Tuesday, September 30, 2008

Amygdalas and alcohol

The amygdala, hippocampus and ventral striatum are regions of the brain involved in remembering emotions, fear, reward, and aversion and reductions in the volumes of these areas have been associated with drug and alcohol problems. A German study of 103 people compared 51 alcohol-dependent people with 52 healthy controls. Before the study started the alcohol-dependent group participated in a 3-week inpatient detoxification programme and had been abstinent for 5 days. The study measured the participants' craving for alcohol and the volumes of their amygdalas, hippocampi and ventral striatums. After imaging and clinical assessments the alcohol-dependent group were followed for 6 months and their alcohol intake was recorded. The heavy drinkers showed reduced amygdala, hippocampus and ventral striatum volumes and reported stronger cravings for alcohol than the control group. However, only amygdala volume and craving differentiated between subsequent relapsers and abstainers. A significant decrease of amygdala volume in alcohol-dependent subjects was associated with increased alcohol craving before imaging and an increased alcohol intake during the 6-month follow-up period.

Wrase, Jana ... [et al] - Amygdala volume associated with alcohol abuse relapse and craving American Journal of Psychiatry September 2008, 165(9), 1179-1184

Children and maternal depression

Maternal depression has consistently been shown to be a risk factor for mental-health problems in mothers' offspring. The disorders suffered by children tend to vary by age with anxiety and behaviour disorders developing before puberty, depression in early adolescence and substance-abuse disorders in late adolescence or early adulthood. However, until recently little has been known about the effect of treatment for depressed mothers on their offspring. A study of 151 mother-child pairs in the U.S. examined the children of depressed women at baseline and in periodic follow-ups over a year. It found that over the course of a year's treatment of their mother's decreases in the children's psychiatric symptoms were significantly associated with decreases in the severity of their mother's depression. The children improved regardless of how quickly the mothers responded to treatment but not if their mothers did not respond to treatment.

Piolowsky, Daniel J. ... [et al] - Children of depressed mothers 1 year after the initiation of maternal treatment: findings from the STAR*D-Child study American Journal of Psychiatry September 2008, 165(9), 1136-1147

Monday, September 29, 2008

Oestrogen for psychosis

An Australian study looked into the effectiveness of oestrogen, combined with antipsychotic drugs, in the treatment of schizophrenia. The study included 102 women of child-bearing age with schizophrenia. For 28 days 56 of the women received 100 micrograms of estradiol daily via a skin patch while the rest of the women wore a placebo patch. The women's psychotic symptoms, including delusions and hallucinatory behaviour were assessed weekly and those taking estradiol showed a greater improvement in symptoms. However, the oestrogen treatment had no effect in improving the negative symptoms of schizophrenia.

You can find out more about this research at


Autism and eye contact

A U.S. study used eye-mapping technology to measure levels of eye contact in autistic children compared to other developmentally-delayed children and to children with no learning disabilities. Children with autism (which affects 3.4 out of every 1,000 children between the ages of 3 and 10) are thought to have problems making eye contact but this is the first study to measure it in such a sophisticated way. The study, by researchers at the Children's Hospital of Pittsburgh, compared 15 children with autism, 15 children with other developmental disabilities and 36 normally developing children. The children were shown 10 videos of adults looking directly into the camera and mimicking caregiving and playing with the child. The children with autism looked at the eyes about 30% of the time, compared to 55% for both of the other groups. The children with autism spent almost 40% of the time looking at the mouth area, compared to only 24% of the time in the children in the other groups.

You can find out more about this research at


Children in the U.S. more likely to be drugged

Researchers from the School of Pharmacy at the University of Maryland looked into the prescription of psychotropic drugs to children for conditions such as ADHD and bipolar disorder and compared the rates of prescription between different countries. The study found that children in the U.S. were three times as likely to be prescribed mind-altering drugs. In the U.S. 6.7% of children took them, compared to 2.9% in the Netherlands and 2% in Germany. The use of antidepressants and stimulants was three times higher and the use of antipsychotic drugs was 1.5-2.2 x greater in the U.S. than in Germany or the Netherlands.

You can find out more about this research at


Active social life prevents dementia

An active social life may reduce the risk of Alzheimer's disease in later life, according to a study by U.S. researchers. The study - carried out by researchers at the Center [sic] on Aging and Health at the Johns Hopkins Bloomberg School of Public Health - looked at 147 pairs of twins (all of whom were male) over the course of 28 years. Reduced dementia risk was most strongly associated with participation in home and family activities, visiting with friends and relatives, club activities (such as attending parties or playing card games) and home hobbies. Reading, studying for courses and doing extra work (overtime or other employment) all had a protective effect - but to a lesser degree - as did watching television, listening to the radio, going to the pictures or seeing theatre, art and music shows.

You can find out more about this research at


Friday, September 26, 2008

Metabolic syndrome and depression

Metabolic syndrome is a range of different risk factors for cardiovascular disease including three of the following: abdominal obesity, elevated triglycerides, low levels of high-density lipoprotein, hypertension and elevated glucose levels. Depression has been linked to metabolic syndrome but there have only been a few studies into this and gender-related differences have been largely overlooked. An Israeli study of 3,880 people who underwent a routine health check between 2003 and 2005 found that depression among women, but not men, was associated with a nearly twofold risk of metabolic syndrome and with more than twice the risk of elevated waist circumference and blood-glucose levels. Among men depression was associated with elevated waist circumference only.

Toker, Sharon, Shirom, Arie and Melamed, Samuel - Depression and the metabolic syndrome: gender-dependent association Depression and Anxiety 25(8), 661-669

Children inheriting depression

Children of depressed parents are more likely to become depressed themselves and this effect increases when both parents have problems with depression. A Dutch study of 349 people between the ages of 16 and 25 from 263 families looked into the links between gender and depression. The study found that daughters had a higher risk of depression and anxiety than sons and that the children of depressed mothers had a higher risk of anxiety than the children of depressed fathers. The sons of depressed fathers had the lowest risk of anxiety and depression relative to the other groups. A second affected parent tended to increase the risk of depression and significantly increased the risk of anxiety; this effect was most prominent in daughters when the second affected parent was the father. The daughters' risk of mental-health problems was increased by paternal and maternal depression but sons' risk only increased with maternal depression. Intergenerational transmission of emotional disorders was strongest when the female gender was involved, either in the form of a daughter or a depressed mother.

Karlien, M. C. ... [et al] - Risk of emotional disorder in offspring of depressed parents: gender differences in the effect of a second emotionally affected parent Depression and Anxiety 25(8), 653-660

New money for Alzheimer's research

The Government has announced a new pot of money for research into Alzheimer's disease. £18m of funding from the Department of Health will be split between the NHS and universities.

You can find out more about this initiative at


Wednesday, September 24, 2008

Interventions for childhood trauma

Childhood trauma can lead on to mental-health problems such as depression, anxiety and post-traumatic stress disorder (PTSD). An analysis of treatments for childhood trauma carried out by researchers at the U.S. Centers [sic] for Disease Control and Prevention in Atlanta looked into the effectiveness of individual and group cognitive behaviour therapy (CBT), play therapy, art therapy, psychodynamic therapy, psychological debriefing and drug therapy in people under 21. CBT was proven to be effective but there was a lack of evidence to support the other interventions.

You can find out more about this research at


Antipsychotic side effects in youngsters

Second-generation, or atypical, antipsychotic drugs used to treat children and adolescents with early-onset schizophrenia are no better than first-generation drugs according to a study of 119 young people by researchers at the University of North Carolina. The study compared the second-generation drugs olanzapine and risperidone to the first-generation one molindone. All three drugs had similar response rates and magnitude of reduction of symptoms and all three had frequent adverse effects. But the two atypical antipsychotics carried a significantly higher risk of weight gain and olanzapine led to a risk of increases in cholesterol, low-density lipoprotein, insulin and liver transaminase. Molindone was linked to a greater risk of akathisia (extreme and unpleasant restlessness). In the long-term the metabolic side effects of the medications could lead on to cardiovascular problems.

You can find out more about this research at


Bulimia in pregnant women

Eating disorders can occur at any age although they often begin in adolescence and women are ten times more likely to develop them than men. A study of 41,000 pregnant women taking part in the Norwegian Mother and Child Study found that 96 suffered from bulimia in the first trimester of their pregnancies, 67 had suffered from bulimia six months before their pregnancy, while 26 had developed bulimia after becoming pregnant. The women with bulimia reported lower self-esteem and less satisfaction with life and their relationship with their partner and also had a higher prevalence of symptoms associated with anxiety and depression. Women with bulimia reported a higher prevalence of life-long physical abuse, sexual abuse and major depression compared to other women.

You can read more about this research at



Post-traumatic stress disorder (PTSD) is usually associated with people who have been involved in warfare or traumatic incidents such as car accidents etc. However, research by scientists at the University of Washington School of Medicine in Seattle has found that people who have passed through intensive care units (ICUs) may also suffer from PTSD. Using data from 15 previously published studies the authors evaluated PTSD symptoms in 1,745 former ICU patients. The studies took place in the UK, US and a number of European countries. It found that 19% of patients developed PTSD after ICU treatment. Those who had had mental-health problems before going into an ICU were more likely to develop PTSD as were those people who had been sedated with benzodiazepines and those who had had frightening experiences in the ICU.

You can read more about this research at


Sweet smells, sweet dreams

Researchers in Germany looked into the links between smells and people's dreams. They exposed people who were asleep to the smells of rotten eggs or roses and then asked them about their dreams when they were woken up. Those who had been exposed to the pleasant smell were more likely to have had pleasant dreams, while those who had been exposed to the rotten eggs were more likely to have had unpleasant ones.

You can read more about this research at


Telephone therapy for depression

A review of studies by researchers at Northwestern University's Feinberg School of Medicine in the U.S. looked into the effectiveness of telephone therapy for depression. People with depression often have problems with motivation and of those expressing an interest in psychotherapy only 20% actually show up for a referral and half later drop out of treatment. Patients can have trouble with transportation and in finding the time to see a therapist. The review found that the average drop out rate for telephone therapy was only 7.6% compared to nearly 50% for face-to-face therapy. Telephone therapy was also found to be as effective as face-to-face therapy in reducing the symptoms of depression.

You can find out more about this research at


Narcissism and social networking

Around 100 million people now use the social-networking site Facebook. Researchers at the University of Georgia looked into the links between people's Facebook page and their personality, and, in particular, how the content of people's pages correlated with the personality trait of narcissism. Narcissists are superficially charming people who often end up using people for their own advantage and who have difficulty in forming healthy long-term relationships. They often hurt the people around them and hurt themselves in the long run. The study administered questionnaires to nearly 130 Facebook users, analyzed the content of their pages and asked untrained strangers to view their pages and rate their impression of the owner's narcissism. The study found that the number of friends and wall posts a person had correlated with narcissism reflecting the fact that narcissists tend to have numerous but shallow relationships. The untrained observers used quantity of social interaction, attractiveness of the individual and the degree of self-promotion in their profile picture to rate people's narcissism and were fairly accurate in their judgements. Narcissists were also more likely to choose glamorous, self-promoting photos as their profile picture, whereas other people tended to choose snap shots.

You can find out more about this research at


Monday, September 22, 2008

Risk factors for medication non-adherence

Antipsychotic medications are a cornerstone of treatment and recovery for people with schizophrenia. However, many people have difficulty adhering to prescribed treatments and the average rate of non-adherence for schizophrenia is 50%. Failure to take medication is the most important risk factor leading to relapse and can result in a fivefold increase in the rate of relapse. An Australian study of 81 service users looked into the factors behind medication omission, including the participants' levels of insight into their condition and their experience and feelings of stigma as a consequence of their mental illness. Most participants had insight into their illness and were aware of the stigma attached to it. Around 70% of them had experienced annoying side effects while nearly half admitted alcohol consumption. About a fifth admitted they had missed taking medication in the previous week. A younger age, the perception of negative side effects and lack of access to a psychiatrist all made it less likely that people would adhere to their medication.

McCann, T.V.., Boardman, G. and Clark, E. - Risk profiles for non-adherence to anti-psychotic medications Journal of Psychiatric and Mental Health Nursing October 2008, 15(8), 622-629

Perfectionism and anorexia

Perfectionism is the tendency to set and pursue unrealistically high standards despite the occurence of adverse consequences. Perfectionism has long been known to be linked to anorexia but there have been relatively few long-term studies into this link. A Swedish study of 68 patients assessed their eating disorder symptoms, mental-health and perfectionism 8 and 16 years after their first use of child and adolescent psychiatric services. Even after the participants' anorexia symptoms and general mental health had improved their levels of perfectionism stayed the same and the more perfectionist they were the longer it took them to recover.

Nilsson, Karin, Sundbom, Elisabet and Hagglof, Bruno - A longitudinal study of perfectionism in adolescent onset anorexia nervosa - restricting type European Eating Disorders Review September-October 2008, 16(5), 386-394

Day hospitals for eating disorders

Day hospital treatment of eating disorders is growing in importance and has financial and clinical advantages in comparison to inpatient settings. It is cheaper and day-hospital treatment allows patients to maintain their social contacts and to apply the lessons learnt in the course of their treatment in their everyday lives. A study of 83 eating-disorder patients in Germany (47 with anorexia and 36 with bulimia) assessed them before treatment in a day hospital, at the end of their treatment and 18 months after treatment. Outcome measures were body-mass index, disturbed eating attitudes and behaviours, frequencies of binging and purging and general mental health. At the end of the day-hospital treatment significant improvement could be found on all outcome variables and the effects were maintained or improved until follow-up. At follow-up 40.2% of anorexia patients and 40.4% of bulimia patients could be classified as remitted and the patients' general mental health was also significantly improved.

Fittig, Eike ... [et al] - Effectiveness of day hospital treatment for anorexia nervosa and bulimia nervosa European Eating Disorders Review September-October 2008, 16(5), 341-351

Emotional problems and schizophrenia

Abnormalities in the way people process emotions are thought to be central to schizophrenia. People with schizophrenia have a number of different emotional problems including affective flattening, inappropriate affect, anhedonia (inability to experience pleasure), depression, anxiety and anger. They also have abnormalities in emotion perception, emotion experience, emotion regulation and emotional expression. A review of studies by researchers in the U.S. looked at people who were not suffering from schizophrenia but who were thought to be at high risk of the condition including those who had a family history of the illness but who had not developed psychosis themselves, those who were deemed to have schizophrenic tendencies and those who had sought treatment for their psychoses but who had not developed the full-blown condition. This was done to stop results being affected by the effects of the condition itself or the drugs used to treat it. The study found that the individuals at high risk demonstrated similar abnormalities to those with schizophrenia but a lower level. The most common emotional problems in this group were reduced emotional perception, anhedonia and increased negative affect (see post below).

Phillips, Laura K. and Seidman, Larry J. - Emotion processing in persons at risk for schizophrenia Schizophrenia Bulletin September 2008, 34(5), 888-903

Negative and positive affect and schizophrenia

Recent research on personality traits has tended to coalesce around the idea that there are three main variables - at least in part influenced by biology - in people's personality. Negative affect (NA) reflects individual differences in the extent to which a person views the world as threatening, problematic and distressing. People with high NA experience elevated levels of negative emotions and report a broad array of psychological and physical problems whereas people with low NA are calm, emotionally stable and satisfied with themselves and their lives. Positive affect (PA) involves an individual's willingness to engage with their environment. People with a high PA approach life actively, with energy and enthusiasm, cheerfulness and confidence and seek out and enjoy the company of others. In contrast those low on PA tend to be reserved and socially aloof and have lower levels of energy and confidence. The third variable is inhibition/disinhibition - individual differences in the tendency to behave in a controlled or uncontrolled manner. Researchers in the U.S. reviewed studies into NA and PA in people with schizophrenia. They found that people with schizophrenia reported a pattern of stably elevated NA and low PA throughout the course of their illness. The traits were found to be associated with variability in functional outcome, quality of life and stress reactivity.

Horan, William P. ... [et al] - Affective traits in schizophrenia and schizotypy Schizophrenia Bulletin September 2008, 34(5), 856-874

Trauma and hearing voices

The cognitive behavioural model of voice hearing states that it is not the occurence of voices per se that causes distress but the beliefs people hold about them that produce negative behavioural and emotional consequences. Whether voices are seen as malevolent or benevolent, powerful or benign is influenced - according to this theory - by core beliefs that are in turn influenced by people's life history. A Welsh study of 43 voice hearers compared those with predominantly positive beliefs about their voices to those with predominantly negative beliefs. Both groups had had a high prevalence of traumatic life events but those with negative beliefs about their voices were more likely to be experiencing a form of post-traumatic stress disorder (PTSD) and were more likely to have experienced childhood sexual abuse. Current trauma symptoms (re-experience, avoidance and hyper-arousal) were found to be a significant predictor of beliefs about voices and also accounted for a significant proportion of the variance in anxiety and depression.

Andrew, E.M., Gray, N.S. and Snowden, R.J. - The relationship between trauma and beliefs about hearing voices: a study of psychiatric and non-psychiatric voice hearers Psychological Medicine October 2008, 38(10), 1409-1417

Central coherence and eating disorders

Recent research has looked into the links between cognition problems and the development of eating disorders. People with eating disorders tend to have poorer performance in set-shifting tasks where they are asked to transfer their attention from one element to another. There has also been research into the links between central coherence and eating disorders; central coherence being the ability to understand context and see 'the big picture.' A review of 16 studies into central coherence and eating disorders has found that the majority of them found that people with eating disorders did have global processing difficulties i.e. a weak central coherence. However, there was little evidence that people with eating disorders had stronger 'local' processing in terms of tackling detailed, specific tasks.

Lopez, C. ... [et al] - Central coherence in eating disorders: a systematic review Psychological Medicine October 2008, 38(10), 1393-1404

Social phobia in childhood

A large body of research in adults indicates that social phobia is linked to social, educational and occupational functional impairment as well as depression, drug abuse and suicide attempts. Among children and adolescents estimates of the rate of social phobia range from 0.3% to 5.4%. However, only a small number of studies have looked at the characteristics of social phobia in children and this research has been limited to clinical samples. A U.S. study of 101 children compared 45 children with social phobia to 56 children who were anxious but who did not have social phobia. The children with social phobia feared and avoided a significantly greater number of social situations. They were more likely to have trouble making friends and to prefer being alone to being with other children. All the children with social phobia also met the criteria for at least one other mental-health problem. Greater severity of social phobia was significantly associated with poorer social skills, poorer leadership skills, greater attention difficulties and greater learning problems in the classroom.

Bernstein, Gail A. ... [et al] - Symptom presentation and classroom functioning in a nonclinical sample of children with social phobia Depression and Anxiety 65(9), 752-760

Child abuse and OCD

Childhood trauma - physical, emotional or sexual abuse, and emotional or physical neglect - has been linked to a variety of mental-health problems including depression, anxiety and eating and personality disorders. However, the relationship between childhood trauma and obsessive-compulsive disorder (OCD) has not been well studied. A U.S. study of 938 college students found that 13-30% of them met the criteria for childhood trauma with emotional neglect the most commonly reported experience. There was an association between emotional abuse, physical abuse and high levels of OCD symptoms which remained significant even after allowing for the effects of co-occuring anxiety. There were also associations between emotional neglect, sexual abuse and conscientiousness and between conscientiousness and OCD symptoms suggesting that this could be an indirect route by which childhood trauma leads to OCD.

Mathews, Carol A., Kaur, Nirmaljit and Stein, Murray B. - Childhood trauma and obsessive-compulsive disorder Depression and Anxiety 25(9), 742-751

Friday, September 19, 2008

New gene linked to depression and anxiety

Attempts to establish a link between people's genes and their tendency to suffer from anxiety and depression have only been partially successful. A study of 3,107 people in Germany and the U.S. looked into the genetic origins of neuroticism. Neuroticism is a personality trait that reflects a tendency towards negative mood states and has been consistently associated with the likelihood of having symptoms of anxiety and depression. The study tested more than 420,000 genetic markers for their association with neuroticism. The most 'promising' gene for neuroticism, i.e. the one with the strongest link, was a gene called MAMDC1 on the 14th chromosome.

van den Oord, Edwin J.C.G. ... [et al] - Genomewide association analysis followed by a replication study implicates a novel candidate gene for neuroticism Archives of General Psychiatry September 2008, 65(9), 1062-1071

Tuesday, September 16, 2008

Access and sucess in drug services

Health services in England have been urged to develop integrated care pathways for both drug and alcohol misusers in order to standardize elements of care, improve treatment efficiency and effectiveness and deliver value for money. However, the factors that influence client access to treatment and subsequent completion of detoxification programmes are complex. A study of 6,745 people admitted to an independent sector inpatient detoxification service between January 1995 and March 2003 looked into the factors that influenced completion of treatment and compared those who had referred themselves to the service with those who had been referred by GPs or other health professionals. Factors predictive of treatment completion were found to be older age, being female, being employed and being referred by a GP. People with a stable address were more likely to be referred to the service by a GP, leading to fears that young men, with an unstable housing situation, could be excluded from treatment.

Webb, Lucy, Ryan, Tony and Meier, Petra - Care pathways to in-patient alcohol detoxification and their effects on predictors of treatment completion Journal of Substance Use August 2008, 13(4), 255-267

Drug treatment and health

Misusing illegal drugs can have a number of negative affects, both on drug users themselves and on their families. Jobs may be lost, relationships with families and friends jeopardized, children neglected or abused and time spent in prison. Illegal drug users can also experience a variety of health problems as a direct consequence of their drug use but there has been little research into the health benefits of drug treatment in the UK. A study of 566 drug addicts in Scotland inteviewed them as they started their treatment and again after 8, 16 and 33 months. The study found that decreases in people's use of illegal drugs, or their dependence on them, was associated with significant improvements in physical and psychological health and in reductions in attendance at A&E departments.

Mcintosh, J., Bloor, M. and Robertson, M. - The health benefits of reductions in individuals' use of illegal drugs Journal of Substance Use August 2008, 13(4), 247-254

Friday, September 05, 2008

Psychosis in children - hallucinations-on-Avon

Many mental illnesses occur on a continuum with many more people showing at least some symptoms of them without being diagnosed with the full-blown condition. Several studies have indicated that psychosis could fall into this category with some people in 'non-clinical' populations displaying psychosis-like symptoms. A study of 6,455 12-year-old children in Avon looked into the prevalence of psychotic symptoms (auditory and visual hallucinations, and delusions) and how they were linked to IQ. There is a link between IQ and the risk of schizophrenia (the risk rises as IQ falls) but the relationship between IQ and psychosis-like symptoms is not clearly established. The researchers found that in the last 6 months 13.7% of the children had had at least one psychotic symptom. Those who had below-average IQ scores had an increased risk of such symptoms but for children of average, or above-average IQ there was no link between IQ and psychosis-like symptoms.

Horwood, Jeremy ... [et al] - IQ and non-clinical psychotic symptoms in 12-year-olds: results from the ALSPAC birth cohort British Journal of Psychiatry September 2008, 193(3), 185-191

Computerised CBT - the evidence so far

Depression and anxiety are common mental disorders, usually treated by GPs. Recognition of both disorders by GPs is often poor and the proportion of people who actually receive treatment is low. Medication is usually the first, and often the only treatment, offered but it can have unwanted side effects. There is substantial evidence to support the use of psychological therapies, particularly cognitive behavioural therapy (CBT) but it is expensive and there is a shortage of therapists leading to long waiting lists. Alternative methods of providing CBT have been developed, including computerised CBT (CCBT). A study of CCBT in the British Journal of Psychiatry reviewed previous research on the technique and found that 'there is some evidence to support the effectiveness of CCBT for the treatment of depression.' However, the studies examined had considerable drop-out rates and little evidence was presented regarding participants' preferences and the acceptability of the therapy.

Kaltenthaler, Eva ... [et al] - Computerised cognitive behavioural therapy for depression: systematic review British Journal of Psychiatry September 2008, 193(3), 181-184

Thursday, September 04, 2008

Antipsychotics and stroke - definitive evidence?

Concerns about an increased risk of stroke among people taking antipsychotic drugs, particularly in people with dementia, were first raised in 2002 and in 2004 the Committee on Safety of Medicines recommended that these drugs should not be used in people with dementia. This policy has now been vindicated by a study done by researchers at the London School of Hygiene and Tropical Medicine. The researchers looked at data from the General Practice Research Database which contains information from more than six million patients. They assessed the effect of exposure to antipsychotic medication on the incidence of stroke in 6,790 patients with a recorded incident of stroke and at least one prescription of an antipsychotic between January 1988 and the end of 2002. The authors of the study found that people with dementia taking the drugs were 3.5 times more likely to have a stroke, and people without dementia 1.7 times more likely than at times when they were not taking antipsychotics.

You can find out more about this research at


Antidepressants in men and women

A U.S. study of 2,876 men and women with a diagnosis of major depression has found intriguing differences in the way in which men and women respond to the antidepressant citalopram. Researchers from the University of Michigan Depression Center [sic] looked into people taking citalopram over a number of weeks with the doses increasing over time. All of the patients had been experiencing depression for years; on average 12 years. Women were 33% more likely to achieve a full remission of their depression, despite the fact that they were more severely depressed than the men when the study began.

You can find out more about this research at


Family therapy for bipolar disorder

Between a half and two-thirds of patients with bipolar disorder develop the condition before the age of 18. Early onset of illness is associated with an unremitting course of illness, frequent switches of polarity, a high risk of suicide and poor functioning or quality of life. A study of 58 adolescents by researchers at the University of Colorado, Boulder, looked into the effectiveness of family therapy and pharmacotherapy compared to pharmacotherapy and usual care. The researchers found no difference between the two groups in rates of recovery or in the amount of time that elapsed before a subsequent mood episode. However, patients in the family-therapy group recovered from depressive symptoms more quickly, spent fewer weeks in depressive episodes over the two-year period and had an overall more favourable trajectory of depressive symptoms.

You can find out more about this research at


Older fathers and bipolar

Older paternal age has been linked to a higher risk of complex neurodevelopmental disorders, including schizophrenia and autism. Now a Swedish study of 80,568 people has also linked older fathers to an increased likelihood of bipolar disorder. Researchers compared 13,428 people with bipolar to 67,140 controls and found that people with fathers over the age of 29 were at an increased risk of developing the condition. The offspring of fathers over the age of 55 were found to have a 37% higher risk than those of fathers who were between 20 and 24. The offspring of older mothers also had an increased risk but it was less-pronounced than that of having an older father.

You can find out more about this research at


Low birth-weight and mental-health problems

Low birth weight has been associated with a range of health problems in later life including mental-health problems in childhood. A study of 823 children in Detroit looked into the effects of low birth weight on children's mental health and compared 413 children from a socially-disadvantaged community to 410 children from a middle-class suburban one. In both groups children with low birth weights were more likely to have externalising (bad behaviour) and internalising (unhappiness and anxiety) problems. Low-birth-weight children from the socially-disadvantaged community were also more likely to have problems with attention which is important as attention problems at the start of schooling are linked to lower academic achievement later.

You can find out more about this research at


Exercise and memory

An Australian study of 170 people aged 50 and over has added further evidence to the links between exercise and mental health. The participants in the study were divided into two groups: a control group and a group which took 2 1/2 hours of physical activity a week, ranging from walking and swimming to ballroom dancing. The participants' cognition was tested at intervals over an 18-month period and those who took part in physical activity continually out-scored the control group, which actually reported an overall decline in cognition.

You can find out more about this research at


Zen and the art of dealing with distractions

Distracting thoughts have been implicated in a number of different mental-health problems including attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety and major depression. One way of dealing with distracting thoughts is by meditation and a study of 24 people by researchers at Emory University School of Medicine has found that people who practise Zen meditation are able to recover from distractions more quickly than other people. Researchers compared 12 experienced Zen meditators with 12 non-meditators. Participants in the study took part in breathing exercises and were distracted at periodic intervals by a task in which they had to distinguish between real and nonsense words. At the same time participants' brains were scanned using magnetic resonance imaging (MRI). The participants who were experienced Zen meditators were able to bring activity in a region called the default mode network - associated with spontaneous thoughts and mind-wandering - under control after the interruptions more quickly than non-meditating participants.

You can find out more about this research at


Monday, September 01, 2008

Intrusive mental images in grief

Intrusive mental images can be defined as 'fragments of specific autobiographical events or imaginal extensions of such events that predominantly possess sensory qualities and enter awareness suddenly and unintentionally.' Flashbacks have long been known to be part of post-traumatic stress disorder (PTSD) but intrusive mental images have also been implicated in depression, anxiety and other mental disorders. A team of Dutch researchers looked into intrusive images in grief, studying a sample of 131 mourners. They examined the frequency and correlates of four specific types of intrusive image: positive intrusive memories of the deceased, intrusive images of the death, re-enactment fantasies, and negative images of the future. All were common and all were correlated with the severity of complicated grief symptoms. Intrusive images of death, re-enactment fantasies and negative images of the future were all correlated with the severity of symptoms of depression and anxiety.

Boelen, Paul A. and Huntjens, Rafaele J. C. - Intrusive images in grief: an exploratory study Clinical Psychology and Psychotherapy July-August 2008, 15(4), 217-226

Emotional-regulation, self-harm and CBT

Emotional-regulation has been defined as 'the awareness, understanding and acceptance of emotions, as well as the ability to control behaviour in the context of emotional distress.' People who deliberately harm themselves often have trouble with emotional-regulation having lower emotional awareness and clarity, lower acceptance of emotions and difficulty in controlling their behaviour when experiencing negative emotions. A trial on 90 people aged between 15 and 35 looked at how cognitive behaviour therapy (CBT) affected people's tendency to harm themselves. The study found that the most important factor in the effectiveness of CBT was how much it was able to improve the participants' emotion-regulation, particularly their impulse control and goal-directed behaviours rather than its effect on depression, anxiety and suicidal cognitions.

Slee, Nadja ... [et al] - Emotion regulation as mediator of treatment outcome in therapy for deliberate self-harm Clinical Psychology and Psychotherapy July-August 2008, 15(4), 205-216