Antipsychotics and older people - new evidence on health risks

There has been much criticism in the past about the overuse of newer, atypical antipsychotic drugs to manage problem behaviour in elderly people with dementia. However, a new study by researchers from Brigham and Women's Hospital in Boston has suggested that alternative drugs may be just as dangerous. The researchers studied 10,900 people who were admitted to nursing homes in British Columbia between 1996 and 2006 and who received a psychotropic drug within 90 days of admission. The study found that people taking conventional antipsychotics, antidepressants and benzodiazepines were at higher risk of death and fractures of the femur. Levels of pneumonia and heart failure did not differ between those taking atypical antipsychotics and those taking other drugs.

ADHD and creativity

Adults with Attention Deficit Hyperactivity Disorder (ADHD) could be more creative than other people. Holly A. White from the University of Memphis and Priti Shah from the University of Michigan in Ann Arbor studied 60 people, 30 of whom had ADHD. They found that the adults with ADHD had higher levels of real-world creative achievement and displayed higher levels of creative thinking on a test of creativity. People with ADHD showed an inclination towards idea generation while those without ADHD were stronger at problem clarification and developing ideas.

Body acceptance and social support

Women's acceptance of their bodies could have more to do with how other people see them than their actual weight. Researchers from Ohio State University studied 801 women between the ages of 18 and 65. They found that the most important influence on how women saw their bodies was how they thought important people in their life saw them and that the more women focused on how their bodies functioned and felt the more they appreciated them. In turn, the more women appreciated their bodies the more likely they were to eat intuitively, i.e. in response to hunger rather than emotions or the presence of food. The study also found that women who thought they had strong levels of social support were more likely to accept their bodies. For women aged between 26 and 65 those who weighed more were less likely to eat intuitively and more likely to think that others didn't accept their bodies if they weighed more. Women aged between 26 and 39 were most likely to achieve body appreciation by focusing more on how their bodies functioned.

Ecstasy research moves into the real world

Studies into the effects of ecstasy tend to be carried out in the laboratory and don't always reflect what goes on in real life. A team of researchers led by Dr Rod Irvine from the University of Adelaide tried to get round this by sending researchers to parties where they thought people might be taking the drug. The researchers managed to persuade 56 people to invite them to house parties where they collected samples of pills and measured the users' levels of MDMA - the active ingredient of ecstasy. The researchers found that only half of the pills consisted entirely of MDMA; some pills contained no MDMA at all while others contained methamphetamine or chemicals related to MDMA such as MDEA or MDA. The pills that did contain MDMA ranged in quantity from 25mg to ten times that amount. Most users took more than one pill while some took as many as five. In 14 people the amount of MDMA in the blood reached levels that had never been studied in humans in the laboratory although noone suffered any immediate health problems.

Why goody two-shoes isn't always top of the class

Better-behaved children don't always get better marks at school and naughtier ones don't always do worse. A team of researchers from the University of North Carolina studied 350 children in seven schools over a five-year period. They looked at teachers' assessments of children's behaviour and achievements and at the actual level of pupils' work. They found that teachers were more likely to report that well-behaved students did better academically and expected more of them - even when some of these students were struggling with school-work. At the same time, students who were naughty in school were seen as having more academic difficulties, even though this was not always the case.

New research shows how violence spreads through society

Being exposed to violence, either watching it on TV, seeing it in the flesh or suffering it oneself is more likely to make children think it is normal and could lead to them behaving violently themselves. A team of researchers, led by Izaskun Orue from the University of Duesto in Spain, studied nearly 800 children aged between eight and twelve. They asked them if they had witnessed violence in their own lives or on TV and if they had been a victim of violence. They were also asked about their attitudes to violence by being asked whether they agreed with statements such as 'sometimes you have to hit others because they deserve it.' The children were asked about their own levels of violence and their classmates rated how violent they were. Six months later the children were surveyed again. The schoolchildren who had witnessed or been a victim of violence were more aggressive and observing violence at the first phase of the study was associated with increased aggression six months later. The increased aggression was caused in part by a change in how the children thought that violence was normal. Seeing violence -- at home, school, on TV, or as its victim -- made it seem common, normal, and acceptable and thinking that aggression was normal led to more of it.

Psychosis, insight and hearing voices

People with psychosis are said to lack insight when they have a poor awareness that they are mentally ill and don't think they need to get help. Lack of insight is associated with poorer outcomes and worse adherence to treatment while improved insight has been linked to better treatment compliance and less hostility. A team of researchers led by Guillem Lera from the Hospital de la Ribera in Valencia looked into the links between insight and auditory hallucinations in a study of 168 psychotic patients. They found that patients with persistent auditory hallucinations had significantly less insight than patients with occasional or no hallucinations. The further away the hallucinations were thought to come from the less insight people had. The patients who heard voices 'in their head' showed better insight than those who heard voices coming from outside themselves.

Lera, Guillem ... [et al] - Insight among psychotic patients with auditory hallucinations
Journal of Clinical Psychology, 67(7), 1-8

Anxiety sensitivity and cannabis use

Anxiety sensitivity can be defined as being anxious about being anxious. People with anxiety sensitivity are anxious about the physical symptoms of being anxious (an upset tummy, sweaty palms, pounding heart), mental incapacitation (losing control and not being able to think properly) and social concerns such as other people seeing them with a red face or in a panic. Some researchers think anxiety sensitivity plays a part in cannabis use and a team of researchers led by Julia D. Buckner from Louisiana State University looked into this in a study of 49 current cannabis users who were asked to fill in assessments about their mood at random times over a two-week period. The researchers found that at the start of the study fears about mental incapacitation were significantly related to more severe cannabis problems. Over the course of the study fears about mental incapacitation and social concerns were linked to subsequent cannabis use.

Buckner, Julia D. ... [et al] - Anxiety sensitivity and marijuana use: an analysis from ecological momentary assessment Depression and Anxiety DOI 10.1002/da.20816

Genetic link to suicide risk

Researchers from Johns Hopkins University in Baltimore have identified a gene that could be linked to an increased risk of attempting suicide. The researchers studied 2,698 people with bipolar disorder, 1,201 of whom had a history of suicide attempts. Those with one copy of a genetic variation on chromosome 2 were 1.4x as likely to have attempted suicide while those with two variations were almost three times as likely. The gene involved - ACP1 - leads to increased levels of a protein called ACP1 in the brains of people who had committed suicide. The protein is thought to influence the same biological pathway - albeit in a different direction - as lithium, a drug known to reduce the rate of suicidal behaviour.

Childhood problems and adult happiness

Psychological problems in people's childhoods could reduce their earnings later in life and their chances of forming a lasting relationship. A team of researchers led by Alissa Goodman from the U.K.'s Institute for Fiscal Studies looked at data from the National Child Development Study which followed 17,634 children born in Britain during the first week of March 1958 over a fifty-year period. The researchers found that family income was about a quarter lower, on average, among those who experienced serious psychological problems in childhood. Childhood psychological problems were also associated with being less conscientious, being less likely to marry and having less stable personal relationships later in life. By contrast major physical health problems in childhood only reduced income by an average of 9%.

For the very paranoid everyone is a threat

Previous research has shown that even neutral social contact can trigger paranoid thinking in people with paranoia. Social contact can have a wide variety of different contexts from complete strangers to friends and family and a team of researchers led by Dina Collip from Maastricht University studied 154 people assessing their paranoia and asking them to record their feelings in everyday life. People with low and medium levels of paranoia reported higher levels of perceived social threat when they were with less familiar people, however, people with high levels of paranoia showed no difference in the level of perceived threat between familiar and unfamiliar people.

Collip, D. ... [et al] - Social world interactions: how company connects to paranoia Psychological Medicine (2011), 41: 911-921

Immigration and psychosis

Migration is an accepted risk factor for schizophrenia but the level of risk in second-generation immigrants in unclear. A team of researchers from McGill University in Canada reviewed 21 studies into psychosis among immigrants. They found that while first-generation immigrants were 2.3x as likely to develop psychosis as other people second-generation immigrants were 2.1x as likely. While there was no significant difference in risk between the generations there were wide variations in levels of psychosis between different ethnic groups and different host countries.

Bourque, F., van der Ven, E. and Malla, A. - A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants Psychological Medicine (2011), 41: 897-910

Elder abuse - who suffers most?

Researchers from the University of Illinois at Chicago have been looking into the issue of older abuse. They used data from two trauma units in Chicago to compare people over 60 admitted after suffering from elder abuse to people of the same age admitted for different reasons. The researchers found that patients admitted after elder abuse were more likely to be women, to suffer from a neurological or mental disorder and to use drugs and were more than twice as likely to have a drink problem. The people who had suffered elder abuse had more severe injuries and worse outcomes. 85% of the perpetrators were family members or partners and 17% of the victims expressed a desire to return to the perpetrator and not to press charges.

Neglectful parents and mental-health problems

Emotional neglect can be defined as 'emotional unresponsiveness, unavailability and neglect characterised by a lack of interaction between parent and child.' It has been linked to children developing more mental-health problems but most research so far has been based on adults' memories of their childhood not how children feel at the time. A team of researchers from the University of Glasgow and the Medical Research Council in Glasgow studied 1,694 children. The children filled out a questionnaire called the Parental Bonding Instrument at 11 to assess their relationship with their parents and then had a computerised psychiatric interview at 15 to assess any mental-health problems. 3% of the children perceived their parents as almost always emotionally neglectful and controlling and this group had more than twice the risk of developing mental-health problems at 15.

Young, Robert, Lennie, Susan and Minnis, Helen - Children’s perceptions of parental emotional

neglect and control and psychopathology Journal of Child Psychology and Psychiatry
doi:10.1111/j.1469-7610.2011.02390.x

Even moderate stress can cause long-term problems

A study of more than 17,000 working adults by researchers from the University of Bristol and the Karolinska Institute in Sweden has found that even mild psychological stress can have an effect on people's health. The study followed the participants between 2002 and 2007 and found that higher levels of stress at the start of the study were associated with a significantly greater likelihood of subsequently being awarded long-term disability benefits. However, even those with mild stress were up to 70% more likely to receive disability benefits. One in four of the benefits awarded for physical illnesses such as high blood pressure, angina and stroke and almost two-thirds of those awarded for mental illness were attributable to stress.

Childhood epilepsy and mental-health problems

Children with epilepsy are more likely to have mental-health problems. A team of researchers led by Dr Kristin Alfstad from the National Centre for Epilepsy at Oslo University Hospital in Norway, studied information collected from 14,699 parents by the Norwegian Health Services Research Centre. 110 of the children in the survey had epilepsy and they were over twice as likely to have psychiatric symptoms as other children (38% vs 17%). Girls with epilepsy were more likely to have emotional problems while boys were more likely to have hyperactivity, inattention and problems with relationships. Having epilepsy was a much stronger risk factor for developing mental-health problems in boys than in girls.

Prematurity, poverty and child development

In 2006 12.8% of births in the U.S. were premature. Premature births are linked to delays in motor/neurologic function, intellectual and academic development, language problems, poorer executive functioning and worse behaviour. Premature births are more common in poorer people. Being poor also has an effect on child development and children who are both premature and have poor parents are at an even greater risk of developmental problems. A team of researchers from the University of Maryland and Pennsylvania State University looked into some of these problems in a study of 122 African-American women with premature babies. They found that psychosocial risk (mothers' depression, stress and self-efficacy) and sociodemographic risk (poverty, mothers' education and marital status) were linked to maternal sensitivity which in turn affected the strength of the attachment between the mothers and their children at 12 months. However, the health of the children did not affect maternal sensitivity or later attachment.

Candelaria, Margo,  Teti, Douglas M. and Black, Maureen M. - Multi-risk infants: predicting attachment

security from sociodemographic, psychosocial, and health risk among African-American preterm infants Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2011.02361.x

Hippocampal size and PTSD

The hippocampus is a region of the brain involved in memory and how we interpret the world around us. MRI (magnetic resonance imaging) studies have shown that the hippocampus shrinks in people with chronic post-traumatic stress disorder (PTSD) and that a smaller hippocampus could make people more vulnerable to the condition. A team of researchers, led by Brigitte A. Apfel from the San Francisco Veterans Affairs Medical Center, compared hippocampal volumes in veterans from the Gulf War. Some had developed PTSD and recovered from it, others had chronic PTSD and others had never had it. The study found that those veterans who had recovered from PTSD had larger hippocampi than those who had not recovered and were similar in size to those who had never had it. The study supports the idea that a smaller hippocampi is a risk factor for PTSD. This could be because common biological factors make people have smaller hippocampi and be more vulnerable to stress or that stress early in life makes people's hippocampi smaller and increases their vulnerability to stress later on.

Sickies - skiving or strategic problem avoidance?

The same levels of illness can lead different people - or the same person at different times - to either take a sickie or struggle into work. A team of researchers, led by Hanna Hultin from the Karolinska Institutet in Sweden, interviewed more than 400 people from six different workplaces within a few days of them taking sick leave. They found that problems in relationships with colleagues and superiors were more frequent in the days before people took sick leave and that people with a minor ailment were more likely to report sick when they expected that the following workday would be particularly stressful.

NICE issues new Alzheimer's guidelines

The U.K.'s National Institute for Health and Clinical Excellence (NICE) has changed its policy on the Alzheimer's drugs Aricept, Exelon and Reminyl. Previously the drugs could only be prescribed to people with moderate to severe symptoms but they can now be prescribed to people with milder symptoms as well. The drugs cost around £2.80 per day and slow down the progress of the disease helping people put their affairs in order and stay independent for longer. A fourth drug, Ebixa, which was previously only given late in the progression of the disease can also now be prescribed earlier.

You can find out more about this story here.

Scotland - a nation drinking itself to death

NHS Health Scotland, the state-funded body responsible for trying to promote healthy living in Scotland, has produced an alarming report about the scale of Scotland's drinking problem. Since 1994 sales of pure alcohol per adult per year have increased by 11% to the equivalent of 11.9 litres per person, 21% more than levels in England and Wales and enough, on average, for every adult to exceed the sensible drinking guidelines every week of the year. One in 20 deaths in Scotland is attributable to the effects of alcohol and death rates are six times higher in the most deprived communities than in the most affluent ones. Wine sales have doubled since 1994 and purchases from supermarkets and off licences have increased by 53%. The report links the rise in alcohol consumption to falling prices, relative to income, and the increased public acceptability of drinking.

Christie, Bryan - Increase in alcohol sales in Scotland is driven by low prices and rising affluence British Medical Journal BMJ 2011; 342:d1852

Computer systems cut down medication errors

The psychiatric unit at Johns Hopkins Hospital in Baltimore has significantly reduced medication errors by using a computerised prescription system and a new computer system for recording drug side effects. Medication errors can be caused by illegible handwriting, misinterpretation of orders, fatigue, dispensing errors and administrative mistakes. The computer programme used at Johns Hopkins includes help for doctors with drug dosages, drug allergies and drug interactions and patient monitoring. The Patient Safety Net system allows for the recording of all mistakes, no matter how small, and for follow-up, corrective action and the ability to learn from common mistakes. After the introduction of the two systems the medication error rate fell from 27.89 per 1,000 patient days in 2003 to 3.43 per 1,000 patient days in 2007.

You can find out more about this story here.

One in seven U.K. mental-health workers attacked

A new survey of staff working in the U.K.'s National Health Service has shown that one in seven mental health workers suffered physical violence from service users or members of the public last year. The NHS staff survey also showed that 18% of mental-health professionals had suffered bullying, harassment and abuse from service users or the public in 2010. 31% of mental-health workers suffered from stress, second only to ambulance workers. The number of staff suffering violence was down slightly from 18% in 2009 to 15% in 2010 but only 40% of those who experienced verbal abuse and 51% of those who suffered physical abuse felt that their employer would take effective action to deal with it.

Premenstrual troubles and bipolar disorder

Researchers from Massachusetts General Hospital in Boston have been studying the interaction between premenstrual symptoms and bipolar disorder. They studied 293 women over a year and found that the women with premenstrual worsening of their bipolar disorder had more 'episodes' - mostly of depression - than the other women. They had more symptoms of depression and mania overall, relapsed more rapidly and had more severe symptoms.

Study shows shocking health of mentally ill

People with severe mental illness can have a life expectancy up to 25 years less than other people. However, this is not due to their illness itself but to poor physical health and unhealthy lifestyles. Researchers from the University of East Anglia surveyed 782 people with severe mental illness. They found that inactivity, a poor diet and smoking and drinking too much were the norm. Two thirds of people in the study were overweight or obese and a third had high blood pressure. 52% of them had high cholesterol and a large number of them were being prescribed atypical antipsychotic drugs which are associated with weight gain.

Siblings, autism and theory of mind

Theory of Mind (ToM) can be defined as the ability to work out what other people are thinking and how this might affect their behaviour. In most children ToM shows a significant advance between the ages of three and five. However, the development of ToM is severely delayed in children with autism. Several studies have shown that having brothers and sisters can improve children's ToM and researchers from the University of Queensland in Australia studied 60 children with autism to see if this was the case for them too. The researchers measured the children's ToM, executive functioning, verbal mental age and autism symptoms and compared this to the number of siblings the children had and where they fitted into the sequence. The researchers found that the children with older siblings actually had a weaker ToM, perhaps because their older brothers and sisters helped them to interpret other people's actions and stopped them from developing their own skills. Having younger siblings led to a weak improvement in ToM but this was not significant once mental age and autism symptoms were taken into account.

O'Brien, Karen,  Slaughter, Virginia and Peterson, Candida C. - Sibling influences on theory of mind

development for children with ASD Journal of Child Psychology and Psychiatry
doi:10.1111/j.1469-7610.2011.02389.x

Higher up and happier at work sleep better

Researchers from the University of Surrey have been looking into the links between people's working lives and the quality of their sleep. They used data from the Understanding Society survey of 40,000 households carried out by the Institute of Social and Economic Research at the University of Essex. The survey found that people who were unemployed were over 40% more likely to report sleep difficulties. A third of the people who were least satisfied with their jobs reported poor sleep quality compared to only 18% of the most satisfied. Overall the best sleep was reported by people with higher levels of education and by married people and those in routine occupations reported less sleep than those in professional ones. Women were more likely than men to report poor-quality sleep.

Having children - short-term struggles, long-term happiness

Parents of crying babies, temperamental toddlers and troublesome teenagers should draw comfort from a new study which shows that while having more children makes younger parents less happy the opposite is true for older parents. The World Value Surveys questioned more than 200,000 men and women between 1981 and 2005 and researchers from the Max Planck Institute for Demographic Research in Rostock, Germany and the University of Pennsylvania have been analysing the results. They found that for parents under 30 levels of happiness decreased with their first child and with every additional child. Mums and dads between 30 and 40 were as happy as their childless peers unless they had four or more children in which case they were less happy. After 40 parents were happier than childless couples unless they had three or more children and people over 50 were happier if they had children, regardless of how many they had. The researchers concluded that after the rigours of rearing young children the children themselves became a source of greater satisfaction and financial and emotional support to their parents. The difference between the levels of happiness of younger and older parents was less marked in countries with more generous welfare systems. So for parents suffering sleepless nights, the terrible twos or staying up late to pick their kids up from the school disco the message is - keep going it will be worth it in the end!

How parents can stop their children binge drinking

Anna-Karin Danielsson from the Department of Public Health Sciences at the Karolinska Institutet in Sweden has been looking into the factors behind teenage binge drinking in her Ph.D. thesis. She monitored 1,200 pupils aged between 13 and 19 between 2001 and 2006. She found that the teenagers who displayed risky behaviour at 13 were more at risk of high alcohol consumption and associated problems with their health, school work, parents and friends later. For boys the risk was reduced when parents kept an eye on what they were up to while for girls an emotionally-stable and close parent-child relationship had more of a protective effect. The study also compared drinking patterns in different countries and found that Scandinavian countries and the U.K. were different to other countries insofar as girls were just as likely to binge drink as boys.

Green fingers help older adults stay blooming

Green fingers could be just the thing to keep people young in spirit as they get older. Researchers from Texas A & M and Texas State Universities studied 298 people over 50. They found that people who gardened were more satisfied with their lives, were more likely to plan for the future and had more energy. They had a higher level of physical activity, were more likely to rate their health as 'good' or 'excellent' and ate more fruit and vegetables.

Atrial fibrillation and dementia risk

Atrial fibrillation is a disturbance in people's heartbeat. It is harmless in itself but can increase the risk of stroke. A new study, by researchers at the University of East Anglia, suggests that those people who have atrial fibrillation after a stroke are at an increased risk of developing dementia. The researchers analysed 15 studies and found that stroke survivors with atrial fibrillation were 2.4 times as likely to develop dementia. Blood-thinning drugs and medication to slow people's irregular heartbeats are often prescribed to reduce the risk of further strokes and this study shows that they could reduce the incidence of dementia as well.

Why misery guts might have the last laugh

One might think that being cheerful, worrying less and taking things easy would be the passports to a long and healthy life but new research from the University of California, Riverside suggests that this could be wrong. The researchers used information first gathered by the Stanford University Psychologist Louis Terman on more than 1,500 gifted children who were around 10 when they were first studied in 1921 and who were tracked throughout their lives. The study found that the children who were the most cheerful and who had the best sense of humour as children lived shorter lives on average while those people who were most prudent and persistent throughout their lives lived longest. The cheerful, happy-go-lucky children tended to take more risks with their health over the years. People who were more committed to, and involved in, their work also lived longer while starting formal schooling early was a risk factor for early mortality. People who felt loved and cared for felt a greater sense of wellbeing but didn't necessarily live any longer.

Cracking the puzzle of callous children

Badly-behaved children who also have callous and emotional traits such as a lack of guilt, no empathy with other people and a callous use of others are more likely to become serious and long-term criminals. However, there is limited evidence about what the risk factors for callous and emotional traits are. A team of researchers, led by Edward D. Barker from Birkbeck University, used information from the Avon Longitudinal Study of Parents and Children to study around 7,000 mothers and their children to find out more. They looked at risks to do with the mother - such as whether the mothers had mental-health problems, were criminals or had drug problems before their children were born - whether the child had a 'fearless' temperament at two and the effects of harsh and warm parenting. Maternal risk was found to increase fearless temperament at two and bad behaviour and callous unemotional traits at 13. Fearless temperament at two was also associated with bad behaviour and callousness at thirteen, above and beyond the influence of parenting and maternal prenatal risk. Fearless temperament in boys manifested itself as an indifference to punishment while in girls it showed itself as boldness towards new people and situations.

Barker, Edward D. ... [et al] - The impact of prenatal maternal risk, fearless temperament and early parenting on adolescent callous-unemotional traits: a 14-year longitudinal investigation Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2011.02397.x

Coping strategies and binge eating

Researchers from the University of Oviedo in Spain have been looking into the prevalence and causes of binge eating and in particular how people's coping styles affect how likely they are to binge eat. They studied 1,913 children between 12 and 18 who filled out a questionnaire about their eating habits and how they coped with the problems in their life. The study found that 6.94% of the children reported bingeing in the last six months. The adolescents who binged were more likely to blame themselves for their problems and were more introverted while those who used more positive-effortful coping were less likely to binge. The authors of the study concluded that helping teenagers deal with problems more constructively could be a good way of cutting down the rates of bingeing.

Sierra-Baigrie, Susana ... [et al] - Exploring the relationship between coping strategies and binge eating in nonclinical adolescents European Eating Disorders Review DOI: 10.1002/erv.1103

Breastfeeding and brighter babies

Scientists have already found a number of benefits to breastfeeding one's babies and a new study by researchers at Oxford University and the Institute for Social and Economic Research at Essex University has found that an increase in children's intelligence could be another. The researchers studied more than 10,000 children from the Bristol area and found that those who were breastfed for at least the first four weeks of life performed better, by an average of three to five points, on IQ tests at five, seven, 11 and 14. The researchers thought that the difference could be due to either long-chain fatty acids in breast milk which help the brain to develop or to the stronger mother-child relationship formed during breastfeeding.

Alzheimer's decline could start much earlier

People with Alzheimer's disease could start going downhill years before they develop the condition. Researchers from the Rush Alzheimer's Disease Center in Chicago studied 2,071 older adults who were all free of dementia at the beginning of the study. Over the course of the study the participants were tested on working memory, perceptual speed and visuo-spatial ability. Over 16 years 462 people developed Alzheimer's disease. The researchers found that Alzheimer's disease was preceded by an average of five to six years of cognitive decline during which the rate of cognitive decline accelerated more than 15-fold. Mild cognitive impairment - the precursor to Alzheimer's disease - was also preceded by about six years of cognitive decline.

Earlier drinkers more likely to turn to the bottle to relieve stress

Children who have their first alcoholic drink at an early age are known to be at a greater risk of developing alcohol problems later in life and new research suggests that they may be especially vulnerable when they are suffering from stress. Researchers from the Central Institute of Mental Health in Mannheim, Germany studied 306 people. They were asked how old they were when they had their first drink, about stressful life events in the last three years and daily hassles in the last month and about their drinking at 22. The earlier the participants started drinking the stronger the link was between stress and drinking as young adults.

Mothers' depression and children's problems

Mothers' depression can also put their children at risk of developing mental-health problems. Researchers from the U.S. National Institute of Mental Health studied 80 women with depression and their children who were aged between seven and 17. The mothers were taking part in a study designed to help patients whose first few attempts at treatments by doctors had failed. The children of women who got better earlier showed improved mental health and got on better at home and school. Those whose mothers did not get better over the two years of the study showed no improvement in mental health and more instances of bad behaviour. The study is important as it shows that even where mothers have been ill for a while their children's mental health improves as soon as they (the mothers) start to get better.

Understanding the causes of prenatal depression

Many women suffer from postnatal depression but they can also suffer from prenatal depression as well. Anxiety and depression during pregnancy can result in premature birth or low birthweight and can affect children's health even into their early school years. Researchers from the Norwegain Institute of Public Health studied 50,000 expectant mothers in an attempt to find out more about the causes of prenatal depression. They found that the most important factor was the amount of support women received from their partners - those women who were most unhappy with their relationship were the most likely to be depressed. The women who were happy with their partner were better able to cope with difficulties at work, lack of money and other stressful situations such as moving house or being ill. Older mothers coped better than younger ones and illness, trouble at work and problems with alcohol in the year beforehand were all linked to more emotional distress.

Why quality is as important as quantity in the jobs market

Politicians and economists spend a lot of time thinking about levels of unemployment and about how to get unemployed people back into the workplace but much less about the quality of jobs on offer. However, a new study led by Peter Butterworth from the Australian National University in Canberra has found that having a badly-paid, poorly-supported and short-term job can be worse for people's mental health than not having a job at all. The researchers surveyed 7,000 people of working age who were asked about their employment status and mental health every year for seven years. Overall being unemployed was worse for people's mental health, however, once factors such as educational attainment and marital status were taken into account the mental health of those who were jobless was comparable to, if not better than, that of people in poor-quality jobs. Those people who were in the poorest quality jobs experienced the sharpest decline in mental health over time. Getting a high-quality job after being unemployed improved mental health by an average of three points on the scale used by the researchers but getting a poor-quality job actually decreased mental health by 5.6 points.

U.S. report reveals huge Alzheimer's burden

The 2011 annual report of the U.S. Alzheimer's Association has revealed the huge burden of the condition. It is estimated that 5.4 million people in the U.S. suffer from Alzheimer's - about one in eight senior citizens. Nearly 15 million people in the U.S. look after someone with Alzheimer's disease amounting to 17 billion hours of unpaid care worth more than $202bn. More than 60% of caregivers said they were stressed and more than a third said they were depressed. The $202bn in unpaid care comes on top of around $183bn of formal care from healthcare workers, hospitals and nursing homes, up $11bn on a year ago.

You can find out more about this story here.

Expressed emotion and teenage troubles

Expressed emotion occurs in families where a member is suffering from a mental-health problem. It is made up of three elements: hostility, a negative attitude towards the patient because the family feels the disorder is controllable and that the patient is choosing not to get better; emotional over-involvement when the family blame themselves for the mental illness and critical comments. High expressed emotion has been associated with a slower recovery and a greater likelihood of relapse. A team of Dutch researchers from Utrecht University looked into the links between maternal expressed emotion and mental-health problems in a study of 497 Dutch teenagers and their mothers. Every year, over three years, the mothers were asked about their expressed emotion and the teenagers about their behavioural and emotional problems. The main conclusion of the research was that it was the children's level of emotional and behavioural problems that influenced the mother's expressed emotion and not vice versa.

Hale III, William ... [et al] - How does longitudinally measured maternal expressed emotion affect internalizing and externalizing symptoms of adolescents from the general community? Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2011.02400.x

Depressed dads are quicker spankers

Fathers who are depressed are more likely to spank their children. A team of researchers led by Dr R. Neal Davis from Intermountain Healthcare in Utah interviewed more than 1,700 new fathers from 20 large cities in the U.S. 40% of depressed men said that they had spanked their kids in the last month compared to only 13% of men without symptoms. According to a 2009 report from the Institute of Medicine more than 15 million American children are living with an adult who suffers from depression. Although 77% of men and 65% of women in the U.S. are in favour of spanking both the American Academy of Pediatrics and the American Psychological Association discourage it.

You can find out more about this research here.

Which drugs work best for anxiety?

A team of researchers led by David Baldwin from the University of Southampton have been reviewing trials into drug therapy for generalised anxiety disorder. They reviewed 27 trials comparing nine drugs: duloxetine, escitalopram, fluoxetine, lorazepam, paroxetine, pregabalin, sertraline, tiagabine and venlafaxine. They found that fluoxetine was the most effective and sertraline was the best tolerated i.e. had fewer side effects. Among treatments currently licensed in the UK duloxetine had the best response, escitalopram was ranked first for depression and pregabalin had the fewest side effects.

Baldwin, David ... [et al] - Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis British Medical Journal BMJ 2011; 342:d1199

Panic attacks and other problems

There is an increasing amount of evidence to suggest that people who suffer from panic attacks are also more likely to suffer from other physical and mental-health problems. Researchers from the University of Manitoba in Winnipeg, Canada used information from the huge U.S. National Epidemioligic Survey on Alcohol and Related Conditions. They studied 34,653 people who were asked about their health in 2001-2 and 2004-5. The study found that those people who had panic attacks in 2001-2 were more likely to have generalised anxiety disorder, panic disorder, social phobia, depression and mania in 2004-5.

Kinley, D. Jolene ... [et al] - Panic attacks as a risk for later psychopathology: results from a nationally representative survey Depression and Anxiety DOI 10.1002/da.20809

Tackling weight and eating problems in Spanish schools

More and more teenagers have problems with eating and weight, either because they are too fat or because they show signs of developing an eating disorder. Universal prevention programmes are ones which involve boys and girls and are given to everyone in a particular school or year. They aim to improve pupil's body image, their knowledge of eating disorders and reduce shape and weight concern. Researchers from the Universitat Autonoma de Barcelona studied 443 children. 201 formed a control group while 143 took part in a media-literacy programme and 99 in the media-literacy and a nutrition-awareness one as well. The children's attitudes to eating, body weight and nutrition were assessed a month, seven months and 30 months after the programmes. The children who had taken part in both programmes had 'healthier' scores on the assessments than those who hadn't.

Gonzalez, Marcela ... [et al] - Disordered eating prevention programme in schools: a 30-month follow up European Eating Disorders Review DOI: 10.1002/erv.1102

Cocaine, genes and shrinking brains

People who are addicted to cocaine have less grey matter in the frontal parts of their brain and in their hippocampi. The frontal parts of the brain are important for paying attention and organising one's behaviour while the hippocampus is important in learning and memory. A team of researchers led by Nelly Alia-Klein at the U.S. Department of Energy's Brookhaven National Laboratory have found that people with a certain genetic make up may be more vulnerable to the adverse effects of cocaine use than other people. The researchers studied 82 people. 40 of them were addicted to cocaine and 42 were healthy controls. The researchers took DNA samples and scanned the subjects' brains. The cocaine addicts with a low MAOA (monoamine oxidase A) genotype had lower grey-matter density in the frontal parts of the brain than the other cocaine addicts. The genes are responsible for levels of MAOA, an enzyme which regulates neurotransmitters such as serotonin and dopamine that regulate mood.

Schools and children's mental health

There has been a lot of research about the effect of the workplace on adults' mental health but much less research on the effect of children's workplaces i.e. schools. Researchers from the University of Maryland studied 10,700 Year One pupils whose parents and teachers were interviewed. The authors looked at four different areas to assess their children's mental health: learning, behaviour, relationships and emotions. They found that children in classrooms which lacked material resources - such as paper, pencils, child-friendly furniture, computers and musical instruments - and children whose teachers felt their colleagues did not respect them had more problems in all of these areas.

Depression and kidney disease

Depression is already linked to an increased risk of cardiovascular disease and a new study by researchers from the University of Tilburg in the Netherlands suggests that it could be linked to an increased risk of kidney disease too. The researchers studied 5,785 people in the U.S. over a 10-year period. The participants were all over 65 and filled out a questionnaire measuring their levels of depression as well as having a series of medical tests to assess their kidney function. Depression was 20% more common in people with kidney disease than in those without. Over the ten years of the study depression predicted a rapid decline in kidney function, new cases of severe kidney disease and hospitalisation. As well as the physiological effects of depression on the immune and nervous systems the researchers also thought that depression could be associated with delaying seeing a doctor and poor communication between patients and physicians.

Child abuse and eating disorders

A team of researchers from the Universitat Autonoma de Barcelona have been looking into the links between disordered eating and childhood physical and sexual abuse. They studied 708 female undergraduates aged between 18 and 30 asking them about traumatic events in their past and about their current attitudes to food and their weight. The study found that 14.3% of the sample had suffered childhood sexual abuse and 3.8% childhood physical abuse. The women who had been sexually abused as children were more concerned about weight, however, once depression, anxiety, self-esteem, body-mass index, age and socioeconomic status were taken into account there was no link between sexual abuse and disordered eating behaviours. Childhood physical abuse was associated with a decreased risk of disordered eating and the researchers thought that this was because women who had been physically abused were more concerned with just having a safe, healthy body rather than their weight or physical appearance.

Villarroel, Ana M. ... [et al] - Childhood physical and sexual abuse in Spanish female undergraduates: does it affect eating disturbances? European Eating Disorders Review DOI: 10.1002/erv.1086

Study finds more eating disorders in Muslim girls

Researchers from the University of Granada in Spain have been looking into the prevalence of eating disorders in different cultures. They studied 494 students aged between 12 and 20 from the town of Cueta where 30% of the population is Muslim. They found that the incidence of eating disorders was 2.3x higher among the Muslim youngsters and body dissatisfaction was 80% greater. Overall the study found that one in four of the youngsters had some kind of eating problem and that 15% of them suffered from body dissatisfaction.

Jollying along could be best approach for toddlers' tantrums

Jollying children along could be a better way of coping with toddlers' tantrums than punishing them. Researchers from the University of Illinois studied 107 children who were taking part in a larger study of children's social and emotional development. When the children were 33 months old their parents were asked how often their children displayed angry or 'social fearfulness,' and how they dealt with this behaviour by their children. Some of the parents jollied their children along saying 'stop behaving like a baby,' for example while others punished them sending them to their room, taking away toys or removing privileges. When the children reached 39 months their parents were asked about their behaviour again. Those who were more likely to punish their children were more likely to have children who were anxious and withdrawn. This was particularly the case among boys who had a higher level of negative emotions at 33 months.

Brain grows to boost willpower in teenagers

Parents often worry about their children going bad ways when they reach adolescence but a new brain-scan study by a team led by Jennifer H. Pfeifer from the University of Oregon suggests that their willpower (or at least the part of the brain responsible for it) might actually be increasing at this time. The team studied 38 children, once when they were 10 and once when they were 13, monitoring their brain activity when they were presented with pictures of faces making neutral, angry, frightened, happy and sad expressions. Between the ages of 10 and 13 brain activity significantly increased in the ventral striatum and the ventral medial portion of the prefrontal cortex. The ventral striatum is associated with people's responses to rewards and the higher the children themselves rated their ability to resist peer influence the more activity there was in these areas. The team also noticed an increase in the brain's response to sad faces between 10 and 13 which is interesting as rates of depression often increase in adolescence.

Surveying suicide worldwide

A team of researchers led by Guilherme Borges from the Universidad Autonoma Metropolitana in Mexico has been looking into patterns and risk factors for suicide using information from the World Health Organisation's World Mental Health Surveys. The surveys were carried out between 2001 and 2007 and involved 108,705 adults from 21 countries. The researchers found that being young, being female, being less well-educated, unemployed, single, suffering from certain mental illnesses, having mentally-ill parents and having had a difficult childhood were all associated with increased suicidal behaviour. Suicide rates were similar in developed and developing countries although they were highest in Lithuania, Belarus and Russia and lower in Muslim countries. Social support and access to weapons or lethal substances were also important risk factors for suicide attempts.

Genes, brainpower and scary areas

Most researchers now think that our genes, our environment, our experiences and our behaviour work together to increase, or decrease, our risk of disease. One gene which is linked to an increased risk of developing Alzheimer's disease is APOE4 and researchers from Drexel University School of Public Health in Philadelphia have been researching how this gene is affected by living in a 'psychosocially hazardous' - i.e. scary - neighbourhood. They studied 1,124 people aged between 50 and 70, testing them for the gene and giving them a series of cognitive tests. The people with the risky variation of the gene who lived in the scariest neighbourhoods performed worst in the tests. However, those without the gene who lived in the scary areas and those with the gene who lived in less-frightening parts of town were at no greater risk of worse performance.

Seasonal changes in postnatal depression

Postnatal depression is the most common complication of childbirth affecting up to 14.5% of new mothers in the first three months after childbirth. There has been little research into whether postnatal depression varies across the seasons so a team of researchers from the University of Pittsburgh studied this issue in 9,339 new mothers. They screened the mothers for depression four to six weeks after the birth of their child and looked for seasonal variations in levels of depression and suicidal ideation (thoughts of killing oneself). They found that 14% of the women had significant levels of depression and 3% of them had had suicidal thoughts. Although the risk for depression varied over the year with the highest risk being in December there was no seasonal variation in suicidal thoughts.

Sit, Dorothy, Seltman, Howard and Wisner, Katherine L. - Seasonal effects on depression risk and suicidal symptoms in postpartum women Depression and Anxiety DOI 10.1002/da.20807

Recurrence in teenage depression

Major depression is one of the most common mental-health problems in adolescence with rates of around 5.9% among girls and 4.6% among boys. It is associated with functional impairment, risk of suicide and a risk of depression in adulthood. A team of researchers from Duke University in North Carolina looked into the long-term outcomes of 196 adolescents, aged between 14 and 22, who had originally participated in a study into the effectiveness of different kinds of treatment for depression. The researchers found that 96.4% of the participants had recovered by the time they were followed up five years after the original study. Recovery by two years was more likely in participants who responded quickly to treatment (96.2%) than for those who responded only partially or not at all (79.1%). Of the 189 participants who recovered 46.6% had a recurrence. Girls (57%) were more likely than boys (32.9%) to have a relapse.

Curry, John ... [et al] - Recovery and recurrence following treatment for adolescent major depression Archives of General Psychiatry 2011; 68(3):263-270.

Another gene linked to increased risk of mental illness

A team of researchers from Shanghai Jiao Tong University have been looking into the links between genetics and schizophrenia. They studied 12,229 people in Shanghai: 5,772 had no mental-health problems, 4,187 had schizophrenia, 1,135 had bipolar disorder and 1,135 had depression. The study found that variations in the BCL9 gene led to a greater risk of schizophrenia and were also associated with bipolar disorder and depression.

Li, Junyan ... [et al] - Common variants in the BCL9 gene conferring risk of schizophrenia Archives of General Psychiatry 2011; 68(3): 232-241

Weighing in in anorexia treatment

Weighing people is of crucial importance in anorexia. For something that sounds quite simple there are a number of issues to think about including the privacy and dignity of patients, what they wear while they are being weighed and whether they are able to falsify their weights or not. A team of researchers from the Phoenix Centre in Fulbourn, Cambridgeshire looked into this in a survey of 20 former patients and 98 health professionals. The majority of professionals in outpatient settings said that they weighed patients in normal or light clothing, while in inpatient units the majority said that they weighed patients in underwear. The percentage of patients weighed in underwear who were comfortable with this was double that of those weighed in normal clothing and patients overwhelmingly recommended that weighing should be in underwear; the patients were more concerned with the accuracy of their weight measurement than issues of privacy and dignity. More than half of the ex patients reported having falsified their weights in the outpatient setting and the patients who got weighed in their underwear were just as likely to falsify their weights. The patients who got weighed in clothes falsified their weights by carrying heavy items in their pockets while those who got weighed in their underwear falsified their weights by drinking lots of water before they got weighed.

Jaffa, Tony,  Davies, Sarah and Sardesai, Anagha - What patients with anorexia nervosa should wear when they are being weighed: report of two pilot surveys European Eating Disorders Review
DOI: 10.1002/erv.1093

Growing up in the UK - not so bad after all?

In 2007 a Unicef report rated Britain's children as some of the most unahppy in the developed world. However, a new study, by researchers at the Institute for Social and Economic Research at the University of Essex has painted a rosier picture finding that 70% of children between 10 and 15 rated themselves as happy or very happy. The researchers surveyed more than 2,000 children and found little difference between those living in households in the top fifth of income and those in the bottom fifth. A more important factor was whether children lived with both parents and the happiness of their parents' relationship, particularly that of the mother. 60% of the children said they were completely happy with their family situation with children in one-parent families being less likely to report themselves completely happy. Having older siblings had no effect on happiness but having younger brothers and sisters was associated with less happiness and the effect was greater if there were more younger siblings. Children who quarelled more than once a week with their parents and didn't discuss important matters with them only had a 28% chance of saying they were completely happy with their families but children who ate dinner with their family at least three times a week were more likely to say they were happy with their family. How much television children watched was completely unrelated to how happy they were with family life.

Keep smiling - you might live longer

Being unhappy could be worse for your health than being obese. Professor Ed Diener from the University of Illinois reviewed 160 studies into the connection between a positive state of mind and overall health and longevity. The overwhelming majority of studies supported the idea that happiness was associated with a longer life and the connection was stronger than that between obesity and early death. In the laboratory positive moods were found to reduce stress-related hormones, increase immune function and help the heart recover following exertion.

Miscarriage effects last for years

The trauma of miscarriage can last for years after the event even after a subsequent healthy birth. Dr Emma Robertson Blackmore of Rochester University in New York State used information from 13,000 women in the Bristol area compiled as part of the Avon Longitudinal Study of Parents and Children; the women were all pregnant in 1991 and 1992. The 2,800 women who had suffered a miscarriage or stillbirth were much more likely to be depressed and anxious during their next pregnancy and for up to three years afterwards. Up to a fifth of pregnancies end in miscarriage while 0.5% result in stillbirth.

A tiny tipple could stave off dementia

Moderate drinking - a glass of wine, or a pint of beer a day - could cut dementia risk by almost a third. Researchers from the Central Institute of Mental Health in Mannheim in Germany studied 3,200 people over three years. The participants were all over 75 at the start of the study and none of them had symptoms of dementia, although 217 developed the condition as the study went on. Those participants who drank between two or three units of alchohol a day were 29% less likely to develop dementia than those who were teetotal. However, drinking only protected against Alzheimer's disease not vascular dementia or cognitive decline and prolonged heavy drinking is associated with about one in 10 cases of dementia.

Metabolic syndrome makes for more senior moments

Metabolic syndrome is a catch-all term used to cover a number of different risk factors for health problems, such as high blood pressure, a pot belly, high blood fats (triglycerides), high blood sugar and low 'good' cholesterol - to be defined as having metabolic syndrome you need to have at least three of the above. Researchers from the French National Institute of Health Research in Bordeaux studied 7,087 people aged 65 and over from three French cities. They tested them for metabolic syndrome and gave them a series of memory and cognitive tests two and four years later. Those people (16%) with metabolic syndrome were 20% more likely to show a decline on the memory test and 13% more likely to show a decline on a test of visual working memory.Specifically, higher triglycerides and low HDL cholesterol were linked to poorer memory scores; diabetes, but not higher fasting blood sugar, was linked to poorer visual working memory and word fluency scores.

Humbleness, honesty and work performance

Humility and honesty could be the keys to high performance at work. Researchers from Baylor University in Texas studied 269 people providing health care for 'challenging' clients. The participants worked for 25 different companies in 20 different states. They filled out a personality questionnaire and their supervisors rated their performance on 35 different job skills. Those who scored highest for honesty and humility - defined as high levels of fairness, lack of avarice, sincerity and modesty - were rated as having the highest job performance. The link between humility-honesty and job performance was stronger than those to other positive character traits such as agreeableness and conscientiousness.

Researching regret

Most people have some regrets in life, whether about career choices, romantic relationships or things they wish they had, or hadn't done. Researchers from Concordia University in Montreal looked into regret in a study of 104 adults. The participants completed a survey about their greatest regrets, were asked how they thought the severity of their regrets compared to other people's and were asked about their health. People's age did not determine how effectively they dealth with their regrets but those who felt their regrets were worse than other people's felt worse overall and were more likely to report cold symptoms over the next few months.

Cannabis use and psychosis

Much research has been devoted to the links between cannabis use and psychosis and a team of researchers from Maastricht University in the Netherlands has added to the evidence to suggest that there is a link. The researchers studied 1,923 people who were aged between 14 and 24 at the start of the study. They were asked about their cannabis use and assessed for psychosis symptoms at the start of the study (T1), 3.5 years later (T2) and 8.4 years later (T3). The researchers found that people who hadn't used cannabis at the start of the study but who used it between T1 and T2 had nearly twice the risk of developing psychosis symptoms by the end of the study. If they carried on using cannabis between T2 and the end of the study their risk was 2.2 times greater. By the end of the study the incidence rate of psychosis symptoms was 14% in those who had smoked cannabis compared to only 8% in those who hadn't.

Kuepper, Rebecca ... [et al] - Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study British Medical Journal doi: 10.1136/bmj.d738

Spanish study shows drugs' effect on cognition

As well as having adverse effects on people's physical health drug abuse can also affect people's cognition, including their ability to recognise emotions in other people. Researchers from the University of Granada in Spain compared 123 drug users with 67 non users on a variety of different tests. 70% of the drug users showed some type of neuropsychological deterioration, regardless of the type of substance consumed. The study showed deterioration in the drug users' working memory, fluency, flexibility, planning and multitasking abilities. The study also found that drug users had difficulty in recognising negative emotions such as anger, disgust, fear and sadness.

Study gives thumbs up to school emotional-intelligence programmes

Researchers from Loyola University Chicago and the University of Illinois at Chicago have been looking into the effectiveness of school-based social and emotional learning programmes. The programmes aim to help children recognise and manage their emotions, establish and maintain positive relationships, set and achieve positive goals, make responsible decisions and constructively handle interpersonal situations. The researchers reviewed studies into 213 school-based programmes involving more than 270,000 children. Compared to chidlren in the control groups the children in the programmes showed significantly improved social and emotional skills, caring attitudes and positive social behaviour and less disruptive behaviour and emotional distress. In studies where the children's academic performance was also assessed the children in the programmes performed significantly better.

Why depressed people are at the back of the queue for heart-attack care

Depression is known to increase peoples' risk of developing heart disease and lead to worse outcomes for those who develop cardiovascular problems. Now a new study by researchers from the Institute of Clinical Evaluation Sciences in Canada has found that people with depression who go to hospital emergency departments with the symptoms of a heart attack are less likely to receive priority treatment. The researchers' study looked at 6,874 patients admitted to 96 acute-care hospitals in Ontario from April 2004 to March 2005. 39% of the patients with depression were given a low-priority triage score compared to only 32.7% of the other patients with similar symptoms. Less than 10% of patients who come to emergency rooms with heart-attack symptoms such as chest pains or shortness of breath are actually found to be suffering from heart problems and the researchers think that medical staff might be more inclined to assign these symptoms to psychological causes in people who have suffered, or are suffering from, depression.

Alzheimer's. More risk on the mother's side?

Alzheimer's disease is known to have a hereditary element and people with first-degree relatives with the condition are four to 10 times more likely to develop the disease themselves compared to people with no family history of it. Researchers from the University of Kansas School of Medicine studied 53 people aged 60 and over who were followed for two years. 11 had a mother with Alzheimer's disease, 10 had a father with Alzheimer's and 32 had no family history of the condition. The groups took cognitive tests and had brain scans throughout the study. The researchers found that those participants who had a mother with Alzheimer's disease had twice as much grey-matter shrinkage and one-and-a-half times as much whole-brain shrinkage as people whose fathers had had the disease or who had no family history of it.