Schizophrenia rates in different countries

It has long been thought that schizophrenia has a better prognosis in countries in the developing world than in developed countries. Evidence has come from three World Health Organization (WHO) studies: the International Pilot Study of Schizophrenia, the Determinants of Outcome of Severe Mental Disorder study and the International Study of Schizophrenia. A review of research conducted outside the auspices of WHO looked at 23 studies of schizophrenia outcomes in 11 low- and middle- income countries. The study looked at clinical, disability and social outcomes and found little difference compared to more-developed countries. The researchers concluded that 'it is time to re-examine presumed wisdom about schizophrenia outcomes in low- and middle-income countries'

Cohen, Alex ... [et al] - Questioning an axiom: better prognosis for schizophrenia in the developing world? Schizophrenia Bulletin 34(2), 229-244

Abdominal obesity and Alzheimer's

A study of 6,583 people in northern California measured their abdominal fat between the ages of 40 and 45 then followed them up an average of 36 years later. By that time 16% of the participants had been diagnosed with dementia. A pot belly increased the risk of dementia regardless of whether the participants were of normal weight, overweight or obese and regardless of existing health conditions including diabetes, stroke and cardiovascular disease. Those who were overweight with a large belly were at 2.3 times greater risk while those who were obese with a large belly were at 3.6 times greater risk. Women were more likely than men to have abdominal obesity, along with non-whites, smokers, people with high blood pressure, high cholesterol or diabetes and those who were less well educated.

You can read more about this research at

http://psychcentral.com/news/2008/03/28/big-belly-could-up-risk-of-dementia/2092.html

Genetics and schizophrenia

Emerging evidence suggests that many people with schizophrenia have small genetic abnormalities that affected their brain in childhood and adolescence. In a series of new studies on adult-onset schizophrenia scientists from the National Institute for Health in the U.S. found that people with the condition possessed high rates of rare genetic deletions and duplications that apparently disrupted their brain during youth. The genes affected in patients were involved in creating the infrastructure by which neurons communicate, neuronal growth, migration, proliferation, differentiation and cell death. The genetic abnormalities were found in 15% of the adult-onset patients and 20% of the childhood- or adolescent-onset schizophrenia sufferers compared to only 5% of a healthy control group. The mutations occured across the whole of the genome and were often specific to single cases or families ; virtually every mutation in a sample of 150 adults with schizophrenia was different.

You can find out more about this research at

http://psychcentral.com/news/2008/03/31/genetic-disturbance-linked-to-schizophrenia/2097.html

Young families and happiness

It is often thought that those people who start a family early miss out on career opportunities, make poor choices of partners and can experience other problems. A study of 8,000 young adults in the U.S. compared those who set up a family over the course of a five-year period to those who remained single or who had not had children. Those who had set up a family early in their lives were more likely to come from low-income families, have less well-educated parents and to have lived in a household with one or no biological parents. However, despite these disadvantages there were very few differences in overall happiness between the two groups. Those who had broken up with a live-in partner had higher levels of depression but this group only made up 14% of the people in the 'early families' group. The researchers speculated that leaving to live together, marry or have children may provide an opportunity to escape from an unloving home and create a more positive family.

You can read more about this research at

http://psychcentral.com/news/2008/03/31/delayed-marriage-and-parenting-not-always-best/2098.html

Paranoia on the Piccadilly Line

A virtual-reality Tube ride used by researchers at the Institute of Psychiatry in London has found that suspicious and paranoid thoughts are far more common in the general population than was previously thought and are almost as common as anxiety and depression. Wearing virtual-reality headsets 200 participants walked around a virtual Tube-train carriage in a four-minute journey between station stops. The carriage contained computer-generated people who breathed, looked around and sometimes met the gaze of the participants. The participants interpreted the same computer characters very differently. The most common reaction was to find them friendly or neutral but almost 40% of the participants experienced at least one paranoid thought. Those who were anxious, worried, focused on the worst-case scenario and had low self-esteem were the most likely to have paranoid thoughts.

You can find out more about this research at

http://psychcentral.com/news/2008/04/01/paranoid-thoughts-are-relatively-common/2104.html

Autism and PMS

Most menstruating women experience some pre-menstrual syndromes (PMS) with about 20-40% seeking medical attention. A study of 62 women in the UK compared women with a learning disability but not autism to those with both a learning disability and autism. The study found that while only 11% of the non-autistic group suffered from PMS 92% of the autistic group did so.

Obaydi, H. and Puri, B.K. - Prevalence of premenstrual syndrome in autism: a prospective, observer-rated study The Journal of International Medical Research March/April 2008, 36(2), 269-272

Social anxiety and insomnia

Anxiety is commonly associated with insomnia. Social anxiety disorder is one of the most common forms of anxiety and a U.S. study of 176 college students looked into the links between social anxiety and insomnia. The researchers found that social anxiety was associated with increased insomnia symptoms, sleep dissatisfaction, sleep-related functional impairment, perception of a sleep problem to others and distress about sleep problems. The relationship between social anxiety and insomnia was mediated (influenced) by depressive symptoms which were thought to play an important role in the link between social anxiety and poor-quality sleep.

Buckner, Julia D. ... [et al] - Social anxiety and insomnia : the mediating role of depressive symptoms Depression and Anxiety 2008, 25(2), 124-130

Bipolar disorder and anxiety

Bipolar disorders are characterized by mood disturbances with alternating periods of depression and mania or hypomania. Bipolar disorder can often occur alongside other mental illnesses including substance abuse, eating disorders and conduct disorder. Anxiety disorders, such as panic disorder, post-traumatic stress disorder, and obsessive-compulsive disorder are the most frequent types of co-occuring conditions and a study of 44 treatment-resistant bipolar patients in Seattle compared those with and without anxiety disorders. The researchers found that 'on several measures, bipolar patients with comorbid anxiety disorders were more significantly ill than bipolar patients without comorbid anxiety disorders'. Those bipolar patients with anxiety disorders had an earlier onset of illness, were more depressed and had a lower level of functioning. They had a more frequent history of substance abuse and were more likely to have suicidal thoughts.

Lee, John H. and Dunner, David L. - The effect of anxiety disorder comorbidity on treatment resistant bipolar disorders Depression and Anxiety 2008, 25(2), 91-97

Personality traits and treatment for depression

Certain personality traits are thought to contribute towards the development and maintenance of depression. Individuals high in self-criticism are characterized as highly competitive and judgmental towards themselves and others and are highly sensitive to stressors because of a fear of disapproval or criticism from others. People high in dependency need more emotional support but are not necessarily more satisfied with their interactions and relationships and are more likely to have problems when confronted with an interpersonal stressor. A Canadian study of 102 people with depression divided them into three groups. One group received cognitive-behavioural therapy (CBT), another group received interpersonal therapy while a third group received pharmacotherapy with clinical management. The researchers found that high levels of self-criticism led to a reduction in the effectiveness of interpersonal therapy but actually proved helpful in those being given pharmacotherapy. A tendency towards dependency predicted a worse response to CBT.

Marshall, Margarita B. ... [et al] - Self-criticism predicts differential response to treatment for major depression Journal of Clinical Psychology March 2008, 64(3), 231-244

Genes, environment and PTSD

Post-traumatic stress disorder (PTSD) is a debilitating, stress-related psychiatric disorder with prevalence rates of about 7-8% in the U.S. population and with much higher rates among military veterans and those living in high-violence areas. PTSD suffered as a result of abuse in childhood is also a significant problem. A U.S. study of 900 black men and women who had suffered from significant levels of childhood abuse as well as other types of trauma found that variations in a gene called FKBP5 influenced the interaction between the levels of abuse in childhood and the tendency of people to develop PTSD. The gene is related to stress response and the gene-environment interaction remained significant even when depression, age, sex and levels of trauma other than child abuse were taken into account.

You can read more about this research at

http://psychcentral.com/news/2008/03/18/genes-may-increase-risk-for-ptsd/2045.html

Girls with ADHD fifteen years on

A study of 881 Canadian girls which followed them from the ages of six to twenty-one looked into how hyperactive or aggressive behaviour in childhood could affect early adulthood. The researchers found that one in ten of the girls monitored showed high levels of hyperactive behaviour and another one in ten showed high levels of hyperactivity and physically aggressive behaviour. Hyperactive and/or aggressive girls were more likely to take up smoking and perform poorly in school. Girls with both hyperactivity and physical aggression reported more physical and psychological aggression towards their partners, were more likely to become pregnant and were more likely to be dependent on welfare.

You can find out more about this research at

http://psychcentral.com/news/2008/03/20/girls-with-adhd-face-risks-as-adults/2057.html

Marrriage and blood pressure

A study of 303 people in the U.S. compared the blood pressure of happily-married people, unhappily-married people and single people. The participants in the study were given portable blood-pressure monitors to wear for 24 hours. The monitors recorded blood pressure at random intervals throughout the day - even while participants were asleep. Each participant's blood pressure was recorded about 72 times. All participants drew up a list of friends in their social network and answered questions about the quality of those relationships. Married participants also completed questionnaires on the quality of the relationship with their spouses. Blood pressure at night - a risk factor for cardiovascular problems - was much lower in married people, particularly happily-married people, than in single people although overall unhappily married people had higher blood pressure than either single or happily-married people. Men and women in happy marriages scored four points lower on 24-hour blood pressure than single people and even having a supportive network of friends did not translate into improved blood pressure for single of unhappily-married people.

You can read more about this research at

http://psychcentral.com/news/2008/03/20/health-benefits-of-a-happy-marriage/2059.html

Infra-red and Alzheimer's diagnosis

Although there is no cure for Alzheimer's disease treatments can slow its progress especially if they are administered early on. Because Alzheimer's affects the brain it is very difficult to make a physical diagnosis of the condition. A diagnosis is usually made on the basis of symptoms, sometimes being confirmed retrospectively via post mortem examination. However, a new technique using near-infrared light could allow Alzheimer's to be diagnosed much earlier. Near-infrared light can safely penetrate the skull and pass harmlessly through the brain. Inside the head some of the infrared light scatters, however, and how the light scatters can tell researchers about the condition of the brain. The plaques in the brain formed in Alzheimer's disease scatter the light differently from normal tissue - a difference the researchers were able to pick up and measure.

You can find out more about this research at

http://psychcentral.com/news/2008/03/21/new-method-to-detect-alzheimers/2064.html

Depression and diabetes

A study of 2,400 residents of Saskatchewan, Canada, who were diagnosed with depression and who were taking antidepressants has found that they had a 30% increased risk of type 2 (adult onset) diabetes. The participants in the study were divided into four groups : those who took older, tricyclic antidepressants ; those who took newer SSRI antidepressants ; those who took a combination of older and newer drugs and those in the process of switching from one medication to another. The risk of developing type 2 diabetes was almost doubled for those patients who were using a combination of older and newer antidepressants. People are usually prescribed more than one type of medication if they have severe depression or if they are having a problem finding the right therapy.

You can find out more about this research at

http://psychcentral.com/news/2008/03/26/depression-ups-risk-of-diabetes/2079.html

Ex-forensic patients in the community

People with severe mental disorders and a history of violent offending are often seen as a difficult-to-manage population: most have schizophrenia or severe affective disorders while some suffer from severe personality disorders. They are over-represented among prisoners and are characterized by a high rate of crime recidivism, poor compliance with community programmes and aftercare and homelessness. People often go from secure units to a non-forensic residential facility and an Italian survey of 2,962 residents of such facilities compared those who had previously been in forensic units with those who had never been in one. The majority had a diagnosis of schizophrenia or a related disorder but overall the 'symptom profile' was similar between the two groups. The rate of violent behaviour of ex-forensic patients was low and limited to a very small group. The researchers concluded that the ex-forensic patients would be 'able to remain in this type of accomodation without posing a significant danger in terms of violent behaviour or threats'.

Preti, Antonio ... [et al] - A comparison between former forensic and non-forensic patients living in psychiatric residential facilities: a national survey in Italy Journal of Forensic Psychiatry and Psychology March 2008, 19(1), 108-126

Metabolic syndrome in forensic inpatients

Metabolic syndrome is a combination of disturbed glucose and insulin metabolism, being overweight with abdominal fat distribution, dyslipidaemia and high blood pressure and is often a precursor of type II diabetes and cardiovascular problems. It is particularly common in people with schizophrenia as the second generation antipsychotics used to treat the condition can lead to weight gain. A study of 221 people in Finland looked at the factors influencing metabolic syndrome in psychotic forensic inpatients. The researchers found that using clozapine, quetiapine and olanzapine increased the risk of developing metabolic syndrome by 8.1, 7.7 and 3.6 times respectively. However, increased levels of 'good' cholesterol were found in participants who were taking SSRI antidepressants and who had been diagnosed with alcohol dependence at some point, even if they were not alcohol-dependent at the time of the study.

Ojala, Kari ... [et al] - Characterization of metabolic syndrome among forensic psychiatric inpatients Journal of Forensic Psychiatry and Psychology March 2008, 19(1), 33-51

AMBR and eating disorders

The Attunement in Mind, Body and Relationships (AMBR) programme uses cognitive behaviour therapy, dialectical behaviour therapy and innovative methods such as interactive discourse, meditation and yoga to treat eating disorders. A small-scale six-eight week study into the effectiveness of the AMBR programme found that it reduced participants' desire to be thinner, concern with dieting, fear of gaining weight and body dissatisfaction.

Cook-Cottone, Catherine, Beck, Meredith and Kane, Linda - Manualized group treatment of eating disorders: Attunement in Mind, Body and Relationship (AMBR) Journal for Specialists in Group Work March 2008, 33(1), 61-83

Group work for fathers

Research and theories about child-rearing have tended to concentrate on the role and influence of mothers rather than fathers. However, in the last few years there has been much more research into fatherhood, pointing to its importance in exerting a positive influence on areas such as academic performance, ego and moral development, communication, individual well being and relationships. Involvement of fathers has been found to promote healthier adaptation in adolescents, prevent the development of stereotypical attitudes, problems with substance abuse and sexual activity and involvement with the police. This has led to the development of fathering programmes. The Re:Membering Fatherhood programme is designed to strengthen a father's capacity, self-awareness and confidence in performing the nurturing dimensions of fatherhood and to strengthen families as a whole by preparing them to play a more meaningful and active fathering role. A study of 29 fathers using the programme found that it led to significant improvements for fathers and their participation within the family including role performance, involvement, communication, task accomplishment within the family, self-esteem, a sense of increased competence and decreased stress in parenting.

Gearing, Robert Edward ... [et al] - Re:membering fatherhood: evaluating the impact of a group intervention on fathering Journal for Specialists in Group Work March 2008, 33(1), 22-42

Physical symptoms in disaster survivors

People who have survived disasters often suffer from psychosomatic symptoms such as fatigue, headaches and pains in their bones and muscles. However, little is known about the risk factors for these symptoms among disaster survivors. A study of 1,567 survivors of an explosion at a fireworks depot in Holland, which killed 23 people in May 2000, found that women, immigrants and people with pre-existing psychological problems were more likely to suffer from psychosomatic symptoms. Intrusive thoughts, avoidance, depression, anxiety and sleeping problems all played a part in perpetuating physical symptoms.

Berg, B. van den ... [et al] - Risk factors for physical symptoms after a disaster: a longitudinal study Psychological Medicine April 2008, 38(4), 499-510

Mental health after Chernobyl

The Chernobyl nuclear power plant accident in April 1986 was the world's worst nuclear disaster. 31 people died of radiation sickness in its immediate aftermath and another 19 people had died from the long-term effects of radiation poisoning by 2005. Around 600,000 people were sent in to help with the clean-up and although these people are regularly checked for cancer there has been little research into their psychological well-being. A study of 692 people in the Ukraine compared people who had taken part in the clean-up in 1986 with other people living in the area. They found that clean-up workers had slightly higher rates of depression (18% vs 13.1%), were more than twice as likely to have had suicidal thoughts, were over four times more likely to suffer from post-traumatic stress disorder and over five times more likely to suffer from headaches.

Loganovsky, K. ... [et al] - The mental health of clean-up workers 18 years after the Chernobyl accident Psychological Medicine April 2008, 38(4), 481-488