Low spirits and pot bellies

Having a pot belly can be associated with a number of different health complaints including cardiovascular problems and diabetes. Depression has also been linked to these conditions and a study of 2,088 adults, aged between 70 and 79 in Amsterdam, has found that depression can be linked to the development of a larger abdominal circumference. Participants in the study were screened for depression at the beginning of the research and had their overall and abdominal fat measured over a 5-year period. At the beginning of the study 4% of the participants had depression and, after adjusting for a number of other factors, this was found to be associated with an increase in abdominal fat. The researchers thought this might be because chronic stress and depression leads to the increased production of a hormone called cortisol, which promotes the accumulation of visceral (abdominal) fat. It is also possible that people with depression may have less healthy lifestyles, including a poorer diet, than other people.

You can find out more about this research by clicking on the link in the title of this post.

Coerced medication

Laws governing involuntary psychiatric treatment exist in all EU member states and in other developed countries. Under these laws an increased risk to oneself and others provides the ethical and legal justification for detaining and treating people with mental-health problems without their consent. In the U.K. this often takes the form of coerced medication (CM) whereas in the rest of Europe seclusion and mechanical restraint are more likely to be used. Researchers from the Institute of Psychiatry and City University (both London) analysed 14 papers about CM from seven different countries, published between 1987 and 2004. They found that patients receiving CM were more likely to be in their thirties with a diagnosis of schizophrenia, bipolar disorder or another psychotic disorder and most of them had been admitted to psychiatric care on an involuntary basis. Service users experienced a range of negative feelings when they received CM including fear, embarrassment, anger and helplessness, although in retrospect many said they agreed with the practice. The studies showed a lack of detailed exploration into the events leading up to CM and a complete absence of investigation into alternatives. The authors concluded that their review highlighted a lack of clinical evidence on which to base CM and point out that the practice may discourage people from seeking help from, or engaging with, mental-health services.

You can find out more about this study by clicking on the link in the title of this post.

The Happiness Bug

Happiness can be contagious, according to a study carried out by researchers at Harvard Medical School and the University of California, San Diego. The researchers used data from the Framingham Heart Study, a famous ongoing study into cardiovascular risk with participants in the town of Framingham, Massachusetts. Their study focused on 4,739 participants in the Framingham Heart Study who completed a range of information about their levels of happiness and their social networks. The researchers found that when someone became happy a friend, living within a mile, experienced a 25% increased chance of becoming happy themselves. Their spouse had an 8% increased chance, siblings living within a mile 14% and next-door-neighbours 34%. However, not only did that person's friends become happier, their friends' friends had a 10% chance of increase happiness and their friends' friends' friends had a 5.6% chance of increased happiness. The effects were limited by geographical distance from the original person and time, lasting about a year. People who were at the centre of social networks were happier than those at the fringes. Having a $5,000 boost to one's income, however, was only associated with a 2% increase in happiness. Sadness was not found to 'flow' through networks in the same way that happiness did.

You can find out more about this research by clicking on the link in the title of this post.

Depression in junior doctors

A study of 481 junior doctors in Brazil has found high levels of depression among them. The researchers carrying out the study divided depression symptoms into three clusters: affective, cognitive and somatic. Affective symptoms were the students' levels of sadness, dissatisfaction, episodes of crying, irritability and social withdrawal. The cognitive symptoms were pessimism, a sense of failure or guilt, an expectation of punishment, dislike of self, suicidal ideation, indecisiveness and a change of body image. The somatic cluster were slowness, insomnia, fatigue, weight changes and loss of sexual interest. The study found a high prevalence of depressive symptoms among the medical students, particularly female students, mainly involving the somatic and affective clusters. 38% of the students had at least 10 out of a possible 63 symptoms of depression. Depression scores were higher in the early years of participants' training as they moved into the hospital environment. Having a parent who was a doctor was found to reduce the risk of depression.

You can find out more about this study by clicking the link in the title of this post.

Tai chi and dementia

Most of the research effort into Alzheimer's disease has tended to concentrate on drug treatment but other approaches to treating the condition can also be effective. Researchers at the University of Illinois looked at the effectiveness of an intensive 40-week programme of twice-weekly sessions of cognitive behaviour therapy and support groups, along with three sessions a week of qigong (Chinese meditation) and tai-chi. A control group was placed on a waiting list for the programme. After 20 weeks those taking part in the programme had improved balance and lower-leg strength, higher self-esteem and a slight improvement in their mental functioning. No additional benefits were seen after 40 weeks but participants were able to maintain their initial gains and the intervention proved very popular with the participants and their caregivers.

You can find out more about this research by clicking on the link in the title above.

Drink, drugs and ICUs

People with drug and alcohol problems already cost the health service a significant amount of money and now researchers in Salt Lake City have found that they are more likely to end up staying in an ICU as well. The researchers carrying out the study looked at the medical records of 742 patients admitted to the intensive care unit at Salt Lake City's LDS Hospital. The study found that 19% of them had a history of drug and alcohol dependence prior to being admitted; twice the rate of the general population. The patients with drug and alcohol dependence were, on average, six years younger than the rest of the ICU patients.

You can find out more about this study by clicking on the link in the title of this post.

Cognition, video games and silver surfers

Playing computer games has traditionally been seen as a young person's activity but an increasing number of older people are 'silver surfers' and a recent study has shown that playing video games can improve cognition in this group. Researchers from the University of Illinois studied 40 older adults in their 60s and 70s. Half of them received training in a video game called Rise of Nations where players have to make decisions on resource allocation to feed and employ people, maintain their military and expand their population in an imaginary country; the other half received no training. Before, during and after the training both groups of participants took a series of cognitive tests. The video gamers became better, and faster, at switching between tasks. Their working memory was improved and their reasoning ability was enhanced. Their short-term memory of visual cues was also better than the control group's. Those who performed better on the game also performed better on the cognitive tests. The results are significant as previous research has shown that training people on a particular task improved their ability to complete the task itself, without being transferable to other situations.

You can find out more about this research by copying and pasting the URL below into your browser.

http://psychcentral.com/news/2008/12/12/video-games-improve-cognitive-skills-in-older-adults/3497.html

Carbs, calories and cognition

People who cut out carbohydrates as part of a diet may be reducing their brainpower as well as their waistline according to a study by researchers at Tufts University in the U.S. The study compared nine women on a low-carbohydrate, Atkins-style diet and ten women following a low-calorie diet based on advice from the American Dietetic Association. The dieters completed five testing sessions which assessed attention, long-term memory, short-term memory, visual attention and spatial memory. The low-carb dieters showed a gradual decrease in performance on the memory-related tasks compared to the low-calorie dieters. Their reaction times were slower and their visual-spatial memory worse. However, the low-carb dieters did do better than the low-calorie ones on the attention task; perhaps because fat and protein, which tend to be consumed more on these kind of diets, can improve people's attention in the short term.

You can find out more about this research at

http://psychcentral.com/news/2008/12/12/low-carb-diets-can-affect-cognition/3498.html

Conscientiousness and life expectancy

A review of 20 studies involving more than 8,900 participants in the U.S., Canada, Germany, Norway, Japan and Sweden looked into the links between personality and life expectancy. The review found that people who scored highly on levels of conscientiousness tended to live between two and four years longer than people who had low scores for conscientiousness. The influence of contientiousness was found to be as large, or larger, than many other factors affecting longevity such as socio-economic status. Within conscientiousness the sub-factors that were particularly associated with increased life expectancy were ambition and self-discipline with responsibility and self-control being less important.

Kern, Margaret L., Friedman, Howard S. - Do conscientious individuals live longer? A quantitative review Health Psychology 2008, 27(5), 505-512

Panic disorder and heart disease

A study of 405,000 people by researchers from University College London looked into the links between panic disorder and heart problems. The study found that people who were younger than 50 when first diagnosed with panic disorder were 38% more likely to have a heart attack and 44% more likely to develop heart disease than those in the general population. People who were over 50 when first diagnosed had an 11% greater risk. However, people with panic disorder had a lower risk of dying from heart disease than the rest of the population. The researchers who wrote the study weren't sure whether the symptoms of heart disease were being misdiagnosed as panic disorder or whether panic disorder actually led to an increased risk of developing heart problems.

You can find out more about this research at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=115361&cn=1

Antipsychotics: is it time to end the generation game?

Antipsychotic drugs have usually been divided into first- and second-generation drugs with the latter being perceived as having fewer side effects than the former. Researchers from universities in Munich and Chicago looked at 150 studies comparing the effectiveness of antipsychotic drugs, which, altogether had 21,000 participants. They found that four second-generation drugs - amisulpride, clozapine, olanzapine and risperidone - were more effective than first-generation ones but that the rest were no better. When compared with the powerful first-generation drug haloperidol the second-generation drugs had less side effects but compared to other first-generation drugs there was little difference. Haloperidol - but not other first-generation drugs - produced less weight gain than most second-generation drugs. The authors called for an end to the division of drugs into first- and second-generation and an individualized treatment of schizophrenia based on efficacy, side effects and cost.

You can read more about this study at

http://psychcentral.com/news/2008/12/08/better-classification-of-psychotic-drugs-recommended/3466.html

Cholinesterase inhibitors for dementia

Researchers at Indiana University School of Medicine looked into the effectiveness of drugs called cholinesterase inhibitors at treating the behavioural and psychological symptoms of dementia. The drugs work by raising the level of a neurotransmitter called acetylcholine in the brain, which assists memory, thought and judgement. The researchers reviewed the results of nine clinical trials of the drugs and found that they led to a statistically-significant reduction in behavioural and psychological symptoms such as aggression, wandering and paranoia. The drugs were found to be safe and produced no side effects in contrast to the antipsychotic drugs that are sometimes used on this group of service users.

You can find out more about this study at

http://psychcentral.com/news/2008/12/10/medication-helps-alzheimers-symptoms/3481.html

Service users' siblings

Little is known about the impact of learning disabilities and mental illness on service users' siblings. Researchers from the University of Wisconsin-Madison studied 351 people over a 46-year period all of whom had at least one sibling with either a mental illness or a learning disability and compared them to 791 people with unaffected siblings. The researchers found that people who had siblings with mental illnesses were 63% more likely to report having a depressive episode during their lifetime. Siblings of people with learning disabilities were more likely to live in the same states as them but reported much less contact with their learning-disabled siblings and reported feeling less emotionally close to them. People with a brother with a mental illness had lower levels of psychological wellbeing than those in the comparison group but people with a sister with mental illness were not at increased risk of a mental-health problem.

http://psychcentral.com/news/2008/12/10/challenges-for-siblings-of-mentally-disabled/3482.html

Postnatal depression and sleep

All new mothers experience some sleep loss following childbirth as their oestrogen and progesterone levels plunge, and they typically spend 20% more of the day awake than average during the first six weeks after birth. It is estimated that between 6.5 and 13% of new mothers in the U.S. suffer from postnatal depression and a study of 46 women by researchers at Drexel University in the U.S. looked into the links between sleep problems and postnatal depression. The study found that the mothers suffering from postnatal depression took longer to fall asleep and slept for shorter periods. The worse the women's sleep quality the worse their depression.

You can read more about this research at

http://psychcentral.com/news/2008/12/11/postpartum-depression-tied-to-sleep/3489.html

Exercise and anger in children

Exercise has been shown to be effective in improving children's depression and anxiety. A study by researchers at the Medical College of Georgia School of Medicine looked at the effectiveness of a 10-15 week after-school aerobic exercise programme in reducing anger among children. The researchers found that exercise had a significant effect in reducing children's anger expression as well as helping them to lose weight.

You can read more about this study at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=115089&cn=28

Valproate and autism

Previous research has shown that the anti-epilepsy drug valproate can contribute to birth defects, in particular neural tube defects, and now a study by the Liverpool and Manchester Neurodevelopment Group has suggested that it could also raise the risk of children developing autism. The study, of 632 live births from 620 women, compared those taking anti-epilepsy drugs at the beginning of their pregnancy with women unaffected by epilepsy. The children were assessed for autism, or related conditions, at 1,3 and 6 years of age. Around 6.3% of the children exposed to valproate developed autistic spectrum disorders, a rate seven times higher than that in the control group. However, another anti-seizure drug called lamotrigine was not associated with an increase in the risk of autism.

You can find out more about this study at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=115105&cn=20

Law Lords ruling on duty of care to inpatients

The Law Lords have ruled that people detained under the Mental Health Act have the same 'right to life' as those in prison. Hospitals must now be seen to take responsibility to take reasonable measures to avoid real and immediate harm to patients who have been sectioned. The ruling results from a case brought by Anna Savage against South Essex NHS Trust, concerning her mother Carol, who killed herself in July 2004 after absconding from Runwell Hospital where she was being detained. The ruling holds health authorities responsible for taking measures to properly assess and prevent the risk of suicide. The High Court had previously ruled that unless gross negligence could be established, they could not be held liable for a breach of the right to life.

You can read the MIND press release about this judgement at

http://www.mind.org.uk/News+policy+and+campaigns/Press/2008-12-11-savage.htm

Locked wards raise aggression

A leading academic has presented research suggesting that locked wards in psychiatric hospitals may actually raise levels of aggression in inpatients. Delivering the annual Eileen Skellern lecture at London South Bank University on the 2nd of December Professor Len Bowers of City University presented the results of 50,000 responses from questionnaires and interviews with staff, service users and visitors from 130 of the 500 acute psychiatric wards in England. They found that a 'locked-door' policy led to service users feeling frustrated, stigmatised and depressed. It increased the risk of physical aggression to others by 11% and self-harm by 20%. Patients in locked wards were also more likely to refuse medication.

You can read the press release sent out to accompany the lecture at

http://www.tc-of.org.uk/wiki/index.php?title=Eileen_Skellern_2008

PCOS and mental health

Polycystic ovary syndrome (PCOS) is estimated to affect between 5-10% of women of reproductive age and its symptoms include weight problems, lack of regular ovulation and/or menstruation and excessive amounts of androgenic (masculinizing) hormones. While the causes are unknown insulin resistance, diabetes and obesity are all strongly correlated with PCOS. A study of 84 women in Turkey used two common measures, the General Health Questionnaire and the Beck Depression Inventory, to compare levels of mental-health problems in women with and without PCOS. The women with PCOS had significantly higher levels of mental distress than the other women and their levels of mental distress were correlated with their Body Mass Index and their Waist-to-Hip Ratio, i.e. the heavier they were and the larger their waists the worse their mental-health was.

Adali, E. ... [et al] - The relationship between clinico-biochemical characteristics and psychiatric distress in young women with polycystic ovary syndrome The Journal of International Medical Research November/December 2008, 36(6), 1188-1196

Self-harm after hospital

The risk of suicide in the month after psychiatric inpatient care is about 100 times greater than that of the general population. Although the high risk of suicide shortly after discharge is well documented less is known about the rates of non-fatal self-harm. A study of 75,401 people discharged from psychiatric inpatient care between April 2004 and March 2005 found that 6.5% of them were admitted at least once for self-harm in the following 12 months. The risk of self-harm was greatest in the four weeks after discharge. The strongest risk factor for self-harm after discharge was an admission for self-harm in the previous 12 months. The risk of self-harm was also higher in women, younger people, those with diagnoses of depression, personality disorder and substance abuse and those with short lengths of stay.

Gunnell, David ... [et al] - Hospital admissions for self-harm after discharge from psychiatric inpatient care: cohort study British Medical Journal December 6, 2008, 1331-1334