Wednesday, April 29, 2009

Are depression trials really realistic

Not all people with depression are eligible to take part in medical trials. Some people are excluded from phase III trials which compare drugs against a placebo because they have milder depression (which may be more likely to respond to a placebo effect), or because they have chronic depression, other mental-health problems or physical illnesses. Researchers from the University of Pittsburgh Graduate School of Public Health compared the effects of treatment on people who did, or did not, meet the criteria for phase III trials. Of 2,855 patients being treated with citalopram fewer than one in four (22.2%) met the inclusion criteria. People who met the criteria for the trials were more likely to get better and had less severe side effects suggesting that reports about the effectiveness of antidepressants might not be as encouraging in the 'real world.'

You can find out more about this research at

Depression takes it toll on the waistline

A number of studies have shown that depression is linked to heart disease but the exact nature of the link is unclear. Researchers at Rush University Medical Center in the U.S. studied 409 middle-aged women, half of whom were African-American and half of whom were white. The study measured the women's levels of depression and their visceral fat. Visceral fat is internal fat, stored between the organs around the waist and is known to be worse than other kinds of fat in terms of increasing the risks of cardiovascular disease and diabetes. The study found that there was a strong correlation between depression and visceral fat, particularly among overweight and obese women. The results were the same even when other factors, such as physical activity, were taken into account. The author of the study thought that depression might increase levels of visceral fat by stimulating the production of hormones such as cortisol which are released in response to stress.

You can find out more about this research at

Low dose of rivastigmine just as effective for Alzheimer's

Rivastigmine can slow down the progression of Alzheimer's disease although it cannot cure it. Unfortunately it can have a number of side effects such as nausea, vomiting, diaorrhea, stomach pain, dizziness, lack of appetite and fainting. Previous studies have shown that smaller, more frequent doses of rivastigmine can still be effective and reduce the incidence of side effects. A review of nine studies by the Cochrane Collaboration (one of the world's leading authorities in evidence-based medicine) has found that a skin patch which delivers smaller doses of the drug was just as effective but produced fewer side effects. The studies - which included a total of 4,775 participants found that people taking the lower dose of the drug scored similarly on cognitive function tests. However, only half of the people taking the lower dose suffered side effects, compared to two-thirds of those taking the higher dose.

You can find out more about this research at

Risk factors for violence in schizophrenia

Most people with schizophrenia are not violent but they are more likely to commit violent acts than other people. This can be especially true if people with schizophrenia also abuse drugs or alcohol or have a history of violence before diagnosis. A team of researchers, led by Dr Seena Fazel at Warneford Hospital in Oxford analyzed data from 13,800 people with schizophrenia in Sweden. They found that those people whose parents had been convicted of a violent crime were 65-83% more likely to commit one themselves. The researchers thought that this could be due either to a genetic cause which led to both parents and their children becoming more violent, or the effects on children of growing up in a violent home.

You can find out more about this research at

Inflammation and Alzheimer's

Alzheimer's disease has been associated with inflammation and some studies have suggested that taking non-steroidal anti-inflammatory drugs (or NSAIDs) could help to prevent its development. Researchers at the University of Washington and the U.S. Department of Veterans' Affairs in Seattle studied 2,736 people who had an average age of 75 and no signs of dementia at the start of the study. Over the 12-year course of the study the risk of developing Alzheimer's among heavy NSAID users was actually 66% higher than among people with little or no NSAID use.

You can find out more about this research at

Counting the cost of childhood mental-health problems

Mental illness is the most expensive childhood condition in the U.S. The Agency for Healthcare Research and Quality found that it cost $8.9bn to treat in 2006. An estimated 4.6million children were treated in 2006 at an average cost of $1,931 per child.

You can find out more about this report at

New research on drugs for ADHD

There has been much controversy over the use of stimulants for children with attention-deficit hyperactivity disorder (ADHD) but new research from the University of California in Berkeley has found that they may improve children's reading and writing. The study followed 594 children diagnosed with ADHD from kindergarten to fifth grade and found that those who took drugs such as Ritalin and Adderall were several months ahead of those who had not been given drugs. Those who are left untreated do poorly in school, have higher dropout rates, are more likely to use drugs and be arrested and can suffer from social isolation. The study was funded by the U.S. government with no drug-company involvement.

You can find out more about this research at

Teaching social skills to autistic teenagers

People with autism and Asperger's syndrome often have problems forming relationships and getting on with other people. Researchers at the University of California, Los Angeles, have developed a 12-week class - called PEERS - which aims to boost the social skills of teenagers with milder forms of autism and Asperger's. The programme is made up of 12 weekly classes where teenagers are taught how to pick the right peer group, join in conversations, be a good 'host' for get togethers and handle teasing or arguments. A trial of the programme on 33 12-17-year-olds led to parents reporting improvements in their children's social skills and the teenagers having more interaction with their friends outside school.

You can find out more about this research at

Work stress and depression

In any given month 4.4% of U.S. workers have major depression. Stress at work has been linked to an increased risk of depression and researchers at the University of Calgary in Canada have been looking into this link. They measured people's job stress in 1994-5 and again in 2000-1 and asked them about their levels of depression at the end of the study. They found that those who were under stress at both the start and the end of the study were twice as likely (8%) to be depressed as those who were under little stress at both times (4%). For people whose jobs got less stressful over the period of the study the depression rate was 4.4% while for those whose jobs got more stressful it was 6.9%.

You can find out more about this research at

Autism and genetics

An international team of researchers have been looking into the genetic factors behind autism. They looked at the DNA of more than 12,000 people, some from families affected by autism and others from unaffected volunteers. The team of researchers found a series of genetic variations which, they believe, could account for as many as 15% of cases of autism. Most of the genes are involved in synapses - the connections between brain cells - and although these variations are common in the general population they occur about 20% more often in children with autism. This is the first time there has been such good evidence linking a set of genetic variations to autism.

You can find out more about this research at

Tuesday, April 28, 2009

Mentally-ill murderers' modus operandi

The overall murder rate in England and Wales is low compared to other countries and people with mental-health problems only commit a small percentage of them. There has been no research into the kinds of murder committed by people with mental-health problems in England and Wales so researchers from the University of Manchester analysed 3,930 murders committed between 1997 and 2003. The use of firearms was rare and in 36% of cases a sharp instrument was used. Murderers with schizophrenia tended to use a sharp instrument and predominantly killed a family member or spouse in the home. Murderers diagnosed with an affective disorder were more likely to use strangulation or suffocation while alcoholics used hitting or kicking more often, mainly to kill acquaintances. Drug-dependent murderers were more likely to use 'non-violent' methods such as poisoning.

Rodway, Cathryn ... [et al] - Methods of homicide in England and Wales: a comparison by diagnostic group Journal of Forensic Psychiatry and Psychology April 2009, 20(2), 286-305

Where do they go to after the unit?

When secure forensic services are set up people often worry that service users - who can be drawn from a wide geographical area - will be discharged close to the unit leading to an increased burden on local health services and a rise in the crime rate. There has been no research into whether this actually happens or not so a study of service users at the Norvic Clinic in Norwich tried to find out. The study looked at the addresses service users had been discharged to between 1984 and 2006 and found that they lived considerably closer to the clinic on discharge than they had on admission and that this increase was concentrated in a few geographical areas. 76% of patients moved area at some point and this was more common after longer admissions and for patients admitted from high-secure hospitals. The study found that patients were discharged disproportionately to areas around the clinic.

Jones, Christopher N. - Community residence on discharge from a medium secure unit: where have all the patients gone? Journal of Forensic Psychiatry and Psychology April 2009, 20(2), 225-238

Coronary heart disease and psychosis

People with psychosis die, on average, nine years earlier than the rest of the population. The main cause of this reduced life expectancy is not suicide brought on by psychosis but coronary heart disease (CHD) and the death rate from CHD is 90% higher among people with psychosis than among other people. Some of this increased risk is due to the side effects of antipsychotic drugs but it is also due to the unhealthy lifestyles of people with psychosis. Researchers at the University of Pavia, in Italy, studied 123 participants with psychosis. They found that 6.9% had high blood pressure, 20.5% high cholesterol, 6.5% diabetes and 20.3% were obese. 63% smoked, 26% drank every day, 8% did not eat fruit and vegetables and 34% did not exercise on a daily basis.

Fusar-Poli, Paolo ... [et al] - Lifestyles and cardiovascular risk in individuals with functional psychoses Perspectives in psychiatric care April 2009, 45(2), 87-99

Personality and depression

The relationship between personality and depression is complicated. Certain personality traits could cause someone to be more at risk of depression, be a consequence of being depressed or be a psychological 'scar' from a previous episode of depression. Neuroticism - a proneness to anxiety, emotional instability and self-consciousness - and introversion have both been linked to depression but it is still unclear how much they are causes, and how much symptoms of it. Researchers in Finland compared 193 people with major depression to 388 people from the general population. They compared the participants' scores for neuroticism and depression at the start of the study and again after six and 18 months. They found that among the depressed participants neuroticism and introversion decreased as they recovered from their depression. Those people suffering from depression were more neurotic and introverted than the rest of the participants. The study also found that depressive episodes were unlikely to result in a personality 'scar' over the medium term.

Jylha, Pekka ... [et al] - Neuroticism, introversion, and major depressive disorder - traits, states or scars? Depression and Anxiety April 2009, 26(4), 325-334

RGS2, GAD and what happens after a hurricane

Generalized anxiety disorder (GAD) is characterized by exaggerated and uncontrollable worry or tension about everyday events, at a level more severe than warranted by the situation. It is estimated that 5.7% of people suffer from GAD over the course of their lives with 3.1% of people suffering it at any one time. Genetic factors are thought to be behind about a third (31%) of the risk of GAD, with environmental factors making up the rest of the risk. Little is known about the genes responsible for a greater risk of GAD and how they interact with environmental factors. Researchers from Harvard Public School of Health in Boston, U.S. looked into the links between a variation in the RGS2 gene, exposure to the 2004 Florida hurricane and the development of GAD. 607 adults sent samples of DNA from a cheek swab in by post and were asked about their experience of the hurricane, their levels of social support and their GAD symptoms. The study found that after allowing for age, sex, ancestry, hurricane exposure and social support each variation in the RGS2 gene was associated with a doubling of the risk for GAD.

Koenen, Karestan C. ... [et al] - RGS2 and generalized anxiety disorder in an epidemiologic sample of hurricane-exposed adults Depression and Anxiety April 2009, 26(4), 309-315

Wednesday, April 22, 2009

Tourette's syndrome and ADHD

People with Tourette's syndrome often have other problems as well, the most common of which is attention-deficit hyperactivity disorder (ADHD). Researchers at the universities of Calgary and Toronto studied 400 children with Tourette's some of whom had ADHD and some of whom did not. They found that children with low birth weights, who had been born prematurely and whose mothers had smoked during their pregnancy were two-or-three times more likely to have ADHD, replicating results in the general population.

You can find out more about this research at

New study on childhood wellbeing

A survey of levels of happiness and worry among 200,000 children in the U.K. by researchers at the University of Hertfordshire has found mixed results. 82% of the children, who were aged between six and 14, said they felt happy most of the time but only 11% said they were completely carefree. Girls were a little happier than boys and younger children happier than older ones. 51% of the sample worried about their parents arguing or divorcing and over half worried about violence and street crime. 72% said that boredom was what made them unhappy.

You can find out more about this research at

New survey sheds light on video-game addiction

A study of 1,178 American youngsters, aged eight to 18, by researchers from Iowa State University, looked into the nature and extent of addiction to video games. The researchers used the same criteria for video game addiction as that used to diagnose pathological gambling. The study found that 8.5% of the gamers were pathological players whose game playing caused damage to their family, social and school lives and whose mental health was being affected by their obsession. The pathological gamers played video games 24 hours per week and were more likely to have video-game systems in their bedrooms. They had more trouble paying attention in school, received poorer grades and had more health problems. They were also more than twice as likely to have been diagnosed with attention-deficit hyperactivity disorder (ADHD).

You can find out more about this research at

Researchers try out new Alzheimer's drug

A protein called SAP is thought to be involved in the development of Alzheimer's disease. Researchers at University College, London tried out a new drug called CPHPC on five Alzheimer's patients over a three-month period and found it made SAP disappear. However, it is too soon to know whether the removal of SAP would lead to clinical benefits for patients and there have been many false dawns in Alzheimer's research before.

You can find out more about this research at

Health and PTSD risk

Soldiers involved in fighting in Iraq and Afghanistan can often develop post-traumatic stress disorder (PTSD) afterwards but some people seem to be more resilient than others. Researchers from the Naval Health Research Center in San Diego surveyed the mental and physical health of 5,410 servicemen before and after combat duty in Iraq or Afghanistan. They found that those who had the worst mental health beforehand were three times more likely to develop PTSD than the rest of the participants. Those with the worst physical health were also more at risk being twice as likely to develop PTSD.

You can find out more about this research at

Statins not a wonder drug for dementia

Statins are drugs increasingly prescribed to middle-aged people to reduce their cholesterol and blood pressure. Some research has suggested that statins could also reduce the incidence of Alzheimer's as high blood pressure and high cholesterol are linked to this condition. The Cochrane Database of Systematic Reviews looked at two major studies of the statin drugs simvastatin and pravastatin which compared them to placebos and which included 26,340 participants. Sadly, they concluded that statins had no significant effects on people's cognition and no effect in preventing Alzheimer's disease or dementia.

You can find out more about this research at

Tuesday, April 21, 2009

Antipsychotics and Alzheimer's: more evidence of harm and ineffectiveness

Despite increasing evidence of their harmful effects antipsychotic drugs are often prescribed to elderly people with Alzheimer's disease to control their behaviour. A study of 421 outpatients with Alzheimer's disease by researchers at the University of Southern California, Los Angeles looked into the effects of antipsychotic drugs on people's weight and cholesterol levels. They found that women taking the drugs gained an average of 0.14 lbs per week and the longer they took the drugs the more likely they were to put on weight. The effect on weight was significant for olanzapine and quetiapine but less so for risperidone. Olanzapine was also significantly associated with an increased waist circumference and lowered levels of 'good' cholesterol. Men showed no significant weight gain but the drugs did not improve people's quality of life or function and did not decrease their need for care.

You can find out more about this research at

Autism, sleep problems and melatonin

Up to 89% of children with autism have trouble sleeping. Melatonin is a naturally-occuring hormone that is important in regulating people's body clocks and researchers at the University of California in Sacramento carried out a four-week study on 18 children, between two and 15, with either autism or fragile X syndrome, to see whether melatonin could help them with their sleep problems. The children were given either 3mg of melatonin or a placebo every night for 2 weeks and then swapped over into the other group. The study found that treatment with melatonin was associated with longer sleep each night (by 20 minutes), less sleepiness and getting to sleep earlier (42 minutes on average).

You can find out more about this research at

Monday, April 20, 2009

Depression, cognition and old age

The prevalence of major depression is estimated at 2-3% in adults of all ages. Depression can affect people's cognition, in particular information processing, memory and executive functions and this effect is particularly pronounced among older people. However, it is not known whether this effect of depression on cognition is due to the particular nature of late-life depression, or to the general effects of the aging process on people's mental abilities. Researchers from Newcastle University in the U.K. compared the cognition of 157 people with and without depression. Within the two groups half of the participants were over 60 and half under. The study found that those people who were depressed and over 60 had more problems with verbal learning and memory and coordination, but not with executive functioning. The researchers concluded that 'late-life depression is associated with more severe impairment in verbal learning and memory, and motor speed than depression in earlier life and this is not due to ageing alone.'

Thomas, A.J. ... [et al] - A comparison of neurocognitive impairment in younger and older adults with major depression Psychological Medicine May 2009, 39(5), 725-733

The computer will see you now ...

Cognitive behaviour therapy (CBT) is now the most commonly practised psychotherapy in the NHS. However, demand for it is much greater than the NHS can supply and many services are only open in the day making them inaccessible to many users. Computerised cognitive behaviour therapy (cCBT) aims to offer CBT to people while reducing the number and costs of therapists needed, and has been recommended for use for people with mild-to-moderate depression and anxiety. However, there has been little research into the barriers that might stop people using it. Researchers at St John's Hospital in Scotland and at the University of York reviewed studies into the effectiveness of cCBT to see if they could find any clues. They found that large numbers of people dropped out of the trials with little explanation. In trials comparing cCBT to other treatments participants receiving cCBT were twice as likely to drop out. Only a median* of 56% of people in the trials completed a full course of cCBT and 'personal circumstance' was a more common cause of dropout than difficulties with the technology or social background. The risks of cCBT were rarely assessed in the majority of programmes and significant staff time was needed to support the participants. Therapists were actually more negative about cCBT than those receiving it.

Waller, R. and Gilbody, S. - Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence Psychological Medicine May 2009, 39(5), 705-712

*see here for an explanation of the statistical term median

Friday, April 17, 2009

Diabetes and dementia

People with diabetes lack the ability to control the amount of sugar in their bloodstream. High levels of sugar can be damaging to people's health and there is known to be a link between diabetes and Alzheimer's disease. But very low levels of blood sugar can be just as damaging and researchers from the Kaiser Permanente health organisation in the U.S. looked into the links between being admitted to hospital suffering from low levels of blood sugar and the risk of developing dementia. They studied records covering over 20 years from more than 16,600 people with type 2 diabetes. They found that people who had been to hospital once with low blood sugar had a 2.6% greater risk of dementia, those who had been twice had a 115% greater risk and those who had been three times had a 160% greater risk.

You can find out more about this research at

Depression, coronary artery disease and heart failure

Depression is known to be linked to worse outcomes in people who have had a heart attack and new research suggests that this could also be the case for people with coronary artery disease as well. Researchers at the Intermountain Medical Centre in Utah studied 13,708 people who did not have a history of depression, heart failure or antidepressant use when they were first diagnosed with coronary artery disease. Of those who were subsequently diagnosed with depression 16.4% went on to have a heart attack, compared to only 3.6% of those who were not depressed. For those people who were depressed, whether or not they took an antidepressant made little difference to their chances of having a heart attack. However, for those people who were not diagnosed with depression but who were taking antidepressants the antidepressants did not lead to an increased risk of heart failure.

You can find out more about this research at

Asperger's and cortisol

When most people wake up they usually experience a surge in the levels of a hormone called cortisol, which helps them to deal with the stress of the new day. However, this may not be the case for adolescent boys with Asperger's syndrome, according to a study by researchers at the University of Bath, in the U.K. The study compared the levels of cortisol in 20 adolescent boys with Asperger's and 18 controls when they woke up, and 30 minutes later. The boys with Asperger's did not have a surge in their cortisol levels, something which may explain why they have a need for routine and a resistance to change.

You can find out more about this research at

Meth using mums and children's brains

Methamphetamine abuse is a big problem in the U.S. and in 2007 about 13 million Americans used the drug. The children of mothers who took methamphetamine when they were pregnant often have developmental abnormalities and researchers at the University of Hawaii carried out brain scans on 29 3- and-4-year-olds whose mothers used amphetamine and 37 3- and-4-year-olds whose mothers had not. They found that water molecules moved much more slowly through the white brain matter of the children whose mothers had used methamphetamine suggesting that it was more densely-packed.

You can find out more about this research at

Snoring and mental health in children

Snoring has been linked to a bad night's sleep and health problems in adults and it could also be linked to poorer mental health in children. Researchers from Helsinki University Central Hospital compared 43 pre-school children who snored to 46 who did not. They found a higher rate of mood problems, especially anxiety and depression, among the children who snored. The snoring children also had decreased attention and language skills and were more likely to have other sleep problems such as nightmares, talking in their sleep or difficulties going to bed. However, the children who snored were no more likely to have behaviour problems than the non-snorers.

You can find out more about this research at

Dangers of valproate for unborn children

Valproate is a drug widely prescribed for epilepsy, migraines and bipolar disorder. Studies have shown that prenatal exposure to valproate can cause major birth defects in one in 10 children and British researchers have found that it can raise the risk of autism. Now researchers from Emory University in Atlanta have found that it can also lower children's IQ as well. Their study found that the IQ of three-year-old children whose mothers took other valproate were six to nine points lower than that of children whose mothers took other anti-epilepsy drugs although it is not clear whether the differences continue later in life. Stopping the drug suddenly can cause seizures which also run the risk of damaging the unborn child.

You can find out more about this research at

Older people miss out on antidepressants

A study of older suicide victims by researchers at Weill Cornell Medical College in New York has found that very few of them - less than a quarter - were taking antidepressants at the time of their death. The study of 255 suicide victims who were all over 65 and who killed themselves between 2001 and 2004 found that only 23% of the sample had been taking antidepressants at the time of their death. Only 16.7% of those over 85 had been taking antidepressants.

You can find out more about this study at

Wednesday, April 15, 2009

People with delusions jump to conclusions

Some people think that people with delusions are more likely to jump to conclusions than other people; something that helps them to maintain their delusional beliefs even when there is very little evidence. Psychologists measure this with the 'beads-in-a-jar' test. They pull different-coloured beads at random from a jar and ask people to make decisions about the proportion of different-coloured beads e.g 50:50 black and white, 90:10 red and green etc. Some people with delusions have been known to make a decision after just one bead! Researchers at Manchester University studied 39 students, 17 of whom were judged to be 'delusion-prone.' The delusion-prone students were found to be much quicker at jumping to conclusions than the other participants. The students were also asked to rate how rushed they felt when carrying out the task. Those who felt more rushed were quicker to jump to conclusions suggesting that a feeling of being rushed could be one of the factors leading people with delusions to make hasty judgements.

White, Lars O. and Mansell, Warren - Failing to ponder? Delusion-prone individuals rush to conclusions Clinical Psychology and Psychotherapy March 2009, 16(2), 111-124

Building a good therapeutic alliance

The therapeutic alliance - therapist and client working together towards recovery - plays a significant role in psychotherapy and is an important factor in its success and effectiveness. However, the role of the therapist in the development of the alliance has not been extensively investigated and studies of the alliance in long-term psychotherapy are virtually non-existent. Norwegian researchers studied the therapeutic alliance in 201 clients and 61 therapists in long-term (more than 120 sessions) therapy. The higher therapists scored on the cold/detached scale of personality measurement - being distanced, disconnected or indifferent - the worse the alliance. The more professional training the therapists had had the worse the patients rated the quality of the alliance. The more experienced the therapists were the lower they rated the quality of the alliance. Therapists who reported better maternal care up to their adolescence were more likely to have patients who thought they had a good therapeutic alliance.

Hersoug, Anne Grete ... [et al] - Therapist characteristics influencing the quality of alliance in long-term psychotherapy Clinical Psychology and Psychotherapy March-April 2009, 16(2), 100-110

Dropping out of depression treatment

People who drop out of treatment for their depression are less likely to recover but why people drop out has received little study. Researchers from the University of Texas studied 179 people being treated for depression over the course of a year. 23% had dropped out after six months, 47% after a year. Beliefs about the perceived harmfulness of antidepressants predicted dropping out. Younger age and fewer side effects at baseline were associated with dropping out after six months. Younger age, better perceived physical functioning and more negative attitudes about antidepressants were associated with dropping out after a year.

Warden, Diane ... [et al] - Predictors of attrition during one year of depression treatment: a roadmap to personalized intervention Journal of Psychiatric Practice March 2009, 15(2), 113-124

CBT: is it the C or the B that helps people recover?

There is a lot of evidence for the effectiveness of cognitive behaviour therapy (CBT) in treating a number of different mental-health problems, including depression, but it is unclear whether the cognitive part of the therapy (changing people's thought patterns) or the behavioural part (in the case of people with depression getting them to do pleasurable things again) is more effective. Researchers from Pacific University in Oregon and Harvard University studied the effect of CBT on 105 people receiving treatment in a private, psychiatric, partial-hospital setting. They found that a decrease in negative thoughts and an increase in positive behaviour both predicted a decrease in depressive symptoms. However, only a decrease in negative thoughts was predictive of patients' overall levels of psychological distress. The study found that a CBT intervention, adapted for use in a partial-hospital setting, could be an effective treatment for severe mood disorders.

Christopher, Michael S. ... [et al] - Cognitive and behavioral changes related to symptom improvement among patients with a mood disorder receiving intensive cognitive-behavioral therapy Journal of Psychiatric Practice March 2009, 15(2), 95-102

Levels of adolescent mental-health problems

There have been remarkably few studies into levels of mental-health problems among teenagers using official diagnostic criteria. Researchers from Texas University studied 3,154 children (between the ages of 11 and 17) and their parents over the course of a year. They found that 2.8% had anxiety, 1.5% mood disorders, 1.2% attention-deficit hyperactivity disorder (ADHD), 2.5% disruptive disorder, 2.9% substance abuse/dependence and 7.5% one or more mental-health problems. The most consistent factor in predicting mental-health problems was levels of stress with family problems being particularly important. The presence of more than one risk factor substantially increased the chances of developing a mental-health problem while personal qualities such as mastery protected against them.

Roberts, Robert E., Roberts, Catherine R. and Chan, Wenyaw - One-year incidence of psychiatric disorders and associated risk factors among adolescents in the community Journal of Child Psychology and Psychiatry April 2009, 50(4), 405-415

Temperament and child care: it's quality not quantity that counts

As well as being looked after by their parents most children experience some form of child care. Research into the effects of child care has produced mixed results but this could be because it has not taken into account children's temperaments*. Researchers at Birkbeck University in London studied 968 families at ten different locations across the U.S. They found that the effects of the quantity and type of child care were similar for all children. However, the effects of quality of child care were much more pronounced in children with a 'difficult' temperament. Low-quality child care led to more behaviour problems in these children than in children with an 'easy' temperament. High-quality child care though led to the children with 'difficult' temperaments having fewer behaviour problems than those with 'easy' temperaments.

Pluess, Michael and Belsky, Jay - Differential susceptibility to rearing experience: the case of childcare Journal of Child Psychology and Psychiatry April 2009, 50(4), 396-404

*For an explanation of the psychological concept of temperament see

Thursday, April 09, 2009

Mothers' personalities and children's diets

A survey of 27,673 mothers in Norway has found that those with more negative thoughts and feelings are more likely to give their children unhealthy food. The mothers were asked about their mental states and how often they gave their 18-month-old children 36 types of food and drink. Mothers who were emotionally unstable, anxious, angry, sad, had poor self-confidence and who had a negative view of the world were more likely to give their children sweet and fatty food, although they also gave them as much healthy food as the other mothers. The findings took into account the child's sex; maternal smoking, age, education and body-mass index (BMI); whether the child went to nursery; number of children; income and marital status. Even when all these factors had been taken into account the link between the mothers' personality and the children's diets remained. Mothers who smoked, had a high BMI, had many children, had a male child and who sent their children to nursery were more likely to feed their children an unhealthy diet. Older women, and women who had been through higher education were more likely to feed their children healthily.

You can find out more about this research at

Tae kwon do helps service users in Norwich

People with severe mental-health problems in Norwich, U.K. have been learning tae kwon do. Ben Curran from Julian Housing Support Group got £10,000 from the National Lottery and £14,000 from Sport Relief to provide a year-long programme of weekly classes for up to 20 service users. All the participants said they felt more confident and motivated after going to their classes; their fitness improved and they took better care of themselves.

You can find out more about this initiative at

27? It's all downhill from here ...

People's mental powers could start declining from the age of 27, according to a study of 2,000 healthy adults (aged 18-60) by researchers at the University of Virginia. The participants were tested at the start of the study, and again seven years later, on their ability to solve puzzles, recall words and details from stories and identify patterns in collections of letters and symbols. Abstract reasoning, mental speed and puzzle-solving started to decline at 27 and dips in memory began around 37. However, most people continue to function at a high level in later years and vocabulary and general knowledge tend to increase as we get older - so there may still be hope for those of us on the wrong side of 35!

You can find out more about this research at

Cognitive problems don't always turn into dementia

The risk of mild cognitive impairment (MCI) developing into dementia could be less than previously thought, according to a review of studies carried out by researchers at Leicester University and Nottinghamshire Healthcare NHS Trust. Using information from 41 studies they found that only 10% of people in high-risk groups and 5% of people in low-risk groups with MCI went on to develop dementia. Even after a longer time only 20-40% of people with MCI went on to develop dementia.

Treating depression after bypass surgery

About one in every five patients suffers a major bout of depression following heart bypass surgery and at least that many again develop milder forms of depression. Researchers from the University of St Louis divided 123 depressed bypass patients into three groups. A third received cognitive behaviour therapy (CBT), a third received supportive stress management and a third received 'usual care.' Within each group about half the participants were taking antidepressants. After three months 71% of the people in the CBT group and 57% in the supportive stress management group saw their depression symptoms lift compared to just 33% in the 'usual care' group; figures which remained about the same after nine months. Whether or not the participants were taking antidepressants seemed to have little effect on what happened to their depression.

Suicide and troubled childhoods

Researchers from Turku University in Finland followed 5,302 people born in 1981 looking for the factors linked to suicide. Of the whole sample 27 women and 27 men had made serious suicide attempts by the time they got to 24; of these people 13 men and two women died. 78% of the suicidal men had shown bad behaviour by the time they were eight including: disruptive fits of temper, disobedience, aggression or cruelty towards others, destroying of property, stealing, lying, inattention or hyperactivity. In women mental-health problems only became apparent after puberty.

You can find out more about this research at

APOE4, Alzheimer's and busy brains

A variation in a gene called APOE4 is found in about a quarter of the population. Those who have one copy have four times the normal risk of developing Alzheimer's disease and those who have two copies have ten times the risk. Researchers at Imperial College London used MRI (magnetic resonance imaging) scans to see what was going on in the brains of people with and without the variations in the gene. They found that even when they were just lying still people with the variations in the APOE4 gene had much busier brains than other people. When the participants in the study did a memory task those with the variation had more activity in a part of the brain called the hippocampus which is linked to long-term memory and navigation and is one of the first areas to be affected in Alzheimer's. The researchers thought that the extra activity in the brains of the people with the gener variation might cause them to wear out sooner although they stressed that not everyone with an APOE4 variation will go on to develop the condition.

You can find out more about the research at:

Childhood sleep problems and adolescent abilities

A study of 1,037 children by researchers at the University of London has found that sleep problems during childhood can affect mental performance during adolescence. Parents assessed their children's sleep problems at five, seven and nine and the children's mental abilities were tested at 13. Persistent sleep problems in childhood predicted poorer performance in the tests in early adolescence.

You can find out more about this research at
The Ombudsman (a U.K. body which deals with complaints against public services) has published its report into the death of six people with learning disabilities who were being 'looked after' by health and local-authority services at the time.

You can download the Ombudsman's report here

The report follows a similar one from the learning-disability charity Mencap - Death by Indifference - which highlighted an 'appalling catalogue of neglect of people with a learning disability.'

You can download the Death by Indifference report here

Tuesday, April 07, 2009

Social capital and children's mental health

Social capital has been defined as 'the social cohesion of a community, and the sense of belonging and the level of involvement in community affairs.' Recently researchers have become increasingly interested in the links between social capital and health, in particular mental illness. Evidence from the U.S. suggests that social capital is strongly linked to children's well being but it is not clear if this is the case in the U.K. Researchers from Birmingham University studied 90 parents who had children between the ages of 4 and 18 with either an emotional or a behavioural disorder. They gave them questionnaires about their children's behaviour and asked them about social capital. Overall, the researchers found no significant link between the parents' social-capital scores and their children's diagnosis, and the severity of their problems. However, two aspects of social capital did have an effect on the children's mental health. 'Perceptions of the local area,' was significantly associated with the severity of the children's problems i.e. the worse people thought an area was the worse their children's problems were. Parents of children with emotional disorders were found to have significantly poorer social networks than parents of children with behavioural disorders.

Pearson, Laura Jane and Oyebode, Femi - Social capital and childhood psychiatric disorders: a cross-sectional study Clinical Child Psychology and Psychiatry April 2009, 14(2), 183-194

Themes and feelings in teenage depression

Qualitative research aims to bring out and discover people's feelings by conducting interviews and analysing them later. In-depth interviews are carried out with small groups of people and researchers try and find themes in what the participants say. Researchers from Bristol and the University of Plymouth interviewed six adolescent girls about their depression. They found three main themes emerged: communication, 'hurt self', and difference. These themes were based on communication processes in the girls' families and with peers, issues relating to shifts in identity through adolescence and feelings of being damaged, distressed, and hurt. Attachment theory* was found to be particularly relevant and helpful in interpreting these themes.

Shaw, Samantha K., Dallos, Rudi and Shoebridge, Philip - Depression in female adolescents: an IPA analysis Clinical Child Psychology and Psychiatry April 2009, 14(2), 167-181

*For an explanation of attachment theory see

Monday, April 06, 2009

Asylum seekers and mental health: detention and despair

The number of asylum seekers, refugees and people driven out of their homes but still living in their own country rose to 20.8 million at the beginning of 2006. In 2005, in the U.K., 29,210 people left detention of whom 59% were deported. Asylum seekers have often experienced traumatic events in their country of origin and while they are detained they can suffer from the extra stress caused by loss of liberty, not knowing whether they will be sent back to their country of origin, social isolation and abuse from staff. A team of researchers from the U.K. reviewed ten studies into the mental health of people detained as asylum seekers. They found that anxiety, depression, post-traumatic stress disorder (PTSD), self-harm and suicidal thoughts were commonly reported. The longer people had been in detention the more likely they were to suffer from a mental-health problem. There was some evidence that people's mental health improved after they were released but there was a long-lasting negative affect from detention.

Robjant, Katy, Hassan, Rita and Katona, Cornelius - Mental health implications of detaining asylum seekers: systematic review British Journal of Psychiatry April 2009, 194(4), 306-312

Frontotemporal dementia and psychosis

Fronto-temporal dementia (FD) is a clinical syndrome caused by degeneration of the frontal lobe of the brain. Researchers from the University of Melbourne thought that people with FD were often diagnosed with schizophrenia or bipolar disorder before the real cause of their problem became apparent. They reviewed the cases of 17 people with FD and found that four of them had initially been diagnosed with pyschosis and one with bipolar disorder. These diagnoses had been given, on average, five years before they were found to be suffering from FD. A third of patients aged 30 and under and a quarter of those aged 40 and under had initially been diagnosed with psychosis.

Velakoulis, D. ... [et al] - Frontotemporal dementia presenting as schizophrenia-like psychosis in young people: clinicopathological series and review of cases British Journal of Psychiatry April 2009, 194(4), 298-305

Preference and performance in mental-health treatment

People with mental-health problems often express a preference about the kind of people they wish to be treated by and the kind of treatment they would prefer to receive. But there is some doubt about whether getting one's preferred treatment actually improves people's problems more than not getting their preferred treatment. Researchers in the U.S. reviewed 26 studies into this question involving more than 2,300 participants. They found that people matched to their preferred treatment had a 58% chance of showing a greater improvement than those who weren't matched, and were half as likely to drop out of treatment.

Swift, Joshua K. and Callahan, Jennifer L. - The impact of client treatment preferences on outcome: a meta-analysis Journal of Clinical Psychology April 2009, 65(4), 368-381

Preventing students' mental-health problems: a question of moderation

Prevention of mental-health problems is coming to be seen as as important - if not more than - treating them once they have started. Preventing problems in college students, or people of the same age outside college, could be particularly useful as this is a time of upheaval and stress when many mental-health problems begin. Researchers in the U.S. looked into an early-intervention programme for college students made up of parts of the cognitive-behavioural analysis system of psychotherapy. The programme was given in a 2-hour, computer-based educational programme. The researchers wanted to look at the moderating factors affecting the programme's effectiveness. A moderating factor is a third factor affecting the link between two other ones. For example, a driver's skill might be a moderating factor between the power of a racing car and its speed around a circuit. The researchers found that the effectiveness of the programme on depression was moderated by insomnia, its effectiveness for anxiety was moderated by past post-traumatic stress disorder (PTSD), phobias and sleep-problems linked to nightmares and its effectiveness on symptoms of general negative mood was moderated by social phobia and suicidal thoughts.

Cukrowicz, Kelly C. ... [et al] - The moderation of an early intervention program for anxiety and depression by specific psychological symptoms Journal of Clinical Psychology April 2009, 65(4), 337-351

Thursday, April 02, 2009

Dying newborns and survivor siblings

Researchers at Dartmouth-Hitchcock Medical centre in the U.S. looked into the effects of the deaths of children in neonatal intensive care units on their surviving siblings. The qualitative (feelings not numbers) study of 13 adults and 1 adolescent found that they felt a sense of confusion surrounding the event. They reported a lack of communication about the death itself and believed that their parents had never mourned the loss of the child. The study also found that rituals, photographs and shared memories played an important part in the healing process.

Mental-health and homelessness

A new report by the U.K. homeless charity Crisis has underlined the links between mental-health problems and homelessness. If found that 85% of residents in one homeless shelter had a range of personality, anxiety or post-traumatic stress disorders that had not been formally diagnosed. The number of rough sleepers has fallen dramatically over the last ten years but 3,000 people spent some time sleeping on the streets in London last year. In November 2008 the housing minister, Margaret Beckett, announced a £200m programme to strengthen assertive outreach services and introduce individual budgets for homeless people.

You can download the Crisis report from

Testing for Alzheimer's - a question of balance

Researchers are always looking for new ways to predict which people are most at risk of developing Alzheimer's as this allows them to treat people earlier and more effectively. Scientists from the University of Toulouse looked into the growing evidence of a link between physical performance and cognitive decline. 686 people took part in the study. They were evaluated by a geriatrician every six months, their degree of cognitive impairment was measured and they were also asked to stand on one leg for as long as possible. The study found that those participants who were unable to stand on one leg for at least five seconds had a significantly greater decline in memory and thinking at 12, 18 and 24 months.

You can find out more about this research at

Naltrexone and kleptomania

Naltrexone is used to treat people with alcohol and drugs problems but it could also help people with kleptomania as well. Researchers at the University of Minnesota tested it for two months on 25 people who said they spent at least one hour a week stealing. Those who took naltrexone reported significantly less stealing behaviour compared to those given a placebo.

You can find out more about this research at

Computer monitoring helps social skills

People with autism or Asperger's syndrome can often talk at great length about their interests or interrupt others. Psychologists at the University of Illinois have developed a new way of giving people feedback about their conversation skills. They digitize the conversation and feed it back into a monitor. People's voices appear in colour growing in size if the voice gets louder, overlapping another colour if it interrupts and narrowing with silence. It is hoped that this feedback will help people with Asperger's modify their conversation in family or couple therapy.

You can find out more about this research at

Insomnia and suicide

People with sleep problems are more likely to think about killing themselves or actually make a suicide attempt, according to a study of 5,692 people by researchers at the University of Michigan. The study found that people with two or more sleep problems - such as waking up too early, difficulty falling asleep or lying awake at night - were more than two-and-a-half times more likely to make a suicide attempt. About a third of the volunteers reported at least one type of sleep disturbance over the preceding year. After taking into account substance abuse, depression, age, gender and marital and financial status the biggest risk factor - as far as sleep was concerned - was waking up at least two hours earlier than desired in the morning. People with this problem were twice as likely to have had suicidal thoughts or planned a suicide and nearly three times as likely to have tried to kill themselves. The researchers did not know why there was a link between insomnia and suicide but though that it might be because a lack of sleep affects cognitive function, leading to poorer judgement and increased hopelessness. Previous studies have shown this link in teenagers and people with mental-health problems but this was the first study to show it in the general population.

You can find out more about this research at