Thursday, May 31, 2007

Suicide in psychiatric hospitals

There are between 150 and 200 suicides by mental health-inpatients each year in England and Wales, a figure which might be reduceable given the close proximity of mental-health professionals at the time. A study of the 222 patients who killed themselves between the first of April 1999 and the 31 December 2000 looked into the circumstances and risk factors around people's suicides. Nearly a quarter of the suicides took place within the first week of admission with most people dying on the ward or after absconding. After the first week, however, most suicides took place away from the ward, while the patients were on 'leave'. Previous self-harm, recent adverse life events and symptoms of mental illness were all associated with suicide and being off the ward without staff consent was a particularly strong predictor. Other predictors of in-patient suicide were being male, being diagnosed with depression and a history of self-harm.

Hunt, Isabelle M. ... [et al] - Suicide in current psychiatric in-patients : a case-control study Psychological Medicine June 2007, 37(6), 831-837

Suicidal thoughts

A survey of 8,580 people between the ages of 16 and 74 in the UK has found that younger adults are three times more likely to suffer from them than older people. However older people with suicidal thoughts were more likely to be suffering from depression. Tiredness with life and thoughts of death were also more common in the older group. For all ages having a small circle of friends, being divorced or separated and having poor health were all associated with an increased incidence of suicidal thoughts. Being single was an important risk factor for younger age groups while widowhood was an important risk factor for older people.

Dennis, Michael ... [et al] - The spectrum of suicidal ideation in Great Britain : comparisons across a 16-74 years age range Psychological Medicine June 2007, 37(6), 795-805

Korea veterans still suffer fifty years on

The Korean war (1950-1953) which occured when Communist troops from North Korea invaded the South is often overlooked in comparison with other conflicts such as the Second World War, the Vietnam War and the two Gulf Wars despite it being the first collective military action by the United Nations with a total of more than 4 million casualties on both sides. There have been few studies into the psychological problems experienced by Korean War veterans yet a study of 7, 632 people in Australia which compared the mental health of veterans with a control group who did not fight in the conflict found that the veterans experienced significantly more post-traumatic stress. The heavier the combat and the lower the rank of the veterans the more severe their post-traumatic stress was.

Ikin, Jillian F. ... [et al] - Anxiety, post-traumatic stress disorder and depression in Korean War veterans 50 years after the war British Journal of Psychiatry June 2007, 190, 475-483

More time in the womb, less later gloom

Being born prematurely often means that children have lower birth weights than children who are born after a full, nine-month pregnancy. Low birth weight is associated with increased risks of cardiovascular disease and type 2 diabetes later in life and with an increased risk of depression. However, there has been little research into whether being born prematurely can, in itself, lead to an increased risk of depression, regardless of the weight of the baby. A study of 1,371 people in Finland born between 1934 and 1944 asked them about their current levels of depression and compared this with the information about their birth measurements and length of gestation. The researchers found that the less time people spent in the womb the more likely they were to be depressed later regardless of how big they were at birth. The relationship between gestation length and depression still held true even when socioeconomic factors and current weight and height (early babies are more likely to be overweight and obese later in life) were taken into account.

Raikkonen, Katri ... [et al] - Length of gestation and depressive symptoms at age 60 years British Journal of Psychiatry June 2007, 190, 469-474

Wednesday, May 30, 2007

SARS leaves scars

In 2003 the world was hit by the SARS (severe acute respiratory distress syndrome) epidemic with more than 8,000 people in 29 countries being infected over the course of seven months. In Hong Kong alone 1,755 individuals were infected and 299 died. A study of people in Hong Kong both before and after the epidemic found that people who survived the disease had higher levels of stress at the time of the outbreak and that this elevated level of stress persisted a year later. By 2004 SARS survivors also showed worrying levels of depression, anxiety and post-traumatic symptoms. Those SARS survivors who were health workers at the time of the original outbreak had significantly higher stress levels then other SARS survivors in 2004 and had higher scores for depression, anxiety and post-traumatic symptoms.

Lee, Antoinette M. ... [et al] - Stress and psychological distress among SARS survivors 1 year after the outbreak Canadian Journal of Psychiatry 2007; 52: 233-240

Mindfulness may not be a magic solution for depression and anxiety

Mindfulness has been defined as the 'awareness that emerges through paying attention, on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment by moment'. Mindfulness-based stress reduction (MBSR) has been used to treat a wide range of conditions including depression, anxiety, chronic pain, cancer, eating disorders and fibromyalgia. However, a review of fifteen studies into MBSR for depression and anxiety has found the evidence of effects for its benefits to be 'equivocal'. MBSR was better than no treatment at all but this could be due to the attention paid to people by and interaction with researchers. When compared to an 'active' control group MBSR 'did not show any effect on depression and anxiety' and 'the relation between practising mindfulness and changes in depression and anxiety' was 'equivocal'. The researchers did point out, however, that relatively few trials had been done on MBSR and that much more research was needed.

Toneatto, Tony and Nguyen, Linda - Does mindfulness meditation improve anxiety and mood symptoms ? A review of the controlled research Canadian Journal of Psychiatry 2007; 52: 260-266

Borderline personality disorder

Borderline personality disorder (BPD) is characterized by unstable moods, impulsiveness, a fear of abandonment, unstable and intense personal relationships and recurrent suicide attempts. Rates of the disorder range from 0.7% in Norway to 1.8% in the U.S. 10% of people with borderline personality disorder commit suicide ; fifty times the rate of the rest of the population. One of the most promising treatments for the condition is Dialectical Behaviour Therapy (DBT) which was developed by Marsha Linehan in the 1980s and is a mixture of cognitive behaviour therapy and Eastern meditative philosophy. It aims to reduce life-threatening and suicidal behaviour and increase coping skills by improving mindfulness (living 'in the moment'), the ability to tolerate distress, personal relationships and the ability to govern one's emotions. A trial of a six-month programme of DBT on eleven women with BPD in Australia found that it was effective in reducing the number of suicide attempts. The women in the study needed less help from mental health services and their psychological, social and occupational functioning all improved. They also suffered less from depression at the end of the study.

Prendergast, Nicole and McCausland, Jean - Dialectic behaviour therapy : a 12-month collaborative program in a local community setting Behaviour Change 24(1), 2007, 25-35

Coping strategies and gambling

There are many different ways and places for people to gamble these days yet relatively few people go on to develop gambling problems. It has been suggested that individual personality traits or behavioural styles may predispose some people to develop gambling problems. A study of the coping strategies of 65 people by researchers at Monash University, Australia, compared people with gambling problems to those without. Problem gamblers were more likely to be depressed and to use distancing coping strategies ; denying problems, attempting to detach themselves from them and minimising their significance. The gamblers were also more likely to use confrontational coping ; tackling problems head on in a risky or aggressive manner.

Farrelly, Simone ... [et al] - Coping strategies and problem gambling Behaviour Change 24(1), 2007, 14-24

Thursday, May 24, 2007

Childhood trauma and depression

A study of 324 people with depression in the U.K. has added further evidence to the already considerable pile linking childhood trauma with adult mental-health problems. 79.9% of the sample reported at least one kind of childhood trauma, most commonly physical neglect, emotional abuse and emotional neglect. Those who had suffered childhood trauma had an earlier age of onset of depression and the more childhood trauma someone had suffered the earlier they became depressed. Physical neglect was particularly linked to adult anxiety.

Moskvina, Valentina ... [et al] - Interrelationship of childhood trauma, neuroticism, and depressive phenotype Depression and Anxiety 24(3) 163-168

Sociotropy, autonomy and depression

Sociotropy is defined as a combination of beliefs, behavioural tendencies and attitudes that lead a person to attend to and depend on others for personal satisfaction. Highly sociotropic individuals are characterized as emphasizing interpersonal interactions involving relatedness, empathy, approval, affection, protection, guidance and help. Autonomy is almost the opposite and is considered to be a combination of beliefs, behavioural tendencies and attitudes that lead people to focus on their own uniqueness, physical functioning and control over their environment. A highly autonomous person is characterized as emphasizing individuality, self-reliance, personal achievements and a sense of power to do what one wants. Both sociotropic and autonomous people are considered to be more at risk of depression the former because of the uncertainty surrounding all human relationships and the latter because we cannot always control our environments or achieve success in the way that we would like. A study of 261 students in Pennsylvania looked at the way sociotropy and autonomy influenced the way people interacted with people close and less-close to them. Sociotropic individuals were overly nurturant to non-close others but vindictive to people who were closer to them whereas autonomous individuals were domineering to people who were less close to them and offhand towards people who were closer to them. As the way in which we get on with other people can make a big contribution to our mental health these findings could prove useful in dealing with depression in sociotropic and autonomous individuals.

Sato, Toru and McCann, Doug - Sociotropy-autonomy and interpersonal problems Depression and Anxiety 24(3), 153-162

Wednesday, May 23, 2007

Writing autobiographies : better memory, simpler grammar

People's memory often declines as they get older. Strategies to combat this decline include the use of mnemonics (special methods for helping people to remember things) and 'maintenance' activities such as crosswords and Sudoku. A study of 18 people, aged between 62 and 84 in Texas enrolled them on an eight-week writing workshop aimed at teaching them how to write autobiographically. At the end of the eight-week study the participants' scores for verbal memory and attention showed a significant improvement. However, the complexity of the participants' writing, which the researchers had expected to increase as their writing skills improved, actually decreased over the course of the study leading the researchers to hypothesize that as people's writing skills improved they were able to express themselves in simpler, less tortuous sentences.

de Medeiros, Kate ... [et al] - The impact of autobiographic writing on memory performance in older adults : a preliminary investigation The American Journal of Geriatric Psychiatry March 2007, 15(3), 257-261

Social phobia in later life

The hallmark of social phobia is a marked fear of embarrassment in common social situations. This can lead to the avoidance of social activities resulting in impairment at work and in one's personal life and a reduced quality of life. There has been little research done into the prevalence of social phobia among older people but a recent survey of 12,792 people over 55 in Canada found that 4.94% had suffered from social phobia at some point in their lives with 1.32% having suffered during the last year. Current social phobia declined with age and was more common in people with other mental-health problems. There was no correlation between a current diagnosis of social phobia and gender, marital or socioeconomic status.

Cairney, John ... [et al] - Epidemiology of social phobia in later life The American Journal of Geriatric Psychiatry March 2007, 15(3), 224-233

It's official - travel is good for your health !

Previous research on the health effects of travel have concentrated on negative effects such as deep-vein thrombosis, economy-class syndrome and tropical diseases. However, a study of 40 Japanese women on a short package holiday has found more positive results from travel. Nobly agreeing to go on a free holiday with forty women, researchers tested the women's saliva throughout the trip for levels of a substance called chromogranin A (CgA). The higher the levels of the substance the better and, as the trip went on, the women's CgA levels increased. The effect was more pronounced in women who led a healthier lifestyle before the start of the trip.

Toda, Masahiro ... [et al] - Health-related lifestyle and patterns of behavior related to health effects of leisure travel Social Behavior and Personality 2007, 35(3), 287-293

Tuesday, May 22, 2007

Patches for Alzheimer's

Rivastigmine is widely approved for the treatment of mild to moderate Alzheimer's disease and is currently given in the form of capsules which have to be swallowed. The makers of the drug have now developed a patch - similar to the nicotine replacement patches used by smokers - and a trial on 1,195 Alzheimer's patients has found that this is effective as the capsules. The patches caused less nausea and vomiting than the capsules and only 10% of people suffered from skin irritation.

Winblad, Bengt ... [et al] - A six-month double-blind, randomized, placebo-controlled study of a transdermal patch in Alzheimer's disease - rivastigmine patch versus capsule International Journal of Geriatric Psychiatry May 2007 22(5), 456-467

Drinking up with the Joneses

A number of different studies have shown that American college students tend to overestimate how much their fellow students drink and that the more people overestimate how much others drink the more they are likely to drink themselves. Based on the theory that people modify their behaviour to act in accordance with what they see as normal several campaigns have been developed for use on US campuses aiming to correct this misperception about how much other people drink and therefore to reduce levels of alcohol consumption. However there has been little research into whether the same theory holds true on UK campuses where students are legally allowed to drink and where college authorities hold more liberal views about alcohol consumption. A study of 500 students at Paisley University found the same link between how people thought others drank and how they drank themselves (although the researchers also conceded that the link could be down to heavy drinkers justifying themselves by arguing that 'everybody does it'). The majority of respondents to the survey overestimated how much other students drank although this misperception decreased as they got older. The fact that UK students behaved the same as US ones means that some of the US campaigns telling students about the actual level of drinking of their peers could also be used over here.

McAlaney, John and McMahon, John - Normative beliefs, misperceptions and heavy episodic drinking in a British student sample Journal of Studies on Alcohol and Drugs May 2007, 68(3), 385-392

PTSD and drug abuse

There are well-established links between Post-Traumatic Stress Disorder (PTSD) and drug abuse. Among men who experience PTSD in their lifetime 52% develop alcohol problems and 35% develop drug problems and among women the rates are 28% and 27% respectively. Studies have consistently shown greater impairment on a wide variety of measures in those with PTSD and drug abuse compared to those with either problem alone. A study of 428 out-patients with cocaine addiction in the U.S. found that those people suffering from substance abuse and PTSD were more impaired to begin with and responded less well to treatment compared to those who did not have PTSD.

Najavits, Lisa M. ... [et al] - Six-month treatment outcomes of cocaine-dependent patients with and without PTSD in a multisite national trial Journal of Studies on Alcohol and Drugs May 2007, 68(3), 353-361

To sleep, to dream, to tic ...

Sleep disturbances often go hand-in-hand with Attention Deficit Hyperactivity Disorder (ADHD) and tic disorder but there have been relatively few studies of the nature of sleep problems in the two conditions. A study of 32 children in Gottingen, Germany has found that ADHD was primarily characterized by an increse in rapid eye movement (REM) sleep whereas patients with tic disorder had less efficient sleep and were lighter sleepers.

Adolescents, family therapy and anorexia

A number of studies of adolescents with anorexia nervosa have shown positive results for family therapy and several trials comparing family therapy with other treatments have shown that it is more effective than individual psychotherapy and other family interventions. A follow-up study on one of these trials looked at 38 women five years after they had taken part in the original study. The researchers found that 75% of the participants now had no eating disorder symptoms and that only 8% of the patients who had reached a healthy weight by the end of the trial had relapsed. Conjoint family therapy (where the whole family was seen together) was as effective as separated family therapy (where the eating disorder patient was seen seperately from the rest of the family) apart from when the mother of the family was more critical of the child with anorexia. In this group of people separated family therapy was found to be more effective than conjoint family therapy.

Eisler, Ivan ... [et al] - A randomised controlled treatment trial of two forms of family therapy in adolescent anorexia nervosa : a five-year follow-up Journal of Child Psychology and Psychiatry June 2007, 48(6), 552-560

Anorexia - the diminishing self

'Selflessness' - the tendency to relinquish one's own interests and ignore one's own needs in order to serve the interests and well-being of others - is a psychological feature first conceptualized, defined and measured in eating disorder patients and many researchers have emphasised the selflessness of patients with anorexia. Eating disorder patients often feel like selfless souls serving others' needs and cannot imagine other people would be willing to give up - even temporarily - their own interests and viewpoints in order to fulfil their (the eating-disorder sufferer's) needs. A study of 443 women in Israel found that as women recovered from eating disorders their scores for selflessness fell. The researchers concluded that assertion of one's own needs and interests could be an integral part of recovery from anorexia and should be emphasized in therapy.

Bachner-Melman, Rachel ... [et al] - The relationship between selflessness levels and the severity of anorexia nervosa symptomatology European Eating Disorders Review May-June 2007, 15(3), 213-220

CD Roms and bingeing

Obese people who binge eat often become obese earlier than other people and start dieting earlier. Their weight goes up and down more and they have lower self esteem. They are also more likely to suffer from depression, anxiety and personality disorders. A comparison of a self-help CD-Rom - based on cognitive behaviour therapy (CBT) - with group CBT sessions found that more people dropped out of the group-therapy sessions than stopped using the CD-Rom. People on a waiting list for treatment were more likely to choose the CD-Rom than group therapy and people who used the CD-Rom carried on using it after the study had finished. Both treatments were found to reduce bingeing and there was little to choose between them in terms of effectiveness.

Shapiro, Jennifer R. ... [et al] - Feasibility and acceptability of CD-Rom-based cognitive-behavioural treatment for binge-eating disorder European Eating Disorders Review May-June 2007, 15(3), 175-184

Buprenorphine for heroin users

Long-term heroin use can often result in illness or death. Methadone is often used to wean addicts off heroin but it can be sold on to other users and it has been known to cause death by overdose. Recently a drug called buprenorphine has been used instead of methadone as it is less likely to cause death by overdose. A trial on 96 heroin addicts in Sweden compared the effectiveness of using methadone and buprenorphine and found that both were equally effective (about 80%) in weaning people off heroin. Given the safety benefits of buprenorphine the researchers called for it to become the first choice of drug for treating heroin addicts.

Kakko, Johan ... [et al] - A stepped care strategy using buprenorphine and methadone versus conventional methadone maintenance in heroin dependence : a randomized controlled trial American Journal of Psychiatry May 2007, 164 (5), 797-803

Interpersonal psychotherapy and depression

A trial on 124 people hospitalized for major depression in Germany compared the effects of five weeks of interpersonal psychotherapy and antidepressants with the usual treatment for depression, in this case medication plus intensive clinical management. After five weeks those patients who received interpersonal psychotherapy had a significantly greater reduction in symptoms compared to patients in the other group. Response rates were higher for the interpersonal psychotherapy group (70% vs 51%) and remission rates were also higher (49% vs 34%). After three months only 3% of the interpersonal therapy group had relapsed compared to 25% of the other group. However, after nine months there was no significant difference between the two groups.

Schramm, Elisabeth ... [et al] - An intensive treatment program of interpersonal psychotherapy plus pharmacotherapy for depressed patients : acute and long-term results American Journal of Psychiatry May 2007, 164 (5), 768-777

Nutrition and dementia

A Swedish study of people with Alzheimer's disease has found that improving their diet can also help to alleviate some of the symptoms of the condition. The researchers divided the study participants into two groups. One group were treated as normal and the other group were seated together for meals and allowed to help themselves. Over a three-month period the majority of patients who ate together put on weight and those people who gained weight showed a significant improvement in intellectual function with less confusion, anxiety and depression.

Journal of Clinical Nursing (2007) 16 : 987-996

Wednesday, May 16, 2007

Distal support and schizophrenia : putting the care back into community

Since the policy of closing down long-stay psychiatric hospitals and re-integrating people into the community was introduced there has been a lot of research into the best way of helping people settle into the community. This has concentrated on employment and support networks such as friends and families but much less research has been done in the field of casual, routine interactions with other members of the public such as might occur in shops, libraries, gyms, churches etc and which is known as 'distal support'. A study of 58 people with schizophrenia in the U.S. found that extroversion and openness were important in how much distal support a person received, regardless of how severe their symptoms were. Those who received the most distal support also reported a higher quality of life and a greater sense of belonging in their neighbourhood. However, those people who reported high levels of distal support were also more likely to be hospitalized. The researchers speculated that this could be because : i) the more contact people had with others in the community the more likely it was that someone would suggest that they get help when their symptoms worsened ii) that some of the interactions that the people with high distal support had with others in the community were negative and made their symptoms worse or iii) that the extroversion and openness that made people likely to have high levels of distal support also made them more likely to seek help when they felt that their condition was worsening.

Wieland, Melissa E. ... [et al] - Distal support and community living among individuals diagnosed with schizophrenia Psychiatry Spring 2007, 70(1), 1-11

Hoarding up problems

In its most severe forms compulsive hoarding can lead to fires, rat and cockroach infestations, broken bones from tripping over clutter and other health and safety hazards. A review of studies into hoarding found that about a quarter of people with Obsessive-Compulsive Disorder (OCD) were hoarders. Those people with OCD who also hoarded were more impaired than non-hoarders and had ordering compulsions as well as contamination, sexual, religious, symmetry and somatic (to do with the body) obsessions. Hoarders were also more likely to suffer from social phobia, substance abuse and bipolar disorder. Male hoarders had higher levels of social phobia than non-hoarders whereas female hoarders had higher rates of bipolar disorder, substance abuse, alcohol abuse, panic disorder, social phobia and binge-eating. Paroxetine (an anti-depressant) has been shown to be effective in improving the mental health of people who hoard while Cognitive Behaviour Therapy (CBT) has also proved effective.

Kaplan, Aline - Hoarding : studies characterize phenotype, demonstrate treatment efficacy Psychiatric Times May 2007, 24(6), 1

Bullying - victims and perpetrators at increased risk

A study of 2,341 children, aged 13-19 in New York looked at bullying and its potential association with depression and suicidal behaviour among adolescents. About 20% of the sample reported that they were victims of bullying in school and another 10% said that they were bullied outside school. 25% of students said that they bullied other students in school and 15% said that they bullied people outside school. Children who were frequent victims of bullying in school were five times as likely to have suicidal thoughts and four times as likely to have attempted suicide than other children. However, those children who engaged in bullying behaviour were three times as likely to have suicidal thoughts and to have made suicide attempts than other children. Students who were both victims and perpetrators of bullying were at the highest risk for depression and suicidal behaviour.

Klomek, A.B. ... [et al] - Bullying, depression and suicidality in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 2007, 46, 40-49

Tuesday, May 15, 2007

Number sectioned remains steady

New figures from the Information Centre for Health and Social Care show that the number of people detained in mental health units has remained steady at 47, 400. Formal admissions under the Mental Health Act rose slightly from 26, 800 in 2004-5 to 27, 400 in 2005-6. At the 31st of March 2006 there were 14, 600 patients detained in hospital ; 12,100 in NHS facilities, 2,500 in the private sector. The rate of detentions was 87 per 100,000 population. The number of people detained under Place of Safety Orders - which allow police to remove a person who appears to have a mental disorder to a place of safety - rose from 5,100 in 2004-5 to 5,900 in 2005-6.

You can find more information about the survey at

Learning disabled children suffer

A new report by the Foundation for People with Learning Disabilities and Lancaster University has found that children with learning disabilities are up to six times as likely to suffer from mental-health problems as other children. The study, The Mental Health of Children and Adolescents with Learning Disabilities, found that the increased risk of mental illness is not always due to the learning disability per se but arises because of exposure to greater poverty and social exclusion than experienced by other children. The report, based on a survey of 18,000 children aged 5-15, found that a third of children with learning disabilities had mothers with mental-health problems and nearly half (47%) were living in poverty. Children with learning disabilities had fewer friends than other children and were more likely to suffer abuse or be involved in serious accidents.

Children drink, smoke and take drugs less shock

Children are drinking, smoking and taking drugs less now than they were five years ago, according to a report from the Information Centre for Health and Social Care. The percentage of pupils between 15 and 11 who had drunk alcohol in the previous week fell from 26% to 21% and the proportion of pupils who had never drunk alcohol rose from 40% to 46%. The percentage taking drugs in the last year fell from 19% to 17% and the percentage taking drugs in the last month fell from 11% to 9%. The level of smoking remained unchanged at 9% although the proportion of pupils who had never smoked rose from 47% in 1982 to 61% in 2004.

Monday, May 14, 2007

Risk from forensic units is very low

Secure forensic psychiatric units aim to assess, treat and rehabilitate mentally disordered offenders. Most of the people inside them suffer from severe psychotic disorders, personality disorders and substance abuse and have usually commited offences involving severe violence against the person. Between 1995 and 2001 the number of beds in NHS medium-secure units rose from 1225 to 2225 and there are proposals to increase capacity by another 29% with a similar expansion in private-sector facilities. This can often lead to concern in local communities over the offences that patients might commit when they are on supervised or unsupervised leave from their units. However a study of four medium-secure units in south-east England has found that between 1998 and 2002 only one burglary was commited by a patient on leave with no violent incidents whatsoever.

Gradillas, Vicente ... [et al] - Do forensic psychiatric inpatient units pose a risk to local communities? The Journal of Forensic Psychiatry and Psychology June 2007, 18(2), 261-265

'Just say no' helps dual diagnosis forensic patients

'Dual diagnosis' is when people have a mental-health problem and a substance-abuse problem and is common in forensic units which deal with mentally-ill offenders. Surveys of patients in such units have shown that a third are alcohol abusers and half drug abusers. Substance abuse is of particular concern in forensic mental health services as it increases the risk of crime, particularly theft and violence. As patients are often in forensic units for a considerable period of time they represent a good chance of getting patients off drink and drugs. A study of dual-diagnosis offenders at the Denis Hill unit at the Bethlem Hospital looked at a programme of two stages of 12-week treatment groups supporting people in becoming and remaining drug and alcohol free through motivational interviewing, psycho-education and relapse prevention. After their release the offenders took part in the 'Just Say No' participant-led social group to support their continued abstinence for the six months after their discharge. The study found that the 'Just Say No' group had a significant effect on whether people remained drug-free. By the end of the treatment people reported more insight into their problems, felt more confident that they could stay off drugs and felt less cravings for cannabis.

Miles, Helen ... [et al] - 'Just say no' : a preliminary evaluation of a three-stage model of integrated treatment for substance use problems in conditions of medium security The Journal of Forensic Psychiatry and Psychology June 2007, 18(2), 141-159

Getting by with a little help from their friends

A survey of 270 mental health service users has found mixed attitudes about the relationship between service users and their friends. 62% of service users said that it helped to have their friends around at times of mental distress but 44% didn't want their friends to know they had a mental health problem and nearly half (48%) felt unable to talk to their friends about their mental health problems. Nearly a third said that they had lost friends after they had confessed to a mental health problem although 60% said their friends had reacted sympathetically and 47% said that they had offered support. Two-fifths of people said that they had received more help from their friends than doctors, counsellors, families or partners. The best forms of help were just being around, emotional support and keeping in touch.

You can read the whole survey at the Mental Health Foundation's web site at

Friday, May 11, 2007

Job satisfaction high for mental health staff

The annual survey of NHS staff by the Healthcare Commission has found that, despite having a high chance of being beaten up on the job, mental health staff have one of the highest levels of job satisfaction (73%) in the NHS, second only to primary care staff (75%). 22% had experienced physical and verbal violence from service users - the same level as last year - and 34% had experienced bullying and verbal abuse. However only 10% had suffered from work-related stress or injuries - 4% down on last year. You can read more about the Healthcare Commission's survey at

GPs still neglecting depression

A survey by the mental health charities SANE and the Depression Alliance has found that, of the 450 patients surveyed 40% had not discussed treatment options with their GP while 58% wanted more ongoing support. More than half of those surveyed had stopped taking their antidepressants before the course of medication was completed - 46% because of their side effects, 22% because they wanted to come off treatment and 30% because they felt better.

You can read the full text of the Now we're talking report at

CBT and bereavement by suicide

Bereavement can often lead to psychological problems over and above the normal grieving process - something referred to as 'complicated grief'. This can be characterized by symptoms such as avoidance of reminders of the dead person, purposelessness, detachment, disbelief and bitterness. These symptoms can be particularly acute when the person being mourned has commited suicide. A Dutch trial on 122 relatives who had been bereaved by suicide looked at the effectiveness of a family-based counselling programme of four sessions with a trained psychiatric nurse counsellor between three to six months after the suicide. Unfortunately the trial found that the cognitive-behaviour therapy based treatment was not associated with a reduction in grief although it did help people to blame themselves less for their relative's suicide.

de Groot, Marieke ... [et al] - Cognitive behaviour therapy to prevent complicated grief among relatives and spouses bereaved by suicide : cluster randomised controlled trial British Medical Journal May 12, 2007, 994-996

Aspirin might save your life but it won't make you cleverer

In recent years aspirin has been hailed as something of a wonder drug in terms of reducing people's risk of heart disease and stroke. However a recent trial on 6,377 women in the U.S. has found that aspirin does not improve cognitive function. The women were divided into two groups, one group taking aspirin and the other a placebo, and given tests at periodic intervals. The women who were taking the aspirin performed no better than the placebo group.

Kang, Jae Hee ... [et al] - Low dose aspirin and cognitive function in the women's health study cognitive cohort British Medical Journal 12 May, 2007, 987-990

Thursday, May 10, 2007

Child abuse and PTSD

Many studies have shown that child abuse is responsible for long-term psychiatric disabilities, medical problems, substance abuse, learning problems, interpersonal violence and other serious social and health problems. However, there is also growing evidence that early comprehensive intervention may effectively reverse some of this damage and lessen the risks to children. Victims of child abuse are often diagnosed with Post-Traumatic Stress Disorder (PTSD) and the recommended treatment for this is Trauma-Focused Cognitive Behaviour Therapy (TF-CBT). A trial of a 16-session course of TF-CBT for abused 9-14 year-old children in New Zealand made up of psychosocial strengthening, coping-skills training and gradual exposure to perceived threats together with special issues relevant to trauma and abuse has been found to show 'a good deal of promise' in a pilot study on 4 children.

Feather, Jacqueline and Ronan, Kevin R. - Trauma-focused cognitive and behavioural therapy for abused children with post-traumatic stress disorder : a pilot study New Zealand Journal of Psychology November 2006, 35(3), 132-145

Meditation, relaxation and mental powers

There is a good body of evidence to suggest that meditation can provide considerable emotional and physical benefits to those people who practise it and, in the long-term, it can improve people's intellectual capacity too. A study of 54 people in Australia aimed to see whether meditation could also confer immediate benefits on people's thought processes. People were enrolled in either a short session of meditation or of relaxation then given tests to assess their cognitive functioning. Meditation was not found to be any more effective than relaxation on any of the measures used.

King, Gillian and Coney, Jeffrey - Short term effects of meditation versus relaxation on cognitive functioning The Journal of Transpersonal Psychology 2006, 38(2), 200-215

Mental health and physical illness in Cambodia

Mental distress often manifests itself as an undiagnosed physical illness, something that psychologists call somatic symptoms. A study of 268 people in Cambodia compared people who exhibited unexplained physical symptoms with healthy controls. The researchers found an increased incidence of traumatic events, depression, anxiety and panic in those who had somatic symptoms. Those who had suffered under Pol Pot's regime and the subsequent civil war showed more somatic symptoms and panic while those who had endured domestic violence suffered from increased levels of depression, anxiety and panic.

Perry, Christopher T., Oum, Phalyka and Gray, Sheila Hafter - The body remembers : somatic symptoms in traumatized Khmer Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry Spring 2007, 35(1), 77-84