Neighbourhood and mental health

The possiblity that the quality of neighbourhood as well as the characteristics of individuals can affect people's mental health is of increasing interest to researchers. Factors that are though to be influential include social capital - defined as 'the features of social organisation that facilitate coordination and cooperation for mutual benefit' - and the quality of the residential environment. However, a study of 1,058 individuals between 16 and 75 in Neath, South Wales found that - once all other factors had been taken into account - people's postcodes accounted for only 2% of the variation in levels of mental illness. This compared to 37% for people's household suggesting that domestic circumstances might be more significant than residential ones after all.

Thomas, Hollie ... [et al] - Mental health and quality of residential environment British Journal of Psychiatry December 2007, 191, 500-505

Intellectual disabilities and mental health problems in children

A study of 18,415 children and adolescents in the U.K. compared the rate of mental-health problems among those with intellectual disabilities to that in other children. The researchers found that the prevalence of psychiatric disorders was 36% among children with intellectual disabilities compared to 8% among children without. Children with intellectual disabilities accounted for 14% of all British children with a diagnosable psychiatric disorder. Children with intellectual disabilities were 33.4 times more likely to suffer from autism, 8.4 times more likely to be hyperkinetic and 5.7 times more likely to have conduct disorders. The cumulative risk of exposure to social disadvantage was associated with increased prevalence of mental health problems.

Emerson, Eric and Hatton, Chris - Mental health of children and adolescents with intellectual disabilities in Britain British Journal of Psychiatry December 2007, 191, 493-499

Polypharmacy in pregnancy

There is increasing concern about the use of multiple medications (polypharmacy) among people with mental-health problems and this is particularly the case when people are pregnant as the effects of taking multiple medications during pregnancy are unknown. A study of 115 pregnant women with mental-health problems in the U.S. found that the average number of medications taken during pregnancy was three although over a quarter (26.8%) of the women took between six and ten different drugs over the course of their pregnancy. The researchers found that no dose changes were made to the prescribed medications to reflect changes in metabolism during pregnancy and that the most frequently prescribed drugs for this group of women were from the opiate family.

Peindl, Kathleen S. ... [et al] - Polypharmacy in pregnant women with major psychiatric illnesses : a pilot study Journal of Psychiatric Practice, November 2007, 13(6), 385-392

Paedophiles and sex offenders compared

A study of 837 sex offenders in New York compared those who had committed offences against adolescents and adults with those who had committed offences against children. Paedophiles were older and less likely to use a weapon or force than other offenders. They were more likely to molest males or victims of both genders than female victims. They were also more likely to commit multiple acts and engage in 'deviant intercourse' (oral and anal sex) with their victims and less likely to have 'conventional' sex with them. Offenders against adolescents tended to fall halfway between paedophiles and other sex offenders.

Cohen, Lisa J. ... [et al] - Comparison of sexual offenders against children with sexual offenders against adolescents and adults : data from the New York State Sex Offender Registry Journal of Psychiatric Practice November 2007, 13(6), 373-384

OCD and sexual functioning

Obsessive-compulsive disorder (OCD) is often associated with difficulties in interpersonal relationships. The more severe people's OCD the greater the difficulties but even subclinical (some of the symptoms but not the full-blown disorder) OCD is associated with some impairment in social functioning. People with OCD often have low self-esteem, a sense of shame and dissatisfaction with their social functioning and avoid activities and contact with other people. A study of OCD and romantic functioning looked at 64 people with the condition who completed measures of OCD symptoms, depressive symptoms, intimacy, self-disclosure, relationship satisfaction and relationship worry. The more severe people's OCD the more problems they had with intimacy, relationship satisfaction and self-disclosure. However, two compulsive behaviours (washing and neutralizing) were positively correlated with several relationship variables. Fear of contamination from sexual activity was linked to the severity of OCD symptoms.

Abbey, Richard D., Clopton, James R. and Humphreys, Joy D. - Obsessive-compulsive disorder and romantic functioning Journal of Clinical Psychology December 2007, 63(12), 1181-1192

Expressed emotion and depression

Expressed emotion is a measure of the amount of criticism, hostility and emotional over-involvement that a relative expresses in reference to a psychiatric patient and has been shown to have negative effects on symptom fluctuations, treatment outcomes and relapse rates across many disorders. However, three recent studies have shown no linkage between expressed emotion and these variables. These studies asked about influential people in patients' lives not people they lived with so a study of 66 students suffering from depression in the U.S. compared those who experienced expressed emotion from people they lived with to those who experienced it from other, significant people in their lives. Only expressed emotion from family members or romantic partners who lived with participants predicted a change in depressive symptoms.

Renshaw, Keith D. - Perceived criticism only matters when it comes from those you live with Journal of Clinical Psychology December 2007, 1171-1179

Anorexia in twins

A new study of nearly 4,500 twins has found that men who have a twin sister are more likely to develop anorexia than other men, including those who have a twin brother. The study of Swedish twins born between 1935 and 1958 found that female twins were more likely than male twins to develop anorexia but where one twin was male and the other female the man's risk was as great as the woman's. The authors suggested that "a plausible explanation for this phenomenon is that in pregnancies bearing a female foetus a substance is produced, probably hormonal, that increases the risk of having anorexia nervosa in adulthood".

You can find out more about this research at

http://psychcentral.com/news/2007/12/05/males-with-female-twin-risk-anorexia/1616.html

Schizophrenia and cancer

Despite often having poor diets and smoking people with schizophrenia have lower rates of cancer than other people. Many of the genes associated with schizophrenia are the same as the genes associated with cancer but the cells that contain the genes use them in different ways in the two disorders. In cancer the genes cause the cells to go into metabolic overdrive and multiply rapidly whereas in schizophrenia the cells slow to a crawl. It is hoped that further research will allow doctors to target these pathways leading to treatments for both schizophrenia and cancer.

You can find out more about the latest research on this topic at

http://psychcentral.com/news/2007/12/10/schizophrenia-and-lower-rates-of-cancer/1633.html

CBT and PTSD

An Israeli study of 248 adults with early symptoms of post-traumatic stress disorder (PTSD) has found that cognitive therapy initiated within a month of the event may help to prevent subsequent trauma-related suffering. Patients were treated for 12 weeks with cognitive therapy, cognitive behavioural therapy, an antidepressant, placebo or no intervention at all. After three months those patients who had had cognitive or cognitive behavioural therapy had significantly less PTSD symptoms than the other groups.

You can find out more about this study at

http://psychcentral.com/news/2007/12/10/early-psychotherapy-aids-recovery-from-stressful-events/1634.html

Depression and heart attacks

New research suggests that depression nearly triples the risk of death following a heart attack. The U.S. study showed that among 360 depressed post-heart-attack patients followed for more than six years those who did not recover from their depression in the first six months were more than twice as likely to die. Depression has increasingly been recognized to increase the risk for cardiovascular disease ; possible reasons for this association include sticky platelets, a condition depressed people are likely to have, or autonomic nervous activity, which increase heart irritability.

You can find out more about this research at

http://psychcentral.com/news/2007/12/10/depression-can-be-deadly-for-cardiac-survivors/1635.html

Rhythym and blues in bipolar patients

Interpersonal and social rhythym therapy (ISRT) is a treatment for bipolar disorder which aims to help patients maintain a consistent sleep schedule and waking-up time. People with bipolar disorder tend to have extremely sensitive body clocks which makes it much more difficult for them to recover from disruptions in sleep and routine. These can lead to night-time sleepiness and daytime exhaustion which can increase the risk of new episodes of mania and depression. ISRT involves patients working with a therapist and using a self-monitoring instrument to record and monitor the regularity of their daily routines. A study of 175 patients by researchers at the University of Pittsburgh compared the effectiveness of ISRT and conventional treatment focusing on patients' mood symptoms and the management of medication side effects (both groups took lithium carbonate). The study found that patients who participated in ISRT were able to go longer without a new episode of mania or depression than those who received clinical management.

You can find out more about this research at

http://psychcentral.com/news/2007/12/10/regular-routines-sleep-helps-improve-bipolar/1639.html

Divorce and parenting

A large U.S. study by researchers at the University of Alberta compared parenting practices in 208 divorced households to those in 4,796 intact ones. The study looked at three different measures of parenting behaviour - nurturing, consistent and punitive parenting - and found no differences between divorced and stably married parents either before or after a divorce had occured.

You can find out more about this study at

http://psychcentral.com/news/2007/12/11/parenting-skills-intact-after-divorce/1641.html

Birth weight and depression

A long-term study of people's mental health by researchers at Cambridge University and the Medical Research Council has found that events very early in people's lives can have effects on their mental health years later. The forty-year study focused on anxiety and depression and found that those with poorer mental health over time were more likely to be smaller at birth and tended to reach developmental milestones later than those with good mental health. The differences with regards to early development were apparent not only for those with severe problems with their mental health but also for those with mild to moderate symptoms of depression and anxiety over time. The study supports a proposed 'fetal programming' model for depression which suggests that prenatal stress may result in permanent maladaptive changes to the developing child's brain.

You can read more about this research at

http://psychcentral.com/news/2007/12/11/understanding-mood-and-anxiety-disorders/1643.html

Spiritual interventions : how effective are they ?

The term spirituality refers to transcendent experiences with, and understandings about, God or other forces in the universe while 'religious' refers to an institutional system of beliefs, values and activities based on spiritual creeds. People can be neither, one or the other or both but both concepts have consistently been found to have an impact on people's mental health and religious or spiritual interventions have become more common in psychotherapy. A review of 31 studies of spiritual therapies carried out between 1984 and 2005 found that spiritual therapies could be effective for individuals with depression, anxiety, stress and eating disorders.

Smith, Timothy B., Bartz, Jeremy and Richards, P. Scott - Outcomes of religious and spiritual adaptations to psychotherapy : a meta-analytic review Psychotherapy Research November 2007, 17(6), 643-655

Dementia and euthanasia

A survey of 725 people in London and the South East has found that in the face of severe dementia less than 40% of people would wish to be resuscitated after a heart attack, nearly three-quarters wanted to be allowed to die passively and almost 60% agreed with euthanasia. People were more likely to be in favour of life-sustaining treatments for their partner than for themselves but less likely to be in favour of euthanasia for their partners than themselves. White people were significantly more likely to refuse life-sustaining treatment and to agree to euthanasia compared to Black and Asian people.

Williams, Nia - Public attitudes to life-sustaining treatments and euthanasia in dementia International Journal of Geriatric Psychiatry December 2007, 22(12), 1229-1234

Benzodiazepines and cognition

Despite advice to keep the duration of treatment short benzodiazepines are often prescribed for long periods of time, particularly in older people. Many people think benzodiazepines have a negative effect on people's cognition although the evidence from the research so far is inconclusive. A study of 2,105 people over 62 in Holland looked at people's benzodiazepine usage and tested their memory, intelligence and cognitive functioning over a 9-year period. At the end of the study the researchers found that benzodiazepines had a small, but statistically significant negative effect on people's long-term cognitive functioning.

Bierman, E. J.M. ... [et al] - The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent ? International Journal of Geriatric Psychiatry December 2007, 22(12), 1194-1200

Depression and diabetes

Depression is common among people with diabetes and can contribute to people not taking medicines, not following prescribed diets and an overall reduction in the quality of life for people with the condition. A five-year study of depression among primary-care patients in New York, Philadelphia and Pittsburgh found that depressed people with diabetes who received more resources for depression were half as likely to die over the course of the study than those who had recieved no help for their depression.

You can find out more about this study at

http://psychcentral.com/news/2007/11/28/depression-care-for-diabetics-2/1588.html

Genes, gender and depression

Two studies of the interactions between genes, gender, stress and depression have shown that the relationships between these different factors are more complex than many newspaper reports would suggest. Researchers looked at two groups of people one who had had deprived childhoods (suffered stress early in life) and the other who were caregivers (suffered stress later in life). They examined levels of stress and depression and related them to a variation in a gene that regulates levels of serotonin, a brain chemical known to be linked to depression. The researchers found that women with the 'short' version of the gene were more likely to suffer from depression when they were stressed whereas for men it was the 'long' version of the gene which placed them more at risk. The effect of the stress was consistent regardless of whether it occured early or late in life. The researchers suggested that those people with the gene variation ('short' in women 'long' in men) that increased the risk of stress-related depression and who are in stressful situations could benefit from preventive measures such as positive social support or training in stress-coping skills to prevent them from becoming depressed.

You can find out more about this study at

http://psychcentral.com/news/2007/11/30/genetics-place-women-at-risk-for-depression/1595.html

Brain activity and anorexia

A comparison of brain functioning between anorexic and normal-weight women has found differences in functioning between the two groups that could help to shed light on the development of the condition. Participants in the study were asked to guess whether a flashing question mark on a screen represented a number higher or lower than five. Correct guesses were rewarded with $2 while incorrect guesses forfeited $1. At the same time the women's brain activity was monitored. In the healthy women the brain region responsible for emotional responses, the anterior ventral striatum, showed strong differences between winning and losing, while the same regions in the anorexic women showed much less response. However, the caudate regions of the brains of the anorexic women, a region which deals with outcome and planning, were more active, suggesting that they were more focused on the consequences of their choices. The healthy women responded to wins and losses by living in the moment and moving on to the next task while the anorexic women tried to find strategies within the game and were more concerned about making mistakes. This fits in with previous research which shows that anorexics tend to worry about the future and be more perfectionist than other people.

You can find out more about this research at

http://psychcentral.com/news/2007/12/03/new-insights-on-anorexia/1603.html

Parkinson's and mental-health problems

A study of 1,850 relatives of people with Parkinson's disease in Minnesota, U.S. has found that they are at an increased risk of developing depression and anxiety disorders. Previous studies have shown that relatives of patients with Parkinson's disease have an increased risk of developing the condition themselves, and of cognitive impairment and dementia, but their risk of developing other psychiatric disorders was unknown. The study looked at brothers, sisters, mothers, fathers, sons and daughters of people with Parkinson's disease and used medical records to obtain information about mental-health problems.

You can find out more about the study at

http://psychcentral.com/news/2007/12/04/mental-disorders-among-parkinsons-family-members/1609.html