Dieting and depression - the perils of the plateau

People on diets often experience a plateau after their initial weight loss when their weight stubbornly refuses to go down any further. A study of 11 fat men on a diet found that losing around 10% of their body weight slowed down their metabolism (meaning they burnt up less calories) and made them more hungry. The men showed increased 'cognitive dietary restraint' and their mental and physical health remained unchanged. Their risk of depression had significantly increased compared to before their weight loss. The researchers called for 'caution and reasonable objectives when prescribing a weight reduction programme for obese individuals'

Chaput, Jean-Philippe ... [et al] - Psychobiological effects observed in obese men experiencing body weight loss plateau Depression and Anxiety 24(7), 518-521

Antipsychotics for depression and anxiety

Major depression often goes hand-in-hand with anxiety. 85% of adults with major depression exhibit significant symptoms of anxiety and 58% of them have a diagnosable anxiety disorder in their lifetime. Anxiety on top of depression leads to more severe symptoms, decreased psychosocial functioning, a higher risk of suicide and longer-lasting depression. Selective serotonin reuptake inhibitors (SSRIs) and venlafaxine are the first-line treatments for depression and anxiety but in some cases only a partial cure is achieved meaning that symptoms can flare up again later. In these cases other medication is used - not always successfully. Antipsychotic drugs have been used for people with hard-to-treat depression and for people with bipolar disorder and anxiety and a recent Canadian trial on 58 patients has shown that these drugs can also be effective in patients with major depression and anxiety. Quetiapine worked quickly, produced a significant reduction in depression compared to a placebo and reduced feelings of guilt, suicide and tension. The most common side effect was an increase in sleepiness and lethargy. The researchers called for further, larger-scale studies of the drug in people with depression and anxiety.

McIntyre, Alexander, Gendron, Alain and McIntyre, Amanda - Quetiapine adjunct to selective serotonin reuptake inhibitors or venlafaxine in patients with major depression, comorbid anxiety, and residual depressive symptoms : a randomized, placebo-controlled pilot study Depression and Anxiety 24(7), 484-494

Prenatal alcohol exposure and childhood drinking problems

Prenatal alcohol exposure has been associated with childhood problems such as bad behaviour, criminality, attention deficit hyperactivity disorder (ADHD) and alcohol problems. A U.S. study of 8,621 children of 4,912 mothers found that there was an association between prenatal alcohol exposure and childhood behaviour problems even when taking all the other environmental factors into account. However, the children of mothers who drank more heavily in one pregnancy than another were found to be at equal risk of ADHD suggesting that for this condition at least environmental and genetic factors were more important than prenatal alcohol exposure.

D'Onofrio, Brian M. ... [et al] - Causal inferences regarding prenatal alcohol exposure and childhood externalizing problems Archives of General Psychiatry November 2007, 64(11), 1296-1304

Psychosis and sex offending

Studies on sex offenders have focused mainly on paraphilias, personality disorders, psychopathy and substance abuse but there has been little research into the links between psychosis and sex offending. A Danish study of 358,180 people (everyone born between 1944 and 1947) found that 2.2% of them had been hospitalized with psychosis. These men committed 8.4% of the physically aggressive sexual offences and 9% of the non-physically aggressive sexual offences committed by the men in the study. People with psychosis but not a personality disorder or a drug problem were no more likely to commit a violent sexual offence than other people but were three times more likely to commit a non-violent sexual offence. People who had psychosis and a personality disorder or a drug problem were six times more likely to commit a violent sex offence and three or five times more likely to commit a non-violent sex offence.

Alden, Amanda ... [et al] - Psychotic disorders and sex offending in a Danish birth cohort Archives of General Psychiatry November 2007, 64(11), 1251-1258

Eating disorders and motivation to change

Motivation to change - the level of people's motivation to recover from their mental-health problems - has received considerable research attention in recent years. It has been examined in smoking, cocaine addiction, anxiety disorders, obesity and alcohol problems but much less work has been done on motivation to change and eating disorders. A Spanish study of 218 patients with eating disorders found that those with bulimia were more motivated to change than those with anorexia or EDNOS (eating disorders not otherwise specified). For all groups younger patients had less motivation to change than older ones.

Casasnovas, C. ... [et al] - Motivation to change in eating disorders : clinical and therapeutic implications European Eating Disorders Review November-December 2007 15(6), 449-456

Bulimia and borderline personality disorder

People with bulimia can range from only slightly disturbed individuals who recover with little help to people with severe personality disorders. In people with bulimia and a severe personality disorder other symptoms can include self-destructive behaviour, emotional instability, suicidal ideation and profound interpersonal and social problems. Those people with bulimia and borderline personality disorder (BPD) are regarded as the most difficult bulimia subgroup to treat and the one with the worst prognosis. A German study of 240 bulimia patients found that 13.8% of them had a diagnosis of BPD. There were no differences in binging and purging behaviour between those with and without BPD but BPD patients had significantly more feelings of ineffectiveness and less emotional self-awareness. Although the BPD group began treatment with more mental-health problems they improved as much as the other patients over the course of their treatment.

Zeeck, A. ... [et al] - Symptom severity and treatment course of bulimic patients with and without a borderline personality disorder European Eating Disorders Review November-December 2007, 15(6), 430-438

Asthma and depression in teenagers

A study of 1,300 children between the ages of 11 and 17 in the U.S. has found that those who had asthma were nearly twice as likely to suffer from anxiety and depression. Previous studies have suggested a link between asthma and other mental-health problems such as panic disorder. After controlling for other variables children with asthma were found to be 1.9 times as likely to suffer from anxiety and depression. Children with asthma and a mental-health problem are more likely to smoke making it harder to treat their asthma. Girls and children living in a single-parent household were more likely to suffer from anxiety and depression as were those who had recently been diagnosed with asthma and those who had higher levels of physical impairment because of the condition.

You can find out more about this research at

http://psychcentral.com/news/2007/11/07/link-between-asthma-and-depression/1501.html

Early sex - surprising findings

A U.S. study of 534 same-sex twin pairs has found that those who had sex earlier were actually less likely to exhibit delinquent behaviour later in life. The study runs counter to most assumptions that relate early sex to later drug use, criminality, antisocial behaviour and emotional problems. By studying twins the researchers were able to eliminate the genetic and socio-economic variables that might otherwise influence the behaviour of adolescents. The study found that those people who had sex earlier developed better social relationships in early adulthood. The authors of the study plan further research to look at the type of relationships involved, how old the partners were and how long the relationships lasted.

You can read more about the research at

http://psychcentral.com/news/2007/11/13/early-sex-may-not-predict-delinquency/1527.html

Brain maturation and ADHD

There has been a lot of coverage in the media recently about ADHD with new research claiming that medication for the condition is virtually useless. Now a new study by American researchers suggests that ADHD might be caused by delayed brain development and is something that children will eventually grow out of. Researchers studied 446 participants over a period of years and found that the development of the prefrontal cortex, which helps to suppress inappropriate actions and thoughts, focus attention, remember things from moment to moment, work for reward and control movement was delayed in children with ADHD. Conversely the motor cortex matured faster than normal in children with ADHD which could explain the restlessness and fidgetiness common in these children. On average the cortex sites attained peak thickness at an average age of 10.5 in those with ADHD compared to 7.5 for the other children.

You can read more about this research at

http://psychcentral.com/news/2007/11/13/immature-brain-may-cause-adhd/1528.html

Personality and depression in older people

Diagnosis - particularly of mental-health problems - is not a completely objective process and can often be influenced by factors such as age, race and sex that are nothing to do with a patient's symptoms. A U.S. study of 318 older adults looked into the effects of people's personality on their diagnosis of depression. Previous studies have shown that neurotic, introverted people are more likely to suffer from depression. The researchers tested the participants' personality and measured their depressive symptoms. They found that, regardless of their actual symptoms neurotic and introverted people were more likely to be diagnosed as depressed whereas those people who were highly conscientious were less likely to be labelled as depressed

McCray, Laura W. ... [et al] - The role of patient personality in the identification of depression in older primary care patients International Journal of Geriatric Psychiatry November 2007, 22(11), 1095-1100

Depression, illness and old age

Depression in older people is a major public health problem and is often associated with physical illness. However, it is unclear whether it is the illness itself that causes the depression i.e. there is some physiological link between the illness and depression - or whether it is the effects of the illness, in terms of pain, discomfort and restricted functioning that makes people depressed. A Singaporean study of 2,611 people over 55 looked at the links between physical illness and depression. The researchers found that high blood pressure, eye problems, diabetes, arthritis, heart disease, asthma, stroke, osteoporosis, heart failure, thyroid problems and gastric problems all raised the risk of depression. However, once people's feelings about their illness and their restricted functioning were taken into account only asthma, gastric diseases, arthritis and heart problems were found still to be linked to depression.

Niti, Matthew ... [et al] - Depression and chronic medical illnesses in Asian older adults : the role of subjective health and functional status International Journal of Geriatric Psychiatry November 2007, 22(11), 1087-1094

Stress, anxiety and sleep

Experts recommend that adults get seven or eight hours sleep a night ; adolescents need nine hours, school-aged children 10-11 and pre-school children 11-13. However, a Finnish study of 19,199 people has found that stressful life situations can disturb an individual's sleep for at least six months after the event. For people sensitive to anxiety the chances for sleep disturbances were 2-3 times greater following a stressful event. The five-year study measured people's propensity for anxiety at the start and monitored their sleep patterns, and any stressful life events that may have occured, over the course of the study. After 'severe' life events men with anxiety were 3.11 times as likely to suffer from sleep disturbances compared with 1.13 times for men without anxiety. After divorce anxious men and women were 2.05 times as likely to have disturbed sleep compared to 1.47 times for non-anxious people.

You can find out more about the study at

http://psychcentral.com/news/2007/11/02/high-blood-pressure-speeds-alzheimers/1479.html

Cardiovascular disease and Alzheimer's

A study of 135 people over 65 and newly diagnosed with Alzheimer's disease in Utah has found that high blood pressure and a form of irregular heartbeat called atrial fibrillation may accelerate cognitive decline associated with Alzheimer's disease. The results of the study showed that those with high blood pressure at the time of their diagnosis showed a rate of memory loss twice as fast as those with normal blood pressure. Those with atrial fibrillation at the time of their diagnosis showed a rate of memory decline 75% faster than those with normal heartbeats. The researchers involved in the study are now looking at drugs aimed at lowering blood pressure and stabilising hearbeats to see how effective they are at staving off cognitive decline.

You can find out more about this study at

http://psychcentral.com/news/2007/11/02/high-blood-pressure-speeds-alzheimers/1479.html

Common sense, logic and schizophrenia

Common sense and logic are not always in agreement and a new study by British researchers suggests that there might be differences in the way people with schizophrenia approach conflicts between the two compared to other people. 36 people took part in the study. Participants were given a series of statements in the form of a syllogism (e.g. all plants photosynthesize, grass is a plant, therefore grass photosynthesizes) and were told that, for the purposes of the study, they should treat the first two parts of the syllogism as true. Some of the syllogisms were perfectly logical but their content was nonsense e.g. all buildings speak, hospitals do not speak therefore hospitals are not buildings while others were illogical but grounded in common sense e.g. if the sun rises then the sun is in the east, the sun is in the east, therefore the sun rises. People with schizophrenia were more successful on the task suggesting that theoretical thinking was more important to them than commonsense.

You can find out more about this study at

http://psychcentral.com/news/2007/11/02/the-logic-of-schizophrenia/1480.html

Energy drinks and alcohol - a dangerous cocktail

Some students drink 'energy' drinks alongside alcohol to counteract alcohol's depressive effect and to enable them to stay awake, and drink, longer. A U.S. study of 4,271 students from 10 universities found that those who mixed alcohol with energy drinks drank significantly more during a typical drinking session and got drunk twice as often. Even adjusting for the amount of alcohol drunk those who also used energy drinks were twice as likely to be hurt or injured, twice as likely to require medical attention and twice as likely to get into a car with a drunken driver. They were also twice as likely to take advantage of, or be taken advantage by someone sexually. White, male students who played sport were more likely to mix alcohol and energy drinks.

You can find out more about this study at

http://www1.wfubmc.edu/news/NewsArticle.htm?Articleid=2193

Overweight mothers and ADHD

A study of 12,500 children in Sweden, Finland and Denmark has suggested a link between mothers who are overweight when they become pregnant and an increased risk of Attention Deficity Hyperactivity Disorder (ADHD) in their children. The children were monitored from their time in the womb up to school age when their teachers were asked to answer a questionnaire about the child's behaviour. The correlation between the mothers' weight and ADHD was found in moderately overweight as well as obese women. Overweight women who gained a lot of weight during their pregnancy were more at risk of having a child with ADHD than normal weight women who gained the same amount of weight while expecting.

You can find out more about this study at

http://psychcentral.com/news/2007/11/05/overweight-moms-deliver-adhd-kids/1487.html

Mum, metabolism and memory loss

A U.S. study into Alzheimer's disease has suggested that people may be more at risk of developing the condition if their mothers had it. The researchers studied people with a family history of the disease as people with an affected parent are 4-10 times more likely to develop it. In the last twenty years a number of studies have shown that people with Alzheimer's have significant reductions in energy metabolism in certain parts of the brain and these reductions are apparent years before symptoms develop. The study, of 49 people, compared energy metabolism in the medial temporal lobes and the posterior cingulate cortex - two brain regions involved with memory storage and retrieval. The participants were also administered neuropyschological and clinical tests. People whose mother had had the disease had the largest reduction in glucose metabolism ; down by 25% in the posteriour cingulate cortex. People with no family history of the disease or whose fathers had had it showed no signs of a decrease in energy metabolism.

You can find out more about this study at

http://psychcentral.com/news/2007/11/06/at-risk-if-mom-has-alzheimers/1491.html

Interventions for problem behaviour - what are the long-term effects ?

Disruptive-behaviour problems in childhood 'predict' maladjustment (e.g. violence, criminality and school drop-out) during adolescence and adulthood. A number of intervention programmes have attempted to tackle disruptive behaviours in childhood so as to reduce these problems in later life but their long-term effects are rarely evaluated. A study of 895 boys in Montreal looked into the effect of a two-year intervention programme which the boys undertook between the ages of seven and nine. The boys were then followed up at twenty-four to see how they had got on. The intervention was made up of three different elements : social skills training aimed at promoting changes in behaviour towards peers, social acceptance and less inclination towards antisocial peers ; parenting training and the provision of information and support for teachers. Significantly more boys in the intervention group graduated from high school and fewer had a criminal record compared to the control group.

Boisjoli, Rachel ... [et al] - Impact and clinical significance of a preventive intervention for disruptive boys British Journal of Psychiatry November 2007, 164, 415-419

Depression in Europe - who are the gloomiest ?

Depression is common in later life but different studies in different countries produce different prevalence rates for the condition. A study of 22,777 people in ten different European countries (not including the UK) used the Euro-D questionnaire which was specifically designed to be used in a wide variety of different languages and cultures. Even after all the other factors had been taken into account France, Italy and Spain had the highest rates of depression. Women were more likely to suffer from mood problems while older people and those with poor verbal fluency were more likely to have problems with motivation.

Castro-Costa, E. .... [et al] - Prevalence of depressive symptoms and syndromes in later life in ten European countries : the SHARE study British Journal of Psychiatry November 2007, 164, 393-401

Schemas of juvenile delinquents

Maladaptive schemas are defined as 'cognitive structures that bias information processing regarding the self, others and the world and give rise to negative automatic thoughts and depressive feelings.' Many children with 'conduct disorder' are also suffering from depression and a study of 82 youngsters in Belgium referred for antisocial-behaviour problems compared those diagnosed with depression to the rest of the sample. The depressed children felt more disconnection from, and rejection by, their parents. In terms of their relationship with their mothers the depressed children scored higher for the maladaptive schema defectiveness/shame. The depressed children's relationships with their fathers were characterised by the maladaptive schemas abandonment/instability, emotional deprivation and defectiveness/shame. The depressed children perceived their parents as more cold, unstable, unreliable and unpredictable than the other children's.

Vlierberghe, Leen Van ... [et al] - Parental schemas in youngsters referred for antisocial behaviour problems demonstrating depressive symptoms The Journal of Forensic Psychiatry and Psychology December 2007, 18(4), 515-533