Friday, December 21, 2007

Social capital and children's mental health

The last decade has seen a lot of research into the links between social capital and mental health. Social capital is a measure of the community spirit of a neighbourhood and looks at things like community activities, electoral turn out and levels of voluntary work. Most of these studies have focused on adults and very few have looked into the relationship between social capital and children and adolescents' mental health. A study of 3,340 11-16 year-olds spread out over 426 different postcodes collected information on the health and socio-economic status of the children, measures of social capital and neighbourhood prosperity and how safe the children felt in their neighbourhood and how trustworthy they felt people in their area were. The researchers found that the less safe the children felt and the less trustworthy they perceived their neighbours to be the more likely they were to suffer from mental-health problems and that this perception was more important than the socio-economic nature of the neighbourhood. However, there was no link between children's actual behaviour, e.g. going to the park or the shops on their own, and their levels of mental-health problems.

Meltzer, Howard ... [et al] - Children's perceptions of neighbourhood trustworthiness and safety and their mental health Journal of Child Psychology and Psychiatry December 2007, 48(12), 1208-1213

Anxiety disorders : from childhood to adolescence

Anxiety disorders occur frequently in childhood and adolescence, are associated with substantial impairment and disability and may have a chronic (lasting) course. Children with one type of anxiety disorder can often have other types as well and childhood anxiety can lead to depression and alcohol abuse in later life. However, there have been few long-term studies into anxiety disorders following people from childhood to adolescence and beyond. A study of 906 children in North Carolina, U.S. carried out by German and Australian researchers followed three sets of children aged 9, 11 and 13 through to the age of 19. They found that childhood separation anxiety disorder carried on into adolescence. Childhood over-anxious disorder also carried on into adolescence but also led on to panic attacks, depression and conduct disorder. General anxiety disorder in childhood was related only to conduct disorder in adolescence. Social phobia in childhood led on to adolescent over-anxious disorder, social phobia and attention deficit hyperactivity disorder.

Bittner, Antje ... [et al] - What do childhood anxiety disorders predict ? Journal of Child Psychology and Psychiatry December 2007, 48(12), 1174-1183

Eating disorders in minority ethnic groups

Most studies on eating disorders have focused on white, middle-class women who are usually seen as being at more risk than other groups. Our knowledge of how eating disorders affect other ethnic and socio-economic groups is limited. A U.S. study of 884 first-year students looked at the rates of eating disorders in an ethnically diverse, low-income group and at the risk factors of physical abuse and sexual abuse before and after the age of 13. The study found that 12.2% of the girls and 7.3% of the boys could be diagnosed with an eating disorder. For women child abuse and sexual abuse both contributed equally to the development of an eating disorder while for men only sexual abuse did so. The results show that ethnic minority populations can suffer from relatively high rates of self-reported eating disorders.

Gentile, Katie ... [et al] - It doesn't happen here : eating disorders in an ethnically diverse sample of economically disadvantaged, urban college students Eating Disorders October-December 2007, 15(5), 405-425

Costs of eating disorders vs costs of substance abuse

Surveys looking into the prevalence of drug abuse usually ask people about the costs associated with their drug or alcohol use. These can include problems with physical and mental health, friendships and social life, home life and marriage, work, studies, financial well-being and housing. However, these questions are not usually asked in studies about eating disorders. A Canadian study of 1,043 women, aged between 18 and 25 asked them about their dieting, bingeing, vomiting and laxative-using behaviour as well as their use of alcohol, cigarettes and cannabis. The women were all asked how they felt these activities impeded their friendships and social lives, their physical health,their family relationships, their studies, work or employment, their financial situation and their happiness. The researchers found that the percentages of women who reported adverse consequences relating to eating disordered behaviour were comparable, if not higher, than the percentages of women who reported adverse consequences related to their substance use suggesting that future surveys into the prevalence of eating disorders should include questions about their effects on people's lives.

Piran, Niva, Robinson, Shannon R. and Cormier, Holly C. - Disordered eating behaviors and substance use in women : a comparison of perceived adverse consequences Eating Disorders October-December 2007, 15(5), 391-403

Influences on adolescent drinking

Alcohol misuse among adolescents is a substantial problem throughout the Western world and has been linked to a wide range of problems such as school problems and aggression, alcohol-related injuries and deaths, suicidal ideation and even impaired brain development. There have been various studies examining the links between drinking by adolescents' parents, siblings and within their peer group and adolescent drinking. Most of the research has been inconclusive as far as the influence of parents' drinking is concerned but there seems to be a definite link between peer-group drinking and adolescent drinking. A study of 3,760 twins in Holland has confirmed this picture, showing that in each of the three age groups studied - 12-15, 16-20 and 21-25 - regular drinking of same-sex co-twins and friends posed the highest risk for regular drinking. As adolescents got older they became less susceptible to the influence of their siblings and peer groups. For all age groups regular drinking by fathers and mothers posed the lowest risk.

Scholte, Ron H. J. ... [et al] - Relative risks of adolescent and young adult alcohol use : the role of drinking fathers, mothers, siblings, and friends Addictive Behaviors 33(2008), 1-14

Drug deaths in Scotland

Drug-related deaths (DRDs) have been increasing in Scotland over the last ten years. A team of Scottish researchers looked at the coroner's records for all the drug-related deaths in Scotland in 2003 to see what trends emerged. 80% of the deaths were male and the mean age at death was 32.8. 51% of those who died injected drugs and those who injected drugs were more likely to be younger and male. 25-44-year-olds made up 79% of the deaths by drug injection but only 47% of the other drug deaths. Heroin was involved in 87% of the deaths but two-thirds of the DRDs also tested positive for benzodiazepines.

Zador, Deborah ... [et al] - Difference between injectors and non-injectors, and high prevalence of benzodiazepines among drug related deaths in Scotland 2003 Addiction Research and Theory December 2007, 15(6), 651-662

Drink early, drink often

Young people often consume alcohol at home before a night out. Alcohol is much cheaper from off-licences and supermarkets and drink brought in this way makes up an increasing proportion of total alcohol sales. A study of 380 young people in the North West of England asked them whether they drank before they went out, how much alcohol they drank and whether they had had bad experiences on a night out. The study found that over a quarter (26.5%) of female and 15.4% of male alcohol consumption occured before going out. Those who drank before going out drank significantly more alcohol, were four times as likely to drink 20 or more units of alcohol and 2.5 times as likely to have been involved in a fight in the last year.

Hughes, Karen ... [et al] - Alchohol, nightlife and violence : the relative contributions of drinking before and during nights out to negative health and criminal justice outcomes Addiction 103(1), 60-65

Thursday, December 20, 2007

Danish suicide study shows surprising results

Studies dating back over a hundred years have highlighted the links between the risk of suicide and low income, unemployment, educational underachievement and singleness. However, a similar consistency between suicide and these factors has not been found among people with psychiatric disorders. This is important as nearly half the people who kill themselves have previously been admitted to hospital with a psychiatric disorder and more than 90% of people who commit suicide have a diagnosable psychiatric illness. A study of 96,369 patients admitted to hospital in Denmark with psychiatric problems found that higher income, employment, postgraduate education and marriage were all linked to a higher risk of suicide in this group. However, loss of earnings, employment and marriage among people who had previously had them was found to increase the risk of suicide.

Agerbo, Eshen - High income, employment, postgraduate education, and marriage : a suicidal cocktail among psychiatric patients Archives of General Psychiatry December 2007, 64(12), 1377-1384

Schizophrenia, bipolar disorder and cancer

There is a lot of speculation that people with schizophrenia have lower rates of cancer than the rest of the population. The results from the research are mixed with some studies finding lower rates, some higher and others little difference. The largest and most sophisticated study of the subject yet attempted looked at thousands of cases of six types of cancer and related them to schizophrenia and bipolar disorder. The results were adjusted to take into account the effects of smoking, body mass index, socio-economic status, other illnesses and prescribed medication. The researchers found that schizophrenia nearly doubled the risk of colon cancer and that schizophrenia patients who took antipsychotic medication had three times the risk of colon cancer. However, people with schizophrenia did have a 47% lower risk of lung cancer. People with bipolar disorder had the same risks for cancer as the rest of the population.

Hippisley-Cox, Julia ... [et al] - Risk of malignancy in patients with schizophrenia and bipolar disorder Archives of General Psychiatry December 2007, 64(12), 1368-1376

Wednesday, December 19, 2007

Hostility, drinking and death

Hostility - defined by psychologists as the willful refusal to accept that one's perceptions of the world are wrong not as anger or aggression - has been shown to predict the development of heart disease and raise the risk of death from other causes as well. Several studies have reported positive associations between hostility and alcohol consumption although they have only measured total alcohol intake rather than patterns of drinking. This is important as a pattern of heavy episodic drinking is worse for you than the same amount of alcohol spread out over a number of days. A study of 3,326 Vietnam veterans in the U.S. looked at their levels of hostility, their drinking patterns and their mortality and found that there was a link between hostility and total monthly intake of alcohol, drinks per drinking day and heavy episodic drinking and that hostility, drinks per drinking day, heavy episodic drinking and total monthly alcohol intake were all associated with an increased risk of death. The study concluded that high hostility was associated with elevated mortality and a deleterious drinking pattern characterized by relatively high intake per drinking session. The researchers suggested that this pattern of binge drinking among hostile people could help to explain why they tend to die earlier than other people.

Boyle, Stephen H. ... [et al] - Hostility, drinking pattern and mortality Addiction January 2008, 103(1), 54-59

Child rearing and suicide

Depressed people's perceptions of how they were brought up remain remarkably consistent over time regardless of the levels of depression they are experiencing. Studies have demonstrated links between suicidal thoughts and suicidal behaviour in individuals and their perception of rejecting, guilt-engendering and neglectful parents. Childhood abuse, and specifically childhood sexual abuse, have also been found to relate to suicidality. A ten-year study of 343 patients referred to a mood disorders unit in Sydney compared their perceptions of their childhood with the number of times they had tried to kill themselves. The researchers found that female patients who perceived themselves as rejected and/or neglected by either parent in childhood had a greater chance of making at least one suicide attempt in their life. However, there was no such link in male patients.

Ehnvall, A. ... [et al] - Perception of reglecting and neglectful parenting in childhood relates to lifetime suicide attempts for females - but not for males Acta Psychiatrica Scandinavica January 2008, 117, 50-56

Risk factors for post-partum psychosis

Post-partum psychosis is characterized by a rapid development of bizarre delusions, affective symptoms, sleeplessness and disorganized behaviour that jeopardizes the safety of the new-born baby and the mother as well as the long-term mental health of the infant. The incidence of psychosis within the first 3 months after delivery is 14 times higher than during the two years before pregnancy and leads to hospital admission in about one woman per 1,000 deliveries. A study of 1,133,368 first-time mothers in Sweden over a 29-year period found 1,413 hospitalized cases of post-partum psychosis. Breathing problems in the child, severe birth asphyxia, pre-term birth, caesarean section, perinatal death (of the infant) and small birthweight were all associated with an increased risk of postpartum psychosis. However, after adjustment for previous hospitalization for psychiatric problems only pre-term birth and caesarean section remained significant risk factors increasing risk by a factor of 1.2 and 1.3 respectively. Previous hospitalization for psychiatric problems increased the risk of postpartum psychosis more than a hundredfold.

A. Nager ... [et al] - Obstetric complications and postpartum psychosis : a follow-up study of 1.1 million first-time mothers between 1975 and 2003 in Sweden Acta Psychiatrica Scandinavica January 2008, 117, 12-19

High blood pressure and mild cognitive impairment

Mild cognitive impairment (MCI) - an age-related condition that involves difficulties with thinking and learning - has attracted increasing interest during the last few years as people with MCI have a five-to-six times greater than average risk of going on to develop Alzheimer's disease. There is also a link between high blood pressure and Alzheimer's disease. A study of 918 people over 65 in the U.S. checked their health and cognitive functioning over an average of 4.7 years. Over this period 334 of the participants developed MCI, 160 of them with memory problems and 174 without. High blood pressure was associated with MCI but not with memory problems or a decline in language abilities.

You can find out more about this research at

Mixed results for new schizophrenia drug

Schizophrenia is one of the most debilitating of the major psychiatric disorders and is also one of the most difficult to treat. Although a number of drugs are available to treat the condition they can cause significant side effects ; many patients experience only a partial improvement in their symptoms while up to 30% experience no relief at all. A study of 444 patients compared those taking a placebo with those taking an existing anti-psychotic drug, olanzapine and those taking a new anti-psychotic drug paliperidone. Although the new drug was found to be no more effective than olanzapine it can be taken in a long-acting, extended-release form and was found to be relatively safe.

You can find out more about this research at

Big Brother methods add to workplace stress

A study by the Economic and Social Research Council has suggested that modern working practices can put as much strain on a woman's family relationships as working an extra 120 hours a year. Team-based forms of work organization, performance-related pay and policies that emphasize the development of individual potential all create a pressure to perform which can have a detrimental effect on employees' families. Women's family relationships are more likely to be adversely effected by these employment practices than men although both sexes can suffer stress over childcare arrangements. Women are also less likely to get help from men around the home when men are subject to modern working practices.

The study also looked at computerized surveillance in the workplace which now affects more than half of all British employees. This surveillance has led to a sharp increase in work strain and feelings of exhaustion, anxiety and worry which is particularly strong among administrative and white-collar staff in places such as call centres.

You can find out more about this research at

Stress, CBT and pregnancy

Stress can have many effects on the body, including on fertility. Stress can affect the pituitary gland which can slow the release of the luteinizing hormone which triggers ovulation. A shortage of luteinizing hormone can also lead to a lower level of progesterone, a hormone necessary to nourish and sustain an embryo's implantation and early development. However, researchers from Emory University in the U.S. have shown that psychotherapy can reduce stress-related infertility. The study of 16 women divided them into two groups, one receiving cognitive behaviour therapy and relaxation techniques, the other receiving no treatment. Six of the eight women in the CBT/relaxation group regained full fertility, compared to only one in the other group, and two of them became pregnant within two months.

You can find out more about this research at

Psychotherapy for tics

People with tics are often given medication to help them with their problem but the drugs used can have limited effectiveness, unwanted side effects and poor adherence. However, a new review of the research has indicated that behavioural programmes and procedures can effectively reduce the symptoms of tic disorders. Habit-reversal training emphasizes sensitivity to tic sensations and replaces the tic behaviour with a more appropriate competing response while exposure prevention and response prevention focus on the process of habituation. All these psychological techniques were found to be effective at reducing symptoms.

You can find out more about this research at

Tuesday, December 18, 2007

PTSD, cognition and trauma

Verbal memory is partially dependent on a region of the brain called the hippocampus. Studies have shown that, in animals, stress can lead to cells dying in this area and some studies have shown a decrease in the volume of the hippocampus, together with memory problems in people suffering from post-traumatic stress disorder (PTSD). PTSD can also involve dysfunctional cognition such as an overly negative appraisal of the traumatic event ('wasn't it dreadful' rather than 'thank goodness I survived'), intrusive thoughts, worry, self-punishment, loss of control and lack of self-confidence. A study of 89 people in Germany compared people who had suffered no trauma, those who had suffered a recent trauma but were yet to develop PTSD and those suffering from PTSD. The researchers found no differences in verbal memory between any of the groups. The recent trauma victims hardly differed from the controls in terms of dysfunctional thought processes but those suffering from PTSD showed more negative appraisal, worry, self-punishment and loss of control than the other groups. Within the group of people who had recently suffered a trauma negative appraisals grew the longer it had been since the original trauma.

Elsesser, Karin and Sartory, Gudrun - Memory performance and dysfunctional cognitions in recent trauma victims and patients with post-traumatic stress disorder Clinical Psychology and Psychiatry November-December 2007, 14(6), 464-474

Mindfulness and cognition

Mindfulness is a form of meditation with rooots in Buddhist spiritual practices that has been used in a number of ways in clinical psychology including mindfulness-based stress reduction (MBSR) and dialectical behaviour therapy. Mindfulness meditation is distinguished from concentration-based meditation which trains participants to focus their attention on a single stimulus such as an object or a word. By contrast mindfulness meditation involves a broader observation of one's present moment experience i.e. physical sensations, thoughts and feelings. There is a growing body of research suggesting that mindfulness-based techniques are effective for a wide variety of conditions including depression, stress, anxiety and pain but less research on the underlying mechanisms whereby mindfulness affects cognition. A team of researchers in Canada studied 72 people to compare how MBSR affected people's concentration, attention and cognition as well as their emotional well-being and mindfulness. Those people who had undertaken an MBSR course showed improvements in emotional well-being and mindfulness but no improvements in attention. However, those people who had improved their mindfulness were better at picking objects out of drawings when asked to do so.

Anderson, Nicole D. ... [et al] - Mindfulness-based stress reduction and attentional control Clinical Psychology and Psychotherapy November-December 2007, 14(6), 449-463

Monday, December 17, 2007

Newer antidepressants in pregnancy

There has been lots of research on the use of selective serotonin reuptake inhibitors (SSRIs) in pregnancy but much less is known about more recently-introduced anti-depressants such as venlafaxine, mirtazapine, mianserin and reboxetine. A study of 732 women in Sweden who used the new drugs in pregnancy looked at the kinds of people who took them and their effects on their pregnancies and babies. The study found that the women who used the new antidepressants were older, were more likely to have been having their first child, were heavier smokers, were heavier and were more likely to be native Swedes. They were more likely to have premature births and their children were more likely to suffer from symptoms such as breathing difficulties, poor health, hypoglycemia and convulsions.

Lennestal, Roland and Kallen, Bengt - Delivery outcome in relation to maternal use of some recently introduced antidepressants Journal of Clinical Psychopharmacology December 2007, 27(6), 607-613

Friday, December 14, 2007

Antipsychotics and stroke risk in dementia patients

Neuropsychiatric symptoms, including hallucinations, agitation, delusions and aggressive behaviour are commonly seen in elderly patients with dementia. Antipsychotic drugs have been shown to be effective in treating some of these symptoms although the side effects associated with first-generation antipsychotics severely limited their use. The introduction of second-generation antipsychotics in the 1980s and 1990s which had much less severe side effects led to them becoming more popular but recent research has linked them with an increased risk of stroke. A U.S. study of 14,029 patients aged over 65 compared the risk of stroke in patients using first-generation antipsychotics, second-generation anti-psychotics and no antipsychotic drugs at all and found no difference in the level of risk of stroke between the groups.

Barnett, Mitchell J., Wehring, Heidi and Perry, Paul J. - Comparison of risk of cerebrovascular events in an elderly VA population with dementia between antipsychotic and non-antipsychotic users Journal of Clinical Psychopharmacology December 2007, 27(6), 595-601

Neighbourhood and mental health

The possiblity that the quality of neighbourhood as well as the characteristics of individuals can affect people's mental health is of increasing interest to researchers. Factors that are though to be influential include social capital - defined as 'the features of social organisation that facilitate coordination and cooperation for mutual benefit' - and the quality of the residential environment. However, a study of 1,058 individuals between 16 and 75 in Neath, South Wales found that - once all other factors had been taken into account - people's postcodes accounted for only 2% of the variation in levels of mental illness. This compared to 37% for people's household suggesting that domestic circumstances might be more significant than residential ones after all.

Thomas, Hollie ... [et al] - Mental health and quality of residential environment British Journal of Psychiatry December 2007, 191, 500-505

Intellectual disabilities and mental health problems in children

A study of 18,415 children and adolescents in the U.K. compared the rate of mental-health problems among those with intellectual disabilities to that in other children. The researchers found that the prevalence of psychiatric disorders was 36% among children with intellectual disabilities compared to 8% among children without. Children with intellectual disabilities accounted for 14% of all British children with a diagnosable psychiatric disorder. Children with intellectual disabilities were 33.4 times more likely to suffer from autism, 8.4 times more likely to be hyperkinetic and 5.7 times more likely to have conduct disorders. The cumulative risk of exposure to social disadvantage was associated with increased prevalence of mental health problems.

Emerson, Eric and Hatton, Chris - Mental health of children and adolescents with intellectual disabilities in Britain British Journal of Psychiatry December 2007, 191, 493-499

Polypharmacy in pregnancy

There is increasing concern about the use of multiple medications (polypharmacy) among people with mental-health problems and this is particularly the case when people are pregnant as the effects of taking multiple medications during pregnancy are unknown. A study of 115 pregnant women with mental-health problems in the U.S. found that the average number of medications taken during pregnancy was three although over a quarter (26.8%) of the women took between six and ten different drugs over the course of their pregnancy. The researchers found that no dose changes were made to the prescribed medications to reflect changes in metabolism during pregnancy and that the most frequently prescribed drugs for this group of women were from the opiate family.

Peindl, Kathleen S. ... [et al] - Polypharmacy in pregnant women with major psychiatric illnesses : a pilot study Journal of Psychiatric Practice, November 2007, 13(6), 385-392

Paedophiles and sex offenders compared

A study of 837 sex offenders in New York compared those who had committed offences against adolescents and adults with those who had committed offences against children. Paedophiles were older and less likely to use a weapon or force than other offenders. They were more likely to molest males or victims of both genders than female victims. They were also more likely to commit multiple acts and engage in 'deviant intercourse' (oral and anal sex) with their victims and less likely to have 'conventional' sex with them. Offenders against adolescents tended to fall halfway between paedophiles and other sex offenders.

Cohen, Lisa J. ... [et al] - Comparison of sexual offenders against children with sexual offenders against adolescents and adults : data from the New York State Sex Offender Registry Journal of Psychiatric Practice November 2007, 13(6), 373-384

OCD and sexual functioning

Obsessive-compulsive disorder (OCD) is often associated with difficulties in interpersonal relationships. The more severe people's OCD the greater the difficulties but even subclinical (some of the symptoms but not the full-blown disorder) OCD is associated with some impairment in social functioning. People with OCD often have low self-esteem, a sense of shame and dissatisfaction with their social functioning and avoid activities and contact with other people. A study of OCD and romantic functioning looked at 64 people with the condition who completed measures of OCD symptoms, depressive symptoms, intimacy, self-disclosure, relationship satisfaction and relationship worry. The more severe people's OCD the more problems they had with intimacy, relationship satisfaction and self-disclosure. However, two compulsive behaviours (washing and neutralizing) were positively correlated with several relationship variables. Fear of contamination from sexual activity was linked to the severity of OCD symptoms.

Abbey, Richard D., Clopton, James R. and Humphreys, Joy D. - Obsessive-compulsive disorder and romantic functioning Journal of Clinical Psychology December 2007, 63(12), 1181-1192

Expressed emotion and depression

Expressed emotion is a measure of the amount of criticism, hostility and emotional over-involvement that a relative expresses in reference to a psychiatric patient and has been shown to have negative effects on symptom fluctuations, treatment outcomes and relapse rates across many disorders. However, three recent studies have shown no linkage between expressed emotion and these variables. These studies asked about influential people in patients' lives not people they lived with so a study of 66 students suffering from depression in the U.S. compared those who experienced expressed emotion from people they lived with to those who experienced it from other, significant people in their lives. Only expressed emotion from family members or romantic partners who lived with participants predicted a change in depressive symptoms.

Renshaw, Keith D. - Perceived criticism only matters when it comes from those you live with Journal of Clinical Psychology December 2007, 1171-1179

Wednesday, December 12, 2007

Anorexia in twins

A new study of nearly 4,500 twins has found that men who have a twin sister are more likely to develop anorexia than other men, including those who have a twin brother. The study of Swedish twins born between 1935 and 1958 found that female twins were more likely than male twins to develop anorexia but where one twin was male and the other female the man's risk was as great as the woman's. The authors suggested that "a plausible explanation for this phenomenon is that in pregnancies bearing a female foetus a substance is produced, probably hormonal, that increases the risk of having anorexia nervosa in adulthood".

You can find out more about this research at

Schizophrenia and cancer

Despite often having poor diets and smoking people with schizophrenia have lower rates of cancer than other people. Many of the genes associated with schizophrenia are the same as the genes associated with cancer but the cells that contain the genes use them in different ways in the two disorders. In cancer the genes cause the cells to go into metabolic overdrive and multiply rapidly whereas in schizophrenia the cells slow to a crawl. It is hoped that further research will allow doctors to target these pathways leading to treatments for both schizophrenia and cancer.

You can find out more about the latest research on this topic at


An Israeli study of 248 adults with early symptoms of post-traumatic stress disorder (PTSD) has found that cognitive therapy initiated within a month of the event may help to prevent subsequent trauma-related suffering. Patients were treated for 12 weeks with cognitive therapy, cognitive behavioural therapy, an antidepressant, placebo or no intervention at all. After three months those patients who had had cognitive or cognitive behavioural therapy had significantly less PTSD symptoms than the other groups.

You can find out more about this study at

Depression and heart attacks

New research suggests that depression nearly triples the risk of death following a heart attack. The U.S. study showed that among 360 depressed post-heart-attack patients followed for more than six years those who did not recover from their depression in the first six months were more than twice as likely to die. Depression has increasingly been recognized to increase the risk for cardiovascular disease ; possible reasons for this association include sticky platelets, a condition depressed people are likely to have, or autonomic nervous activity, which increase heart irritability.

You can find out more about this research at

Rhythym and blues in bipolar patients

Interpersonal and social rhythym therapy (ISRT) is a treatment for bipolar disorder which aims to help patients maintain a consistent sleep schedule and waking-up time. People with bipolar disorder tend to have extremely sensitive body clocks which makes it much more difficult for them to recover from disruptions in sleep and routine. These can lead to night-time sleepiness and daytime exhaustion which can increase the risk of new episodes of mania and depression. ISRT involves patients working with a therapist and using a self-monitoring instrument to record and monitor the regularity of their daily routines. A study of 175 patients by researchers at the University of Pittsburgh compared the effectiveness of ISRT and conventional treatment focusing on patients' mood symptoms and the management of medication side effects (both groups took lithium carbonate). The study found that patients who participated in ISRT were able to go longer without a new episode of mania or depression than those who received clinical management.

You can find out more about this research at

Divorce and parenting

A large U.S. study by researchers at the University of Alberta compared parenting practices in 208 divorced households to those in 4,796 intact ones. The study looked at three different measures of parenting behaviour - nurturing, consistent and punitive parenting - and found no differences between divorced and stably married parents either before or after a divorce had occured.

You can find out more about this study at

Birth weight and depression

A long-term study of people's mental health by researchers at Cambridge University and the Medical Research Council has found that events very early in people's lives can have effects on their mental health years later. The forty-year study focused on anxiety and depression and found that those with poorer mental health over time were more likely to be smaller at birth and tended to reach developmental milestones later than those with good mental health. The differences with regards to early development were apparent not only for those with severe problems with their mental health but also for those with mild to moderate symptoms of depression and anxiety over time. The study supports a proposed 'fetal programming' model for depression which suggests that prenatal stress may result in permanent maladaptive changes to the developing child's brain.

You can read more about this research at

Tuesday, December 11, 2007

Spiritual interventions : how effective are they ?

The term spirituality refers to transcendent experiences with, and understandings about, God or other forces in the universe while 'religious' refers to an institutional system of beliefs, values and activities based on spiritual creeds. People can be neither, one or the other or both but both concepts have consistently been found to have an impact on people's mental health and religious or spiritual interventions have become more common in psychotherapy. A review of 31 studies of spiritual therapies carried out between 1984 and 2005 found that spiritual therapies could be effective for individuals with depression, anxiety, stress and eating disorders.

Smith, Timothy B., Bartz, Jeremy and Richards, P. Scott - Outcomes of religious and spiritual adaptations to psychotherapy : a meta-analytic review Psychotherapy Research November 2007, 17(6), 643-655

Dementia and euthanasia

A survey of 725 people in London and the South East has found that in the face of severe dementia less than 40% of people would wish to be resuscitated after a heart attack, nearly three-quarters wanted to be allowed to die passively and almost 60% agreed with euthanasia. People were more likely to be in favour of life-sustaining treatments for their partner than for themselves but less likely to be in favour of euthanasia for their partners than themselves. White people were significantly more likely to refuse life-sustaining treatment and to agree to euthanasia compared to Black and Asian people.

Williams, Nia - Public attitudes to life-sustaining treatments and euthanasia in dementia International Journal of Geriatric Psychiatry December 2007, 22(12), 1229-1234

Benzodiazepines and cognition

Despite advice to keep the duration of treatment short benzodiazepines are often prescribed for long periods of time, particularly in older people. Many people think benzodiazepines have a negative effect on people's cognition although the evidence from the research so far is inconclusive. A study of 2,105 people over 62 in Holland looked at people's benzodiazepine usage and tested their memory, intelligence and cognitive functioning over a 9-year period. At the end of the study the researchers found that benzodiazepines had a small, but statistically significant negative effect on people's long-term cognitive functioning.

Bierman, E. J.M. ... [et al] - The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent ? International Journal of Geriatric Psychiatry December 2007, 22(12), 1194-1200

Wednesday, December 05, 2007

Depression and diabetes

Depression is common among people with diabetes and can contribute to people not taking medicines, not following prescribed diets and an overall reduction in the quality of life for people with the condition. A five-year study of depression among primary-care patients in New York, Philadelphia and Pittsburgh found that depressed people with diabetes who received more resources for depression were half as likely to die over the course of the study than those who had recieved no help for their depression.

You can find out more about this study at

Genes, gender and depression

Two studies of the interactions between genes, gender, stress and depression have shown that the relationships between these different factors are more complex than many newspaper reports would suggest. Researchers looked at two groups of people one who had had deprived childhoods (suffered stress early in life) and the other who were caregivers (suffered stress later in life). They examined levels of stress and depression and related them to a variation in a gene that regulates levels of serotonin, a brain chemical known to be linked to depression. The researchers found that women with the 'short' version of the gene were more likely to suffer from depression when they were stressed whereas for men it was the 'long' version of the gene which placed them more at risk. The effect of the stress was consistent regardless of whether it occured early or late in life. The researchers suggested that those people with the gene variation ('short' in women 'long' in men) that increased the risk of stress-related depression and who are in stressful situations could benefit from preventive measures such as positive social support or training in stress-coping skills to prevent them from becoming depressed.

You can find out more about this study at

Brain activity and anorexia

A comparison of brain functioning between anorexic and normal-weight women has found differences in functioning between the two groups that could help to shed light on the development of the condition. Participants in the study were asked to guess whether a flashing question mark on a screen represented a number higher or lower than five. Correct guesses were rewarded with $2 while incorrect guesses forfeited $1. At the same time the women's brain activity was monitored. In the healthy women the brain region responsible for emotional responses, the anterior ventral striatum, showed strong differences between winning and losing, while the same regions in the anorexic women showed much less response. However, the caudate regions of the brains of the anorexic women, a region which deals with outcome and planning, were more active, suggesting that they were more focused on the consequences of their choices. The healthy women responded to wins and losses by living in the moment and moving on to the next task while the anorexic women tried to find strategies within the game and were more concerned about making mistakes. This fits in with previous research which shows that anorexics tend to worry about the future and be more perfectionist than other people.

You can find out more about this research at

Parkinson's and mental-health problems

A study of 1,850 relatives of people with Parkinson's disease in Minnesota, U.S. has found that they are at an increased risk of developing depression and anxiety disorders. Previous studies have shown that relatives of patients with Parkinson's disease have an increased risk of developing the condition themselves, and of cognitive impairment and dementia, but their risk of developing other psychiatric disorders was unknown. The study looked at brothers, sisters, mothers, fathers, sons and daughters of people with Parkinson's disease and used medical records to obtain information about mental-health problems.

You can find out more about the study at

Wednesday, November 28, 2007

Binge drinking and the metabolic syndrome

The term metabolic syndrome describes a cluster of metabolic risk factors that increase the chances of developing heart disease, stroke and type 2 diabetes including obesity, high triglycerides, low HDL cholesterol, high blood pressure and high fasting glucose. A study of 2,800 people in Western New York looked at the links between people's drinking patterns and their risk of developing metabolic syndrome. The researchers found two main patterns of drinking. 'Early peakers' were characterized by early and heavy drinking followed by a sharp reduction in alcohol intake. 'Stable drinkers' were characterized by more modest consumption spread over a longer period of life. Even though 'early peakers' were on average ten years younger they had a modestly higher risk of developing metabolic syndrome. 'Early peakers' generally began drinking earlier than 'stable drinkers' but drank for fewer years, less frequently and consumed less volume of alcohol over their lifetimes. The study raises yet more concerns over the long-term effects of binge drinking by teenagers and young adults.

You can find out more about this research at

Transcranial magnetic stimulation

Transcranial magnetic stimulation (TMS) is a non-invasive technique that excites neurons in the brain by magnetic pulses introduced through the scalp. It has generally mild side effects and is well tolerated by patients. Research studies on smaller groups of patients have been inconclusive as to its benefits but the first large-scale, multi-centre, double-blind, sham-controlled study of TMS carried out by researchers at Rush University Medical Centre in the U.S. has found that TMS was twice as effective as a 'sham' procedure. The study's author said "these results indicate that TMS provides a novel and attractive treatment option for patients with major depression who have not responded to conventional antidepressant medications".

You can find out more about this study at

Social anxiety and drinking

College students often drink heavily but it is not always the most confident people who are the heaviest drinkers. In fact research has found that it is often the most socially anxious students who drink the most. Researchers at the University of Cincinnati in the U.S. launched a pilot programme using motivational interviewing and behavioural therapy to help socially-anxious students curb tendencies that could lead on to hazardous drinking. At the end of the programme students reported a significant reduction in number of drinks consumed and in bouts of heavy drinking. They also reported that they were less fearful about being judged negatively by their peers and felt more confident about turning down a drink around people who were drinking.

You can read more about this research at

Alzheimer's drugs do not delay onset

Mild cognitive impairment (MCI) is the term used to describe the condition where people have memory problems that are more severe than those normally seen in others of their age but who otherwise have no symptoms of dementia. It is believed that people with MCI are at high risk of developing Alzheimer's disease and sometimes drugs called cholesterinase inhibitors - donepezil, rivastigmine and galantamine - are given to people with MCI in an attempt to stop them developing full-blown Alzheimer's. However, an Italian review of studies into the effects of cholesterinase inhibitors has found that they do not seem to delay the onset of dementia.

You can read more about this research at

Depression and bone density

Depression has been linked to a number of physical illnesses in particular cardiovascular disorders. Now, a study by the National Institute of Mental Health in America has found that depression can also lead to a reduction in bone mass in pre-menopausal women. The study had 133 participants, between the ages of 21 and 45 and compared bone mass in those women who had depression with those who were not depressed. 17% of depressed women had bone thinning in a part of the hip called the femoral neck compared to only 2% of other women. Low bone mass in the lower back was found in 20% of depressed women but in only 9% of non-depressed women. Blood and urine samples also showed that the depressed women had imbalances in immune-system substances , including those that produce inflammation. One of these substances IL-6 is known to promote bone loss.

You can read more about this research at

Tuesday, November 27, 2007

Insight and schizophrenia

Drug and psychological treatments can significantly reduce symptoms in schizophrenia but the condition remains very difficult to treat compared to other mental-health problems. The long-term course of schizophrenia is frequently characterized by reduced social and occupational functioning, loss of independent living, impaired quality of life, substance abuse and an increased risk of suicidal and violent behaviour. Many clinicians believe that poor insight is partially responsible for the negative prognoses of many schizophrenia patients. Insight has been defined as the awareness of having a mental disorder and of its symptoms and implications and has been shown to be at least partly lacking in approximately 50% of schizophrenia patients. There are concerns that it affects patients' adherence to treatment as they either ascribe their symptoms to other causes or refuse to accept that they are ill at all. A review of studies into insight in schizophrenia has found that insight is associated with adherence during treatment although the link between insight and long-term adherence to medication is less clear. Insight was linked to better long-term functioning but also an increased risk of depression as patients were more aware of the nature and magnitude of their problems.

Lincoln, Tania M., Lullmann, Eva and Rief, Winfried - Correlates and long-term consequences of poor insight in patients with schizophrenia : a systematic review Schizophrenia Bulletin November 2007, 33(6), 1324-1342

Modafinil for schizophrenia

Schizophrenia is considered the most important cause of chronic psychiatric disability. In recent years the cognitive and motivational impairment seen in schizophrenia have been determined to be one of the main causes of the profound and persistent disability typically produced by the disorder. Although the psychotic symptoms of schizophrenia may improve following treatment a range of cognitive deficits will often persist and the disability resulting from them has recently been considered to have a greater impact on long-term functioning than delusions and hallucinations. Recently a drug called modafinil has emerged as a possible drug to improve cognition in schizophrenia. It was initially prescribed to reduce the fatigue and sedation induced by antipsychotic medication but a review of studies into the drug shows that it may lead to better executive functioning and attention performance in patients with schizophrenia. The drugs effectiveness is affected by the patients' current levels of cognitive functioning, genetic make-up and the other drugs that they are taking at the time allowing for future treatment to be targeted at those most likely to benefit.

Morein-Zamir, Sharon, Turner, Danielle C. and Sahakian, Barbara J. - A review of the effects of modafinil on cognition in schizophrenia Schizophrenia Bulletin November 2007, 33(6), 1298-1306

ADHD : drug use soars

A study of the prescribing patterns of child psychiatrists and paediatricians at East Kent Hospitals NHS Trust has shown that drug prescribing for children with attention deficit hyperactivity disorder (ADHD) has soared by 26% in a year. The study found a 22.9% increase in stimulant prescriptions and a 40.1% increase in the prescription of non-stimulant (atomoxetine) drugs between 2005 and 2006. The increase in prescriptions reported in the Kent Journal of Mental Health comes despite recent U.S. research suggesting that drugs are no better than therapy for ADHD in the long term.

Monday, November 26, 2007

Childhood mental-health problems and criminality

There is a high prevalence of mental illness among people involved with the juvenile and criminal justice systems but there is less information about which psychiatric disorders in childhood lead on to law-breaking later. A U.S. study of 1,420 children aged 9, 11 and 13 followed them up to the age of 16 to see whether they developed any mental-health problems and up to the age of 21 to see whether they got into trouble with the law. By the end of the study 31% of the sample had one or more adult criminal charges. Overall 51.4% of male young offenders and 43.6% of female offenders had a history of childhood mental-health problems. 20.6% of the crime attributed to young women and 15.3% of the crime attributed to young men was linked to childhood mental-health problems. Severe and/or violent offences were predicted by the presence of both an emotional and a behavioural disorder during childhood.

Copeland, William E. - Childhood psychiatric disorders and young adult crime : a prospective, population-based study American Journal of Psychiatry November 2007 164(11), 1668-1675

Seasonal depression and cognition

Seasonal affective disorder (SAD) is a mood disorder in which people's depression has a clear, seasonal pattern, usually coming on in the winter months. It is though to affect at least 5% of the population and between 60 and 90% of sufferers are women. It shares many of the symptoms of non-seasonal depression such as depressed, despairing or irritable mood, loss of interest in life, feelings of worthlessness, excessive or inappropriate guilt, low self-esteem, indecisiveness, diminished ability to think or concentrate and inability to experience pleasure. However, while conventional depression usually produces loss of appetite, weight loss and insomnia, seasonal depression usually leads to craving for carbohydrates, weight gain and sleepiness. Depression can also affect people's thinking leading to deficits in verbal fluency, visual search, psychomotor speed, attention and working memory but it is not known if seasonal depression has a similar effect on people's cognitive powers. A U.S. study of 93 people found that SAD was highly prevalent (28%) compared to 8.6% for conventional depression. More women than men were affected by SAD and both SAD and depression were associated with higher rates of cognition problems in comparison to people with no affective symptoms.

Sullivan, Brianna and Payne, Tabitha W. - Affective disorders and cognitive failures : a comparison of seasonal and nonseasonal depression American Journal of Psychiatry November 2007, 164(11), 1663-1667

Friday, November 23, 2007

In case of emergency fill glass - drinking and the emergency services in Norway

Policemen and ambulancemen are often perceived to have a high prevalence of excessive alcohol consumption although there is little actual proof of this. It is thought that the male dominance of both professions, the fact that the work is organised on shift patterns and the high levels of stress involved cause an increased rate of drinking. A survey of 2,372 police and 1,096 ambulance staff in Norway found that they drank much less than their Australian counterparts and at about the same level as Norwegian doctors. 17.7% of policemen and 16.6% of ambulancemen were heavy drinkers compared to 9.1% of policewomen and 7.4% of ambulancewomen. Personnel who were male, younger and had higher levels of neuroticism had higher rates of alcohol problems. Drinking to cope was associated with higher levels of alcohol problems but was found to moderate the effect of depersonalization (e.g. a cynical and distant attitude toward one's work and the people with whom one works) and gender.

Sterud, T. ... [et al] - Occupational stress and alcohol use : a study of two nationwide samples of operational police and ambulance personnel in Norway Journal of Studies on Alchohol and Drugs November 2007, 68(6), 896-904

Mothers and drinking

The consumption of alcohol by mothers during and after pregnancy can have important effects on the developing child and it is estimated that around 1 in a 100 children has a fetal alcohol spectrum disorder. Although women generally reduce their alcohol consumption once they become pregnant they usually return to their normal drinking patterns once they have had their baby. However, frequent heavy maternal drinking is associated with poorer family functioning, poorer intellectual stimulation and increased domestic violence. A study of 381 women in Wisconsin, U.S. who were frequent/heavy drinkers before they became pregnant found that 37.8% of them drank heavily after they had had their babies. 18% reported heavy, episodic drinking, 5% reported frequent drinking only and 15% reported both frequent and heavy drinking. Women who drank heavily after having their babies were more likely than other women to have a heavy drinking partner, to have been unemployed, to have smoked following pregnancy and to have consumed alcohol after becoming pregnant. Women who breast-fed their children were less likely to report heavy drinking.

Jagodzinski, T. and Fleming, M.F. - Postpartum and alcohol-related factors associated with the relapse of heavy drinking Journal of Studies on Alchohol and Drugs November 2007, 68(6), 879-885

ADHD and drug abuse

Studies of adults with attention deficit hyperactivity disorder (ADHD) have consistently found that they are more likely to have drug problems. 17-45% of ADHD adults have histories of alcohol abuse or dependence, while 9-30% have histories of drug abuse or dependence. At the same time the levels of ADHD are much higher among drug abusers than the rest of the population. Some researchers have suggested that the amphetamine-based treatments for ADHD can cause drug problems while others suggest that treating the problem reduces the risks of later drug abuse. A U.S. study of 206 people with ADHD compared those who had had no treatment for the condition, those who had had treatment in the past and those who were being currently treated for it. No differences were found in the prevalence of cigarette smoking, alcohol or drug abuse or dependence between the groups and no differences were found in complications of drug or alcohol use.

Faraone, Stephen V. ... [et al] - A naturalistic study of the effects of pharmacotherapy on substance use disorders among ADHD adults Psychological Medicine 37(12), 1743-1752

'Conduct disorder' and ADHD in girls

Conduct disorder (bad behaviour) in girls is a serious concern and a study using officialy-defined criteria found that 7.1% of women can be diagnosed as having it over the course of their lifetime. Girls with conduct disorder have been found to be at higher risk of arrest, teenage pregnancy and academic failure. There has been a lot of research into the links between conduct disorder and attention deficit hyperactivity disorder (ADHD) in boys but much less research into the links between the two conditions in girls. A 5-year study of 262 girls in the U.S. found that ADHD was a significant risk factor for conduct disorder in childhood and adolescence. Among the girls with ADHD childhood conduct disorder was predicted by paternal antisocial personality disorder while adolescent behaviour problems were predicted by family conflict. Conduct disorder significantly predicted academic, psychiatric and sexual behaviour problems in girls with ADHD.

Monuteaux, Michael C. ... [et al] - Predictors, clinical characteristics, and outcome of conduct disorder in girls with attention-deficit/hyperactivity disorder : a longitudinal study Psychological Medicine 37(12), 1731-1741

Wednesday, November 21, 2007

Delayed distress for US soldiers

A study of U.S. soldiers returning from the conflict in Iraq has found that it sometimes takes months for mental-health problems to develop meaning that there is the potential for many soldiers to go untreated if they are only assessed immediately on their return from battle. After initial findings that mental-health problems took a while to manifest themselves the U.S. Department of Defense started a second screening, to take place three to six months after the first one. A study of the first group of soldiers (88,235 people) to go through this system found that they reported more mental-health concerns such as post-traumatic stress disorder (PTSD), major depression or alcohol misuse during the second screening than at the first one with 4.4% being referred for mental-health treatment at the initial screening compared to 11.7% at the later one. Althogether 20.3% of active and 42.4% of reserve soldiers were identified as needing referral for mental-health problems. Concerns about interpersonal conflict increased fourfold between the two screenings and soldiers were much more likely to report PTSD symptoms at the second screening.

You can find out more about this research at

Asthma and PTSD

Several studies have linked asthma to anxiety disorders and depression. Now a U.S. study of 3,065 pairs of twins who both served in the Vietnam war has suggested that asthma could be linked to post-traumatic stress disorder (PTSD) as well. The study found that among all twins those who suffered from the most PTSD symptoms were 2.3 times as likely to have asthma compared to those who suffered from the least PTSD symptoms. The scientists found the association between asthma and PTSD existed even after they took into account factors such as cigarette smoking, obesity and socioeconomic status, all of which are associated with both anxiety disorders and asthma.

You can find out more about the research at

Schizophrenia and appendicitis

People with schizophrenia often suffer more from ill health than other people and a new Taiwanese study has added another health problem to the list of conditions schizophrenics are more vulnerable to. Researchers looked at the records of 100,000 people, aged 15 and over, hospitalised for appendicitis between 1997 and 2001. They found that 46.7% of schizophrenic, 43.4% of people with other mental-health problems but only 25.1% of other people went on to develop a ruptured appendix. After adjusting for age, gender, ethnicity, socioeconomic background and hospital characteristics the increased risk associated with other mental-health problems disappeared. However, once all the other factors were taken into account patients with schizoprenia were almost three times as likely to suffer from a ruptured appendix as the rest of the population.

You can find out more about this research at

Alzheimer's, ethnicity and survival

A study of 31,000 people with Alzheimer's disease in the U.S. found that people diagnosed with the condition lived, on average, 4.8 years after their diagnosis. However, there were considerable differences in the length of time people from different ethnic backgrounds survived. People from a Latin American background lived 40% longer than White people while African-Americans lived 15% longer. Asian, American Indian and White people all lived with the disease for about the same length of time.

You can find out more about this research at

Early puberty and children's backgrounds

Early puberty in girls has been found to have a negative effect on children's health, increasing the risk of mood disorders, substance abuse, adolescent pregnancy and cancers of the reproductive system. Researchers at the University of Arizona and the University of Wisconsin, Madison, followed 227 pre-school children over a number of years to see which factors led to girls going through puberty earlier. They found that children living in families with greater parental supportiveness (from both mothers and fathers), less marital conflict and less paternal depression went through puberty later than other children. Those whose mothers also started puberty later, who were from better-off families, whose mothers were more supportive of them in pre-school and who were lighter in early childhood also developed later than other children.

You can find out more about this research at

Men, women and responses to stress

Women have twice the rate of depression and anxiety of men and scientists from the University of Pennsylvania School of Medicine have found that different parts of the brain are activated under stress in the two sexes. Researchers studied 16 men and 16 women who received brain scans before, during and after they underwent a challenging arithmetic test under pressure. Participants were frequently prompted for a faster performance and asked to restart the test if they responded incorrectly. In men it was found that stress was associated with increased activity in the right pre-frontal cortex and decreased activity in the left orbitofrontal cortex. In women the limbic system - a part of the brain primarily involved in emotions - showed more activity. Women showed more lasting effects from the task although men produced more of the stress-related hormone cortisol. The research backs up evolutionary theories that men are primed for a 'fight-or-flight' response to stress whereas women tend to a 'tend and befriend' approach nurturing children and strengthening social ties to deal with adversity

Stress and cancer

Stress has been implicated in a number of different illnesses, including cancer. In the past researchers have concentrated on the way stress weakens the immune system, allowing certain tumours to evade the body's defences. Now scientists at Ohio State University believe that stress may also speed the growth of tumours as well. A chemical called noradrenaline is produced at times of stress and the researchers looked at how this chemical affected cancer cells, in the laboratory. The scientists studied multiple myeloma cells, a blood cancer which kills 10,000 Americans a year. They found that in cells in the early stages of cancer noradrenaline stimulated the cells to produce a substance called vascular endothelial growth factor which in turn stimulated the production of blood vessels allowing the cancer to grow and flourish. The research shows yet another way in which stress can damage your health and may lead to new cancer treatments as scientists try to find ways to block the action of noradrenaline.

You can find out more about this research at

Stress in older workers

A U.S. study into stress at work has found that older workers generally cope better than younger ones, who struggle with the demands of raising a family and job security. The study of 1,544 people between the ages of 53 and 85 - all of whom were working at least 20 hours a week - by researchers at the University of Michigan examined the different kinds of work stress experienced by the participants and their levels of happiness and physical health. Just over half said that they suffered from competing demands made on them at work and 47% agreed that time pressures were a source of job stress. However, only 19% said that they had poor job security, only 15% said that work interfered with their personal lives and only 2% said that their personal lives interfered with their work. Those workers who experienced less job stress were more satisfied with their life and in better physical health than those who had higher levels of stress at work.

You can find out more about the study at

Tuesday, November 20, 2007

Auditory hallucinations in children

Hallucinations are considered to be a significant symptom of psychopathology in adulthood but children also experience auditory hallucinations. Children with conduct and emotional disorders, affective syndromes, migraines, anxiety, and adjustment disorders can all have auditory hallucinations. An Australian study of children being seen by community mental health services found strong associations between auditory hallucinations in non-psychotic children and family dysfunction and break-up. The children who heard things also had significant levels of anxiety and depression. Half of the children in the study had imaginary friends.

Best, Nicole T. and Mertin, Peter - Correlates of auditory hallucinations in nonpsychotic children Clinical Child Psychology and Psychiatry October 2007, 12(4), 611-623

Net suicide

Japan has one of the highest suicide rates in the world with 32,325 people killing themselves there in 2004. Recently a new phenomenon called net suicide has developed in which suicide pacts are pre-arranged between strangers who meet over the Internet. It is thought that as many as 60 people a year die in this way. In February 2005 the death of two strangers in London was thought to be Britain's first Internet suicide leading to concerns that it could take root here. An article in the journal Clinical Child Psychology and Psychiatry examines net suicide and, in particular, considers its implications for child and adolescent mental health.

Naito, Ayumi - Internet suicide in Japan : implications for child and adolescent mental health Clinical Child Psychology and Psychiatry October 2007, 12(4), 583-597

Monday, November 19, 2007

Dieting and depression - the perils of the plateau

People on diets often experience a plateau after their initial weight loss when their weight stubbornly refuses to go down any further. A study of 11 fat men on a diet found that losing around 10% of their body weight slowed down their metabolism (meaning they burnt up less calories) and made them more hungry. The men showed increased 'cognitive dietary restraint' and their mental and physical health remained unchanged. Their risk of depression had significantly increased compared to before their weight loss. The researchers called for 'caution and reasonable objectives when prescribing a weight reduction programme for obese individuals'

Chaput, Jean-Philippe ... [et al] - Psychobiological effects observed in obese men experiencing body weight loss plateau Depression and Anxiety 24(7), 518-521

Antipsychotics for depression and anxiety

Major depression often goes hand-in-hand with anxiety. 85% of adults with major depression exhibit significant symptoms of anxiety and 58% of them have a diagnosable anxiety disorder in their lifetime. Anxiety on top of depression leads to more severe symptoms, decreased psychosocial functioning, a higher risk of suicide and longer-lasting depression. Selective serotonin reuptake inhibitors (SSRIs) and venlafaxine are the first-line treatments for depression and anxiety but in some cases only a partial cure is achieved meaning that symptoms can flare up again later. In these cases other medication is used - not always successfully. Antipsychotic drugs have been used for people with hard-to-treat depression and for people with bipolar disorder and anxiety and a recent Canadian trial on 58 patients has shown that these drugs can also be effective in patients with major depression and anxiety. Quetiapine worked quickly, produced a significant reduction in depression compared to a placebo and reduced feelings of guilt, suicide and tension. The most common side effect was an increase in sleepiness and lethargy. The researchers called for further, larger-scale studies of the drug in people with depression and anxiety.

McIntyre, Alexander, Gendron, Alain and McIntyre, Amanda - Quetiapine adjunct to selective serotonin reuptake inhibitors or venlafaxine in patients with major depression, comorbid anxiety, and residual depressive symptoms : a randomized, placebo-controlled pilot study Depression and Anxiety 24(7), 484-494

Friday, November 16, 2007

Prenatal alcohol exposure and childhood drinking problems

Prenatal alcohol exposure has been associated with childhood problems such as bad behaviour, criminality, attention deficit hyperactivity disorder (ADHD) and alcohol problems. A U.S. study of 8,621 children of 4,912 mothers found that there was an association between prenatal alcohol exposure and childhood behaviour problems even when taking all the other environmental factors into account. However, the children of mothers who drank more heavily in one pregnancy than another were found to be at equal risk of ADHD suggesting that for this condition at least environmental and genetic factors were more important than prenatal alcohol exposure.

D'Onofrio, Brian M. ... [et al] - Causal inferences regarding prenatal alcohol exposure and childhood externalizing problems Archives of General Psychiatry November 2007, 64(11), 1296-1304

Psychosis and sex offending

Studies on sex offenders have focused mainly on paraphilias, personality disorders, psychopathy and substance abuse but there has been little research into the links between psychosis and sex offending. A Danish study of 358,180 people (everyone born between 1944 and 1947) found that 2.2% of them had been hospitalized with psychosis. These men committed 8.4% of the physically aggressive sexual offences and 9% of the non-physically aggressive sexual offences committed by the men in the study. People with psychosis but not a personality disorder or a drug problem were no more likely to commit a violent sexual offence than other people but were three times more likely to commit a non-violent sexual offence. People who had psychosis and a personality disorder or a drug problem were six times more likely to commit a violent sex offence and three or five times more likely to commit a non-violent sex offence.

Alden, Amanda ... [et al] - Psychotic disorders and sex offending in a Danish birth cohort Archives of General Psychiatry November 2007, 64(11), 1251-1258

Thursday, November 15, 2007

Eating disorders and motivation to change

Motivation to change - the level of people's motivation to recover from their mental-health problems - has received considerable research attention in recent years. It has been examined in smoking, cocaine addiction, anxiety disorders, obesity and alcohol problems but much less work has been done on motivation to change and eating disorders. A Spanish study of 218 patients with eating disorders found that those with bulimia were more motivated to change than those with anorexia or EDNOS (eating disorders not otherwise specified). For all groups younger patients had less motivation to change than older ones.

Casasnovas, C. ... [et al] - Motivation to change in eating disorders : clinical and therapeutic implications European Eating Disorders Review November-December 2007 15(6), 449-456

Bulimia and borderline personality disorder

People with bulimia can range from only slightly disturbed individuals who recover with little help to people with severe personality disorders. In people with bulimia and a severe personality disorder other symptoms can include self-destructive behaviour, emotional instability, suicidal ideation and profound interpersonal and social problems. Those people with bulimia and borderline personality disorder (BPD) are regarded as the most difficult bulimia subgroup to treat and the one with the worst prognosis. A German study of 240 bulimia patients found that 13.8% of them had a diagnosis of BPD. There were no differences in binging and purging behaviour between those with and without BPD but BPD patients had significantly more feelings of ineffectiveness and less emotional self-awareness. Although the BPD group began treatment with more mental-health problems they improved as much as the other patients over the course of their treatment.

Zeeck, A. ... [et al] - Symptom severity and treatment course of bulimic patients with and without a borderline personality disorder European Eating Disorders Review November-December 2007, 15(6), 430-438

Wednesday, November 14, 2007

Asthma and depression in teenagers

A study of 1,300 children between the ages of 11 and 17 in the U.S. has found that those who had asthma were nearly twice as likely to suffer from anxiety and depression. Previous studies have suggested a link between asthma and other mental-health problems such as panic disorder. After controlling for other variables children with asthma were found to be 1.9 times as likely to suffer from anxiety and depression. Children with asthma and a mental-health problem are more likely to smoke making it harder to treat their asthma. Girls and children living in a single-parent household were more likely to suffer from anxiety and depression as were those who had recently been diagnosed with asthma and those who had higher levels of physical impairment because of the condition.

You can find out more about this research at

Early sex - surprising findings

A U.S. study of 534 same-sex twin pairs has found that those who had sex earlier were actually less likely to exhibit delinquent behaviour later in life. The study runs counter to most assumptions that relate early sex to later drug use, criminality, antisocial behaviour and emotional problems. By studying twins the researchers were able to eliminate the genetic and socio-economic variables that might otherwise influence the behaviour of adolescents. The study found that those people who had sex earlier developed better social relationships in early adulthood. The authors of the study plan further research to look at the type of relationships involved, how old the partners were and how long the relationships lasted.

You can read more about the research at

Brain maturation and ADHD

There has been a lot of coverage in the media recently about ADHD with new research claiming that medication for the condition is virtually useless. Now a new study by American researchers suggests that ADHD might be caused by delayed brain development and is something that children will eventually grow out of. Researchers studied 446 participants over a period of years and found that the development of the prefrontal cortex, which helps to suppress inappropriate actions and thoughts, focus attention, remember things from moment to moment, work for reward and control movement was delayed in children with ADHD. Conversely the motor cortex matured faster than normal in children with ADHD which could explain the restlessness and fidgetiness common in these children. On average the cortex sites attained peak thickness at an average age of 10.5 in those with ADHD compared to 7.5 for the other children.

You can read more about this research at

Monday, November 12, 2007

Personality and depression in older people

Diagnosis - particularly of mental-health problems - is not a completely objective process and can often be influenced by factors such as age, race and sex that are nothing to do with a patient's symptoms. A U.S. study of 318 older adults looked into the effects of people's personality on their diagnosis of depression. Previous studies have shown that neurotic, introverted people are more likely to suffer from depression. The researchers tested the participants' personality and measured their depressive symptoms. They found that, regardless of their actual symptoms neurotic and introverted people were more likely to be diagnosed as depressed whereas those people who were highly conscientious were less likely to be labelled as depressed

McCray, Laura W. ... [et al] - The role of patient personality in the identification of depression in older primary care patients International Journal of Geriatric Psychiatry November 2007, 22(11), 1095-1100

Depression, illness and old age

Depression in older people is a major public health problem and is often associated with physical illness. However, it is unclear whether it is the illness itself that causes the depression i.e. there is some physiological link between the illness and depression - or whether it is the effects of the illness, in terms of pain, discomfort and restricted functioning that makes people depressed. A Singaporean study of 2,611 people over 55 looked at the links between physical illness and depression. The researchers found that high blood pressure, eye problems, diabetes, arthritis, heart disease, asthma, stroke, osteoporosis, heart failure, thyroid problems and gastric problems all raised the risk of depression. However, once people's feelings about their illness and their restricted functioning were taken into account only asthma, gastric diseases, arthritis and heart problems were found still to be linked to depression.

Niti, Matthew ... [et al] - Depression and chronic medical illnesses in Asian older adults : the role of subjective health and functional status International Journal of Geriatric Psychiatry November 2007, 22(11), 1087-1094

Wednesday, November 07, 2007

Stress, anxiety and sleep

Experts recommend that adults get seven or eight hours sleep a night ; adolescents need nine hours, school-aged children 10-11 and pre-school children 11-13. However, a Finnish study of 19,199 people has found that stressful life situations can disturb an individual's sleep for at least six months after the event. For people sensitive to anxiety the chances for sleep disturbances were 2-3 times greater following a stressful event. The five-year study measured people's propensity for anxiety at the start and monitored their sleep patterns, and any stressful life events that may have occured, over the course of the study. After 'severe' life events men with anxiety were 3.11 times as likely to suffer from sleep disturbances compared with 1.13 times for men without anxiety. After divorce anxious men and women were 2.05 times as likely to have disturbed sleep compared to 1.47 times for non-anxious people.

You can find out more about the study at

Cardiovascular disease and Alzheimer's

A study of 135 people over 65 and newly diagnosed with Alzheimer's disease in Utah has found that high blood pressure and a form of irregular heartbeat called atrial fibrillation may accelerate cognitive decline associated with Alzheimer's disease. The results of the study showed that those with high blood pressure at the time of their diagnosis showed a rate of memory loss twice as fast as those with normal blood pressure. Those with atrial fibrillation at the time of their diagnosis showed a rate of memory decline 75% faster than those with normal heartbeats. The researchers involved in the study are now looking at drugs aimed at lowering blood pressure and stabilising hearbeats to see how effective they are at staving off cognitive decline.

You can find out more about this study at

Common sense, logic and schizophrenia

Common sense and logic are not always in agreement and a new study by British researchers suggests that there might be differences in the way people with schizophrenia approach conflicts between the two compared to other people. 36 people took part in the study. Participants were given a series of statements in the form of a syllogism (e.g. all plants photosynthesize, grass is a plant, therefore grass photosynthesizes) and were told that, for the purposes of the study, they should treat the first two parts of the syllogism as true. Some of the syllogisms were perfectly logical but their content was nonsense e.g. all buildings speak, hospitals do not speak therefore hospitals are not buildings while others were illogical but grounded in common sense e.g. if the sun rises then the sun is in the east, the sun is in the east, therefore the sun rises. People with schizophrenia were more successful on the task suggesting that theoretical thinking was more important to them than commonsense.

You can find out more about this study at

Energy drinks and alcohol - a dangerous cocktail

Some students drink 'energy' drinks alongside alcohol to counteract alcohol's depressive effect and to enable them to stay awake, and drink, longer. A U.S. study of 4,271 students from 10 universities found that those who mixed alcohol with energy drinks drank significantly more during a typical drinking session and got drunk twice as often. Even adjusting for the amount of alcohol drunk those who also used energy drinks were twice as likely to be hurt or injured, twice as likely to require medical attention and twice as likely to get into a car with a drunken driver. They were also twice as likely to take advantage of, or be taken advantage by someone sexually. White, male students who played sport were more likely to mix alcohol and energy drinks.

You can find out more about this study at

Overweight mothers and ADHD

A study of 12,500 children in Sweden, Finland and Denmark has suggested a link between mothers who are overweight when they become pregnant and an increased risk of Attention Deficity Hyperactivity Disorder (ADHD) in their children. The children were monitored from their time in the womb up to school age when their teachers were asked to answer a questionnaire about the child's behaviour. The correlation between the mothers' weight and ADHD was found in moderately overweight as well as obese women. Overweight women who gained a lot of weight during their pregnancy were more at risk of having a child with ADHD than normal weight women who gained the same amount of weight while expecting.

You can find out more about this study at

Mum, metabolism and memory loss

A U.S. study into Alzheimer's disease has suggested that people may be more at risk of developing the condition if their mothers had it. The researchers studied people with a family history of the disease as people with an affected parent are 4-10 times more likely to develop it. In the last twenty years a number of studies have shown that people with Alzheimer's have significant reductions in energy metabolism in certain parts of the brain and these reductions are apparent years before symptoms develop. The study, of 49 people, compared energy metabolism in the medial temporal lobes and the posterior cingulate cortex - two brain regions involved with memory storage and retrieval. The participants were also administered neuropyschological and clinical tests. People whose mother had had the disease had the largest reduction in glucose metabolism ; down by 25% in the posteriour cingulate cortex. People with no family history of the disease or whose fathers had had it showed no signs of a decrease in energy metabolism.

You can find out more about this study at

Tuesday, November 06, 2007

Interventions for problem behaviour - what are the long-term effects ?

Disruptive-behaviour problems in childhood 'predict' maladjustment (e.g. violence, criminality and school drop-out) during adolescence and adulthood. A number of intervention programmes have attempted to tackle disruptive behaviours in childhood so as to reduce these problems in later life but their long-term effects are rarely evaluated. A study of 895 boys in Montreal looked into the effect of a two-year intervention programme which the boys undertook between the ages of seven and nine. The boys were then followed up at twenty-four to see how they had got on. The intervention was made up of three different elements : social skills training aimed at promoting changes in behaviour towards peers, social acceptance and less inclination towards antisocial peers ; parenting training and the provision of information and support for teachers. Significantly more boys in the intervention group graduated from high school and fewer had a criminal record compared to the control group.

Boisjoli, Rachel ... [et al] - Impact and clinical significance of a preventive intervention for disruptive boys British Journal of Psychiatry November 2007, 164, 415-419

Depression in Europe - who are the gloomiest ?

Depression is common in later life but different studies in different countries produce different prevalence rates for the condition. A study of 22,777 people in ten different European countries (not including the UK) used the Euro-D questionnaire which was specifically designed to be used in a wide variety of different languages and cultures. Even after all the other factors had been taken into account France, Italy and Spain had the highest rates of depression. Women were more likely to suffer from mood problems while older people and those with poor verbal fluency were more likely to have problems with motivation.

Castro-Costa, E. .... [et al] - Prevalence of depressive symptoms and syndromes in later life in ten European countries : the SHARE study British Journal of Psychiatry November 2007, 164, 393-401

Monday, November 05, 2007

Schemas of juvenile delinquents

Maladaptive schemas are defined as 'cognitive structures that bias information processing regarding the self, others and the world and give rise to negative automatic thoughts and depressive feelings.' Many children with 'conduct disorder' are also suffering from depression and a study of 82 youngsters in Belgium referred for antisocial-behaviour problems compared those diagnosed with depression to the rest of the sample. The depressed children felt more disconnection from, and rejection by, their parents. In terms of their relationship with their mothers the depressed children scored higher for the maladaptive schema defectiveness/shame. The depressed children's relationships with their fathers were characterised by the maladaptive schemas abandonment/instability, emotional deprivation and defectiveness/shame. The depressed children perceived their parents as more cold, unstable, unreliable and unpredictable than the other children's.

Vlierberghe, Leen Van ... [et al] - Parental schemas in youngsters referred for antisocial behaviour problems demonstrating depressive symptoms The Journal of Forensic Psychiatry and Psychology December 2007, 18(4), 515-533

Risk factors for sex offending

Sexual offenses can lead to terrible long and short-term consequences for their victims including post-traumatic stress disorder and depression. A German study of 51 inmates in a high-security forensic hospital compared those who had been convicted of sex offenses with those who had been convicted of other crimes. The researchers found that the sex offenders were more likely to be narcissists and more likely to have been sexually abused as children.

Dudeck, Manuela ... [et al] - Forensic inpatient male sexual offenders : the impact of personality disorder and childhood sexual abuse Journal of Forensic Psychiatry and Psychology December 2007, 18(4), 494-506

Friday, November 02, 2007

Anxiety in children - long-term effects

Anxiety disorders in children are quite common and associated with significant impairment in academic, social and psychological functioning. A study of 149 Black children from low-income backgrounds in the U.S. assessed their anxiety at five and then checked on their progress after seven years. Those who were highly anxious at five had poorer academic achievement and less acceptance among their peers and were more likely to suffer from depression and anxiety.

Grover, Rachel L., Ginsburg, Golda S. and Ialongo, Nick - Psychosocial outcomes of anxious first graders : a seven-year follow-up Depression and Anxiety 24(6), 410-42-

OCD and Body Dysmorphic Disorder

The relationship between Obsessive-Compulsive Disorder (OCD) and Body Dysmorphic Disorder (BDD) is unclear and some psychiatrists think that BDD is part of the same family, or even a variation of OCD. A U.S. study of 295 people compared those with OCD, those with BDD and those with both conditions. The groups were fairly similar demographically, became ill at about the same age and suffered for about the same amount of time. However, people with BDD had poorer insight than those with OCD and were more likely to be delusional. Subjects with BDD were also significantly more likely than those with OCS to have suicidal thoughts, depression and substance abuse problems.

Phillips, Katherine A. ... [et al] - Obsessive-Compulsive disorder versus Body Dysmorphic Disorder : a comparison study of two possibly-related disorders Depression and Anxiety 24(6), 399-409

Thursday, November 01, 2007

Imaginary friends and verbal hallucinations

One of the most interesting psychological features of young children are their relationships to their imaginary friends. Between 28-65% of young children have imaginary friends and contrary to stereotypes of such children being emotionally disturbed, withdrawn and shy recent research has shown having an imaginary friend to be associated with positive developmental outcomes. Some psychologists have wondered how having an imaginary friend in childhood might affect development in adulthood and have observed how talking to an imaginary friend bears a similarity to symptoms of psychopathology such as verbal hallucinations. A study of 80 young children (4-8) in Australia and the north of England asked them whether they had an imaginary friend and then carried out a jumbled speech task on them which measures participants' likelihood of perceiving words in meaningless but speech-like auditory stimuli. The researchers found that those children who had an imaginary friend were more likely to report hearing words and phrases in the jumbled speech task independent of their age, sex and verbal ability. The findings of the study were consistent with the hypothesis that engaging with imaginary friends is one aspect of a general susceptibility to imaginary verbal experiences.

Fernyhough, Charles ... [et al] - Imaginary companions and young children's responses to ambiguous auditory stimuli : implications for typical and atypical development Journal of Child Psychology and Psychiatry November 2007, 48(11), 1094-1101

Intercountry adoption and mental illness

Intercountry adoption is increasingly common and currently involves more than 40,000 children a year in over 100 countries. Large numbers of children adopted from foreign countries are now reaching adulthood, the age of onset for most serious mental disorders, yet little is known about the effects of inter-country adoption on children's mental health. A study of children in Denmark who were adopted from abroad has found that they had a 2.9 times greater risk of developing schizophrenia than native Danes. The increased risk was independent of age at, or the region of, adoption, mental illness among foster parents, the age of foster parents or whether the foster parents lived in the city or the countryside. The foster mother's own children also had an increased (1.92 times) risk of developing schizophrenia. The researchers were not sure why this might be so but speculated that it could be due to hereditary factors in the children, traumatic experiences suffered by children prior to adoption or the disruption caused by the adoption and resettlement process itself.

Cantor-Graae, Elizabeth and Pedersen, Carsten Becker - Risk for schizophrenia in intercountry adoptees : a Danish population-based cohort study Journal of Child Psychology and Psychiatry November 2007, 48(11), 1053-1060

Seasonality and bipolar disorder

Approximately 10% of all cases of mood disorders show a seasonal pattern of recurrence but this figure is thought to be higher in bipolar disorder with some studies showing that 20% of this group have some element of seasonality in their symptoms. Some studies have shown peaks of depression in the autumn and peaks of mania in early spring and late summer while other studies have shown little difference in hospitalization rates with the seasons. A ten-year Spanish study of 325 people with bipolar disorder found that 25.5% of them showed a seasonal pattern of symptoms. There were no demographic differences between those with seasonal and non-seasonal forms of bipolar disorder. People with seasonal bipolar disorder were more likely to have the bipolar II form of the condition and were more likely to have more depression than mania. However, people with a seasonal aspect to their bipolar disorder were no more likely to be suicidal, hospitalized or suffer from psychosis.

Goikolea, J. M. ... [et al] - Clinical and prognostic implications of seasonal pattern in bipolar disorder : a 10-year follow-up of 302 patients Psychological Medicine November 2007 37(11), 1595-1599

Suicidality in adolescence

Suicidality in adolescence and young adults is a well-recognised public-health problem and globally suicide is the fifth leading cause of death in young people taking between 100,000 and 200,000 lives a year. A study of 1,684 young adults in Canada examined whether they had ever had any thoughts about taking their life, their suicide attempts and their completed suicides. The researchers found that approximately 1 in 500 of the group killed themselves. About 33 % of the participants had thought about killing themselves and 9.3 % had made at least one suicide attempt. Over half of those who had attempted to kill themselves had made their first attempt before the age of eighteen. Women were more likely than men to make suicide attempts but men were four times more likely than women to succeed in killing themselves. Apart from gender other risk factors for suicide were disruptive behaviour, childhood anxiety, child abuse and suicidal thoughts.

Brezo, Juliana ... [et al] - Natural history of suicidal behaviors in a population-based sample of young adults Psychological Medicine November 2007, 37(11), 1563-1574