Monday, February 28, 2011

All work and no play ...

Doing paid work for more than twenty hours a week could be bad for schoolchildren. A team of researchers led by Kathryn C. Monahan from the University of Washington studied 1,800 middle-class teenagers from Years 10 and 11. They found that working for more than 20 hours a week was associated with declines in school engagement and how far teenagers were expected to go in school and increases in problem behaviour such as stealing, carrying a weapon and using alcohol and illegal drugs. The study also found that things did not improve when the teenagers who were working more than 20 hours a week cut back their hours or stopped working altogether. By contrast working 20 hours or less a week had negligible academic, psychological or behavioural effects.

Study gives thumbs up to parenting programme

Parenting programmes aim to intervene early to improve child-rearing in vulnerable groups and to get children off to a better start in life. There are a number of different programmes available and researchers from New York University have been studying the effectiveness of one they themselves developed called ParentCorps. The programme is aimed at toddlers and includes a series of 13 group sessions which aim to teach parents ways to establish routines and rules for the family, reinforce positive behaviour and provide effective consequences for misbehaviour. The researchers studied 171 children comparing those in schools which took part in the ParentCorps programme to those which carried on as usual. In schools that too part in the programme parents had improved knowledge of parenting strategies, reported more effective discipline and were more responsive to their children. The children were also rated by their teachers as being better behaved in the classroom and as showing more social and emotional competence.

Teenage happiness lasts well into adult life

Teenage happiness carries on well into adult life. Researchers from the University of Cambridge and the Medical Research Council's Unit for Lifelong Health and Ageing used information from 2,776 people taking part in the 1946 British birth-cohort study of people born in that year. When the participants were between 13 and 15 they were assessed by their teachers as to whether they were 'very popular with other children,' 'unusually happy and contented, made 'friends extremely easily,' and were 'extremely energetic and never tired.' The teachers also rated the children's conduct problems - restlessness, daydreaming, disobedience, lying etc - and emotional problems such as anxiety, fearfulness, diffidence, avoidance of attention etc. The researchers then compared these ratings to people's mental health, job satisfaction, relationships and social activities several decades later. They found that teenagers who were rated positively by their teachers were significantly more likely to have higher levels of well-being later in life, including more job satisfaction, more frequent contact with family and friends and more regular engagement in social and leisure activities. Happy children were also 60% less likely to develop mental disorders throughout their lives, although they were actually more likely to get divorced.

You can find out more information about this study here.

Sexuality, victimization and drug abuse

Researchers from the University of Illinois at Chicago have been looking into the links between sexuality, victimization and drug abuse. They studied 34,635 people using data collected as part of the National Epidemiologic Survey on Alcohol and Related Conditions. The study found that lesbian and bisexual women were more than twice as likely to report victimization over their lifetime and as a whole lesbians, gay men and bisexual women reported a greater number of victimization experiences than heterosexuals. Three times as many lesbians as heterosexual women reported childhood sexual abuse. Homosexual men also reported significantly higher rates of childhood sexual abuse, childhood neglect, partner violence and assault with a weapon than heterosexual men. Regardless of sexual identity women who reported two or more victimization experiences had two to four times the prevalence of alcohol dependence, drug abuse and drug addiction as women who reported no victimization.

Friday, February 25, 2011

Cognitive problems and stroke risk

People with memory problems or other cognitive difficulties could be at a higher risk of having a stroke. Researchers from the University of Alabama at Birmingham studied thousands of people who were aged 45 and over at the start of the study. At the outset of the study 14,842 people took a verbal fluency test and 17,851 took a word-recall memory test. The participants were then followed-up by phone for up to five years to see whether they had had a stroke. Those who scored in the bottom 20% for verbal fluency were 3.6 times more likely to develop a stroke than those who scored in the top 20% while those who were in the top 20% on the memory test were 3.5 times more likely to have a stroke than those in the bottom 20%.

Patriotism and personal happiness

The happier people feel about their countries the better they feel about their lives. Mike Morrison from the University of Illinois at Urbana-Champaign led a team of researchers studying data from a Gallup World Poll of 130,000 people in 128 different countries. People were asked about their job satisfaction, household income and how they felt about their life and their country. Feeling good about one's country turned out to be highly associated with personal well-being but this association was stronger for people with low incomes, those who lived in poorer nations and those in non-Western countries. For people with high incomes and those in Western countries well-being was more closely linked to personal factors such as health, standard of living, and job satisfaction.

Heart risks of antipsychotics start early

Even a short time taking antipsychotic drugs can increase people's risk for heart disease. Researchers from the University of Melbourne reviewed 25 previous studies which tracked risk factors such as high blood pressure, cholesterol levels and body weight of people taking older or newer antipsychotics. Before taking the drugs about 40% of the patients were overweight but after six months 60% were. The patients had gained weight after one month on the drugs and had increases in their cholesterol levels after three or four months. As well as treating people with schizophrenia the drugs are also given to people suffering from bipolar disorder, personality disorders and anxiety.

Study show suicide peak in December for some groups

Researchers from the U.S. Substance Abuse and Mental Health Services Administration have been studying seasonal variations in drug-related suicide attempts. They analysed data from 2004 to 2008 and found that, on average, emergency departments dealt with 178,423 visits for drug-related suicide attempts by people aged 12 and over. For most groups there was little seasonal variation in suicide attempts but both boys (18.9%) and men over 50 (12.9%) were most likely to try and kill themselves in December. Boys were least likely to try and kill themselves in February (2.5%) while older men were least likely to commit suicide in October (5.5%).

Income inequalities and suicide risk

Because of the recent world economic crisis differences in health between rich and poor people have increased, differences which include mental health. Researchers from the World Psychiatric Association looked into this further in a study of depression, suicidal ideation and suicide attempts in South Korea between 1998 and 2007. The researchers found that these problems were more highly concentrated in lower-income groups. This inequality had got worse in recent years, especially in terms of suicide attempts, doubling over the past 10 years as income inequalities became more pronounced following the economic crisis. Over this period the suicide rate in South Korea doubled from 13 per 100,000 to 26 per 100,000 the highest rate among countries belonging to the Organisation for Economic Cooperatin and Development (OECD).

What makes people legally incompetent?

People who have committed crimes are sometimes judged to be not competent to stand trial because of their mental-health problems. Researchers from the City University of New York reviewed 68 studies carried out between 1967 and 2008 to determine which factors were most closely linked to being found incompetent to stand trial. The trials included a total of 26,139 people. Defendants diagnosed with psychosis were eight times more likely to be found incompetent and unemployed defendants twice as likely. The likelihood of being found incompetent was also double for defendants with a previous psychiatric hospitalisation. Those found to be incompetent were slightly older, mostly non-White and unmarried.

Thursday, February 24, 2011

Pesticides and children's IQ

A relatively common household insecticide could have an impact on children's cognition. Researchers from Columbia University's Mailman School of Public Health studied 725 pregnant women assessing them for exposure to a compound used in insecticides called piperonyl butoxide (PBO) and then evaluated them for exposure their children's cognitive and motor development at the age of three. The children who were more exposed to the insecticide scored 3.9 points lower on the Bayley Mental Development Index than those with lower exposures - about the same change found in cases of lead exposure.

Exercise boosts children's IQ

Mens sana in corpore sano - a healthy mind in a healthy body - was long one of the watchwords of the English school system and a new study by researchers at Georgia Health Sciences University has provided interesting new evidence of the effects of improved fitness on children's cognition. The researchers studied 171 overweight seven to 11 year-olds who were all sedentary when the study started. The children were divided into groups taking different amounts of exercise and given tests assessing their planning, maths and reading. A smaller group of children were studied using functional magnetic resonance imaging (fMRI) to measure their brain activity. Those children who exercised for 40 minutes a day after school for three months increased their IQ by an average of 3.8 points and made improvements in maths, although not in reading. The children who exercised showed increased activity in the prefrontal cortex - an area of the brain associated with complex thinking, decision making and social behaviour - and more activity in the part of the brain responsible for executive function. The children's exercise included running games, hula hoops and skipping.


A team of researchers from Emory University and the University of Vermont have found a link between a hormone released during times of stress and the development of post-traumatic stress in women. The researchers studied 64 people who were, in turn, taking part in a larger research project, the Grady Trauma Project which is a study of 1,200 low-income people living in Atlanta who have high levels of post-traumatic stress disorder (PTSD). The 64 participants completed questionnaires on their life histories and provided saliva and blood samples to be analyzed. The study found that women with high levels of a hormone called pituitary adenylate cyclase activating polypeptide (PACAP) had PTSD symptoms five times higher than women with lower-than-average levels. PACAP acts throughout the body and brain affecting central-nervous-system activity, metabolism, blood pressure, pain sensitivity and immune function.

Lifting the lid on the pro-ana websites

Researchers from the University of Cincinnati have been looking into pro-anorexia social networks and web sites in a piece of qualitative research that found four main themes:
  • Staying "true" to the anorexia movement - in which members of social networks or forums "confess" their guilt at eating too much and not exercising enough
  • Promoting self-loathing strategies - when web sites encourage postings that involve people's loathing of their bodies and their mental worthlessness and weakness. In pro-anorexia sites these feelings are accepted and not contradicted as they are in other social networks
  • Pro-anorexia advising - such as tips on dieting and how to deal with family members who are advising healthy eating
  • Pro-anorexia encouragement - affectionate messages that bind the group together and tips and techniques to encourage anorexic behaviour
The researchers carried out their study between October 2006 and May 2007 and most of the members of the sites were thought to be White women or girls between the ages of 13 and 26.

Wednesday, February 23, 2011

Apgar scores and ADHD

An Apgar score is a way of assessing the health of a new-born baby. It is based on several physical signs including breathing, heart rate and muscle tone. A score of seven or higher is considered normal while a nine or a 10 indicate that a baby is in the best possible condition. Researchers at Aarhus University in Denmark have been looking into the links between Apgar scores and attention deficit hyperactivity disorder (ADHD) in a study of more than 980,000 children. The researchers found that compared with children whose scores were nine or 10 those with a five or six had a 63% greater risk of developing ADHD while those with an Apgar score of one to four had a 75% greater risk. The researchers speculated that a low Apgar score could be due to some sort of stress during pregnancy or birth that could also lead to the development of ADHD a few years later.

Language learning could stave off senior moments

People who speak more than two languages could be at a lower risk of developing memory problems as they grow older. Researchers from the Public Research Centre for Health in Luxembourg - where many people are multilingual - studied 230 men and women with an average age of 73. Those people who spoke four or more languages were five times less likely to develop cognitive problems compared to those who were only bilingual and people who spoke three languages were three times less likely. The study's results took into account the age and education of its participants.

U.S. anti-drugs campaign shows early promise

In 2005 the U.S. Office of National Drug Control Policy launched its Above the Influence campaign - funded at a cost of $200m a year - which aimed to prevent teenagers from using cannabis. Unlike previous campaigns, which stressed the risks of the drug, Above the Influence stressed how cannabis could prevent teenagers reaching their own goals and compromise their independence and used the slogan "Getting messed up is just another way of leaving yourself behind." Researchers from Ohio State University studied 3,236 children who were around 12 when the study began in 2005. They were surveyed four times beginning in Year Seven and ending about a year and a half later. Up to 79% of children said they had seen the campaign ads. Only 8% of the students who had seen the ads started using cannabis, compared to 12% of those who hadn't. The results are an encouraging first step but the children will need to be followed up for longer to reach a definitive verdict on the success, or otherwise, of the campaign.

NICE issues new guidelines on alcohol problems

In the U.K. the National Institute for Health and Clinical Excellence (NICE) has issued new guidelines about the treatment of people with alcohol problems. The guidelines call for an initial assessment with a screening tool such as the Alcohol Use Disorder Identification Test (AUDIT) or the Severity of Alcohol Dependence Questionnaire (SADQ). Those who are drinking too much for their own good should be helped with cognitive behaviour therapy, behavioural couples therapy or social network and environment-based therapies. Those with more severe problems should be offered a structured assisted-withdrawal programme after which they should be offered the drugs acamprosate or naltrexone and individual psychotherapy.

You can find out more about the new NICE guidelines here.

Tuesday, February 22, 2011

ADHD kids at greater risk of drug problems

Children with ADHD are two to three times more likely to develop serious substance-abuse problems in adolescence and adulthood. Researchers from the University of California Los Angeles and the University of South Carolina reviewed 27 long-term studies including a total of 10,900 children and following them from childhood to late adolescence and young adulthood. The study found that both boys and girls and children from all ethnic groups with ADHD were more likely to develop a range of problems with substances including nicotine, alcohol, cannabis, cocaine and other drugs.

U.K. couples' sunny outlook

The vast majority of couples in the U.K. are happy. Researchers from the Institute for Social and Economic Research at Essex University asked married and cohabiting couples to rate their happiness on a seven-point scale from the lowest score of 'extremely unhappy,' to the highest point of 'perfect.' 90% of married women and 93% of married men said they were happy in their relationships with the figures being 88% and 92% respectively for cohabiting couples. The happiest couples were those in which both partners were educated to degree level, had no children, that had been together for less than five years and where the man was employed. After taking into account a variety of factors including age, gender, number of children, length of relationship, employment status and education married couples were found to be happier than cohabiting ones.

You can find out more about this research here.

Lithium and bipolar brains

A team of researchers led by Brian Hallahan from the National University of Ireland in Galway have carried out a review of studies into brain volume, bipolar disorder and the effectiveness of lithium. They found that people with bipolar disorder had increased right lateral ventricular, left temporal lobe and right putamen volumes and decreased cerebral and hippocampal volumes. The longer people had been ill for the greater their cerebral volume reduction. However, people with bipolar disorder who took lithium had less reduction in these areas and showed increases in hippocampal and amygdala volume.

Heart risk and cognitive decline

Researchers from the French National Institute of Health and Medical Research have added more weight to the growing body of evidence that a healthy heart is linked to keeping one's mental faculties as one grows older. The researchers studied 4,827 men and women who had an average age of 55 when the study started. At the start of the study the participants were given a Framingham heart-risk score based on their age, sex, cholesterol, blood pressure and whether they smoked or had diabetes. The participants then took cognitive tests measuring their reasoning, memory, fluency and vocabulary three times over the next ten years. The people with a higher cardiovascular risk at the start of the study were more likely to have lower cognitive function and a faster overall rate of cognitive decline. A 10% higher cardiovascular risk was associated with a 2.8% lower score in the memory test for men and a 7.1% fall in women.

Monday, February 21, 2011

Naltrexone for heroin addiction

Heroin addicts are often prescribed methadone as this reduces problems with criminality, contaminated drugs and dirty needles. However, methadone itself is still addictive so Nikolaj Kunoe from the Norwegian Centre for Addiction Research at the University of Oslo looked into the use of a substance called naltrexone. Naltrexone completely blocks the effects of heroin and other morphine-related substances. Kunoe studied 56 heroin addicts who had already been through detoxification treatment. Half of them were implanted with 20 subcutaneous pellets containing naltrexone which was gradually released into the bloodstream and half received treatment as usual. After six months twice as many people in the naltrexone group managed to give up heroin and those who did not give up heroin more than halved their use. By contrast in the control group the majority of people relapsed back into heroin use.

Counting the psychological cost of Deepwater Horizon

In April 2010 there was an explosion and fire on a BP-licensed oil platform in the Gulf of Mexico resulting in millions of gallons of oil spilling out into the Gulf. Researchers from the University of Maryland School of Medicine and the University of Florida, Gainesville have been looking into the psychological impact of the spill in a study of 94 people; 71 of whom lived in Florida and 23 of whom lived in Alabama. The study found raised levels of anxiety and depression in people living in Alabama, where the oil reached the shore, and in Florida where it didn't. Both groups had similar high levels of worry about the impact of the spill on the environment, health and seafood safety. However, the levels of psychological distress were higher among people who had suffered income loss because of the spill. They felt significantly more tension, anger, fatigue and overall mood disturbance than those whose income had not been affected and these people also had lower scores for psychological resilience.

Amphetamines and Parkinson's disease

People who use amphetamines could be at an increased risk of developing Parkinson's disease. Apart from their illegal use amphetamines such as Benzedrine and Dexedrine are often prescribed for people with attention-deficit hyperactivity disorder (ADHD) and narcolepsy, as weight-loss pills and are also used to treat traumatic brain injury. Researchers from the U.S. health organisation Kaiser Permanente studied 66,348 people who were initially studied between 1964 and 1973 and re-evaluated in 1995. 1,154 people had been diagnosed with Parkinson's by the end of the study. The participants were asked about their use of amphetamines - either as weight-loss pills or in the form of Benzedrine or Dexedrine. There was no increase in risk for the people who used amphetamines for weight loss but those who took Benzadrine or Dexedrine were nearly 60% more likely to develop Parkinson's. Amphetamines are known to affect the release and uptake of dopamine, the most important neurotransmitter involved in Parkinson's disease.

Doctors call for more alcohol restrictions as liver deaths soar

Up to a quarter of a million people could die from alcohol abuse if Britain's drink problem carries on getting worse at the same rate. The U.K. has the 16th highest drinking level in the world and a recent report predicted that binge drinking would cost the U.K. £3.8bn by 2015 with 1.5m A&E admissions a year. Up to 30,000 people a year die of liver disease, the majority caused by alcohol abuse, and if rates continue to rise an extra 8,900 people per year could die over the next 20 years. In a letter to the Lancet a group of doctors call for tougher restrictions on the sale of, and more taxes on, alcohol.

You can find out more about this story here.

Thursday, February 17, 2011

How CBT can change your brain waves

A lot of coverage of science concentrates on how what goes on in the brain affects the way we feel and think but the relationship can, of course, work both ways with treatments and good and bad events in people's lives having an effect on what happens between our ears. Researchers from McMaster University in Hamilton, Ontario looked into this in a study of 25 people who were having psychotherapy for social anxiety. The participants had 12 once-a-week sessions of cognitive behaviour therapy and were compared to two control groups; one control group had very high social anxiety, one very low social anxiety and neither group received any psychotherapy. The participants had a series of electroencephalograms (EEGs) and the researchers measured their levels of delta-beta-coupling (DBC) which is associated with anxiety. Before treatment the participants DBC levels were similar to the high-anxiety control group and much higher than the low-anxiety one. However, as their treatment went on their DBC levels fell, matching the improvement recorded both by themselves and their doctors. Once they had finished their psychotherapy the participants' DBC levels were similar to those of the low-anxiety group.

Study shows power of the brain to deal with pain

Researchers from Oxford and Cambridge and two German universities have shed new light on the power of the mind and the brain's ability to cope with pain. They studied 22 volunteers, each of whom had a pain device placed on their skin that was too hot for comfort. The volunteers were asked to score their pain on a scale of 0 to 100 at various points in the study and also had MRI scans to measure the activity in the pain centres of their brains. At first the participants gave their pain an average score of 66, then the researchers gave them some opiate painkillers via an intravenous drip. Before they told the participants they were getting some painkiller their average pain score fell from 66 to 55 but once the researchers told them they were getting some pain relief their scores fell to an average of 39. Without actually stopping the drugs the researchers then said they were shutting off the supply of painkillers at which point the participants' average pain score went back up again to 64. At the same time the MRI scans of the participants' brain activity showed decreased activity in the pain centres when they thought they were getting the drug and increased activity when they thought they weren't receiving them. The study shows how belief in the effectiveness of a drug can be almost as important as the drug's actual effects and sheds light both on the placebo effect and on patients who are 'resistant' to painkillers.

Sex differences, genes and autism

Men are more likely to suffer from autism than women and men with autism have more testosterone than men without the condition. Researchers at Washington State University have been looking into the influence of male and female sex hormones on a gene called RORA. The gene affects the development of the cerebellum and many other processes that are important in autism and also regulates the production of a protein called aromatase - levels of which are reduced in the brains of people with autism. The researchers found that a decrease in aromatase leads to a build up in testosterone which in turn decreases the levels of RORA and further reduces aromatase. Female sex hormones were found to increase the levels of RORA in brain cells which in turn increases levels of aromatase. The researchers think that the effects of these hormones on the RORA gene could be responsible for some of the differences between the sexes in the prevalence of autism.

Wednesday, February 16, 2011

Self portraits and eating disorders

Women who suffer from anorexia and bulimia draw themselves differently from other women. Researchers from the University of Haifa in Israel studied 76 women. 36 had been diagnosed with anorexia or bulimia, 20 had no eating disorders but were overweight and 20 were normal weight. The women with eating disorders drew themselves either with a lager neck, a disconnected neck or no neck at all, they emphasized the mouth more and drew themselves with wider thighs. They also drew themselves either without feet or with disconnected feet. Compared to the women with bulimia the women with anorexia tended to omit breasts from their drawings, draw less defined body lines and draw smaller figures relative to the size of the page.

Ecstasy and cognition

A new study led by John Halpern of Maclean Hospital in Belmont, Massachussetts has found no evidence that ecstasy affects people's cognitive abilities. The study of 111 people compared 52 ecstasy users with 59 non-users. The non-users were also members of the "rave" scene and had also taken part in all-night raves where they suffered from fluid and sleep deprivation. The participants were screened for drug and alcohol use to make sure they were unaffected on the day of testing and the ecstasy users did not habitually use other drugs that might impair their cognition. The study found no signs that ecstasy impaired people's cognitive ability but the study's authors point out that there are still a number of other risks to taking ecstasy including other side effects and the risk of overdosing and contamination.

Review gives thumbs up to peer support

Peer support programmes for depression involve patients and volunteers supporting each other by talking and sharing information with one another. They have been found to decrease isolation, reduce stress, increase the sharing of health information and provide role models, and, because they rely on volunteers and non-professionals they are also cost effective. Researchers from the University of Michigan Medical School reviewed 10 studies into the effectiveness of peer support carried out between 1987 and 2009. They found that the programmes reduced symptoms of depression better than traditional care alone and were about as effective as cognitive behaviour therapy.

Why teenage drinking should be taken seriously

People who are drinking heavily at 18 are more likely to develop an alcohol problem by the time they are 25. Researchers from Indiana University studied 597 Finnish twins assessing them for drinking problems at age 18 and again at 25. The researchers used a questionnaire called the Rutgers Alcohol Problem Index which asks about 23 different negative consequences of alcohol drinking such as getting into a fight with a friend or family member. The more drink-related problems experienced by an adolescent at 18 the likelier it was that they would be diagnosed with alcoholism at 25. The study shows that teenage heavy drinking is something that needs to be taken seriously not just a phase that kids go through.

Tuesday, February 15, 2011

Deafness and dementia

Losing your hearing could increase your risk of developing dementia. Researchers from Johns Hopkins University in Baltimore studied more than 600 men and women over an average of 12 years and all the participants had a hearing test done at the start of the study. Overall 9% of the participants developed dementia over the course of the study. Those with mild hearing loss had twice the risk of developing dementia, while those with moderate hearing loss had three times the risk. People with severe hearing loss had five times the risk of developing dementia.

Suicide and depression - why the greatest risk is on the way back up

Paradoxically people being treated for major depression often experience more suicidal thoughts after they start treatment as they move from a state of complete passivity and acquire enough energy to think about suicide while still being profoundly depressed. A team of researchers led by Paola Rucci from the University of Pittsburgh School of Medicine studied this effect in 291 patients taking part in a trial comparing the effectiveness of interpersonal psychotherapy and treatment with serotonin-specific reuptake inhibitors (SSRIs). Of the 231 patients who weren't thinking of killing themselves at the start of the study 13.8% of them did think about ending it all at some point in the study. The participants taking SSRIs took longer to start thinking about killing themselves than those having psychotherapy. Of the 60 patients who were thinking about killing themselves at the start of the study seven showed more suicidal ideation after starting treatment. Overall though all the patients in the study managed their suicidal ideation successfully within the context of the study.

Rucci, P. ... [et al] - Treatment emergent suicidal ideation during 4 months of acute management of unipolar major depression with SSRI pharmacotherapy or interpersonal psychotherapy in a randomized clinical trial Depression and Anxiety DOI 10.1002/da.20758

Valued action and anxiety

'Valued action' is defined as 'the degree to which one engages in behaviours that are consistent with personally-held values.' A team of researchers from Suffolk University in Massachussetts studied how valued action affected quality of life in people with generalised anxiety disorder (GAD). They compared 30 people with GAD to 30 unaffected people and found that those participants with GAD reported significantly less valued action; something not explained by the depression that often goes alongside GAD. Valued action had a significant association with quality of life and was also associated with less 'experiential avoidance' - avoiding potentially-stressful situations - and distress about emotions. An acceptance-based behavioural therapy, which encourages patients to accept their uncomfortable emotions but still change their behaviour was found to increase valued action in the participants with GAD with 40% achieving clinically-significant change in this area.

Michelson, Susan E. ... [et al] - The role of values-consistent behaviour in generalized anxiety disorder Depression and Anxiety DOI 10.1002/da.20793

Cleft lip/palate and child development

Cleft lip and palate is one of the most common congenital malformations affecting around one in 650 children. Despite the fact that in the developed world surgery is usually carried out for the condition at between three and four months people affected by it have been found to be at an increased risk of psychological difficulties including cognitive problems in infancy and early school, particularly with verbal IQ. Researchers have previously found an association with the quality of mother-child interaction at two months and cognitive development at 18 months; the theory being that shock, worries about forthcoming surgery, feeding problems and the difficulty of engaging with a disfigured child affect the relationship between a mother and her child, in turn affecting children's development. The same team of researchers, led by Francoise Hentges from the University of Reading, followed up a group of 170 children seven years later. 44 had early cleft-palate surgery, 49 late surgery and 77 were unaffected 'controls.' The study found that the children who had had cleft palate scored significantly lower on tests of cognitive development. This was mostly mediated  by 'maternal sensitivity' at two months, even after allowing for the later effects of mother-child interaction. The study shows both how parents of children with cleft lip/palate need support from day one and how crucial the first few months are in a child's development.

Hentges, Francoise ... [et al] - The effect of cleft lip on cognitive development in school-aged children: a paradigm for examining sensitive period effects Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2011.02375.x

Wednesday, February 09, 2011

Is there such a thing as passive drinking?

People who are in close contact with someone with an alcohol problem could end up suffering from something analogous to passive drinking. Researchers from Massey University in Auckland, New Zealand studied 3,068 people aged between 12 and 80. The participants were asked whether they had any heavy drinkers in their life and one in three said they had. People who lived with a heavy drinker had the lowest scores on measures of general health and personal well-being - defined as people's satisfaction with their relationships, work, health and what they were achieving in life. However, even people with a relatively low exposure to heavy drinkers, such as a colleague or a more distant relative with a drink problem, generally reported lower satisfaction with life compared to those who knew no heavy drinkers. The study is interesting but doesn't show which direction the link goes in. It could be the case, for instance, that unhappy people are more attracted to heavy drinkers or that unhappy people drink more but it is their unhappiness not their drinking that affects other people. And of course the fact that two things - heavy drinking and unhappiness - happen together does not meant that they are linked any more than riots in Egypt and Green Bay Packers' Superbowl triumphs are. But the study does add some weight to the commonsense idea that heavy drinking isn't good either for oneself or the people around one.

New gene linked to depression

Everyone experiences some stress in their day-to-day lives but some people calm down after it more quickly than others. A chemical in the brain called neuropeptide Y (NPY) is thought to play a role in this and some variations in people's genes can cause them to produce lower levels of this chemical. Researchers from the University of Michigan Medical School studied 181 people. They analyzed their genes to see how effective they were at producing NPY and studied how they reacted to negative stimuli and whether they suffered from depression. The study found that people whose genes led them to produce low levels of NPY were more responsive to negative stimuli, less resilient to stress and more likely to develop major depression.

Schizophrenia and shrinking brains

Schizophrenia is associated with a decrease in the volume of people's brains. Researchers from the University of Iowa in Iowa City looked further into this topic in a study of 211 schizophrenia patients who underwent regular brain scans over a period of just over seven years. The study examined four factors: how long people had been ill; how severe their illness was; whether they used illegal drugs and whether they had been treated with antipsychotic drugs. Being ill for longer and being treated with antipsychotic drugs were both linked to loss of brain tissue. Higher doses of antipsychotics were linked to overall brain tissue loss, reduced grey matter and progressive declines in white matter. However, illness severity and substance abuse had little or no association with brain tissue changes.

Less use of 'chemical cosh' for dementia patients

Elderly people in the U.S. are being prescribed fewer antipsychotics - which can have side effects including an increased risk of stroke, weight gain and diabetes - to manage their behaviour. The change comes after the Food and Drug Administration issued a 'black-box warning' about using the drugs in this way. Researchers from the University of Michigan in Ann Arbor analyzed data on more than 250,000 veterans from the national Veterans Affairs registers. They found that the overall use of antipsychotics in elderly dementia patients fell from nearly 18% in 1999 to 12% in 2007.

Tuesday, February 08, 2011

Children's IQ and diet

A healthy diet could boost children's IQ. Researchers from Bristol University studied the eating habits of 3,966 children taking part in the long-term Avon Longitudinal Study of Parents and Children. The children's eating habits were recorded at three, four, seven and eight-and-a-half years old. The researchers found three main types of diet: processed diets, high in fat, sugar and convenience foods; traditional diets of meat, potato and vegetables and 'health-conscious' diets of salad, fruit and fish. The children all took IQ tests when they were eight-and-a-half years old and those who ate a diet high in processed foods at the age of three had slightly lower IQs. The researchers took into account the effects of mothers' level of education, social class and duration of breastfeeding.

Childhood behaviour and adult health

Childhood behaviour problems are associated with premature death. To look into this link a little further a team of researchers, led by Sophie von Stumm from the University of Chichester, used information from a study of 12,500 people in Aberdeen. The children's behaviour and psychological problems were assessed by teachers when they were between six and 12 and they were followed up and asked about their health between 2001 and 2003 when they were between 46 and 51. People who had been badly behaved when they were children were 15% more likely to be suffering from a long-term disease in middle age. Bad behaviour in childhood was also associated with a 16% greater risk of obesity and a 20% greater risk of smoking. Childhood hyperactivity was associated with starting to smoke earlier and, in women, smoking more as well as binge drinking for both men and women and having more hangovers in men. Being depressed or anxious as a child was related to a decreased risk of smoking and a later age of starting for those who did smoke.

von Stumm, Sophie ... [et al] - Childhood behavior problems and health at midlife: 35-year follow-up of a Scottish birth cohort Journal of child psychology and psychiatry doi:10.1111/j.1469-7610.2011.02373.x

Cannabis use and psychosis

The extent and nature of the link between cannabis use and psychosis is one of the most controversial areas of psychiatry. A team of researchers, led by Matthew Large from the Prince of Wales Hospital in New South Wales reviewed 83 studies into the relationship between cannabis use and the age at which people become ill with psychosis. They found that people who used cannabis became ill, on average, 2.7 years earlier than those who didn't with people who used any illegal drugs becoming ill 2 years earlier. Alcohol use was not associated with an earlier onset of psychosis.

Large, Matthew - Cannabis use and earlier onset of psychosis Archives of General Psychiatry

Suicide risk and criminal justice

Previous studies have shown that prisoners are substantially more likely to kill themselves but little is known about increased risk among other people who have a brush with the law. Researchers from the University of Manchester and the University of Aarhus in Denmark studied 552,118 people in Denmark 27,219 of whom committed suicide. More than a third of all the men who killed themselves had a criminal-justice history although the relative risk was higher among women with a criminal-justice history. Suicide risk was markedly increased among people who had been in jail but the risk was even greater among people who had been sentenced to psychiatric treatment and who had had charges conditionally withdrawn. The risk of suicide was greater even in people who had not been sent to jail or who had been found innocent and was especially high in people who had had recent or frequent contact with the law or who had been charged with violent offences.

Webb, Roger T. ... [et al] - National study of suicide in all people with a criminal justice history Archives of General Psychiatry doi:10.1001/archgenpsychiatry.2011.7

Friday, February 04, 2011

Depression, anxiety, inequality and ageing

Although research often demonstrates associations between being less well-off and having worse mental health there is less clarity about how age affects things and researchers often lump depression and anxiety together in their analyses. Researchers from the Public Health Sciences Unit in Glasgow studied 3,846 people over a 20-year period and found that social-class differences in anxiety and depression widened with age. The prevalence of anxiety decreased as people aged but decreased less slowly among manual workers. By contrast the prevalence of depression increased with age and increased more in manual workers than in white-collar one.

Green, M.J. and Benzeval, M. - Ageing, social class and common mental disorders: longitudinal evidence from three cohorts in the West of Scotland Psychological Medicine (2011), 41, 565–574

Sense of coherence and depression

Sense of coherence (SOC) is a positive way of looking at life and an ability to successfully manage stressful situations. People with a strong SOC are thought to cope better with stress because they consider stressors to be more predictable, have confidence in their own ability to deal with them and view pressures as meaningful challenges. A strong SOC has been associated with good subjective health, a lower frequency of sickness absence in women and a reduced risk of heart disease in male, white-collar workers. Researchers from the University of Turku in Finland looked into the links between SOC and depression in a study of 1,645 people. They found that people who had a strong SOC at the start of the study were less likely to suffer from depression, both a year and nine years later.

Luutonen, Sinikka ... [et al] - Weak sense of coherence predicts depression: 1-year and 9-year follow-ups of the Finnish Outcomes of Depression International Network (ODIN) sample Journal of Mental Health,
February 2011; 20(1): 43–51

Theory of Mind and eating disorders

Theory of Mind - how we interpret our own and other people's thoughts and emotions - has become one of the most influential ideas in psychology. It is thought to be deficient in people with autism and some psychologists think that people with eating disorders could also have problems in telling what other people are thinking. Researchers from Oxford University looked into this a bit more in a study of 145 women recruited from among university students and local workplaces. The women were asked aobut four different situations: having an argument with a family member, being on one's own at the end of the day, coming back from a date which didn't go well and moving to a new area. As well as writing about their own reactions to these situations the participants were also asked how an attachment figure (usually their mother) and an acquaintance would have reacted. Those women who had a higher number of eating-disorder symptoms had a 'concretised' understanding of their own emotions, i.e. they were more likely to mention food in their responses even though there was no mention of food in the original vignettes, although they did have a sophisticated understanding of a same-sex acquaintance's emotions. Eating-disorder symptoms were also associated with fewer positive thoughts about oneself but also fewer negative emotions about one's own behaviour. People with eating-disorder symptoms were also more likely to mention food when discussing how a same-sex acquaintance would react.

Warren, Louis and Cooper, Myra J. - Understanding Your Own and Other’s Minds: The Relationship to Eating Disorder Related Symptoms European Eating Disorders Review DOI: 10.1002/erv.1079

Spirituality and PTSD

Most psychotherapy for post-traumatic stress disorder (PTSD) involves making new meaning of the traumatic experience but very few talk about spirituality. Nearly equal numbers of trauma survivors describe their spirituality as helpful, hurtful or neutral in their recovery. Those who view their spirituality, church and God as sources of support, validation and acceptance are more able to make healthy meanings and recover while those who see these things as sources of judgment, punishment and rejection were less likely to. Researchers from the Veterans Affairs Medical Center in Minneapolis, Minnesota studied the effectiveness of a programme called Building Spiritual Strength. The programme is not designed to convert people or change their religious affiliation but to help them to recognise and resolve spiritual concerns that can contribute to distress and maintain and enhance areas of spiritual functioning that are contributing to positive adjustment. The researchers compared 26 people going through the programme with 28 on a waiting list - the people taking part in the programme showed a statistically-significant reduction in PTSD symptoms.

Harris, J. Irene ... [et al] - The Effectiveness of a Trauma Focused Spiritually Integrated Intervention

for Veterans Exposed to Trauma Journal of Clinical Psychology January 2011, 67(1), 1-14