Friday, December 21, 2007

Social capital and children's mental health

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

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

Anxiety disorders : from childhood to adolescence

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

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

Eating disorders in minority ethnic groups

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

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

Costs of eating disorders vs costs of substance abuse

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

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

Influences on adolescent drinking

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

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

Drug deaths in Scotland

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

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

Drink early, drink often

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

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

Thursday, December 20, 2007

Danish suicide study shows surprising results

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

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

Schizophrenia, bipolar disorder and cancer

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

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

Wednesday, December 19, 2007

Hostility, drinking and death

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

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

Child rearing and suicide

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

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

Risk factors for post-partum psychosis

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

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

High blood pressure and mild cognitive impairment

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

You can find out more about this research at

Mixed results for new schizophrenia drug

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

You can find out more about this research at

Big Brother methods add to workplace stress

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

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

You can find out more about this research at

Stress, CBT and pregnancy

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

You can find out more about this research at

Psychotherapy for tics

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

You can find out more about this research at

Tuesday, December 18, 2007

PTSD, cognition and trauma

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

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

Mindfulness and cognition

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

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

Monday, December 17, 2007

Newer antidepressants in pregnancy

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

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

Friday, December 14, 2007

Antipsychotics and stroke risk in dementia patients

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

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

Neighbourhood and mental health

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

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

Intellectual disabilities and mental health problems in children

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

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

Polypharmacy in pregnancy

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

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

Paedophiles and sex offenders compared

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

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

OCD and sexual functioning

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

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

Expressed emotion and depression

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

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

Wednesday, December 12, 2007

Anorexia in twins

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

You can find out more about this research at

Schizophrenia and cancer

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

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


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

You can find out more about this study at

Depression and heart attacks

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

You can find out more about this research at

Rhythym and blues in bipolar patients

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

You can find out more about this research at

Divorce and parenting

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

You can find out more about this study at

Birth weight and depression

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

You can read more about this research at

Tuesday, December 11, 2007

Spiritual interventions : how effective are they ?

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

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

Dementia and euthanasia

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

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

Benzodiazepines and cognition

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

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

Wednesday, December 05, 2007

Depression and diabetes

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

You can find out more about this study at

Genes, gender and depression

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

You can find out more about this study at

Brain activity and anorexia

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

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Parkinson's and mental-health problems

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

You can find out more about the study at