Medication use rises in the U.S.

A survey of the drugs being prescribed to children in the U.S. has found increases in the number of prescriptions being written for ADHD drugs and antidepressants. The survey covered the years between 2002 and 2005 and used a database of prescription claims from children with private health insurance, almost four million children altogether. Prescriptions for ADHD drugs rose by 40.4% (63% among girls and 33% among boys) and prescriptions for antidepressants rose by 7% among girls and 4% among boys.

You can find out more about this research at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=114316&cn=28

New research sheds light on genetics of Alzheimer's

A study by researchers at the Institute for Neurological Disease, Massachusetts General Hospital, Boston has found four new genes that they think are implicated in the development of Alzheimer's disease. The researchers tested samples from more than 400 families in which at least three members had Alzheimer's disease. The analysis revealed five genetic markers linked to Alzheimer's. One was a gene called APOE which was already known about but the researchers also found other markers on chromosome 14; in a gene known to cause a movement disorder called spinocerebellar ataxia, in a gene involved in the immune system and in a gene that produces proteins in synapses.

You can find out more about this research at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=114242&cn=231

Combination therapy and childhood anxiety disorders

A study of 488 children between the ages of 7 and 17 by researchers at Columbia University in New York City looked into the effectiveness of cognitive behaviour therapy (CBT), the antidepressant sertraline (brand name Zoloft) and a combination of the two in treating childhood anxiety. One group of children was given a combination of sertraline and CBT, one group was given sertraline on its own, one group was given CBT on its own and a fourth group was given a placebo. Over the course of the 12-week study 81% of the children receiving CBT and sertraline improved, compared with 60% who received CBT alone and 55% who received sertraline alone. Among patients receiving the placebo only 24% showed an improvement.

You can find out more about this research at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=114258&cn=1

Learning disabilities and mental-health problems

The term learning disability covers a variety of clinical presentations, syndromes and underlying pathologies. About 1% of the population have a learning disability and most studies have found that the risk of mental-health problems is higher in people with a learning disability. However, identifying mental health problems in people with a learning disability is difficult. An Australian study used a register of people with learning disabilities and a register of people with mental-health problems to look at people with a 'dual diagnosis' of learning disability and mental illness. The study showed that 31.7% of people with an intellectual disability had a psychiatric disorder, while 1.1% of people with a psychiatric illness had an intellectual disability. Schizophrenia was most closely linked to learning disabilities and 3.7-5.2% of those with intellectual disabilities had co-occuring schizophrenia. Pervasive developmental disorder was much more common among people with 'dual diagnosis' while Down Syndrome was much less common. Individuals with a learning disability and mental health problems were more disabled than those with psychiatric illness alone.

Morgan, Vera A. ... [et al] - Intellectual disability co-occuring with schizophrenia and other psychiatric illness: population-based study British Journal of Psychiatry November 2008, 193(5), 364-372

Cannabis and psychosis

There has been much interest in, and debate about, the links between cannabis use and psychosis. Cannabis intoxication can produce transient psychotic and affective experiences and can have detrimental effects on motivation and memory. Yet people with psychosis also report that it can reduce their anxiety and make them more sociable. A review of 13 studies into the links between cannabis and psychosis carried out by researchers at Bristol University found that cannabis use was consistently associated with relapse and non-adherence to medication. However, the researchers also found that few of the studies took into account how ill people were to begin with and the influence of alcohol or other factors on people's psychosis. Taking these other factors into account resulted in a substantial weakening of the link between cannabis and psychosis.

Zammit, Stanley ... [et al] - Effects of cannabis use on outcomes of psychotic disorders: systematic review British Journal of Psychiatry November 2008, 193(5), 357-363

Religion, depression and meaning in life

There has been a lot of research recently into the links between religion and mental health. Researchers at Temple University in the U.S. studied 918 people and looked into three aspects of religious belief: church attendance, religious well-being (the quality of a person's relationship with a higher power) and existential well-being, a person's sense of meaning and their purpose in life. People with high levels of religious well-being were 1.5 times more likely to have had depression than those with lower levels of religious well-being. However, people who attended church regularly were 30% less likely to have had depression in their lifetime and people who had a clear sense of meaning and purpose in their life were 70% less likely to have suffered from depression.

You can find out more about this research at

http://psychcentral.com/news/2008/10/24/spirituality-tops-religion-for-depression/3196.html

Poverty ups youth suicide risk

A study of 2,779 teenagers in Canada, carried out as part of the National Longitudinal Survey of Children and Youth looked into the risk factors for suicide attempts in this age group and in particular the impact of poverty. Poverty levels in the children's neighbourhoods were measured in early and mid-adolescence based on census data and at 18 or 19 the participants were asked whether they had seriously considered attempting suicide in the last 12 months. Among teenagers from all backgrounds hyperactivity and impulsivity, depression, substance use, low social support, exposure to suicide and negative life events all led to an increase in sucidality but in children from poorer neighbourhoods the effects of hyperactivity and impulsivity were accentuated. Youths from poorer neighbourhoods were twice as likely to report suicidal thoughts as their peers from more affluent neighbourhoods and four times as likely to actually make a suicide attempt.

You can find out more about this research at

http://psychcentral.com/news/2008/10/27/teens-in-poor-neighborhoods-at-greater-risk-for-suicide/3206.html

Earlier the better for child anxiety disorders

A study presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry has suggested that it may be more beneficial for children to confront and manage their fears rather than use other techniques to deal with them. The study found that children were able to complete exercises designed to expose them to and neutralise their fears much earlier than suggested in treatment manuals for childhood anxiety disorders and that treatment that was shorter and began exposure to the child's fear earlier than usual was more effective at improving children's functioning.

You can read more about this research at

http://psychcentral.com/news/2008/10/30/confront-fears-to-reduce-child-anxiety/3233.html

Breast is best for mental health

The health benefits of breast-feeding children are well established and a new study by the American Public Health Association suggests that it may also have benefits for children's mental health. Researchers used data from the 2003 National Survey of Children's Health made up of 102,353 interviews with parents and guardians about the health of their children. The study found that parents of breastfed children were less likely to report concern over their child's behaviour and their children were less likely to have been diagnosed by a health professional with behavioural or conduct problems or to have received mental health care. Parents of breastfed children were also less likely to report concern about their child's ability to learn.

You can find out more about this research at

http://psychcentral.com/news/2008/10/30/breastfed-children-have-less-mental-health-issues/3235.html

Risk factors for methamphetamine abuse

Methamphetamine is a stimulant, also known as 'meth' or 'speed' that can be smoked, snorted or injected and which produces sensations of euphoria, lowered inhibitions, feelings of invincibility, increased wakefulness and an increase in energy. An analysis of 12 studies into the risk factors for methamphetamine abuse, carried out by researchers at the University of Alberta, Canada looked at low-risk (those not involved in any other drug abuse) and high-risk (those who had taken other drugs or who had been in a juvenile detention centre) children. Within the low-risk group a history of engaging in behaviour such as sexual activity, particularly homosexual or bisexual activity, alchohol consumption and smoking was significantly associated with methamphetamine use. Among high-risk youth the risk factors identified were growing up in a family with a history of crime, alcohol and drug use; having received treatment for a psychiatric condition and being a girl.

You can find out more about this research at

http://psychcentral.com/news/2008/10/28/meth-abuse-among-teens/3214.html

The neuroscience of hate

A brain imaging study by researchers at University College London looked at the parts of the brain that are activated by hate. They found that this 'hate circuit' was distinct from those related to threat, fear and danger although it did share a part of the brain related to aggression. The circuit was distinct from that associated with romantic love although it did share at least two common structures with it. To generate hate seventeen people had their brains scanned while looking at a picture of someone they hated. The 'hate circuit' included structures in the cortex and the sub-cortex important in generating aggressive behaviour and translating this into physical action and a part of the frontal cortex involved in predicting the actions of others. Hate activated parts of the brain called the putamen and insula which are both also involved in romantic love although love de-activated the parts of the brain associated with judgement and reasoning more than hate.

You can find out more about this research at

http://psychcentral.com/news/2008/10/29/hate-area-of-brain-identified/3225.html

Older people, risk and stress

Researchers at the University of Southern California Davis School of Gerontology looked into the way that stress affects decision making and found that following a stressful experience older people were much more averse to stress than young ones. The study compared young adults (18-33) with older ones (65-89) and used a driving game to measure their approach to risk. Participants were given points for every second they spent driving on a yellow light but lost points if the light turned red while they were driving meaning they had to take risks to score any points at all. In a control group which had not been exposed to stress the older adults had a higher score but after the participants had been exposed to stress (by putting their hands in a bucket of ice-cold water for three minutes) the older people became much more cautious. They were also jerkier drivers, braking and restarting almost three times as much as older drivers in the control group. The differences in the effects of stress were consistent even when the researchers accounted for gender, level of education, mood and health.

You can read more about this research at

http://psychcentral.com/news/2008/10/29/stress-effect-more-exaggerated-in-older-adults/3226.html

Depression and premature birth

A study of 791 women in and around San Francisco has found that those of them who were suffering with symptoms of depression were much more likely to give birth prematurely. The women were interviewed around the 10th week of their pregnancy when 41% reported 'significant' symptoms of depression and 22% reported 'severe' symptoms. Those with 'severe' symptoms had almost twice the risk of an early birth while those with 'significant' symptoms had a 60% greater risk. Women who were more likely to report depressive symptoms tended to be younger than 25, unmarried, less educated, poorer, Black and have a history of pre-term delivery. But it may not necessarily be the depression itself that leads directly to premature birth. Depression at 10 weeks could itself be a symptom of another underlying process or problem that causes premature birth. At the same time depression is known to be linked with non-compliance with prenatal care, poor nutrition, inadequate sleep and self-medication with alcohol and drugs so it could be these factors that lead to premature birth rather than depressson per se

You can find out more about this research at

http://psychcentral.com/news/2008/10/27/depression-ups-pregnancy-risk/3204.html

Depression and COPD

Depression is already known to be linked to worse outcomes for people recovering from heart attacks or with other cardiovascular problems and now new research has shown that it is also linked to worse outcomes in the lung disease chronic obstructive pulmonary disease (COPD). The study of 491 people with COPD in China found that depression was associated with a 50% worsening of COPD symptoms while anxious patients had instances of worsening symptoms that were nearly twice as long as patients without anxiety.

You can find out more about this research at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=114118&cn=5

Mental health and employment

On Monday this week Incapacity Benefit was replaced with Employment Support and Allowance which aims to get as many claimants back to work as possible, including people with mental-health problems. But with unemployment forecast to rise over the coming months a poll by the mental-health charity MIND has revealed the vulnerability of employment for people with mental-health problems. Of the 279 people who responded to the poll on the charity's web site 58% had had to leave a job because of a lack of mental-health support, 31% had been sacked or forced out of a job after disclosing a mental-health problem and 1 in 4 had had job offers withdrawn when they told employers about their psychological problems. Over 200,000 people with mental distress lose their jobs and have to start claiming benefit each year.

Bipolar below the radar

Bipolar disorder, or manic depression, is a recurrent and long-term mental illness that can seriously affect the lives of sufferers and their relatives. It is characterized by the alternating occurence of manic, hypomanic, depressive and possibly mixed episodes and has been estimated to have a lifetime prevalence of 1.5-2% in the E.U. When service users are in remission they can still be suffering from subsyndromal symptoms which are not quite severe enough for a diagnosis of full-blown bipolar disorder. While subsyndromal manic symptoms can improve functioning subsyndroman depressive ones can lead to impairment and disability. A survey of 157 bipolar outpatients in the Netherlands found that they had fewer symptoms of psychopathology than psychiatric outpatients in general but a significantly lower quality of life than the rest of the population. The more bipolar symptoms they had the worse was their quality of life.

Goossens, Peter J.J. ... [et al] - Self-reported psychopathological symptoms and quality of life in outpatients with bipolar disorder Perspectives in Psychiatric Care October 2008, 44(4), 275-284

Older gamblers' other problems

There has been a steady increase in gambling over the last few years with a deregulation of betting shops, state lotteries and online gambling. The growth in gambling participation has included older adults who have more time on their hands and, if they are lucky, a good disposable income. 35% of older adults reported lifetime gambling in 1975, a figure that had increased to 80% by 1998. In 1975 23% reported having gambled in the past year compared to 50% in 1998. The increase in gambling behaviour among older adults was more dramatic than in all other age groups. While most older adults gamble for recreation and do so responsibly a minority develop problem gambling or pathological gambling. A survey of 40 older adults with lifetime pathological gambling in Illinois and Iowa used established mental-health screening tools to see what other mental-health problems they might have. The results indicated a high level of other mental illnesses including depression, alcohol dependence, panic disorder, anxiety, obsessive-compulsive and avoidant personality disorders.

Kerber, Cindy Sullivan, Black, Donald W. and Buckwater, Kathleen - Comorbid psychiatric disorders among older recovering pathological gamblers. Issues in Mental Health Nursing 2008, 29(9), 1018-1028

Compulsive hoarding and OCD

Compulsive hoarding is a problem that is characterized by excessive collecting and the failure to discard excessive amounts of collected items, in addition to the cluttering of living space and significant distress or impairment caused by the hoarding. Between 15-40% of OCD sufferers report saving and hoarding compulsions but there is some uncertainty about the relationship between hoarding and OCD. A study of 52 people by researchers at the Institute of Psychiatry in London compared 25 people with severe compulsive hoarding and OCD and 27 people with compulsive hoarding without OCD. Overall the nature of hoarding behaviour was similar between the two groups with the majority of the participants in both groups reporting hoarding common items as a result of their emotional and/or intrinsic value. However, about a quarter of the hoarders with OCD hoarded bizarre items and had other obsessions and compulsions related to their hoarding such as a fear of catastrophic consequences, the need to perform checking rituals and the need to perform mental compulsions before discarding any items and these people had a much more severe and disabling form of the disorder. The researchers concluded that in most individuals compulsive hoarding appeared to be a syndrome separate from OCD but that in otheer individuals it is a symptom of OCD and has unique clinical features.

Pertusa, Alberto ... [et al] - Compulsive hoarding: OCD symptom, distinct clinical syndrome or both? American Journal of Psychiatry October 2008, 165(10), 1289-1298

Olanzapine for anorexia

Olanzapine is an antipsychotic drug, mostly used to treat people suffering from psychosis or schizophrenia. However, there has recently been some research into the use of olanzapine in treating people with anorexia. One of the side effects of olanzapine is weight gain and it is also thought to have some effectiveness in combating obsessional thoughts and depression. People whose anorexia involves restricting their calorie intake tend to have obsessional traits while those who binge and then purge often suffer from dysphoric (depressed) mood. A small study of 34 people with anorexia compared a group taking olanzapine with another group taking a placebo. The group taking olanzapine was found to have a greater rate of increase in weight, an earlier achievement of their target body mass index and a greater rate of decrease of obsessive symptoms. No differences in adverse effects were observed between the two treatment conditions.

Bissada, Hany ... [et al] - Olanzapine in the treatment of low body weight and obsessive thinking in women with anorexia nervosa: a randomized, double-blind, placebo-controlled trial American Journal of Psychiatry October 2008, 165(10), 1281-1288

CBT and theories of depression

There is now a lot of evidence for the effectiveness of cognitive behaviour therapy (CBT) as a treatment for major depression but there is still some uncertainty as to how it actually works. The cognitive mediation model says that it works by changing people's dysfunctional attitudes; maladaptive, inflexible and extreme assumptions by which the self or the world is judged. Dysfunctional attitudes are more prevalent in depressed people and decline with treatment but the complication model holds that it is depression that produces dysfunctional attitudes and not vice versa. Other theories are that depression and dysfunctional attitudes contribute to one another or that there is a third, underlying factor, common to both. A study of 130 people with major depression in Canada divided them into three groups. One group received CBT, another group received interpersonal therapy and a third group received pharmacotherapy. A comparison of CBT with interpersonal therapy showed that a reduction in dysfunctional attitudes explained the effectiveness of CBT. However when CBT was compared to pharmacotherapy the complication model was found to fit the facts better.

Quilty, L.C., McBride, C. and Bagby, R.M. - Evidence for the cognitive mediational model of cognitive behavioural therapy for depression Psychological Medicine November 2008, 38(11), 1521-1530