Friday, January 23, 2009

Schizophrenia and the default network

Brain scans allow researchers to monitor people's brain activity as they complete different tasks and to examine the links between brain function and disease. Researchers at the Massachusetts Institute of Technology used brain scans to investigate the links between schizophrenia and a network of brain structures called the default network. The default network is involved in self-reflection and autobiographical memories and tends to become active when we are not engaged in any particular task. The study gave brain scans to 39 people. 13 of them had schizophrenia, 13 of them were relatives of people with schizophrenia and 13 were healthy controls. The participants' brains were scanned while they were resting and while they undertook easy and hard memory tasks. In the participants with schizophrenia there were very strong and active connections in the default network while they were at rest and - unlike the healthy controls - they were unable to suppress the activity in this network as they worked on the memory tasks. The more active this network was and the less able people were to suppress it the worse they performed on the memory task and the worse were their symptoms. The default system was overactive, but to a much lesser extent, in the brains of the relatives of people with schizophrenia.

You can find out more about this research at

Rejection and aggression

Researchers at the University of Kentucky have been looking into the links between social rejection and aggression in a series of experiments involving a total of 190 college students. In one of the experiments 30 people were given a personality test and then bogus feedback about the results. A third of the participants were told their personalities would mean they would probably end up on their own later in life; these were the excluded group. The rest of the participants were either told they would have 'many lasting and meaningful relationships,' or were given no feedback at all. All the participants were then told to read an essay - supposedly by another participant - and rate their impression of the author's actions. They were also told that the authour was a candidate for a research position. Those participants who had been in the excluded group were far more likely to see the authour's actions as hostile and to give them a negative evaluation as suitable for the job. In anther experiment 32 participants were given the same personality test and again some of them were told that they would end up alone. The participants then 'played' a computer game in which they could inflict a blast of white noise on their opponents. Those participants from the excluded group inflicted a higher level of painful noise on their opponents than those participants in the control group.

You can read more about this research at

Caregivers and elder abuse

A survey of 220 caregivers looking after a family member with dementia has found that abuse is more common than was previously thought. The survey was carried out by researchers from University College, London and surveyed people from a range of socio-economic and ethnic backgrounds. A third of caregivers said they frequently swore at or insulted their relative with dementia while half said that they occasionally screamed or yelled at them.

You can find out more about this research at

Thursday, January 22, 2009

Time to Change campaign launched

England's biggest ever anti-stigma campaign, Time to Change, was launched yesterday. The three-year programme aims to reach 24m people at a cost of £18m. The campaign - financed by the Lottery and run by Mind, Rethink and Mental Health Media - will include adverts on television and radio, in newspapers and magazines and on the London Underground. Famous people such as Stephen Fry and Ruby Wax will also be taking part in the campaign.

You can find out more about the Time to Change campaign at

Migraines and mental health

As if they hadn't already got enough to contend with people who suffer from migraines are also at an increased risk of mood and anxiety disorders, according to a study of 7,124 adults by researchers at the University of Manitoba, Winnipeg. The study used data from the German Health Survey, which was carried out between 1997 and 1999. Among the whole sample 11.7% reported a history of migraine headaches and there was a significant association between having migraines in the past year and mood and anxiety disorders.

You can find out more about this research at

Therapists ignore guideline on domestic violence

The following research relates to U.S. couple therapists only

Domestic violence is particularly common among couples seeking couples therapy with estimates of a half to two-thirds of couples seeking treatment reporting some incident of aggression in the previous year. There are guidelines as to how marital therapists treat the issue of domestic violence but little is known about whether therapists stick to them or not. A survey of 620 couples therapists by the American Association for Marriage and Family Therapy found that less than 4% of them consistently followed important published guidelines for domestic-violence screening. Only a minority indicated that they considered the victim's safety as a factor in choosing the course of treatment. The authors of the study concluded that domestic violence may be under-identified by couples therapists and that therapists could be using conjoint (both together) therapy with couples for whom this was not suitable because of relationship violence.

Schacht, Rebecca L. ... [et al] - Domestic violence assessment procedures among couple therapists Journal of Marital and Family Therapy January 2009, 35(1), 47-59

What people do to help marriages in trouble

Being in a bad relationship can cause distress to individuals (including thoughts of suicide), poorer perceived health and problems with one's work and social life. Marital dysfunction also takes a toll on children leading to bad behaviour, depression and anxiety, poor academic achievement and health problems. Approximately a fifth of marriages are distressed at any one time and 40% of marriages end in divorce so the cumulative toll of marital dysfunction is enormous. However, most distressed couples do not seek marital therapy. Only 37% of divorcing couples report seeking any type of counselling or therapy and only 19% of currently-married couples have. People that seek marital therapy tend to be upper-middle-class, White and college-educated. A study of 213 couples over the first five years of their marriage by U.S. researchers found that 36% of couples sought some form of outside help during this period. Individual and relationship difficulties led to an increased use of relationship books and marital therapy in the following year. Attending a marriage retreat or workshop was more closely linked to being religious.

Doss, Brian D. ... [et al] - Marital therapy, retreats, and books: the who, what, when and why of relationship help-seeking Journal of Marital and Family Therapy January 2009, 35(1), 18-29

Wednesday, January 21, 2009

Autism rise could be real - at least in California

The recent rise in the rates of autism has often been explained as a result of better diagnosis and an increased awareness of the condition. However, a review of data from the California Department of Development Services has found that there could be an increase in the actual incidence of the condition. The cumulative incidence of autism per 10,000 births climbed from 6.2 in 1990 to 42.5 in 2001. A change in the age at diagnosis could explain 12% of the increase, while the inclusion of milder cases could explain 56% but the researchers - from the University of California, Davis - concluded that "the possibility of a true increase in incidence deserves serious consideration."

You can find out more about this research at

Heart risk for antipsychotics

One of the main advantages of newer, 'atypical,' drugs for schizophrenia is that they are thought to have less of a risk of serious side effects such as heart attacks. However, a study of 277,000 people in Tennesee by researchers at the Vanderbilt University School of Medicine found that the newer drugs actually led to a greater risk of a heart attack than older medication. The study used files from the Tennesee Medicaid system which is aimed at providing health insurance for people on lower incomes. It found that users of the drugs had twice the rate of fatal heart attacks of non-users and the higher the dose of the drugs the greater the risk. Once patients stopped taking the drugs the risk of a heart attack faded. Although the risks may be outweighed by the benefits for people suffering from schizophrenia the drugs are also prescribed for people with dementia, attention-deficity hyperactivity disorder (ADHD), bipolar disorder and depression where - despite equal risks - there is much less evidence about their effectiveness.

You can find out more about this research at

Sleep medication use rises in the U.S.

A survey by the Reuters news agency has found that younger people in the U.S. are using an increasing amount of sleep medication. The survey found a 50% increase in the use of the drugs among all adults under 45 from 1998 to 2006. The drugs were also being taken for longer periods of time with the average length of use over the same period rising from 64 to 93 days. There was also a near trebling in the use of sleep medication by 18-24-year-olds; up from 599 users per 100,000 in 1998 to 1,524 users per 100,000 in 2004.

You can find out more about this research at

Extra support keeps postnatal depression at bay

Two studies aimed at looking into ways of preventing women developing postnatal depression have had encouraging results. The first study, by researchers at the University of Huddersfield, compared 2,749 women who were supported by health visitors trained in cognitive behaviour therapy (CBT) or person-centred therapy to 1335 women who received conventional health-visitor care. After six months the women who had received extra support from the health visitors had lower scores for depression and these benefits were maintained after a year. In another study researchers from the University of Toronto looked at the benefits of telephone support provided by volunteers who had experienced and recovered from postnatal depression. 701 women at high risk of developing postnatal depression were divided into two groups. One group received telephone support while the other group received the usual care given to vulnerable new mothers. By the end of the 12-week study only 14% of people in the peer support group were showing symptoms of depression compared to 25% in the care-as-usual group.

You can find out more about this research at

Childhood adversity, anxiety and asthma

Psychological factors, like stress and anxiety, can make people's asthma worse. However, a new study of 18,000 adults in the Americas, Europe and Asia has suggested that childhood adversity - such as the death of a parent or physical abuse - and mental-health problems could lead to the development of the condition in adulthood. The study used interviews carried out between 2001 and 2004 as part of the World Mental Health surveys and was analysed by researchers at the University of Otago in Wellington, New Zealand. It found that childhood adversity predicted adult-onset asthma. The more 'adversities,' such as child abuse, parental neglect, parental divorce, parental mental disorder and family violence that a child experienced the greater the risk of developing asthma as an adult. Anxiety and depression in childhood was also a strong predictor of asthma later in life. Stress is known to have an effect on the immune system so this could be the mechanism that leads to the increased risk of asthma.

You can find out more about this research at

Tuesday, January 20, 2009

Calmness, sociability and dementia

Calm, sociable people might be less at risk of developing dementia than isolated, anxious ones according to a study of 506 older people by researchers at the Karolinska Institute, in Sweden. None of the participants in the study had dementia when they were first examined. The participants were given questionnaires to assess their personality traits and lifestyles and their health was assessed over a six-year period. The more socially active and less-stressed participants were 50% less likely to be diagnosed with dementia over the course of the study.

You can find out more about this research at

Emotional eating in children

Loss of control over eating is prevalent among overweight children and adolescents but what makes children binge eat is unknown. Recent studies have shown a relationship between negative emotions and binge eating and found that the experience of a loss of control over eating is significantly related to symptoms of anxiety and depression in children seeking treatment for obesity. A Belgian study of 188 overweight children included those who were seeking treatment (115) and those who were not (73). The study found that those seeking treatment for their obesity were twice as likely to lose control over their eating than those who were not seeking treatment. Increased anxiety was associated with emotional eating (eating too much but not in an uncontrolled fashion) and binge eating whereas increased depression was only associated with emotional eating. Very fat children were more at risk for loss of control over eating.

Goossens, Lien ... [et al] - Loss of control over eating in overweight youngsters: the role of anxiety, depression and emotional eating European Eating Disorders Revies January-February 2009, 17(1), 68-78

Compulsory detention for eating disorders

The compulsory treatment of people with severe eating disorders is considered controversial. The motivation to change is seen as an essential requirement for successful treatment and only a few places are prepared to treat people against their will. There is concern that compulsory treatment can undermine patients' independence and lead to worse outcomes to their treatment. A three-year study of 50 people with anorexia, admitted to the Wedgwood Unit in Stafford, compared detained patients with those being treated voluntarily. The detained patients had become ill at an earlier age and had been hospitalised more often. When admitted they were doing worse than voluntary patients, were more depressed and had more suicidal thoughts. However, both groups improved significantly once they had been admitted to the unit and by the time they were discharged there was no significant difference between them. Two of the voluntary patients died within a year of discharge; none of those who were compulsorily detained did.

Ayton, Agnes, Keen, Catherine, Lask, Bryan - Pros and cons of using the Mental Health Act for severe eating disorders in adolescents European Eating Disorder Review, 17(1), 14-24

Monday, January 19, 2009

Amygdalas and conduct disorders

Bad behaviour in childhood can predict both mental- and physical-health problems later in life. Among children with behaviour problems those with so-called callous-unemotional traits are a particular cause for concern. They show a lack of guilt and empathy for other people similar to that shown by adult psychopaths and tests have shown that they have difficulty recognising fear and sadness in others. Similar problems have been found among neuropsychological patients with damage to a part of the brain called the amygdala leading to suggestions that problems in this area could also exist in children with conduct problems. A brain-scan study of 30 boys - average age 11 - by researchers at the Institute of Psychiatry in London showed them pictures of fearful and neutral faces. Those boys with conduct problems and a higher level of callous-unemotional traits had less activity in the right amygdala when shown the fearful faces.

Jones, Alice P. ... [et al] - Amygdala hypoactivity to fearful faces in boys with conduct problems and callous-unemotional traits American Journal of Psychiatry January 2009, 166(1), 95-102

IQ and mental health

Cognitive reserve refers to differences in the way people's brains are made up with some people's brains having a denser network of links between brain cells and a higher processing efficiency than others. This difference in brain capacity can be measured, very roughly, by IQ tests and there is evidence to show that a higher IQ is linked to a lower risk of mental-health problems. A study of 1,037 people born between 1972 and 1973 in Dunedin, New Zealand measured their IQ at 7,9 and 11 and assessed them for mental-health problems at 18, 21, 26 and 32. The researchers found that a lower childhood IQ was associated with an increased risk of developing schizophrenia, depression and anxiety and people with lower childhood IQs tended to have more persistent mental-health problems. Higher childhood IQ was associated with an increased risk of mania in adulthood.

Koenen, Karestan C. ... [et al] - Childhood IQ and adult mental disorders: a test of the cognitive reserve hypothesis American Journal of Psychiatry January 2009, 166(1), 50-57

Cannabis and anxiety

Taking cannabis can affect people's anxiety levels. Long-term use has been associated with anxiety symptoms, panic attacks and an increased risk of anxiety disorders and sudden and severe increases in anxiety can also occur following cannabis use. However, cannabis use can also lead to sedation and relaxation and many people who take the drug say it makes them feel less anxious. A team of researchers at the Institute of Psychiatry in London gave 15 healthy volunteers (none of whom were regular cannabis users) two chemicals found in cannabis, 9-THC and cannabidiol. They then showed them faces, some of which looked frightened and distressed, designed to make them feel anxious. The participants' anxiety levels were measured by changes in their skin using the same techniques as lie-detectors, and they also underwent a brain scan. 9-THC was found to increase anxiety as well as levels of intoxication, sedation and psychotic symptoms. Cannabidiol reduced anxiety. The two chemicals were also found to affect different parts of the brain. 9-THC affected the frontal and parietal parts of the brain whereas cannabidiol affected the amygdala and the anterior and posterior cingulate cortex.

Fusar-Poli, Paolo ... [et al] - Distinct effects of 9-tetrahydrocannabinol and cannabidiol on neural activation during emotional processing Archives of General Psychiatry January 2009, 66(1), 95-105

Dopamine and schizophrenia

No-one really knows what causes schizophrenia. One theory is that too much activity involving the neurotransmitter dopamine in a part of the brain called the striatum causes the delusions associated with psychosis but it is unclear when the excess dopamine activity starts to occur in the course of the illness. A brain-imaging study of 43 people by researchers at the Institute of Psychiatry in London compared people with schizophrenia, people with prodromal symptoms of schizophrenia (who show certain symptoms and have a high risk of going on to develop full-blown schizophrenia) and a healthy control group. The researchers found that people with schizophrenia had the highest levels of dopamine activity but that those people with prodromal symptoms also had a raised level of dopamine activity compared to the control group. The higher levels of dopamine activity were found in a region of the striatum called the associative striatum.

Howes, Oliver D. ... [et al] - Elevated striatal dopamine function linked to prodromal signs of schizophrenia Archives of General Psychiatry January 2009, 66(1), 13-20

Guilt and PTSD in children

Although guilt is not one of the 'core' symptoms of post-traumatic stress disorder (PTSD) it often goes hand-in-hand with it. There can be guilt at surviving a trauma while others did not and a feeling of responsibility for not preventing the event in the first place. People can also feel guilty about how they behaved during and after the trauma and about how they deal with its consequences. Guilt has been found to be prevalent in about a third of children experiencing acute or non-abusive trauma such as floods, fires and car accidents and among children exposed to recurring trauma or child abuse nearly 60% felt guilt. A study of 87 Californian children between the ages of 5 and 16, all of whom had been exposed to interpersonal violence, found that guilt over things done and not done was highly associated with the severity of the child's PTSD. Feelings of unreality and separation anxiety were also significantly related to PTSD symptoms.

Kletter, Hilit, Weems, Carl F. and Carrion, Victor G. - Guilt and posttraumatic stress symptoms in child victims of interpersonal violence Clinical Child Psychology and Psychiatry January 2009, 14(1), 71-83

Friday, January 16, 2009

PTSD and memory

People with post-traumatic stress disorder (PTSD) often report difficulties with learning, memory and attention and several studies have shown that participants with PTSD display poorer performance on several tests of learning and memory. However, the picture could be complicated by people's age, how old they were when they experienced their trauma, their intelligence, whether they have other mental-health difficulties and if they take illegal drugs or drugs to treat their PTSD. And there have been no studies into the links between PTSD, memory performance and how well people cope in their working and personal lives. A Dutch study compared 25 veterans with PTSD to 25 veterans without the condition. It found that the veterans with PTSD had similar IQ scores but displayed deficits in figural and logical memory, measures of learning and immediate and delayed verbal memory. The worse people's performance on the memory tests the worse was their current social and occupational functioning.

Geuze, Gilbert ... [et al] - Neuropsychological performance is related to current social and occupational functioning in veterans with posttraumatic stress disorder Depression and Anxiety January 2009, 26(1), 7-15

Preoccupation and interrelation

Recurrent negative thinking is common in many mental-health problems. Worry in people who are anxious, rumination (chewing negative thoughts over and over) in depression and body preoccupation in eating disorders can all contribute to the perpetuation of the problem and affect cognition by taking up valuable 'thinking space.' A study of 60 female undergraduates at Oxford University examined how preoccupation affected their ability to process information about social interaction - often a problem for people with mental-health difficulties which can lead to them having problems with their relationships. The participants were chosen because they all had higher-than-average levels of preoccupation with food, body image and weight. One group were told to sit still, close their eyes and relax; another group were shown words and asked to talk about a memory they brought to mind (many of the words had food/body image connotations such as 'chocolate,' 'stomach,''diet,' and 'fat,') and a third group was asked to pick a topic they were worried about and worry about it in their usual way for two minutes. All the participants then watched an eight-minute video about a family conference and were then tested on how well they could remember it. Those who had worried for two minutes scored lower than the other two groups but there was no difference between those who had talked about memories linked to words and those who had relaxed for two minutes.

Lehtonen, Annukka ... [et al] - Effects of preoccupation on interpersonal recall: a pilot study Depression and anxiety January 2009, 26(1), 1-6

New guide to talking therapies

The Mental Health Foundation has written a guide to psychotherapy aimed at helping people find the best therapy for them. The guide explains the different types of therapy and how the profession is regulated. You can download a copy of Talking therapies explained at

Ginkgo biloba and Alzheimer's disease

Ginkgo biloba is widely used for its potential benefits in improving people's memory and cognition. However, a study of 3,069 people in the U.S. has found that it has no effect in reducing the incidence of dementia or Alzheimer's disease. The participants in the study were all over 75 and 482 of them had mild cognitive impairment. All the participants were evaluated every six months and dementia and Alzheimer's disease were determined by an expert panel. The incidence of dementia and Alzheimer's was actually slightly higher in the gingko biloba group although this was not statistically significant i.e. it was probably due to chance.

DeKosky, S.T. ... [et al] - Ginkgo biloba for prevention of dementia Journal of the American Medical Association 300, 19, 2253-2262

Wednesday, January 14, 2009

New RCP guidelines on children on adults' wards

The Royal College of Psychiatrists has developed safeguarding standards for young people placed on adult psychiatric wards. The standards were commissioned by the National Institute for Mental Health in England and are designed to help managers meet their duty to end the unsuitable accomodation of young people in adults' wards by April 2010. There are 170 criteria, covering staffing, training, assessment, administrative processes and the physical environments of the wards. The Government is spending £31m to meet the target.

You can download a copy of the standards at

PTSD and metabolic syndrome

A study by researchers at the San Diego School of Medicine has found that army veterans with post-traumatic stress disorder (PTSD) are more likely to have metabolic syndrome. Metabolic syndrome is composed of a cluster of clinical signs including obesity, high blood pressure and insulin resistance and is associated with diabetes and cardiovascular disease. The researchers studied a group of men and women seeking treatment for PTSD at the Cincinatti Veterans Affairs Medical Centre. The sample was primarily male (92%), White (76%) and had an average age of 52. 71% of them had served in the U.S. army and close to 70% were Vietnam veterans. Over half (55%) had moderate-to-severe levels of PTSD, 64% had major depression and 40% met the criteria for metabolic syndrome. Those people with more severe symptoms were more likely to have metabolic syndrome and the rate of metabolic syndrome was higher (34%) among those with PTSD than in those with depression (29%).

You can find out more about this research at

Fostering and mental health

There are approximately half a million children and adolescents in foster care in the U.S. and it is estimated that between 42 and 60% of them have emotional and behavioural problems. Despite the high prevalence of mental-health problems in these children little is known about how such problems affect the outcome of foster placements. A study of 5,978 children in Illinois looked at their medical records to see whether they had received inpatient mental-health care and followed their progress for several years to see how their foster placements turned out. Five percent of the children had had at least one episode of inpatient mental-health care prior to being placed in foster care. The children who received inpatient psychiatric care had a substantially greater risk for parent-child separation. They were also at a greater risk for frequent placement disruptions and were less likely to be reunited with their birth family or permanently adopted. About half of the sample experienced more than three placement changes during their first spell in foster care. Having had inpatient care raised the risk of placement instability by 75% among White children and 24% among African-American children.

You can find out more about this research at

Caffeine and hallucinations

People who drink large amounts of tea and coffee may be more prone to hallucinations, according to a study of 200 students, carried out by researchers at Durham University. High caffeine users, those people who consumed more than the equivalent of seven cups of coffee a day, were three times more likely to have heard a person's voice when there was nobody there than low caffeine users who drank less than a cup a day. This could be because caffeine stimulates the release of the stress hormone cortisol, or because those students who are more prone to hallucinations use caffeine to cope with their experiences.

You can find out more about this research at

Tuesday, January 13, 2009

Poor start lasts for schoolchildren

A study by researchers at the University of Missouri tracked 474 children from year 1 into years 6 and 7. The researchers found that the children who struggled with their maths and English in year 1 had low self-esteem in year 6 and symptoms of depression in year 7.

You can find out more about this research by clicking on the link in the title of this post.

Racism and mental health on the Internet

It seems that all human life is on the Internet and sadly racism is no exception. A study of adolescents by researchers at the University of Illinois found that 71% of African-American, 71% of White and 67% of multiracial/'other' adolescents had come across racism online. 29% of African-American teenagers, 20% of White children and 42% of multiracial/other youngsters had experienced racial discrimination aimed at themselves via the Internet. Regardless of a victim's racial background discrimination was significantly related to increased depression with girls being more vulnerable than boys. Victimization occurred via instant messaging, discussion forums, online games and social-networking sites.

You can find out more about this research by clicking on the link in the title of this post.

Religion, spirituality and happiness

A study of 320 8-12-year-old children by researchers at the University of British Columbia in Canada looked into the links between spirituality (defined as an inner belief system that a person relies on for strength and comfort), religious practice, temperament and happiness. The study found that those children who said they were more spiritual were happier. Feeling a sense of meaning and value about one's life and the quality and depth of interpersonal relationships were strong predictors of happiness. However, religious practices, such as attending church, praying and meditating had little effect. Temperament was also an important predictor of happiness with happier children being more sociable and less shy.

You can find out more about this research by clicking on the link in the title of this post.

Getting to grips with procrastination

Psychologists at the University of Konstanz in Germany have been looking into the issue of procrastination; what makes some people put off a task until later and others plunge straight into it. The psychologists gave questionnaires to the students and asked them to respond by email (with a payment as a reward) within three weeks. All the questions were about everyday tasks such as opening bank accounts or keeping a diary but some students were asked abstract questions (such as who might keep a diary or why someone would open a bank account) while others were asked about the practicalities of these tasks. Those students who thought about the task in practical terms were less likely to procrastinate suggesting that approaching tasks in a practical fashion and breaking things down into constituent processes was much less likely to result in procrastination.

You can find out more about this research by clicking on the link in this post.

New gene for Alzheimer's

A study of 4,855 people by researchers at the Mayo Clinic, in the U.S. compared those with and without Alzheimer's disease in an attempt to find a genetic link to the condition. Genetic variations can be found on both chromosomes (XX in women and XY in men), one chromosome or not at all. The most significant new variation the researchers found was of a gene called PCDH11X on the X chromosome. The odds ratio of developing Alzheimer's (where 1 is the average risk) was 1.75 for women with two copies, 1.26 for women with one copy and 1.18 for men with one copy. Although statistically significant this is less than the odds ratio for the most significant Alzheimer's gene yet discovered APOE4 which has odds ratios of 11.5 for two copies and 4.8 for one.

You can find out more about this research by clicking on the link in this post.

You never know what you've got until you lose it ...

A study of final-year students at Pomona College in the U.S. has found that thinking that something is about to come to an end can actually make us value it more. The study took place six weeks before the students' graduation. Every day for a fortnight they were asked to write about their college experiences, including the activities they participated in. The experiment was designed so that some of the students thought about graduation as a far-off event and some thought about it as occuring very soon. Those who thought about graduation coming soon participated in more college activities i.e. when they thought about their time at college coming to an end they wanted to make the most of it.

You can find out more about this research by clicking on the title of this post.

Lead and cognition

A long-term study of 134 workers in Pennsylvania compared the cognitive abilities of those who had been exposed to lead (while making batteries) during their working lives and those who had not. The study, which was carried out in 2004, was a follow-up to a study of lead levels originally carried out in 1982. The researchers measured the current levels of lead in the men's blood and the levels of lead in their bones where lead eventually accumulates in the body. They also tested the men's cognition. Among the men who had been exposed to lead those with a higher level of lead in their bones had significantly lower cognitive scores; this was particularly true of spatial ability, learning and memory. The scores were worse even when people's current lead levels were lower suggesting that even when men no longer worked at the battery plants their earlier prolonged exposure was enought to affect their cognitive abilities.

In search of a test for autism

There is no laboratory test for autism at the moment. Scientists are searching for biomarkers, such as abnormal proteins, that appear in the body fluids of people with autism that can provide a way to accurately diagnose autism and track its response to potential treatments. A study published in the Journal of Proteome Research compared the saliva of 27 children with autistic-spectrum disorder to 27 controls. The researchers found that 19 of the 27 children with autism had significantly lower levels of protein phosphorylation - a process that activates proteins so they can work normally.

You can read more about this research by clicking on the link in the title of this post.

Job stress and stroke risk

A long-term study of 6,553 Japanese people has found that job stress can significantly increase the risk of stroke in men. The participants were first interviewed between 1992 and 1995 and were then monitored over the next 11 years. Stress is thought to be caused by a combination of high demands placed upon people and their having low control over their work. The participants were divided into four groups: low demands and high control (low strain), high demands and high control (active), low demands and low control (passive) and high demands and low control (high strain). Men with high-strain jobs had more than twice the risk of men with low-strain jobs. Women in high-strain jobs had a higher risk than those in low-strain jobs although this difference was not statistically significant.

You can find out more about this research by clicking on the link in the title of this post.

Monday, January 12, 2009

Stressed-out in Salford

A study of 172 15- and 16-year-olds preparing to take their GCSEs in Salford, Manchester has found that one in four of them said that they suffered from high levels of stress caused by coursework. Although many of them said that they listened to music, watched TV or played sport to reduce their stress levels 30% said that they drank alcohol, 18% said that they smoked and 6% said that they had used drugs to cope with stress.

You can find out more about this study by clicking on the title of this post.

Problem children, troubled adults

A study of more than 3, 500 British people born in the 1940s asked their teachers to rate their behaviour as severe, mild or no problems at the start of the study when the participants were aged between 13 and 15. They were then followed up between the ages of 36 and 53 when researchers asked them about their mental health and social and economic status. The researchers - from the University of Alberta - found that badly-behaved children were twice as likely to suffer from anxiety and depression, to become pregnant as teenagers or to experience divorce (as adults) as their classmates although they were no more likely to develop alcohol problems.

You can find out more about this research by clicking on the link in the title of this post.

Alzheimer's and smoking

A review of studies into the link between smoking and Alzheimer's disease has found that people who smoke have a 79% higher chance of developing the condition. The review analysed 24 previous studies and found an increased risk for current smokers but not for people who had given up. The link may be due to smoking damaging blood vessels and impairing blood flow accelerating damage to brain tissue. The review was carried out by researchers at Imperial College London.

You can find out more about this research by clicking on the link in the title of this post.

The power of a good cuddle

Emotional and social support is very important for people's emotional and physical health and now researchers at Brigham Young University in Salt Lake City have found that the odd cuddle can be good for you as well. In their study the researchers divided 36 couples into two groups. One group received training in 'listening touch' (increasing awareness of a partner's mood by touching their neck, shoulders and hands) and neck and shoulder massage which they were told to practice together for 30 minutes, three times a week for four weeks. The other group were told to record any physical contact with their partner. By the end of the study the participants in the 'touch' group had higher levels of oxytocin, which is associated with love and emotional closeness, and lower levels of salivary amylase which is associated with stress. The men, but not the women, had reduced blood pressure but there were no differences in the level of the hormone cortisol, which is also associated with stress.

You can find out more about this research by clicking on the title of this post.

Friday, January 09, 2009

PTSD: the agony and the ecstasy

Post-traumatic stress disorder can occur after people have experienced trauma such as war, torture, disasters or sexual assault and symptoms can include anxiety, nightmares, intrusive memories, sleep and concentration difficulties, evasion of situations that remind people of the original trauma and feelings of shame. Treatment typically involves psychotherapy and drugs, usually ones for anxiety and depression. A recent study of 21 people - all of whom had tried a conventional mixture of drugs and psychotherapy - divided them into two groups. A control group took a placebo while the other group took a pharmacological version of MDMA (ecstasy). The participants carried on with their psychotherapy. Two months into the treatment 92% of the MDMA group showed a clinically significant improvement in their condition. They were more open to therapy and were able to 'process' their trauma. They felt less shame and were less dispirited, evasive and afraid. In contrast only 25% of the participants in the placebo group showed progress. Eventually everyone in this group was also offered treatment with MDMA and the results have been good with no serious or lasting side effects. None of the MDMA patients continued to take the drug after treatment. MDMA increases the levels of oxytocin in the brain, a hormone which stimulates emotions such as connection, proximity and trust, meaning that the participants were better able to open up and have confidence in their therapist. It also increases the activity in a part of the brain called the ventromedial prefrontal cortex, an area of the brain that processes fear, lowers stress and enables us to see events in perspective.

You can find out more about this reserch by clicking on the title of this post.

Physical activity and cognitive functioning

Living a sedentary life is now considered a risk factor for stroke and dementia and a study of 42 older women (average age 65) in Calgary, Canada has found that women who took part in regular aerobic activity had better blood flow to their brain and superior cognitive functioning. The study measured the women's cardiovascular health, blood flow to their brain and their cognitive functioning. The study measured the women's cardiovascular health, the blood flow to their brain and their cognitive functioning. Compared to the inactive women the active women had lower blood pressure, higher blood flow to the brain during exercise and higher cognitive function scores.

You can find out more about this research by clicking on the link in the title of this post.

Insomnia and paranoia

On any given night one in three people will have difficulties getting to or staying asleep and for one in ten people this can occur several nights a week. Lack of sleep can lead to anxiety, sadness and irritability and a new study by researchers at the Institute of Psychiatry in London has found that it can also lead to paranoia. The study found that people with insomnia were five times more likely to have high levels of paranoid thinking than people who were sleeping well. Further research by the team found that over half the individuals attending psychiatric services for severe paranoia were found to have clinical insomnia. In a vicious cycle insomnia can make people feel more anxious and fearful leading them to get a worse night's sleep. Cognitive behaviour therapy has been found to be effective in helping people sleep better and can get the sleep-mood cycle moving in a more positive direction.

You can find out more about this research by clicking on the title of this post.

Maternal smoking and aggression

A joint study by researchers in the Netherlands and Canada has found that women who smoke, particularly poorer women with a history of antisocial behaviour, are more at risk of having aggressive children. Aggression was defined as being quick to hit, bite, kick, fight and bully others. Mothers whose lives had involved anti-social behaviour and who smoked more than 10 cigarettes a day had a 67% chance of having an aggressive child while those whose behaviour was just as bad but who smoked less had only a 16% chance of having an aggressive child. Heavy smokers who had a family income of less than $40,000 p.a. had a 40% chance of having an aggressive child compared to only 25% of non-smoking mothers with the same income. The gap was much less significant among mothers with higher incomes. Other risk factors were mothers who were under 21 and who coerced their children to behave. The effect of smoking on the children's aggression remained significant even after divorce, depression, maternal education and the mother's age during pregnancy were taken into account

Huijbregts et al - Maternal prenatal smoking, parental antisocial behavior, and early childhood physical aggression. Development and Psychopathology, 2008; 20 (2)

'Man hands on misery to man' - at least they do in Iowa

A ten-year study of nearly 500 families in Iowa has shown how depression plays a part in perpetuating poverty from one generation to the next. The study found that the children from poorer families were at greater risk of suffering from symptoms of depression by the time they reached adolescence. The depressed teenagers were more likely to have sex, leave home and get married at an earlier age leading to problems such as lower education levels, unemployment and a lack of stable relationships in their lives.

You can find out more about this research by clicking on the link in the title of this post.

Tetris and PTSD

There is a period of up to six hours after an event in which it is possible to affect people's memories of it. This could prove particularly useful in cases of post-traumatic stress disorder in which sufferers have repeated flashbacks of traumatic events. Researchers at Oxford University showed a film to 40 healthy participants, which included traumatic images taken from sources such as road-safety advertisements. After waiting for 30 minutes half the people played the computer game Tetris for 10 minutes while the others did nothing. Those who played the game (beloved of office procrastinators the world over) which involves manipulating shapes composed of square blocks that fall down the screen to create a horizontal line of blocks without gaps had far fewer flashbacks to the film over the next week. The researchers thought that recognising the shapes and moving the blocks around the screen competes with, and to some extent displaces, the visions of trauma retained in the sensory part of the brain.

You can find out more about this research by clicking on the title of this post.

Statins and alzheimer's disease

Although there is no cure for Alzheimer's disease living a healthy lifestyle has been shown to reduce the risk of developing the condition. One of the ways to do this is by lowering cholesterol, something that can also be achieved with drugs called statins. A Dutch study by researchers at the Erasmus Medical Centre in Rotterdam studied 6,992 participants over 55 who were all free of dementia when they were examined between 1990 and 1993. The participants were followed up in 2005 by which point 582 of them had developed Alzheimer's. After taking into account social and demographic factors known to raise the risk of developing the condition statin users had a 43% decreased risk of Alzheimer's something that was true whichever kind of statin they took and whether or not they had a genetic variation which is known to raise the risk of Alzheimer's.

You can find out more about this study by clicking on the title of this post.

Antipsychotics in dementia raise risk of death

Antipsychotic drugs have increasingly been used to treat the personality changes and aggression often associated with Alzheimer's disease but there have been increasing concerns about their effects on people's health. A three-year study by researchers at King's College London compared those taking antipsychotic drugs with those taking a placebo. After a year slightly more people in the antipsychotic group had died but after a year and a half survival in the placebo group was 59% compared to 30% among those taking antipsychotics. Over the course of the study the participants given the placebo were 42% less likely to die than those taking antipsychotics. Antipsychotic drugs are also linked to a higher risk of stroke and a decline in brain function.

You can find out more about this research at

Thursday, January 08, 2009

Dementia services: surveys paint gloomy picture

A series of surveys by the Alzheimer's society has painted a gloomy picture of the state of dementia care in the UK. The first one, produced in conjunction with the Liberal Democrats found that two-thirds of people with dementia were not listed as having dementia on their GPs records, as required under the current GP contract. The research also revealed a huge variation in dementia diagnosis across the country. Another survey of GPs, done with the Daily Mail, found that 29% of them admitted that they did not have enough training to diagnose and manage dementia, 60% said that there was a reluctance to diagnose because of a lack of support services, 40% felt hesitant to make a diagnosis because of a lack of drug treatments and 10% felt that there was nothing that could be done for people with dementia. A third survey, carried out for GP magazine, found that a third of primary care trusts had closed or downgraded dementia services in the past three years and that two-fifths of them failed to provide any specialist services at all.

You can find the Alzheimer's Society web site at

People in PICUs

Psychiatric Intensive Care Units (PICUs) evolved during the 1990s to provide care for patients in an acutely disturbed phase of a serious mental disorder who display behaviour that cannot be managed safely on an ordinary psychiatric ward. An analysis of 332 patients admitted to 7 English PICUs found that they were predominantly White men, in their mid thirties with complex needs and chronic psychotic illness, often complicated by substance misuse. Most people were admitted because of a perceived risk of violence to others. While most admissions were broadly in line with Department of Health guidelines some patients experienced an excessive length of PICU stay. Black African and Black Caribbean people were, proportionally, more likely to be admitted to a PICU.

Brown, Steve, Chhina, Navjyat and Dye, Stephen - The psychiatric intensive care unit: a prospective survey of patient demographics and outcomes at seven English PICUs Journal of Psychiatric Intensive Care June/December 2008, 4(1/2), 17-27

Death rates in eating disorders

Anorexia nervosa is a very serious mental disorder and a number of studies have been carried out into mortality rates among people with anorexia. The standardised mortality ratio (SMR) is the ratio of actual deaths to expected deaths. If firemen, for example, have an SMR of 8, compared to people of a similar age in the general population then that means they are 8 times more likely to die earlier. Studies have estimated the SMR for anorexia at anything between 0 and 17.8. A Swedish study followed 6,009 women who had been discharged from hospital after treatment for anorexia between 1973 and 2003. Every death in Sweden is recorded on a central register, so the researchers were able to compare deaths among the women with anorexia to deaths among women of a similar age in the general population. The overall SMR for anorexia was 6.2. Anorexia itself, psychoactive substance use and suicide were the main causes of excess mortality but the SMR was significantly increased for almost all natural and unnatural causes of death and remained significantly high even 20 years after the first hospitalisation. The mortality from anorexia had fallen in the last two decades. Younger age and a longer hospital stay at first hospitalisation were associated with less mortality whereas the presence of other mental and physical health problems increased the risk of death.

Papadopoulos, Fotios C. ... [et al] - Excess mortality, causes of death and prognostic factors in anorexia nervosa British Journal of Psychiatry January 2009, 194(1), 10-17

Lamotrigine for bipolar disorder

Bipolar disorder is among the top causes of worldwide disability and is characterised by both depressive and manic episodes but the depressive symptoms are now recognised to be the predominant cause of disability in the long term. However, using conventional anti-depressants can run the risk of sending people into the manic phase of the illness. Recent guidelines have suggested a role for lamotrigine. There is good evidence for its long-term effectiveness in preventing relapse but the evidence for its effectiveness in the acute phase of bipolar depression is much more mixed. Researchers from Oxford University pooled the results from five separate studies with a total of 1,072 participants. They found consistent evidence that lamotrigine has a beneficial effect on depressive symptoms. The overall effect was modest although the advantage over placebo was larger in more severely-depressed participants.

Geddes, John R., Calabrese, Joseph R. and Goodwin, Guy M. - Lamotrigine for treatment of bipolar depression: independent meta-analysis and meta-regression of individual patient data from five randomised trials British Journal of Psychiatry January 2009, 194(1), 4-9

Appealing under the Act

The number of people detained under the Mental Health Act rose to an all-time high in 2005-6. At the same time an increasing proportion of these people appealed to mental-health tribunals to overturn the decision to detain them. Several studies have shown that African Caribbean people are more likely to be compulsorily detained than other people. A study of detentions and appeals at an outer-London hospital has found that detentions rose from 203 in 1996 to 279 in 2006. The percentage of cases going to appeal rose from 34% to 81% during the same period. However, there was no real difference in the results of the appeals and the results of the appeals were not associated with gender, ethnicity, mental status or age. About 12% of the appeals were successful.

Dhananjay, Kumar Singh and Moncrieff, Joanna - Trends in mental health review tribunal and hospital managers' hearings in north-east London 1997-2007 Psychiatric Bulletin 2009, 33, 15-17

Tackling self-harm in Sheffield

The incidence of self-harm among teenagers has been rising year-on-year and the UK now has the highest rates of this behaviour in Europe. It is estimated that one in ten adolescents in the UK will self-harm, something that leads to around 24,000 hospital admissions per year. Particular groups at risk include girls (who are seven times more at risk than boys), prisoners and young Asian women. The Oakwood Young People's Centre in Sheffield (an adolescent inpatient psychiatric unit) experienced a sevenfold increase in self-harm in the last few months of 2002 from an average of 1.2 incidents per month to an average of 8.1. Staff at the unit drew up a new policy on self-harm. They offered a range of support and alternative coping techniques including the use of ice, rubber bands and marker pens instead of sharp objects. Diaries, relaxation techniques and distraction were also used as well as a wide range of therapeutic interventions to address the patients' underlying distress and problems. Self-harm was viewed in the same light as the use of alcohol or illegal drugs; as completely unacceptable and resulting in suspension from the unit. Service users were able to return after a suspension but any repeated self-harm was seen as grounds for discharge. The new policy led to a steep decline in the incidence of self-harm to 0.2 incidents per month, below the levels before the increase in 2002.

Livesey, Anthony E. - Self-harm in adolescent in-patients Psychiatric Bulletin 2009, 33, 10-12

Wednesday, January 07, 2009

Childhood trauma and chronic fatigue syndrome

A U.S. study of 237 people by researchers from Emory University in Georgia has found that childhood trauma, particularly emotional maltreatment and sexual abuse is associated with a sixfold increase in the risk of chronic fatigue syndrome. The study compared people with and without chronic fatigue who completed a questionnaire on five different types of childhood trauma including emotional, physical and sexual abuse and emotional and physical neglect. The researchers also collected saliva samples from the participants to measure the levels of the stress hormone cortisol and found that low levels of the hormone - often a symptom of chronic fatigue syndrome - were associated with childhood trauma. Of the people suffering from chronic fatigue syndrome only those who had suffered childhood trauma had low levels of cortisol.

You can read more about this research at

Brain scans and bulimia

Women with bulimia may be more impulsive than other women, according to research carried out at Columbia University in the U.S. The researchers used a task called the Simon Spatial Incompatibility Task to measure impulsiveness. In the task an arrow appears on a computer screen and participants have to decide in which direction it is pointing. The arrow can appear in any place on the screen, so, for instance, an arrow could appear on the right-hand side of the screen but pointing left. The idea behind the test is that more impulsive people will reach a decision based on the arrow's position rather than the direction in which it is pointing and therefore get more wrong answers. The study compared 20 women with bulimia to 20 controls and the participants also undertook a brain scan while they took the tests. The women with bulimia did less well on the task and showed less activity in an area of the brain called the frontostriatal circuits which help individuals control their voluntary behaviour.

You can find out more about this research at

IMHAs for all by April

Primary care trusts (PCTs) have been given four months to ensure independent mental health advocates (IMHAs) are available across England. Under the Mental Health Act, 2007 service users are entitled to access to independent support and advice on their legal rights.

You can read the Government's statement on this at

Prince's Trust survey of mental health

A survey of 2,004 16-25-year-olds by the Prince's Trust has found that 12% of them said that life was meaningless, while 14% thought that 'life has no purpose.' One in five felt like crying 'often' or 'always' and nearly half (47%) felt regularly stressed. 27% claimed to be 'down' or 'depressed' and this figure rose to 37% among those not in employment, education or training. Reasons for unhappiness included feeling no sense of community, not feeling safe to walk around at night and not having anything to do. However, over 70% of those surveyed said they felt happy with life.

You can download the full text of the Prince's Trust report at

Diabetes and cognition

A study of 465 adults between the ages of 53 and 90 by researchers at the University of Alberta has found that diabetes can affect people's thought processes. The study compared 41 people with diabetes with 424 people without the condition. The study found that people with diabetes had slower response times and poorer executive functioning which is the ability to focus, to work with new information to solve problems and to give thoughtful answers to questions. Diabetes is known to raise the risk of Alzheimer's disease and the high blood sugar levels caused by the condition can damage both blood vessels and nerves.

You can find out more about this research at

Premature births and mental-health problems

Children who are born prematurely may be at an increased risk of developing mental-health problems later in life according to a Swedish study of 545,628 people born in the 1970s and tracked until they were between 23 and 29. Compared with those children who were born full-term those born between 24-32 weeks had a 68% higher risk of psychiatric disorders while those born between 33-36 weeks had a 21% higher risk and those born between 36-39 weeks had an 8% higher risk. Alcohol- and drug-related hospital admissions were not more common in those born prematurely.

You can find out more about this research at

Infertility and mental health

A study comparing the mental health of fertile and infertile couples has found that couples who are infertile are more at risk of mental-health problems. The study, by researchers at the University of Siena, compared 81 infertile couples with 70 fertile ones. The infertile women were more likely to suffer from depression and anxiety and also from binge-eating disorder. Infertile men were more likely to show minor symptoms of obsessive-compulsive disorder and social phobia.

You can read more about this research at


A pilot study in Virginia, U.S. has found that transcendental meditation may be helpful for children with Attention Deficit Hyperactivity Disorder (ADHD). Transcendental meditation is a simple meditation technique in which people sit comfortably for 10-15 minutes with their eyes closed, silently repeating a mantra (a sound, word or phrase) to calm the mind or body. Some studies have found that meditation can alter a range of bodily functions including breathing, blood-vessel dilation and stress-hormone regulation. The study had 10 participants, between the ages of 11 and 14, who were attending a school for students with language-related learning disabilities all of whom had been diagnosed with ADHD. The students were taught the transcendental meditation technique and then practised it at school twice a day for 10 minutes at a time. After three months the students reported lower stress and anxiety levels and, according to their teachers and parents, their ADHD symptoms had improved.

You can find out more about this research at