Friday, November 26, 2010

Diabetes and depression

There is good evidence of a link between diabetes and depression and new research from the Harvard School of Public Health suggests that the link could work in both directions. The researchers studied 65,381 women who were aged between 50 and 75 in 1996. The women filled out a questionnaire about their medical history at the start of the study and every two years thereafter. Over the course of the study 2,844 of the women developed type 2 diabetes and 7,415 developed depression. The women with depression were about 17% more likely to develop diabetes, even after taking into account other risk factors such as physical activity and weight, while the women with diabetes were 29% more likely to develop depression.

Pathological gambling and suicide

People with gambling problems are not only at risk financially they are also far more likely to kill themselves. 5% of people who kill themselves are pathological gamblers and gamblers are three times more likely to kill themselves than people who don't bet. Researchers from the Universite de Montreal studied 122 suicides which took place between 2006 and 2009, 49 of whom were pathological gamblers. The gamblers had twice as many personality disorders as the other suicides and were three times less likely to seek help before they killed themselves.

Study gives thumbs up to Canadian family intervention

There has been a lot of research recently into ways in which the Government, health services and other public bodies can intervene early in the lives of disadvantaged children to help them do better later on in life. One such initiative is the Better Begginings, Better Futures project which has recently been studied by researchers from Queen's University in Ontario, Canada. The researchers compared 959 children, 601 of whom were between four and eight and took part in the project and 358 of a similar age who formed a control group. Follow-up data on the children was collected when they were in years 3, 6, 9 and 12 at school. The study found improvements in social and school functioning in the children who took part in the project and fewer emotional and behavioural problems at school. By year 12 the children who took part in the study were less likely to have committed a property crime and their parents were reporting greater feelings of social support, happier marriages and better family functioning. The project proved cost-effective as the Government ended up spending less money helping each child because they did better in the long term.

Study backs religious and spiritual therapies

Religion can be defined as adherence to a belief system and practices associated with a tradition in which there is agreement about what is believed and practiced whereas spirituality can be defined as a more general feeling of closeness and connectedness to the sacred. In recent years psychotherapists have been trying to incorporate both - where appropriate and where the patient wants it - into psychotherapy. A team of researchers from Virginia Commonwealth University reviewed 46 studies, covering a total of 3,290 people, into the effectiveness of 'religious accommodative' and 'nonreligious spirituality' therapies. They found that patients receiving these therapies showed greater improvements in psychological and spiritual outcomes than those receiving alternative secular therapies.

Worthington, Everett L. ... [et al] - Religion and Spirituality Journal of clinical psychology: in session 67(2), 1--11

Thursday, November 25, 2010

Resistance, reactance and psychotherapy

Despite expressing a sincere wish to recover some patients behave in almost exactly the opposite way from that suggested by their psychotherapist - something sometimes called patient resistance. However, a team of researchers from Palo Alto University in California thought that patient resistance was a term which was too pejorative to patients and decided to call it patient reactance instead in an acknowledgement that the therapist's approach could also play a part in this happening. The researchers looked at 12 studies into this issue covering a total of 1,102 participants. They found that those patients who were more inclined to follow their therapist's advice benefited more from a more directive approach (i.e. being told what to do) whereas patients who had high levels of resistance/reactance benefited more from a nondirective approach.

Beutler, Larry E. ... [et al] - Resistance/Reactance Level Journal of Clinical Psychology: in session Vol. 67(2), 1-10 (2011)

Child abuse and drug addiction

Child abuse is known to be a risk factor for a number of different mental-health problems and antisocial behaviour. Researchers from the Albert Einstein College of Medicine in New York studied 143 people in an attempt to find out more about this. 48 of them were child molesters, 25 were recovering opiate addicts and the rest formed a healthy control group. The participants were asked whether they had suffered adult sexual advances while they were children or if they had had sexual intercourse with someone at least five years older before they were 13. The participants who were child molesters or recovering opium addicts had lost their virginity at a younger age than the healthy controls. However, while the child molesters were more likely to have been abused themselves the recovering addicts were no more likely to have suffered child abuse than the control group. But, this was a relatively small study and a number of other researchers have found a link between child abuse and drug addiction.

Cohen, Lisa J. ... [et al] - Comparison of Childhood Sexual Histories in Subjects with Pedophilia or Opiate Addiction and Healthy Controls: Is Childhood Sexual Abuse a Risk Factor for Addictions? Journal of Psychiatric Practice 16(6):394-404, November 2010

Tuesday, November 23, 2010

New approach bears dividends after 7/7 attacks

People caught up in attacks by terrorists often suffer from psychological as well as physical trauma yet studies of what happened after events like the 1995 Oklahoma City bombings and the 9/11 attacks show that those caught up in them do not always contact their GP or get the help they need. Following the July 2005 attacks in London the U.K.'s Department of Health set up a Trauma Response Programme. They used contact details of people known to have been caught up in the attacks from a variety of sources including the telephone help-line NHS Direct, hospitals, charitable relief funds and the police. People received a letter or a telephone call and a brief two-page questionnaire designed to ascertain mental-health problems. At the same time a media campaign advertised the programme and encouraged individuals to contact it. The programme contacted 910 people of whom 596 filled out the questionnaire. 217 people were adjudged to need treatment and they received either trauma-focused cognitive behaviour therapy or eye-movement desensitization and reprocessing (EMDR). The treatments were found to be very effective and gains made in treatment were maintained one year later.

Brewin, C. R. ... [et al] - Outreach and screening following the 2005 London bombings: usage and outcomes (2010), 40, 2049–2057
Psychological Medicine

Most people don't stay the course with antidepressants

Most people who take antidepressants give them up before they are supposed to. Researchers from the Catalan Institute of Health studied 7,525 people who were starting antidepressant treatment. They found that 56% stopped taking their medication during the first four months and only 25% continued their treatment for more than 11 months. Only 22% of the sample completed their treatment although women were more likely to carry on taking the pills than men and those who took more than one kind of medication stuck with their pills better than those who just took antidepressants. Doctors recommend taking antidepressants for at least six months.

Premature babies have more problems at six

Children born between 34 and 36 weeks into their mothers' pregnancies could be at greater risk of developing cognitive and emotional problems. Researchers from Michigan State University studied a group of children born between 1983 and 1985 and compared at what stage during their mothers' pregnancies they were born to information collected when they were six. The children born between 34 and 36 weeks had lower levels of cognitive performance and higher levels of behavioural problems even after accounting for socioeconomic factors and maternal IQ.

Talking and trauma

Talking or writing about trauma that one might have experienced (emotional disclosure) is widely seen as being therapeutic for people but the evidence about this is mixed and the best way of achieving it is unclear. Researchers from Wayne State University in Detroit looked into this issue in a study of 214 people who had 'unresolved stressful experiences.' Some of the participants formed a control group while the rest of them had a 30-minute session of either written or private spoken disclosure, talking to a passive listener or talking to an active facilitator. After six weeks both the disclosure groups and the control group showed similar reductions in stress i.e. disclosure had no more effect than the passage of time. However, those people who had spoken or written about their experiences did show more post-traumatic growth; something defined as finding meaning in the experience, changing one's priorities, seeing new possibilities, increasing understanding and appreciation of life, improving relationships and making spiritual changes. There was no difference between the different methods of disclosure in the amount of post-traumatic growth they engendered.

Slavin-Spenny, Olga M. ... [et al] - The Effects of Different Methods of Emotional Disclosure: Differentiating

Post-Traumatic Growth From Stress Symptoms Journal of Clinical Psychology  DOI: 10.1002/jclp.20750

Monday, November 22, 2010

Genes and anorexia

A team of researchers from the Center for Applied Genomics at The Children's Hospital of Philadelphia has been looking into the genetics of anorexia nervosa. They studied 4,736 people, 1,003 of whom had anorexia and compared their genes. The study found that variations in two genes - OPRD1 and HTR1D - increased the risk of developing the condition. However, most scientists think that although genes might increase the risk of developing mental-health problems the true causes of these conditions lie in a combination of genetics and people's upbringing and experiences.

Girls less likely to be diagnosed with autism even if their symptoms are just as bad

Girls are less likely to be diagnosed with autism than boys even if their symptoms are just as bad. Previous research has shown that boys are four times as likely to have autism than girls but not everyone with symptoms of autism receives a diagnosis. Researchers from the universities of Bristol and Exeter used information from the Avon Longitudinal Study of Parents and Children to look into this issue further. They found that even in children with similar levels of autism symptoms boys were more likely to be diagnosed with the condition. Although autistic symptoms were worse in children with older mothers these children were much more likely to receive a diagnosis suggesting that older mothers might be better at identifying problems in their children and more confident in dealing with health professionals. Ethnic origin, social class and marital status did not predict an increase in either autism diagnosis or symptoms.

Albumin and cognitive decline

Having a protein called albumin in one's urine can be a symptom of disease and new research suggests that it could also be linked to cognitive decline. Researchers from Brigham and Women's Hospital in Boston studied 1,200 women over 70 who were tested on their cognition and provided urine samples. The women were assessed every two years until they had been tested three times. The women who had albumin in their urine suffered cognitive decline at a rate between two and seven times quicker than would be expected during the normal ageing process. In another study researchers from Stanford University studied 19,399 people over 3.8 years, 1,184 of whom developed cognitive impairment. The people with albumin in their urine were 31-57% more likely to develop cognitive impairment.

Friday, November 19, 2010

PTSD and cardiovascular disease

Researchers from the Greater Los Angeles Veterans Administration Center have been strengthening the research linking post-traumatic stress disorder (PTSD) to heart disease. The researchers looked at the medical records of 286,194 veterans, 637 of whom had scans showing the thickness of their arteries. About three quarters of the veterans with PTSD had hardening of the arteries compared to 59% of those without PTSD. The veterans with PTSD were nearly two-and-a-half times more likely to die (of all causes) during the course of the study. Among the veterans with calcium build up in their arteries those with PTSD had a 48% greater risk of death overall and a 41% greater risk of dying fom cardiovascular disease.

Body clocks, genes and depression

People suffering from depression can often suffer from sleep problems as well, particularly waking up early in the morning and not being able to get back to sleep again. Researchers from Ohio State University compared 30 people with a history of depression to 30 people who had never had it. They looked into levels of a substance called messenger RNA related to four genes which help govern people's body clocks. The participants who had had depression had a higher level of activity in the 'Clock' gene suggesting that they had a problem with their body clocks.

HRT and dementia

Researchers from the Kaiser Permanente health organization in the U.S. have been looking into the effects of hormone therapy on women's risk of developing dementia. They took a large sample of women and asked them about their hormone use during middle age and old age; 1,524 of the women were diagnosed with dementia during the course of the study. The study found that women who took the hormones in both middle age and old age had a similar risk of dementia while women who took hormones only in old age had a 48% higher risk of developing it. Women who took hormones only in middle age had a 26% lower risk of developing dementia.

Delayed gratification and ADHD

One could say that the ability to delay gratification - not to want everything right here and right now - is one of the hallmarks of becoming a mature, civilized human being, albeit one sadly missing from a lot of people. The inability to take the long-term view is sometimes thought to be one of the symptoms of attention-deficit hyperactivity disorder (ADHD) and a team of researchers from Oregon Health & Sciences University sought to test this theory in a study of 58 seven-to-nine-year-olds. The children were asked whether they wanted to receive a smaller sum of money straight away or a larger one at some point in the future. Once the effect of IQ was taken into account the children with ADHD were no more likely to opt for instant gratification than the children without it.

Wilson, Vanessa B. ... [et al] - Delay discounting of reward in ADHD: application in young children

Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2010.02347.x

Wednesday, November 17, 2010

Old musicians stave off brain decay

The auditory cortex is the part of the brain that deals with processing sound and new research from the University of Toronto suggests that in older musicians it might be better preserved than in other adults of a similar age. The researchers studied a group of musicians and a group of non-musicians on an active-listening task - where they were told to focus on the sounds - and a passive listening task where they carried out another activity. During the tests the researchers used electroencephalography to measure the activity in the participants' brains. During the periods of attentive listening the older musicians' brains performed as well as younger adults whereas the older participants who weren't musicians showed a decline with age.

Energy drinks and drink problems

Students often drink so-called energy drinks, which contain large amounts of caffeine, so they can either study or stay up longer socialising. However, new research by scientists at the University of Maryland suggests that they could also lead to more students developing a drink problem. The researchers studied more than a 1,000 students who were asked about their consumption of energy drinks and alcohol over the last year. Those who drank energy drinks once a week or more were more likely to get drunk at an earlier age and drink more per drinking session, and were more likely to develop alcohol dependence than those who used them less. The researchers thought that this was in part because the energy drink counteracted some of the effects - if not the damage - of the students' drinking.

Getting to grips with the neuroscience of Alzheimer's

Researchers from Rush University Medical Center in Chicago have been using MRI scans to investigate what happens in people's brains when they develop Alzheimer's disease. They followed 52 people with mild cognitive impairment, often seen as a forerunner of dementia, over five to six years; 23 of them went on to develop full-blown Alzheimer's. The researchers concentrated on a region deep within the brain called the substantia innominata. They found that although this region was unaffected the parts of the cerebral cortex (which is responsible for reasoning and memory) that received signals from it were significantly thinner in those people who went on to develop Alzheimer's.

Children's memories and trauma

Psychologists have researched how people's memories of a traumatic event can effect how likely they are to develop post-traumatic stress disorder (PTSD) as a result of it. They've found that among adults with PTSD and acute stress disorder (ASD) trauma memories are fragmented and disorganised; are expressed more through the senses than words, and show increased emotional content. However, there has been much less research into how this process works in children. Researchers from the Institute of Psychiatry, King's College London studied 50 children being treated in hospital after an assault or a road-traffic accident. Some of the children developed ASD while others didn't and the children were asked to write the story (or narrative), both of the traumatic event itself and of another event which was unpleasant, but not traumatic. The children with ASD had significantly higher levels of disorganization in their trauma narrative compared to children without ASD and with their own non-trauma narrative. For all the children trauma narratives had significantly higher sensory content and lower positive emotion content than the comparison story. The severity of the children's ASD symptoms was significantly predicted by the level of disorganisation in the trauma narrative and the child's negative appraisals (e.g. 'this event has ruined my life,' 'I'm going mad to feel like this.') of the event.

Salmond, C. H. ... [et al] - The nature of trauma memories in acute stress disorder in children and adolescents Journal of Child Psychology and Psychiatry doi: 10.1111/j.1469-7610.2010.02340.x

Tuesday, November 16, 2010

Mothers' mental health and children's feeding problems

Mothers' eating disorders, depression and anxiety are all known to cause feeding difficulties in their children, however, there have been few studies investigating how eating disorders interact with mothers' other mental-health problems to create feeding difficulties in children. A team of researchers from the Institute of Psychiatry, King's College London studied 10,902 women taking part in the long-term Avon Longitudinal Study of Parenting and Children. They found that mothers having an eating disorder had a direct effect on children's feeding problems and also had an indirect effect by making women more depressed and anxious. Having a child with feeding difficulties also increased the mothers' distress over time.

Micali, Nadia ... [et al] - Maternal eating disorders and infant feeding difficulties: maternal and child mediators in a longitudinal general population study Journal of Child Psychology and Psychiatry DOI: 10.1111/j.1469-7610.2010.02341.x

Homeless youngsters' drug problems

Compared to other young people homeless youngsters are more likely to start taking drugs at a younger age and to take them more often. However, little research has been done into the specific factors that lead homeless youngsters into drug taking. A team of researchers from the University of California, Los Angeles looked into this issue in a sample of 156 homeless youngsters, aged between 15 and 25. They found that the youngsters who perceived their health as being worse and who had poorer coping strategies were more likely to have bigger drug problems.

Nyamathi, Adeline ... [et al] - Correlates of Substance Use Severity Among Homeless Youth Journal of Child and Adolescent Psychiatric Nursing, 23(4), 214–222

Schizophrenia, metabolic syndrome and quality of life

Metabolic syndrome is a collection of factors that can add to people's risk of developing heart disease and other health problems and includes having a pot belly, high cholesterol, being overweight, having high blood pressure and having difficulty controlling one's blood sugar. People with schizophrenia are prone to developing metabolic syndrome, partly because the drugs they take make them put on weight. A team of Spanish researchers looked at the effects of metabolic syndrome on quality of life in a study of 136 people with schizophrenia, of whom 49 had metabolic syndrome. They found that the older people were, the longer they had been ill and the longer they had taken antipsychotics the more likely they were to have metabolic syndrome. Metabolic syndrome was also associated with a lower quality of life and mobility problems. Quality of life was negatively affected most strongly by age but also by metabolic syndrome and mobility problems.

Tomás Sánchez-Araña Moreno ... [et al] - Quality of life in a sample of schizophrenic patients with and without metabolic syndrome Journal of Psychiatric Intensive Care (2010), 6(2): 101-108

Reducing seclusion on mental-health wards

People with severe mental-health problems are sometimes locked in a room on their own for the protection of themselves and other people. This practice is known as seclusion and is very controversial with critics seeing it as degrading and traumatising. There is also the risk that patients might get hurt as they struggle to avoid being placed in the rooms and may come to harm as they are left in isolation; and there are also worries that seclusion can damage people's mental health. In the U.S. a treatment known as sensory modulation is used to reduce the incidence of people being placed in seclusion; this can include weighted blankets, multisensory treatment rooms - which might contain paintings, music and reading material - portable music players and optical lamps. At the same time clinicians often try to assess which things might trigger people to become severely agitated and what the patients themselves feel would be the best things to calm them down. A team of researchers from the Alfred Hospital and Monash University - both in Melbourne - studied the use of sensory modulation and an assessment scheme called Safety Tool in a 30-bed psychiatric intensive-care unit. Before the use of these techniques 65% of the patients had previously been secluded but after their introduction only 26% were. 76% of the staff on the unit thought that Safety Tool should be part of standard care.

Lee, Stuart J. ... [et al] - Sensory assessment and therapy to help reduce seclusion use with service users needing psychiatric intensive care Journal of Psychiatric Intensive Care 6(2) 83-90

Friday, November 12, 2010

Major review backs family interventions for schizophrenia

People with schizophrenia are more likely to suffer a relapse if they come from families where they experience high levels of criticism and hostility and where family members blame themselves for the sufferer's illness. There are a number of ways in which psychologists and health professionals try to reduce these emotions but their effectiveness has not been proven. A team of researchers led by Fiona Pharaoh from Oxford and Buckinghamshire Mental Health NHS Foundation Trust reviewed 53 trials of these techniques involving a total of 4,708 patients. They found that family interventions led to a reduction in relapses, significantly reduced hospital admissions, improved patients' social functioning and encouraged them to take their medication.

Motivation, depression and psychotherapy

Over the last 20 years researchers have begun to recognise that other factors - apart from the kind of treatment used and the nature of people's mental-health problems - affect whether psychotherapy gets people better or not. Two of the most important factors are the therapeutic alliance - the relationship between a psychotherapist and their client - and autonomous motivation which is defined as the extent to which people feel they have gone into treatment of their own free will and without external pressure. A team of researchers from the University of Toronto and McGill University in Montreal studied 74 people being treated for depression who each received 16 sessions of interpersonal therapy. Their study found that overall both the therapeutic alliance and autonomous motivation predicted remission from depression. However, for those patients whose depression was highly-recurrent autonomous motivation had no effect at all in whether they got better.

McBride, Carolina ... [et al] - Autonomous and controlled motivation and interpersonal therapy for depression: Moderating role of recurrent depression British Journal of Clinical Psychology Volume 49, Number 4, November 2010, 529-545

Internet therapy - how many people drop out?

The internet is used more and more to deliver treatment for mental-health problems and research has shown that internet-based treatment is effective for a number of different psychological conditions. However, there are worries about the number of people who drop out of internet-based treatment and researchers from Griffith University in Brisbane and Queensland University of Technology reviewed 19 studies into this issue carried out between 1990 and April 2009. The studies had dropout rates between two and 83% with the average rate being 31%. The researchers also found that there was little evidence to suggest which factors made it more likely that people would drop out of internet therapy.

Melville, Katherine M.; Casey, Leanne M.; Kavanagh, David J. - Dropout from Internet-based treatment for psychological disorders British Journal of Clinical Psychology 49 (4), November 2010, 455-471

Do worry guts children walk less?

Pedometers, which count the number of steps people take, are used both as a research method to monitor people's physical activity and a way of motivating people to take more exercise. In the course of their studies researchers have noted a phenomenon called reactivity in which people's activity increases in response to the fact that they are conscious of being monitored. This can be useful if the object of the exercise is to get people to become more active but not so good if the purpose is to measure people's activity as it distorts the results. Getting children to become more active is very important to prevent childhood obesity and researchers from Hong Kong University studied 156 children aged between nine and 12 to look at whether rehearsal - a tendency to constantly chew over upsetting experiences - is linked to increased pedometer reactivity. The researchers' theory was that the upsetting effect of being monitored would lead to a greater increase in activity in the children who were prone to more rehearsal as they would spend more time thinking about the implications of being monitored. In week one of the study this was, indeed, the case but by week three the children who 'rehearsed' more were showing a decrease in activity levels from week one and were taking far less exercise than average for children of their age group. The study showed both that the effects of reactivity were short-lived and that children who are sedentary may be more prone to dwell on things.

Ling, F. C., Masters, R. S. and McManus, A. M. , Rehearsal and pedometer reactivity in children. Journal of Clinical Psychology, n/a. doi: 10.1002/jclp.20745

Thursday, November 11, 2010

Autism, IQs and emotion recognition

Problems in recognising emotions have been seen as one of the main symptoms of autism but previous laboratory studies have produced mixed results and have had a number of flaws including a small sample size, participants with a narrow range of IQs and an over concentration on visual tests which ignores the ways in which people perceive emotions. A team of researchers led by Catherine R.G. Jones from the Institute of Education in London studied 156 teenagers comparing their ability to recognise emotions both in faces and in voices. They found 'no evidence of a fundamental emotion recognition deficit' in the teenagers with autism and both groups tended to make the same mistakes. The only emotion the teenagers with autism were worse at detecting was surprise. The most important factor in how well the youngsters did was IQ, with the teenagers with a higher IQ doing better on the tests.

Jones, C. R., Pickles, A., Falcaro, M., Marsden, A. J., Happé, F., Scott, S. K., Sauter, D., Tregay, J., Phillips, R. J., Baird, G., Simonoff, E. and Charman, T. A multimodal approach to emotion recognition ability in autism spectrum disorders. Journal of Child Psychology and Psychiatry doi: 10.1111/j.1469-7610.2010.02328.x

Adoption, institutions and executive function

Previous research has shown that children who have spent at least some part of their life in an institution tend to have problems with executive function - which is defined as a combination of working memory, the ability to inhibit one's behaviour, forward planning and the ability to move from one task to another - and attention. Past research has concentrated on children aged between six and 11 so researchers at the University of Pittsburgh studied 418 children who had been adopted from institutions in Russia where they had been psychologically, but not physically, deprived. 130 of the children were pre-school age while the rest were older. The study found that the older the age the children had been adopted at the worse their executive function was and that those who were adopted after they were 18 months old had worse executive function than those who had been adopted when they were younger. The onset of adolescence was associated with a greater increase in executive function deficits for children adopted after 18 months than for those adopted when they were younger.

Merz, E. C. and McCall, R. B. Parent ratings of executive functioning in children adopted from psychosocially depriving institutions Journal of Child Psychology and Psychiatry doi: 10.1111/j.1469-7610.2010.02335.x

Problem-solving and binge eating

Previous studies have shown that people with eating disorders often have poor interpersonal problem-solving skills and a lot of therapy for these problems aims to improve these skills. However, there has been little research into problem-solving skills in people with binge-eating disorder. Researchers from the University of Freiburg in Germany compared 25 women with binge-eating disorder to 30 women who were overweight but who did not have a problem with binge-eating. The women were tested using a series of scenarios which were designed to measure their problem-solving abilities. These started with a problem and ended up with a solution but the women had to come up with the intervening steps themselves. The scenarios were: an argument with a partner; making friends in a new neighbourhood; being avoided by friends or difficulties with one's boss. The women with binge-eating disorder produced less effective and less specific solutions than the group without them and the worse their solutions were the more likely they were to binge.

Svaldi, J., Dorn, C. and Trentowska, M. - Effectiveness for interpersonal problem-solving is reduced in women with binge eating disorder European Eating Disorders Review doi: 10.1002/erv.1050

Publication History

Article first published online: 19 OCT 2010

Wednesday, November 10, 2010

Social cognition and schizophrenia

People with schizophrenia often have problems with their cognition, including what psychologists call social cognition - perceiving people's emotions, recognising social cues and working out what other people are thinking. A team of researchers led by Shaun M. Eack from the University of Pittsburgh studied 133 people in an attempt to find out more about this. 70 of the participants were relatives of people with schizophrenia and were therefore thought to be at greater risk of developing the condition themselves while the rest of them were unaffected controls. The 'at-risk' participants were significantly more likely to assign emotions to neutral faces and to assign the faces negative emotions. They also found it harder to ascertain emotions on faces that were expressing different moods. There was no link between other cognition problems and social cognition. The more people attributed meanings to neutral faces the greater their symptoms of developing schizophrenia were

Eack, Shaun M. ... [et al] - Social cognition deficits among individuals at familial high risk for schizophrenia 36 (6), 1081–1088, 2010
Schizophrenia Bulletin

Child abuse and psychosis

There is a growing recognition that having a difficult or traumatic childhood can increase the likelihood of people developing psychosis later in life but it is difficult to disentangle what types of trauma or abuse are linked to an increased risk. A team of researchers from the Institute of Psychiatry, King's College London looked into this further in a study of 428 people, 182 of whom had psychosis. The researchers asked people about difficulties and problems in their childhood and found that people with psychosis were three times more likely to report severe physical abuse by their mother before they were 12. There was also some - although not statistically significant - evidence that 'severe maternal antipathy' was linked to an increased risk of psychosis. However, paternal maltreatment and other forms of adversity were not linked to an increased risk of psychosis.

Fisher, H.L. ... [et al] - The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder Psychological Medicine (2010), 40, 1967–1978

Major review gives thumbs up to self-help

In guided self-help patients take home a standardized psychological treatment and work through it more or less independently. The treatment can be written down in a book or be available via a web site, television, video or audio and some support is given by a professional therapist or coach. P. Cuijpers from the VU University in Amsterdam reviewed 21 studies, including 810 participants, comparing face-to-face therapy with guided self-help. They concluded that guided self-help was just as effective as face-to-face therapy, that its effects lasted for a year and that people were just as likely to carry on with their treatment.

Cuijpers, P. ... [et al] - Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies Psychological Medicine (2010), 40, 1943–1957

Boosting self-esteem in patients with eating disorders

People with eating disorders can often have low self-esteem, difficulties in relating to others and feelings of dissatisfaction about their relationships. A team of researchers from Barcelona looked into the effectiveness of a group-therapy programme, aimed at boosting self-esteem and social skills, in a study of 160 patients attending a day-hospital treatment programme. At the start of the study the patients with bulimia had lower self-esteem and less confidence in their social skills. After eight sessions of therapy both those with bulimia and those with anorexia showed significant improvements in their perceptions of their physical appearance, their self-esteem, their happiness and their sociability with the patients with bulimia showing a greater improvement.

Lazaro, L. ... [et al] - Effectiveness of Self-esteem and Social Skills Group Therapy in Adolescent Eating
Disorder Patients Attending a Day Hospital Treatment Programme European Eating Disorders Review DOI: 10.1002/erv.1054

Tuesday, November 09, 2010

Parents' death and adolescent suicide risk

Most young people who lose a parent actually adjust remarkably well but a minority go on to develop mental-health problems which are, in turn, known to be a risk factor for suicide, something attempted by 5-8% of adolescents in Western societies. A Danish study - by researchers from the University of Southern Denmark and Odense University Hospital - looked into the links between parental death and suicide in a sample of 72,765 teenagers. They found that young people who had lost one biological parent had a 71% greater risk of going on to kill themselves than those whose parents were still alive while young people who lost more than one parent had a risk that was 2.7 times greater.

Jakobsen, Ida Skytte and Christiansen, Erik - Young people’s risk of suicide attempts in relation to parental death: A population-based register study Journal of Child Psychology and Psychiatry  (2010)doi:10.1111/j.1469-7610.2010.02298.x

9/11 and mental health

Hardly surprisingly the attacks of September 11, 2001 had a huge psychological impact on those who were caught up in them but most studies so far have focused on the prevalence of post-traumatic stress disorder (PTSD) and depression rather than other types of mental-health problem. Researchers from the University of Manitoba in Canada used data from the National Epidemiologic Survey on Alcohol and Related Conditions involving 34,683 people. The participants in the study were asked about their mental health and classified into four groups: no experience of 9/11; indirectly experienced 9/11 (i.e. watched it happen on television); close friend of family member injured or died in 9/11 and directly experienced and/or injured in 9/11. The study found that the more people had been exposed to 9/11 the more likely they were to develop mental-health problems including anxiety as well as PTSD and depression. People who had directly experienced 9/11 had six times the risk of developing PTSD, two-and-a-half times the risk of having an anxiety disorder and nearly double the risk of having any mental-health problem.

Christine A. Henriksen, James M. Bolton and Jitender Sareen - The psychological impact of terrorist attacks: examining a dose-response relationship between exposure to 9/11 and axis I mental disorders Depression and Anxiety 27: 993-1000 (2010)

Non-adherence and crisis in Newcastle

In the U.K. people with mental-health problems who are very ill are referred by community mental-health services to crisis-resolution home treatment (CRHT) services which decide whether to treat them themselves or to refer them on to hospital. Both these things are very expensive so anything which cuts down on their use could potentially save a lot of money. Researchers from Northumberland Tyne and Wear NHS Trust and Newcastle University looked into the impact of non-adherence (people not taking their drugs properly) on referral to CRHTs. They found that 30% of people referred to CRHTs had not been taking their medication properly in the month beforehand. These people were three times as likely to have a drug problem as well as a mental-health one and were two-and-a-half times as likely to be admitted to a psychiatric hospital.

Sreenath, San ... [et al] - Medication adherence in crisis? Journal of Mental Health, October 2010; 19(5): 470–474

One-day communities for personality disorder

The U.K. Government and mental-health services have been making attempts to improve services for people with personality disorders. Sometimes these involve residential therapeutic communities but day therapeutic communities which people take part in once a week are more adaptable, local and cheaper. Researchers from the University of Liverpool studied four one-day therapeutic communities in Manchester and Liverpool between November 2005 and July 2008 looking at patients' mental health, social functioning, self-harm and use of services. The patients reported their own levels of health and were assessed by experts. The researchers found that the centres improved the patients' mental health and social functioning but made only slight improvements in their levels of self-harm and their use of services.

Barr, Wally ... [et al] - Quantitative findings from a mixed methods evaluation of once-weekly therapeutic community day services for people with personality disorder Journal of Mental Health, October 2010; 19(5): 412–421

Monday, November 08, 2010

How a pair of trainers could keep the college blues away

There is quite a lot of evidence to suggest that exercise improve one's mental health. However, most of the research done so far has concentrated on people who already suffer, to some extent at least, from depression and anxiety. A team of researchers from the University of Gloucestershire and the University of Hertfordshire investigated whether exercise could improve mental health in a sample of 100 students. Students are known to be at greater risk of developing mental health problems because of worries about their studies, finances and moving away from home and one study found that they were 64% more likely to experience symptoms of mental ill-health than other young people. The researchers found that those students who engaged in high levels of physical activity showed significantly lower levels of depression and anxiety than the medium- and low-physical-activity groups and the more the students exercised the less depressed and anxious they were.

Tyson, Philip ... [et al] - Physical activity and mental health in a student population Journal of Mental Health, 2010; 1–8, iFirst article

Why people do what the voices tell them to do

People who hear voices often report being given commands by them but not everyone obeys such commands. Researchers from the Adult Learning Disability Service in Prescot, Merseyside and the University of Manchester studied 49 people who were hearing voices. They classified the commands the participants had been given as benign, self-harm or harm-others. The study found that obeying their last self-harm command was associated with 'elevated voice malevolence,' worse symptoms and perceived negative consequences for non-compliance. Compliance with the last harm-others command was associated with more severe symptoms, worse perceived consequences for non-compliance and higher levels of social rank attributed to the voice.

Barrowcliff, Alastair L. and Haddock, Gillian - Factors affecting compliance and resistance to auditory command hallucinations: perceptions of a clinical population Journal of Mental Health, 2010; 1–11, iFirst article

Getting better slowly or gradually - does it make a difference?

People having psychotherapy quite often make sudden gains, displaying abrupt and substantial improvements in symptoms from one session to the next. Sudden gains have been investigated in the context of randomised controlled trials (RCTs), tightly-controlled studies designed to compare one treatment with another, and in therapy carried out by experts but researchers from American University in Washington D.C. looked to see whether these gains could occur in other contexts. They studied 106 outpatients being treated in a university-based psychotherapy training clinic. Overall sudden gains were identified in 29% of the patients, gains which tended to occur early in therapy. However, the gains were more likely to be reversed than in RCTs which usually involve more-experienced therapists. 54% of the sample showed gradual gains which tended to occur later in therapy. Those patients who had had sudden gains did significantly better by the end of therapy than those who showed more gradual gains.

Greenfield, M. F., Gunthert, K. C. and Haaga, D. A. - Sudden gains versus gradual gains in a psychotherapy training clinic Journal of Clinical Psychology n/a. doi: 10.1002/jclp.20748

Getting to the bottom of why people worry

Generalised anxiety disorder (GAD), or chronic worrying, is the most common anxiety disorder and, in any one year, is thought to affect around 2.7% of the population. Two thought processes that are believed to underly GAD are intolerance of uncertainty and what psychologists call negative metacognitive beliefs - worry about worry. Intolerance of uncertainty is a predisposition to react negatively to an uncertain event or situation - to assume that the worst is going to happen. People who are intolerant of uncertainty assess ambiguous situations as being stressful, disturbing and unacceptable and show increased perceptions of threat in situations that are relatively harmless. Worrying about worrying can lead to unhelpful behaviour and ways of controlling one's thoughts that actually lead to more worry in the long-term. Researchers from Swinburne University of Technology in Melbourne studied 119 people in an attempt to investigate these issues further. Their study also looked into the effects of 'parentification' - a situation in which children end up looking after people who are supposed to be looking after them. The idea behind this was that these children are asked to carry out tasks that they are not really capable of which makes them less confident, and more anxious about, their ability to handle difficult situations in the future. The researchers found that intolerance of uncertainty and negative metacognitive beliefs were both associated with an increase in GAD symptoms. However, once the researchers had taken into account the effects of depression parentification was not associated with an increased propensity to worry.

Tan, Shary ... [et al] (2010) Metacognitive, cognitive and developmental predictors of generalised anxiety disorder symptoms Clinical Psychologist 14 (3), 84 - 89

Friday, November 05, 2010

New study - Omega-3s no help with Alzheimer's

Omega-3 fish oils do not slow the cognitive decline of people with Alzheimer's disease. Researchers from Oregon Health and Science University studied 215 people with mild to moderate Alzheimer's disease. Over 18 months 171 of them took fish-oil tablets while the rest took a placebo. The researchers tested the participants' cognitive abilities and, in a smaller group of participants measured their brain volumes with an MRI scanner. The researchers found that taking the fish oil had no beneficial effects on the participants' cognition and no effect on total brain volume. The authors concluded that "in summary these results indicate that DHA (docosahexanoic acid, an Omega-3 found in fish oil) supplementation is not useful for the population of individuals with mild to moderate Alzheimer disease."

Could meditation help preserve your DNA?

A new study by researchers at the University of California, Davis and the University of California, San Francisco has provided more evidence of the links between meditation, psychological wellbeing and health by measuring the levels of an enzyme called telomerase. The researchers studied 60 people comparing 30 who received meditation training with 30 from similar backgrounds who acted as a control group. Telomerase helps to repair telomeres which are sequences of DNA at the end of chromosomes; they function a bit like the bits of plastic at the end of shoelaces helping to stop the chromosomes wearing out. The researchers compared the levels of telomerase in the white blood cells of the meditating and non-meditating participants and found that telomerase activity was about a third higher in the white blood cells of the meditating group. The meditating participants had a greater sense of purpose in life and more mindfulness this led them to feel a greater sense of control over their life and surroundings and less neuroticism which in turn led to the increase in telomerase activity.

Genes, autism and neural connections

Scientists at the Scripps Translational Science Institute in San Diego have been using cutting-edge neuroscience to look into the links between genetics and autism. They used MRI (magnetic resonance imaging) brain scans to study 32 children who had a variation in a gene called CNTNAP2 which is associated with an increased risk of autism, attention deficit hyperactivity disorder (ADHD), Tourette's syndrome and schizophrenia. Half of the children had been diagnosed with autism while half were unaffected. The researchers used the MRI scans to see what was going on in the children's brains while they carried out a language-learning task. Compared to children without the variation in the gene the children with it had a superfluity of connections in their prefrontal cortices and a lack of connections between the prefrontal cortex and the left side of the brain, which is connected with language.

Antiepileptic drugs and cognition

Women with epilepsy who take more than one drug to control their seizures may have children who perform less well at school. Researchers from Karolinska University Hospital and the University of Lund in Sweden studied 1,308,318 children born between 1973 and 1986; 1,235 of them were born to mothers with epilepsy who took more-than-one (429), one (641) or no (165) anti-epileptic drugs when they were pregnant. Those children who had been exposed to more than one anti-epileptic drug in the womb had an increase risk of not receiving a final grade upon completion of their schooling. However, those whose mothers had taken only one kind of anti-epileptic drug showed no decrease in performance.

Wednesday, November 03, 2010

The best way of learning something? Sleep on it.

Getting information into one's long-term memory has been compared to pouring water into a bottle with a narrow neck; it holds a lot but it is difficult to get it in in the first place. A new study by researchers at York University and Harvard Medical School suggests that one of the best ways of doing this could be to sleep on it. The researchers got two groups of volunteers to learn new words. One group learnt them in the evening and were tested in the evening. The group who slept on things, as it were, remembered more words and could recognise them faster. By studying these participants' brain waves the researchers found that it was deep sleep - rather than rapid-eye-movement (REM) or light sleep - that did most to consolidate memory. Sleep spindles, which are sharp bursts of activity reflecting information transfer between the neorcortex on the surface of the brain and the hippocampus deep within it, were particularly associated with memory consolidation.

Mental disorders and risk of suicide in veterans

Researchers from the Department of Veterans Affairs (VA) Healthcare System and the University of Michigan, Ann Arbor have been looking into the links between mental disorders and suicide in U.S. military veterans. They studied more than 3 million veterans who had received any type of care in a VA facility in 1999. They looked at their psychiatric diagnoses from their 1998 and 1999 treatment records and followed them over a seven-year period. By the end of the study 7,684 veterans had killed themselves. 46.8% of those who committed suicide had at least one psychiatric diagnosis and all of the diagnoses studied - depression, schizophrenia, bipolar disorder, drug abuse, post-traumatic stress disorder (PTSD) and anxiety - led to an increased risk of suicide. In men bipolar disorder was associated with the greatest risk of suicide while in the women drug abuse was - overall bipolar disorder led to the greatest increase in risk.

Child sex abuse and schizophrenia risk

Being sexually abused as a child is a risk factor for psychosis and schizophrenia. Researchers from Monash University in Australia studied 7,697 people, 2,759 of whom had - according to police and medical records - been sexuall abused as children. They found that over a 30-year period people who had suffered child abuse had double the rate of psychosis (2.8% vs 1.4%) and nearly treble the rate of schizophrenia (1.9% vs 0.7%). Those who had suffered penetration of an orifice by another person or an object were at an even greater risk of psychosis and schizophrenia - 3.4% and 2.4% respectively.

Faces, places and perception

A Canadian brain-scanning study has shed new light on the differences in the way older and younger people process visual information. Researchers from the University of Toronto used magnetic resonance imaging (MRI) to compare brain activity in younger and older adults. The participants in the study were asked to look at pictures of overlapping faces and places, although they were told only to pay attention to the face and its gender. In the young adults the area of the brain responsible for processing faces was active but the one responsible for processing places wasn't; however, in older adults both regions were active suggesting that they had difficulty screening out the relevant information. But, in a memory test 10 minutes later, the older adults were better at remembering which face went with which building, so, from a less ageist perspective one could say that older people were better at seeing the bigger picture.

Tuesday, November 02, 2010

Anorexia and abortion

Women with anorexia are more likely to have unplanned pregnancies and abortions. Researchers from the University of North Carolina at Chapel Hill, and from Norway, studied 62,060 women as part of the Norwegian Mother and Child Cohort Study. They found that 50% of the women with anorexia reported having an unplanned pregnancy, compared to 18.9% of the women without the eating disorder; for abortions the figures were 24.2% and 14.6% respectively. The researchers thought the difference could be due to the fact that the women with anorexia thought that their condition had rendered them - at least temporarily - infertile.

Brothers, sisters and bullying

Older brothers are more likely to bully their younger siblings than older sisters. Researchers from the Universita' degli Studi Di Firenze in Florence studied 195 children, aged between 10 and 12. They found that children with older brothers were more likely to report being bullied at home and that boys were more likely to bully if they had a younger brother or sister. Older sisters were only likely to bully if they had a bad relationship with their yonger siblings.

New study less hopeful on teenage depression

New research from Duke University in North Carolina has painted a gloomy picture of the recovery rates from adolescent depression. Their study involved 196 participants - 110 of whom were girls - aged between 12 and 17. Some were treated with fluoxetine (Prozac), others with cognitive behaviour therapy (CBT), others with a combination of the two, while a fourth group acted as a control group (i.e. had no psychotherapy and took a placebo instead of Prozac). Nearly 95% of the participants recovered and 88.3% recovered within two years. However, over the five-year period of the study 46.6% of the participants who recovered had another bout of major depression. 57% of the girls had a relapse, compared to 33% of the boys - perhaps, thought the researchers, because the girls were more inclined to chew things over and have feelings of inadequacy. None of the treatments was better at preventing relapse but those teenagers who recovered within two years were less likely to become ill again.

Misusing prescription drugs - the hidden rural drugs problem

Misuse of prescription drugs could be described as a hidden drug problem. One in eight U.S. teenagers abuse prescription opioids at some point, something which is associated with using cocaine and heroin as well as gambling, increased sexual activity and impulsivity. Researchers from the University of Kentucky analyzed data from 17,872 12 to 17-year-olds who took part in the 2008 National Survey on Drug Use and Health. Overall there was no difference in illegal drug use between urban and rural teenagers and the rates of usage were similar for cannabis, cocaine, heroin and hallucinogens. However, 13% of rural teenagers reported abusing prescription drugs compared to 10% of urban ones and they were more likely to have used pain relievers and tranquilizers non-medically. Even after taking other factors into account rural teenagers were 26% more likely to abuse prescription drugs. Poor health, episodes of depression and other substance abuse were all risk factors but children who lived with both parents were 32% less likely to misuse prescription drugs.

Monday, November 01, 2010

PTSD in Iraq troops - levels lower than expected

Researchers from the Institute of Psychiatry, King's College London have been carrying out the first major study into the mental health of the U.K.'s armed forces while they are on deployment. They studied 611 servicemen and women based in eight locations across Iraq. 92.6% rated their overall health as good, very good or excellent. Servicemen and women were more likely to report good health if they were officers, if they felt their unit was very cohesive and had supportive leadership and if they had taken a period of rest and recuperation outside the operational theatre. 20.5% showed signs of experiencing psychological distress and 3.4% were thought to have post-traumatic stress disorder (PTSD) - a rate similar to service personnel not on deployment and lower than in police officers, doctors in emergency departments and disaster workers. Psychological distress was more common among service personnel who were young, women, in the army and of junior rank. PTSD was more common among people of junior rank, those who felt themselves in danger of being killed and those who had been more exposed to combat.

Exercise and preventing depression - it works but only if you're having fun

Exercise can help to stave off depression but only if you do it in your spare time. Researchers from Norway and the Institute of Psychiatry, King's College London studied 40,401 Norwegians asking them about their physical activity and their levels of anxiety and depression. They found that people who took part in regular physical activity - no matter how intense - were less likely to have symptoms of depression. However, this relationship only held true for activity done during leisure time; those people whose work involved physical effort were as likely to be depressed as those people who worked in sedentary jobs. The more people engaged in physical activity during their spare time the less likely they were to be depressed and those who were not active outside work were almost twice as likely to suffer symptoms of depression as more active individuals.

Psychosis and socialising - investigating the connection

Psychosis symptoms are often preceded by a withdrawal from social relationships and a decline in social function. Researchers from Denmark set out to investigate this further in a study of 398 people. 11 of them had some symptoms of psychosis, 12 were defined as 'prodromal' - i.e. about to develop psychosis, 12 met the diagnostic criteria for psychosis and the remainder were an unaffected control group. The researchers used a questionnaire to measure people's interpersonal problems and found that there was an increase in them as their symptoms got worse. The research adds to other studies suggesting that addressing these problems in getting on with other people could be a useful way of helping people at risk of developing psychosis.

Mondrup, Lise and Rosenbaum, Bent - Interpersonal problems in the prodromal state of schizophrenia: an exploratory study Psychosis October 2010, 2(3), 238-247