Schizophrenia and mortality

A review of existing research in the Archives of General Psychiatry has found that people with schizophrenia are falling behind others when it comes to longevity, being 2.5 times more likely to die early than other people. Suicide was the biggest risk with people suffering from schizophrenia being almost thirteen times more likely to kill themselves. Schizophrenia also raised the death rate from cardiovascular diseases as new medications can cause weight gain and type 2 diabetes. People with schizophrenia are also prone to engage in high-risk behaviour such as drug-taking.

Depression and decline in elderly people

A study of more than seven hundred people in the American Journal of Psychiatry suggests that depression in elderly people can increase the risk of subsequent mental impairment and can act as a predictor of future intellectual decline. The researchers from the University of Rochester Medical Centre looked at the loss of executive functions such as making decisions, organizing, planning, and doing a series of things in a logical sequence and found that depression raised the risk of problems with these thought processes.

Mental illness and learning disability

A survey of 651 people with learning disabilities in Glasgow has found that over the two-year course of the study 16.3% of them suffered from mental illness, a rate 1.87 times higher than that of the population as a whole. Factors related to mental illness among this group of people included : type of accomodation and support, previous mental ill-health, urinary incontinence, having a more severe intellectual disability, being abused as an adult and parental divorce in childhood. Deprivation, child abuse, daytime occupation and marital smoking status showed no relation to mental illness in this group of people.

Smiley, E. ... [et al] - Incidence and predictors of mental ill-health in adults with intellectual disabilities British Journal of Psychiatry October 2007, 191, 313-319

Ethnicity and patient satisfaction

Patients from Black and ethnic minority groups are generally perceived to have a poor experience of mental health services but there is little hard data about this. A survey of about 27,000 users of community mental health services (of whom 10% were from ethnic minorities) has found that ethnicity had a smaller effect on patients' experience of mental-health services than other factors. Age, living alone, whether patients had been detained or not and whether they had been admitted as an inpatient were all stronger predictors of patients' experience than ethnicity. Relative to White people Black people did not report more negative experiences although Asian people were more likely to have had a negative experience of services.

Raleigh, Veena S. ... [et al] - Ethnic variations in the experiences of mental health service users in England British Journal of Psychiatry October 2007, 191, 304-312

Social factors and schizophrenia

A wide number of social factors have been linked to an increased incidence of schizophrenia including poverty, living in the inner-city and coming from an ethnic-minority background. A two-year study of 33 wards in South-East London looked at a number of different variables to see how they affected people's chances of developing the condition. The researchers found that low voter turn-out and ethnic segregation both increased the risk of developing schizophrenia. There was also some evidence that ethnic minority individuals were at greater risk of schizophrenia in areas with smaller proportions of minority groups.

Kirkbride, James B. ... [et al] - Neighbourhood-level effects on psychoses : re-examining the role of context Psychological Medicine 2007, 37, 1413-1425

Confabulation and schizophrenia

Confabulation is the production of false memories without the deliberate attempt to lie i.e. the person talking about them really believes they happened. It is a feature of Wernicke-Korsakoff amnesia and of frontal lobe syndrome and has also been documented in schizophrenia. Researchers in Spain looked at the links between confabulation, schizophrenia and other cognitive problems by asking a group of people with schizophrenia and a healthy control group to recall a series of short fables. If the participants in the trial added unecessary or superfluous details to the fables when they recalled them this was seen as evidence of confabulation. Confabulation was seen at a significantly higher rate in the schizophrenic patients than in the control group and predominated in schizophrenia sufferers with disordered thoughts. Confabulation was not related to intelligence or problems with episodic (for events) memory. However, confabulation was linked to problems with semantic (for words) memory.

Lorente-Rovira, E. ... [et al] - Confabulation in schizophrenia and its relationship to clinical and neuropsychological features of the disorder Psychological Medicine 2007, 37, 1403-1412

PTSD in UK soldiers

A study of 5,547 soldiers has found that those who had been deployed for 13 months or more within the last three years were 1.55 times more likely to suffer from post-traumatic stress disorder (PTSD) than soldiers who had had shorter deployments. Those who had seen more active service and more combat were also more likely to have poorer physical health and severe alcohol problems. The number of deployments was less important in causing mental health problems than the length of the deployments and PTSD was also associated with soldiers expecting to be deployed for a certain length of time only to find that they were asked to serve for much longer.

Rona, Roberta J. ... [et al] - Mental health consequences of overstretch in the UK armed forces : first phase of a cohort study British Medical Journal 22nd September 2007, 603-606

Family therapy and bulimia

Bulimia affects between 1 and 2% of adolescents with another 2-3% of teenagers showing some symptoms of bulimia without developing the full-blown condition. Bulimia can cause electrolyte disturbances, swelling of the parotid gland and the loss of dental enamel and is also linked to depression, anxiety and substance abuse. Recently family therapy has been used to combat the condition. Researchers in Chicago compared family therapy with supportive psychotherapy by dividing 80 patients into two groups. After twenty sessions, over a 6-month period 39% of the family-therapy group were free of bulimia symptoms compared to 18% of the supportive-psychotherapy group. After a further six months 29% of the family-therapy group were still symptom free comapared to 10% of the supportive-psychotherapy group.

le Grange, Daniel ... [et al] - A randomized controlled comparison of family-based treatment and supportive psychotherapy for adolescent bulimia nervosa Archives of General Psychiatry September 2007, 64(9), 1049-1056

Bipolar nation

There is increasing evidence that there has been a recent increase in the clinical diagnosis of bipolar disorder among young people. A review of doctors visits in the U.S. between 1994-1995 and 2002-2003 found that the number of youth (0-19) visits to the doctor resulting in a diagnosis of bipolar disorder rose from 25 per 100,000 in 1994-1995 to 1003 per 100,000 in 2002-2003 with adult visits resulting in a bipolar diagnosis rising from 905 per 100,000 to 1,679 over the same period. Most youth bipolar visits (66.5%) were by boys whereas most adult bipolar visits (67.6%) were by women. Nearly a third of young people visiting doctors with bipolar disorder also received a diagnosis of attention deficit hyperactivity disorder. 90.6% of young people and 86.4% of the adults were prescribed a psychotropic medication during their visit.

Moreno, Carmen ... [et al] - National trends in the outpatient diagnosis and treatment of bipolar disorder in youth Archives of General Psychiatry September 2007, 64 (9), 1032-1039

Domestic violence and mental health

A study of 177 women in a domestic violence shelter on the East Coast of America looked at the links between how dangerous their partners were and the women's mental-health problems. The researchers found that the more dangerous the women's partners were the more likely the women were to suffer from anxiety, depression, difficulty concentrating, memory loss, suicide attempts, weight gain and illegal drug use.

Sato-DiLorenzo, Aya and Sharps, Phyllis W. - Dangerous intimate partner relationships and women's mental health and health behaviors Issues in Mental Health Nursing 28 (8), 837-848

Loneliness and the immune system

A study of 153 people in the journal Genome Biology found that people who described themselves as 'lonely' had weaker immune systems than people who felt they had a good network of close friends and family. The genes linked to producing antiviral and antibiotic responses worked less well in socially-isolated people and leukocytes (white blood cells) were expressed differently.

Alzheimer's effect on caregivers

New research published in the Journal of Immunology suggests that the strain of looking after someone with Alzheimer's disease could shorten caregiver's lives by between four to eight years. Researchers from Ohio State University looked at telomeres, areas of genetic material at the ends of a cell's chromosome which deteriorate with age. They compared a group of people looking after Alzheimer's sufferers with a control group matched for age, gender, social class etc. The caregivers' telomeres were four to eight years 'older' than the control group and the caregivers also had higher levels of depression and fewer lymphocytes (which play an important part in the immune system) than the control group.

Depression and early retirement

A study of 3,000 people between the ages of 53 and 58 in the U.S., carried out by researchers at the University of Pennsylvania has found that middle-aged men with symptoms of depression are more likely to take early retirement than other people, while middle-aged women with even mild symptoms were more likely to retire early. The study will appear in the journal Health Services Research in the autumn.

Escitalopram for depression and anxiety

A 12-week French study looked at the effects of a drug called Escitalopram on people suffering from depression, and from depression and anxiety. After 12 weeks, on average, the patients showed significant reductions in their depression and anxiety levels although nearly a third of patients (31%) reported some side effects. The most frequent side effects were nausea which was experienced by 8% of the participants and headaches which were experienced by 5% of the patients. 8% of the study's participants dropped out by the end of the study because of the side effects of the drug. However people taking drugs for mental-health problems often experience some side effects and the researchers concluded that 'escitalopram was well tolerated and efficacious in reducing symptoms of depression in patients with or without comorbid anxiety over a 12-week treatment period'

Olie, Jean-Pierre ... [et al] - A prospective study of escitalopram in the treatment of major depressive episodes in the presence or absence of anxiety Depression and Anxiety 24: 318-324

Rumination and PTSD

Rumination is commonly defined as 'repetitive and recurrent, self-focused negative thinking about past negative experiences and/or negative mood'. It is similar to worry with the main difference being that rumination is to do with events or situations in the past while worry deals with events or situations in the future. Recent studies have shown that rumination is a powerful predictor of persistent post-traumatic stress disorder (PTSD) but it is not understood how rumination contributes to the condition. Two studies of assault survivors one cross-sectional (i.e. people's thoughts and problems here and now) and one over six-months looked at the connections between rumination and PTSD. Both studies found that a compulsion to keep ruminating, the occurence of unproductive thoughts, 'why' and 'what if' type questions and negative emotions before and after rumination were significantly associated with PTSD.

Michael, Tanja ... [et al] - Rumination in posttraumatic stress disorder Depression and Anxiety 24: 307-317

CBT and pathological gambling

A study of 290 people in Spain looked at the effectiveness of group cognitive behaviour therapy (CBT) for people with pathological gambling problems. After 16 weekly sessions of group CBT 76.1% of the sample had stopped gambling and this had risen to 81.5% six months after the end of treatment. 'Psychopathological distress' and symptoms of obsessive-compulsive disorder were both associated with patients being more likely to drop out of treatment.

Jimenez-Murcia, Susana ... [et al] - Cognitive-behavioral group treatment for pathological gambling : analysis of effectiveness and predictors of therapy outcome Psychotherapy Research September 2007; 17(5), 544-552

Poverty and therapy in Sheffield

The 'inverse care law' states that 'the availability of good medical care tends to vary inversely with the need for it in the population served' i.e. rich, healthier people, in more affluent areas tend to get better health care than poorer, sicker people in less well-off areas. This applies even in the NHS, perhaps because better-off people tend to be more assertive in demanding and defending better health services. A study of 725 people in Sheffield examined whether people were offered psychotherapy and which kind of therapy they were offered and compared this with their postcodes which were used as a way of measuring how well-off they were. The researchers found that there was no link between how well-off people were and whether they were offered psychotherapy or not or between their financial circumstances and which kind of psychotherapy (psychoanalysis or cognitive behaviour therapy) they were offered suggesting that the inverse care law did not apply in these circumstances.

Saxon, David - Psychotherapy provision, socioeconomic deprivation, and the inverse care law Psychotherapy Research September 2007; 17(5): 515-521

Feeling fat in anorexia

Feeling fat is one of the key features of anorexia nervosa but other women, without eating disorders feel fat too. A study of 48 women in the UK compared those with anorexia, those who were dieting and those who weren't dieting to see what their experience of feeling fat was and to see whether there were any differences between anorexics and other groups of women. All three groups often felt fat an experience which was associated with distress, negative emotions, internal and external bodily sensations, negative self beliefs and a first memory of feeling fat. Those women with anorexia felt fatter than other women and felt more distress about feeling fat. They felt more negative emotions, had an earlier first memory of feeling fat and had stronger negative beliefs about themselves.

Cooper, Myra J. ... [et al] - The experience of 'feeling fat' in women with anorexia nervosa, dieting and non-dieting women : an exploratory study European Eating Disorders Review 15: 366-372

Eating disorder treatment - what patients think is important

Eating disorders are most prevalent in young women between the ages of fourteen and twenty-four. They are often difficult to treat and can take years to recover from. More than half of patients do not recover. However, there has been little research into what eating-disorder patients themselves consider to be the most important elements in their treatment. A survey of 132 eating disorder patients in Belgium and Holland found that 'improving self-esteem', 'improving body experience' and 'learning problem-solving skills' were seen as the most important parts of treatment ; a view shared by the patients' therapists.

Vanderlinden, J. ... [et al] - Which elements in the treatment of eating disorders are necessary 'ingredients' in the recovery process ? - a comparison between the patient's and therapist's view European Eating Disorders Review 15, 357-365

Self-harm and college students

A number of theories have been developed over the years to explain why people harm themselves. Recently research has focused on the negative emotions and coping strategies of people who self-harm, particularly those people in prison or psychiatric hospitals. Researchers now think that people harm themselves to express negative emotions, decrease negative moods and to avoid fully experiencing unpleasant emotions. People who self-harm are more likely to try and avoid, or escape from, their emotions. Studies of college students in the U.S. have found that 17% have self-harmed at some point in their lives with 9.7% harming themselves in the last year. However, there has been little research into the causes of self-harm among this group. A study of 216 college students in the U.S. found that those who were currently self-harming, or who had self-harmed in the past had higher levels of hostility, guilt and sadness than those who had never self-harmed. There was little difference between those who had given up harming themselves and those who were still doing so suggesting that both groups needed careful monitoring and support.

Brown, Seth A., Williams, Kelly and Collins, Amanda - Past and recent deliberate self-harm : emotion and coping strategy differences Journal of Clinical Psychology 63(9), 791-803