide actions may leave you alive but disabled, iii) suicide hurts other people, iv) suicidal impulses do pass if you hold on, and v) suicide is a waste.