Depression and bone density

Depression has been linked to a number of physical illnesses in particular cardiovascular disorders. Now, a study by the National Institute of Mental Health in America has found that depression can also lead to a reduction in bone mass in pre-menopausal women. The study had 133 participants, between the ages of 21 and 45 and compared bone mass in those women who had depression with those who were not depressed. 17% of depressed women had bone thinning in a part of the hip called the femoral neck compared to only 2% of other women. Low bone mass in the lower back was found in 20% of depressed women but in only 9% of non-depressed women. Blood and urine samples also showed that the depressed women had imbalances in immune-system substances , including those that produce inflammation. One of these substances IL-6 is known to promote bone loss.

You can read more about this research at

http://psychcentral.com/news/2007/11/27/depression-linked-with-reduced-bone-mass/1582.html

Insight and schizophrenia

Drug and psychological treatments can significantly reduce symptoms in schizophrenia but the condition remains very difficult to treat compared to other mental-health problems. The long-term course of schizophrenia is frequently characterized by reduced social and occupational functioning, loss of independent living, impaired quality of life, substance abuse and an increased risk of suicidal and violent behaviour. Many clinicians believe that poor insight is partially responsible for the negative prognoses of many schizophrenia patients. Insight has been defined as the awareness of having a mental disorder and of its symptoms and implications and has been shown to be at least partly lacking in approximately 50% of schizophrenia patients. There are concerns that it affects patients' adherence to treatment as they either ascribe their symptoms to other causes or refuse to accept that they are ill at all. A review of studies into insight in schizophrenia has found that insight is associated with adherence during treatment although the link between insight and long-term adherence to medication is less clear. Insight was linked to better long-term functioning but also an increased risk of depression as patients were more aware of the nature and magnitude of their problems.

Lincoln, Tania M., Lullmann, Eva and Rief, Winfried - Correlates and long-term consequences of poor insight in patients with schizophrenia : a systematic review Schizophrenia Bulletin November 2007, 33(6), 1324-1342

Modafinil for schizophrenia

Schizophrenia is considered the most important cause of chronic psychiatric disability. In recent years the cognitive and motivational impairment seen in schizophrenia have been determined to be one of the main causes of the profound and persistent disability typically produced by the disorder. Although the psychotic symptoms of schizophrenia may improve following treatment a range of cognitive deficits will often persist and the disability resulting from them has recently been considered to have a greater impact on long-term functioning than delusions and hallucinations. Recently a drug called modafinil has emerged as a possible drug to improve cognition in schizophrenia. It was initially prescribed to reduce the fatigue and sedation induced by antipsychotic medication but a review of studies into the drug shows that it may lead to better executive functioning and attention performance in patients with schizophrenia. The drugs effectiveness is affected by the patients' current levels of cognitive functioning, genetic make-up and the other drugs that they are taking at the time allowing for future treatment to be targeted at those most likely to benefit.

Morein-Zamir, Sharon, Turner, Danielle C. and Sahakian, Barbara J. - A review of the effects of modafinil on cognition in schizophrenia Schizophrenia Bulletin November 2007, 33(6), 1298-1306

ADHD : drug use soars

A study of the prescribing patterns of child psychiatrists and paediatricians at East Kent Hospitals NHS Trust has shown that drug prescribing for children with attention deficit hyperactivity disorder (ADHD) has soared by 26% in a year. The study found a 22.9% increase in stimulant prescriptions and a 40.1% increase in the prescription of non-stimulant (atomoxetine) drugs between 2005 and 2006. The increase in prescriptions reported in the Kent Journal of Mental Health comes despite recent U.S. research suggesting that drugs are no better than therapy for ADHD in the long term.

Childhood mental-health problems and criminality

There is a high prevalence of mental illness among people involved with the juvenile and criminal justice systems but there is less information about which psychiatric disorders in childhood lead on to law-breaking later. A U.S. study of 1,420 children aged 9, 11 and 13 followed them up to the age of 16 to see whether they developed any mental-health problems and up to the age of 21 to see whether they got into trouble with the law. By the end of the study 31% of the sample had one or more adult criminal charges. Overall 51.4% of male young offenders and 43.6% of female offenders had a history of childhood mental-health problems. 20.6% of the crime attributed to young women and 15.3% of the crime attributed to young men was linked to childhood mental-health problems. Severe and/or violent offences were predicted by the presence of both an emotional and a behavioural disorder during childhood.

Copeland, William E. - Childhood psychiatric disorders and young adult crime : a prospective, population-based study American Journal of Psychiatry November 2007 164(11), 1668-1675

Seasonal depression and cognition

Seasonal affective disorder (SAD) is a mood disorder in which people's depression has a clear, seasonal pattern, usually coming on in the winter months. It is though to affect at least 5% of the population and between 60 and 90% of sufferers are women. It shares many of the symptoms of non-seasonal depression such as depressed, despairing or irritable mood, loss of interest in life, feelings of worthlessness, excessive or inappropriate guilt, low self-esteem, indecisiveness, diminished ability to think or concentrate and inability to experience pleasure. However, while conventional depression usually produces loss of appetite, weight loss and insomnia, seasonal depression usually leads to craving for carbohydrates, weight gain and sleepiness. Depression can also affect people's thinking leading to deficits in verbal fluency, visual search, psychomotor speed, attention and working memory but it is not known if seasonal depression has a similar effect on people's cognitive powers. A U.S. study of 93 people found that SAD was highly prevalent (28%) compared to 8.6% for conventional depression. More women than men were affected by SAD and both SAD and depression were associated with higher rates of cognition problems in comparison to people with no affective symptoms.

Sullivan, Brianna and Payne, Tabitha W. - Affective disorders and cognitive failures : a comparison of seasonal and nonseasonal depression American Journal of Psychiatry November 2007, 164(11), 1663-1667

In case of emergency fill glass - drinking and the emergency services in Norway

Policemen and ambulancemen are often perceived to have a high prevalence of excessive alcohol consumption although there is little actual proof of this. It is thought that the male dominance of both professions, the fact that the work is organised on shift patterns and the high levels of stress involved cause an increased rate of drinking. A survey of 2,372 police and 1,096 ambulance staff in Norway found that they drank much less than their Australian counterparts and at about the same level as Norwegian doctors. 17.7% of policemen and 16.6% of ambulancemen were heavy drinkers compared to 9.1% of policewomen and 7.4% of ambulancewomen. Personnel who were male, younger and had higher levels of neuroticism had higher rates of alcohol problems. Drinking to cope was associated with higher levels of alcohol problems but was found to moderate the effect of depersonalization (e.g. a cynical and distant attitude toward one's work and the people with whom one works) and gender.

Sterud, T. ... [et al] - Occupational stress and alcohol use : a study of two nationwide samples of operational police and ambulance personnel in Norway Journal of Studies on Alchohol and Drugs November 2007, 68(6), 896-904

Mothers and drinking

The consumption of alcohol by mothers during and after pregnancy can have important effects on the developing child and it is estimated that around 1 in a 100 children has a fetal alcohol spectrum disorder. Although women generally reduce their alcohol consumption once they become pregnant they usually return to their normal drinking patterns once they have had their baby. However, frequent heavy maternal drinking is associated with poorer family functioning, poorer intellectual stimulation and increased domestic violence. A study of 381 women in Wisconsin, U.S. who were frequent/heavy drinkers before they became pregnant found that 37.8% of them drank heavily after they had had their babies. 18% reported heavy, episodic drinking, 5% reported frequent drinking only and 15% reported both frequent and heavy drinking. Women who drank heavily after having their babies were more likely than other women to have a heavy drinking partner, to have been unemployed, to have smoked following pregnancy and to have consumed alcohol after becoming pregnant. Women who breast-fed their children were less likely to report heavy drinking.

Jagodzinski, T. and Fleming, M.F. - Postpartum and alcohol-related factors associated with the relapse of heavy drinking Journal of Studies on Alchohol and Drugs November 2007, 68(6), 879-885

ADHD and drug abuse

Studies of adults with attention deficit hyperactivity disorder (ADHD) have consistently found that they are more likely to have drug problems. 17-45% of ADHD adults have histories of alcohol abuse or dependence, while 9-30% have histories of drug abuse or dependence. At the same time the levels of ADHD are much higher among drug abusers than the rest of the population. Some researchers have suggested that the amphetamine-based treatments for ADHD can cause drug problems while others suggest that treating the problem reduces the risks of later drug abuse. A U.S. study of 206 people with ADHD compared those who had had no treatment for the condition, those who had had treatment in the past and those who were being currently treated for it. No differences were found in the prevalence of cigarette smoking, alcohol or drug abuse or dependence between the groups and no differences were found in complications of drug or alcohol use.

Faraone, Stephen V. ... [et al] - A naturalistic study of the effects of pharmacotherapy on substance use disorders among ADHD adults Psychological Medicine 37(12), 1743-1752

'Conduct disorder' and ADHD in girls

Conduct disorder (bad behaviour) in girls is a serious concern and a study using officialy-defined criteria found that 7.1% of women can be diagnosed as having it over the course of their lifetime. Girls with conduct disorder have been found to be at higher risk of arrest, teenage pregnancy and academic failure. There has been a lot of research into the links between conduct disorder and attention deficit hyperactivity disorder (ADHD) in boys but much less research into the links between the two conditions in girls. A 5-year study of 262 girls in the U.S. found that ADHD was a significant risk factor for conduct disorder in childhood and adolescence. Among the girls with ADHD childhood conduct disorder was predicted by paternal antisocial personality disorder while adolescent behaviour problems were predicted by family conflict. Conduct disorder significantly predicted academic, psychiatric and sexual behaviour problems in girls with ADHD.

Monuteaux, Michael C. ... [et al] - Predictors, clinical characteristics, and outcome of conduct disorder in girls with attention-deficit/hyperactivity disorder : a longitudinal study Psychological Medicine 37(12), 1731-1741

Delayed distress for US soldiers

A study of U.S. soldiers returning from the conflict in Iraq has found that it sometimes takes months for mental-health problems to develop meaning that there is the potential for many soldiers to go untreated if they are only assessed immediately on their return from battle. After initial findings that mental-health problems took a while to manifest themselves the U.S. Department of Defense started a second screening, to take place three to six months after the first one. A study of the first group of soldiers (88,235 people) to go through this system found that they reported more mental-health concerns such as post-traumatic stress disorder (PTSD), major depression or alcohol misuse during the second screening than at the first one with 4.4% being referred for mental-health treatment at the initial screening compared to 11.7% at the later one. Althogether 20.3% of active and 42.4% of reserve soldiers were identified as needing referral for mental-health problems. Concerns about interpersonal conflict increased fourfold between the two screenings and soldiers were much more likely to report PTSD symptoms at the second screening.

You can find out more about this research at

http://psychcentral.com/news/2007/11/14/military-ptsd-may-take-time-to-develop/1534.html

Asthma and PTSD

Several studies have linked asthma to anxiety disorders and depression. Now a U.S. study of 3,065 pairs of twins who both served in the Vietnam war has suggested that asthma could be linked to post-traumatic stress disorder (PTSD) as well. The study found that among all twins those who suffered from the most PTSD symptoms were 2.3 times as likely to have asthma compared to those who suffered from the least PTSD symptoms. The scientists found the association between asthma and PTSD existed even after they took into account factors such as cigarette smoking, obesity and socioeconomic status, all of which are associated with both anxiety disorders and asthma.

You can find out more about the research at

http://psychcentral.com/news/2007/11/15/link-between-asthma-and-ptsd/1539.html

Schizophrenia and appendicitis

People with schizophrenia often suffer more from ill health than other people and a new Taiwanese study has added another health problem to the list of conditions schizophrenics are more vulnerable to. Researchers looked at the records of 100,000 people, aged 15 and over, hospitalised for appendicitis between 1997 and 2001. They found that 46.7% of schizophrenic, 43.4% of people with other mental-health problems but only 25.1% of other people went on to develop a ruptured appendix. After adjusting for age, gender, ethnicity, socioeconomic background and hospital characteristics the increased risk associated with other mental-health problems disappeared. However, once all the other factors were taken into account patients with schizoprenia were almost three times as likely to suffer from a ruptured appendix as the rest of the population.

You can find out more about this research at

http://psychcentral.com/news/2007/11/15/mental-disorders-and-appendicitis/1540.html

Alzheimer's, ethnicity and survival

A study of 31,000 people with Alzheimer's disease in the U.S. found that people diagnosed with the condition lived, on average, 4.8 years after their diagnosis. However, there were considerable differences in the length of time people from different ethnic backgrounds survived. People from a Latin American background lived 40% longer than White people while African-Americans lived 15% longer. Asian, American Indian and White people all lived with the disease for about the same length of time.

You can find out more about this research at

http://psychcentral.com/news/2007/11/15/alzheimers-life-span-varies-by-ethnicity/1541.html

Early puberty and children's backgrounds

Early puberty in girls has been found to have a negative effect on children's health, increasing the risk of mood disorders, substance abuse, adolescent pregnancy and cancers of the reproductive system. Researchers at the University of Arizona and the University of Wisconsin, Madison, followed 227 pre-school children over a number of years to see which factors led to girls going through puberty earlier. They found that children living in families with greater parental supportiveness (from both mothers and fathers), less marital conflict and less paternal depression went through puberty later than other children. Those whose mothers also started puberty later, who were from better-off families, whose mothers were more supportive of them in pre-school and who were lighter in early childhood also developed later than other children.

You can find out more about this research at

http://psychcentral.com/news/2007/11/16/stable-family-slows-onset-of-puberty/1547.html

Men, women and responses to stress

Women have twice the rate of depression and anxiety of men and scientists from the University of Pennsylvania School of Medicine have found that different parts of the brain are activated under stress in the two sexes. Researchers studied 16 men and 16 women who received brain scans before, during and after they underwent a challenging arithmetic test under pressure. Participants were frequently prompted for a faster performance and asked to restart the test if they responded incorrectly. In men it was found that stress was associated with increased activity in the right pre-frontal cortex and decreased activity in the left orbitofrontal cortex. In women the limbic system - a part of the brain primarily involved in emotions - showed more activity. Women showed more lasting effects from the task although men produced more of the stress-related hormone cortisol. The research backs up evolutionary theories that men are primed for a 'fight-or-flight' response to stress whereas women tend to a 'tend and befriend' approach nurturing children and strengthening social ties to deal with adversity

Stress and cancer

Stress has been implicated in a number of different illnesses, including cancer. In the past researchers have concentrated on the way stress weakens the immune system, allowing certain tumours to evade the body's defences. Now scientists at Ohio State University believe that stress may also speed the growth of tumours as well. A chemical called noradrenaline is produced at times of stress and the researchers looked at how this chemical affected cancer cells, in the laboratory. The scientists studied multiple myeloma cells, a blood cancer which kills 10,000 Americans a year. They found that in cells in the early stages of cancer noradrenaline stimulated the cells to produce a substance called vascular endothelial growth factor which in turn stimulated the production of blood vessels allowing the cancer to grow and flourish. The research shows yet another way in which stress can damage your health and may lead to new cancer treatments as scientists try to find ways to block the action of noradrenaline.

You can find out more about this research at

http://psychcentral.com/news/2007/11/20/stress-hormone-can-speed-cancer/1561.html

Stress in older workers

A U.S. study into stress at work has found that older workers generally cope better than younger ones, who struggle with the demands of raising a family and job security. The study of 1,544 people between the ages of 53 and 85 - all of whom were working at least 20 hours a week - by researchers at the University of Michigan examined the different kinds of work stress experienced by the participants and their levels of happiness and physical health. Just over half said that they suffered from competing demands made on them at work and 47% agreed that time pressures were a source of job stress. However, only 19% said that they had poor job security, only 15% said that work interfered with their personal lives and only 2% said that their personal lives interfered with their work. Those workers who experienced less job stress were more satisfied with their life and in better physical health than those who had higher levels of stress at work.

You can find out more about the study at

http://www.ns.umich.edu/htdocs/releases/story.php?id=6188

Auditory hallucinations in children

Hallucinations are considered to be a significant symptom of psychopathology in adulthood but children also experience auditory hallucinations. Children with conduct and emotional disorders, affective syndromes, migraines, anxiety, and adjustment disorders can all have auditory hallucinations. An Australian study of children being seen by community mental health services found strong associations between auditory hallucinations in non-psychotic children and family dysfunction and break-up. The children who heard things also had significant levels of anxiety and depression. Half of the children in the study had imaginary friends.

Best, Nicole T. and Mertin, Peter - Correlates of auditory hallucinations in nonpsychotic children Clinical Child Psychology and Psychiatry October 2007, 12(4), 611-623

Net suicide

Japan has one of the highest suicide rates in the world with 32,325 people killing themselves there in 2004. Recently a new phenomenon called net suicide has developed in which suicide pacts are pre-arranged between strangers who meet over the Internet. It is thought that as many as 60 people a year die in this way. In February 2005 the death of two strangers in London was thought to be Britain's first Internet suicide leading to concerns that it could take root here. An article in the journal Clinical Child Psychology and Psychiatry examines net suicide and, in particular, considers its implications for child and adolescent mental health.

Naito, Ayumi - Internet suicide in Japan : implications for child and adolescent mental health Clinical Child Psychology and Psychiatry October 2007, 12(4), 583-597