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