Medication adherence and antidepressants

Major depression is a pervasive and debilitating mental disorder that affects families and individuals throughout their lives. The prevalence of major depression is 2.9% in Western societies with 12.6% of people suffering from minor depression. Antidepressants can be highly effective but it is important that patients keep taking them for four-to-six months with those people most at risk taking them for at least a year. However, patients with major depression do not always stick to their medication regimes which can drastically reduce the effectiveness of the drugs. A Taiwanese study of 181 patients looked at their compliance with their medication. About 50% of the patients reported good medication adherence. The predictors of adherence to medication were a higher income (even though patients do not pay for these drugs in Taiwan), a feeling that the antidepressants were effective and an understanding of the importance of continuing to take the drugs.

Yeh, Mei-Yu ... [et al] - Predictors of adherence to an antidepressant medication regimen among patients diagnosed with depression in Taiwan Issues in Mental Health Nursing 29(7), 701-717

Child abuse and suicide

A study of 3,338 children in Quebec looked into the prevalence of child abuse - both sexual and physical - and its links to suicidal behaviour later in life. Sexual abuse was reported by 9.9% of the children (men 2.7%, women 18%) physical abuse by 20.6% (men 26.3%, women 12.8%) and both types of abuse by 8.2% (men 4%, women 12.8%). In a third of the sexual abuse cases the abuser was a family member and in about two-thirds of cases the abuse occured on multiple occasions. Overall participants with no history of childhood abuse were less likely to demonstrate suicidal behaviour than those who had been abused. Children who had not been abused had the lowest prevalence of suicidal behaviour (6%) followed by those who had been physically abused (11.7%), those who had been sexually abused (14.8%) and those who had suffered both types of abuse (32.2%). Repeated abuse was more strongly associated with suicide attempts than a single incidence of abuse and abuse by immediate family members was linked to a higher level of risk than abuse by other family members or by strangers.

You can read more about this research at

http://psychcentral.com/news/2008/08/04/suicide-risk-among-abused-children/2685.html

Maturation, Mum and Dad and making trouble

A study of 330 girls by researchers at the University of Alabama, Birmingham, looked into the links between early maturation, parenting and delinquent and aggressive behaviour. A quarter of the girls had matured early, defined as starting their periods a year before the average age for females of their racial and ethnic group. Girls who had matured earlier were more likely to be delinquent than other girls but no more likely to be aggressive, unless they also experienced low levels of parental nurturance, communication and knowledge (of what they were doing and who they were friends with). Early maturing girls could be at more risk of delinquency because they are more likely to be accepted by, and form relationships with, older boys who are more likely than younger children to engage in undesirable behaviour.

You can find out more about this research at

http://psychcentral.com/news/2008/08/05/positive-parenting-produces-adult-benefits/2695.html

Fish - it really is brain food!

Silent brain infarcts are small lesions in the brain that, while they have no effect in themselves, can cause cognitive decline, strokes and dementia. A Finnish study of 2,313 people aged 65 or over gave them brain scans at five-year intervals and asked them about their fish consumption in the intervening time. Those people who ate broiled or baked tuna and other fish high in omega-3 fatty acids three or more times per week had a nearly 26% lower risk of having silent brain infarcts, while even eating one portion of this type of fish a week led to a 13% lower risk.

You can find out more about this research at

http://psychcentral.com/news/2008/08/06/fish-aids-memory-of-older-adults/2700.html

Spongebob Squarepants, competition and cognitive control

A number of studies have shown that children with Attention Deficit Hyperactivity Disorder (ADHD) and autism have trouble in controlling their attention. Tangible rewards - such as sweets - have been found to help with this but it is not known whether less tangible ones are effective in improving cognitive control. A study of 77 children by researchers in the Netherlands looked at how children with ADHD and autism could be motivated. The children were given a task in which they had to identify a character from the cartoon Spongebob Squarepants while other characters from the cartoon tried to distract them. The children took the test under two conditions; a neutral one where they took the test on its own merit and a 'motivation' one when they were told that they were competing with other children. Different children took the tasks in different orders to prevent differences in the results simply being due to the children having had more practice in taking the tests. All the children, those with ADHD, those with autism and an unaffected control group improved their performance when they were told they were competing against other children. Although the boys with ADHD were still slower than the control group in the motivation condition they were just as accurate. The children with autism also improved in speed and accuracy in the motivation condition but this was not statistically significant.

Geurts, Hilde M., Luman, Mariolein and van Meel, Catharina S. - What's in a game: the effect of social motivation on interference control in boys with ADHD and autism spectrum disorder Journal of Child Psychology and Psychiatry August 2008, 49(8), 848-857

Face perception in autism

People with autism tend to have difficulties remembering faces, processing facial expressions and knowing which components of faces convey especially important communicative information. However, it is unknown why people with autism have these difficulties. One theory is that because of their lack of interest in socialising autistic people just do not develop the expertise in 'face processing' that other people do. Another theory is that people with autism have difficulty in perceiving all complex objects, not just faces. A study of 60 children by researchers at the University of Pittsburgh tested them on their ability to recognise different faces and different imaginary creatures called greebles which were designed to be subtly different but not to convey any social information through expressions or body language. Compared to the healthy control group the autistic children found it much harder to differentiate between the faces and the greebles suggesting that it was complicated objects rather than faces per se they had trouble processing.

Scherf, K. Suzanne ... [et al] - Atypical development of face and greeble recognition in autism Journal of Child Psychology and Psychiatry August 2008, 49(8), 838-847

Family meals and substance abuse

Eating meals together as a family could lessen the risks of children smoking or taking drugs according to a study of 806 teenagers by researchers at the University of Minnesota. The children were first surveyed at about 13 and asked how often in the past week their family ate together and about their use of marijuana, cigarette and alcohol. The researchers followed up with a second survey by mail five years later. In the second survey the girls who had reported five or more family meals per week had about half the level of substance use. However, boys showed no significant difference in substance use between those who had regular family meals and those who did not.

You can read more about this research

http://psychcentral.com/news/2008/07/25/school-failure-depresses-girls/2657.html

School failure and depression

A study of 808 children in Seattle by researchers at the University of Washington has found that school failure (defined in the study as expulsion, suspension or dropping out of school before year 12) is linked to later depression in girls but not in boys. Overall 45% of the girls and 68% of the boys (who were drawn from a high-crime area in Seattle) had experienced a major school failure. 22% of the girls were suffering from depression, compared to 17% of the boys. Girls who were expelled from school were more than twice as likely to suffer from depression (44% vs 20%). They were also more likely to suffer from depression if they had dropped out (33% vs 19%) or if they had been suspended (28% vs 19%). There was no link between school failure and depression in boys.

You can read more about this research at

http://psychcentral.com/news/2008/07/25/school-failure-depresses-girls/2657.html

Red Bull and risk taking

Red Bull and other 'energy' drinks are popular among younger people who often use them so they can stay up late and carry on partying. Previous research has concentrated on the potential cardiovascular risks of consuming large amounts of caffeine but a new study of 795 undergraduate students by researchers at the University at Buffalo's Research Institute on Addictions has found a link between energy drink consumption and risk-taking. 39% of the sample reported consuming at least one energy drink in the previous month. Men (46%) were more likely than women (31%) and Whites (40%) more likely than Blacks (25%) to consume the drinks. Those who drank energy drinks more than six times a month were three times more likely to have smoked cigarettes, abused prescription drugs and been in a serious fight in the year prior to the study. They were twice as likely to drink alcohol, have alcohol-related problems and use marijuana and were more likely to engage in other forms of risk-taking such as unsafe sex, not using a seatbelt, participating in extreme sports or doing something dangerous on a dare.

You can read more about this research at

http://psychcentral.com/news/2008/07/25/energy-drinks-linked-to-risk-taking/2658.html

ARBs and dementia

The cholesterol-lowering drugs statins have been linked to a reduced risk of dementia (see below) and now researchers have found that angiotensin receptor blockers (ARBs) can also reduce the risk of the condition. Using data on more than 5 million people scientists from Boston University School of Medicine compared those people taking ARBs with those of similar health status who were taking different medication. Patients taking ARBs had about a 35-40% lower chance of developing Alzheimer disease or dementia. In patients already suffering from these illnesses people taking ARBs had a 45% lower chance of developing delirium, being admitted to a nursing home or dying.

You can find out more about this research at

http://psychcentral.com/news/2008/07/28/some-blood-pressure-meds-decrease-dementia/2661.html

Oxytocin - can it give you rose-tinted memories?

There has been a lot of research recently into the effects of a hormone called oxytocin which is believed to be linked to positive emotions and social interaction. A study of healthy male volunteers gave them either oxytocin or a placebo and presented them with a series of happy, angry and neutral faces on a computer screen. The participants returned the following day when they were presented with another set of faces and asked to pick out the ones they had seen the day before. Those people who had been given oxytocin were more likely to remember the happy faces rather than the angry and neutral ones.

You can find out more about this research at

http://psychcentral.com/news/2008/07/28/hormone-aids-memory-of-positive-moments/2662.html

Dangers of mixing drugs at home

A U.S. study of 50 million death certificates issued between 1983 and 2004 looked at 200,000 deaths from medication errors. Traditionally research into medication errors has focused on clinical settings but an increasing amount of drugs are now being taken in the home. The researchers - from the University of California, San Diego - found that deaths from combining medication with alcohol and/or street drugs rose by 3,196% between the two years whereas deaths in clinical settings rose by just 5%.

You can find out more about this research at

http://psychcentral.com/news/2008/07/29/rx-drugs-street-drugs-alcohol-deadly-combo/2664.html

Statins and dementia risk

Statins are drugs usually used to reduced people's cholesterol. However, a study of 1,674 Mexican Americans over the age of 60 by researchers at the University of Michigan School of Public Health has found that they may also reduce people's risk of dementia. During the five-year study 27% of the participants took a statin drug and a total of 130 people developed dementia or cognitive impairment. After allowing for other risk factors such as education, smoking, diabetes and stroke the study found that statin users were about half as likely to develop dementia.

You can find out more about this research at

http://psychcentral.com/news/2008/07/29/cholesterol-drug-may-reduce-dementia/2665.html

Men, women, ageing and happiness

Women become less happy than men as they age, according to a long-term study carried out by researchers at Cambridge University and the University of Southern California. The study looked at people's expectations for their personal lives and finances and their levels of happiness over time. It found that women are, on average, happier than men in early adulthood but that men overtook women after the age of 48. In later life it was men who came closest to fulfilling their aspirations. Nine out of ten people wanted a happy marriage and the least happy part of a man's life - his 20s - is also the time when he is most likely to be single. Men were more dissatisfied than women with their financial situation earlier in life but this was because their expectations were higher, not because their incomes were lower. Men are more likely than women to be married after 34 and their income rises as they get older as well. On average men become happier than women with their finances at 41 and with their family life at 64.

You can find out more about this research at

http://psychcentral.com/news/2008/07/30/happiness-wanes-as-women-age/2668.html

Anxiety, depression and blood pressure

The idea that psychological factors can influence blood pressure is at least 100 years old. Whether anxiety and depression contribute to the development of high blood pressure has been addressed in several studies although the results have been inconclusive and a recent Norwegian study found that anxiety and depression were actually linked to low blood pressure. The same team of researchers looked at data from 36,530 men and women between the ages of 20 and 78. The participants were asked about their levels of anxiety and depression and their blood pressure between 1984 and 1986 and were re-examined 11 years later. The researchers found that a high symptom level of anxiety and depression at the initial stage of the study predicted low blood pressure eleven years later and that changes in anxiety and depression between the two studies predicted changes in blood pressure.

Hildrum, Bjorn ... [et al] - Effect of anxiety and depression on blood pressure: 11-year longitudinal population study British Journal of Psychiatry August 2008, 193(2), 108-113

Antipsychotics and weight gain. What are effective interventions?

Up to 80% of people being treated with antipsychotics suffer from medication-induced weight gain and young people experiencing a first episode of psychosis are particularly susceptible to rapid and pronounced weight gain. Weight gain has become a major concern in the treatment of psychosis because it may stop people sticking with their treatment and is, in itself, associated with a reduced quality of life, social stigma and greater morbidity (illness) and mortality. A recent review of interventions to reduce weight gain in schizophrenia concluded that there was insufficient evidence to support the use of drugs to prevent weight gain, so a team of researchers from Melbourne looked into non-pharmacological alternatives. A review of previous studies concluded that individual and group interventions, cognitive behaviour therapy (CBT) and nutritional counselling were all effective in reducing or slowing down antipsychotic-induced weight gain.

Alvarez-Jimenez, Mario ... [et al] - Non-pharmacological management of antipsychotic-induced weight gain: systematic review and meta-analysis of randomised controlled trials British Journal of Psychiatry August 2008, 193(2), 101-107

Social rank and eating disorders

Recently research into eating disorders has focused on not just the individual patient but on their relationships with other people and the rest of society. The idea of social rank concerns individual's perceived or actual place in social heirarchies and low social rank can be conceived as; the perception that one is of low social rank, that one has been put down by a dominant other, that one is unable to escape an uncontrollable set of circumstances and the giving up of competing with others through submissive behaviour. Previous studies have found an association between low social rank and eating disorders. A study of 74 female office staff in London looked into the links between various aspects of social rank, eating disorders and depression. It found that submissive behaviour and an unfavourable social comparison were linked to disordered eating while social defeat and internal entrapment predicted depressive symptoms.

Troop, Nicholas A. and Baker, Anna H. - The specificity of social rank in eating disorder versus depressive symptoms Eating Disorders July-September 2008, 16(4), 331-341

Slimness and gymnasts

Despite studies showing a link between disordered eating and involvement in appearance-related sports few studies have examined the effectiveness of interventions designed to reduce disordered eating among female athletes. Canadian researchers looked at the effectiveness of a programme called Body Sense in 62 female gymnasts between the ages of 11 and 18. The Body Sense programme addresses: eating attitudes and beliefs, accurate information about body health, unique body size and shape, resisting pressures to diet, physical activity for enjoyment, helping an athlete feel good about herself, assertiveness, stress management, role models and promoting a balance between sport participation and life outside sport. Participation in the programme resulted in athletes perceiving a reduction in pressure from their sports clubs to be thin although no changes were found in body esteem, the girls' perceptions of society's attitude to thinness or the girls' parents' ideas about thinness and dieting.

Buchholz, Annick ... [et al] - Bodysense: an evaluation of a positive body image intervention on sport climate for female athletes Eating Disorders July-September 2008, 16(4), 308-321

Look into my eyes, not around the eyes ...

Children are more easily hypnotized than adults and hypnotherapy has been found to be effective in childhood disorders such as asthma and chronic and acute pain and in helping children deal with unpleasant procedures associated with cancer treatment. A review of studies on the use of hypnotherapy for mental-health problems in children found 60 articles. Their findings indicated that hypnotherapy may be useful for a wide range of disorders and problems and may be particularly valuable in the treatment of anxiety disorders and trauma-related conditions.

Huynh, Melanie Ekholdt, Vandvik, Inger Helene and Direth, Trond H. - Hypnotherapy in child psychiatry: the state of the art Clinical Child Psychology and Psychiatry July 2008, 13(3), 365-376

BCA and CAMHS

Long waiting times for a first appointment at child and adolescent mental health services (CAMHS) are an international problem and one of the main reasons for service user dissatisfaction. A team of Irish psychologists aimed to get around this by adopting a brief consultation and advisory (BCA) model, which gave service users an appointment within four weeks of referral, a second consultation approximately 2 weeks later and a third, follow-up session after 2-3 months. The model is described as a time-limited, client-centred and solution-focused approach to dealing with common, non-complex referrals. A trial of the approach compared 32 children who received care via the BCA model to 28 who received treatment as usual. Both groups showed improvements on a number of variables after 3 months but only those receiving BCA showed continued improvement at 6 months. Participants in the treatment as usual group expressed dissatisfaction with long waiting times and had a higher drop-out rate than the BCA treatment group. The introduction of the BCA approach did not lead to a decrease in overall mean waiting time.

McGarry, Joan ... [et al] - The clinical effectiveness of a brief consultation and advisory approach compared to treatment as usual in child and adolescent mental health services Clinical Child Psychology and Psychiatry July 2008, 13(3), 365-376