FDA warning reduced antipsychotic use in dementia patients

Antipsychotics are often used as a 'chemical cosh' to control behaviour problems in people with dementia. Studies have shown that this can have damaging effects on people's health and in 2005 the U.S. Food and Drug Administration (FDA) issued a warning about them. Researchers from the University of Rochester Medical Center in New York have been monitoring the prescription of antipsychotics to this group and have found that there has been a 19% fall since 2005.

You can find out more about this study at

http://uk.reuters.com/article/idUKTRE60A5DB20100111?feedType=RSS&feedName=healthNews&sp=true

Brain waves, attention and ADHD

Researchers from the University of California Davis have been analyzing brain activity in children with ADHD (Attention Deficit Hyperactivity Disorder). The children were led to expect either a visual or auditory signal and their brain activity was monitored. In unaffected children signals are sent from the frontal cortex to the parts of the brain that deal with visual or auditory stimuli to prepare them for action, as it were. These signals led to a drop in alpha waves (the brain's 'screensavers') in the appropriate region. However, in the children with ADHD there was no drop in alpha waves indicating a disconnection between the part of the brain that allocates attention and the parts attention is being allocated to.

http://www.sciencedaily.com/releases/2010/01/100111155116.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Reader

Exercise and memory problems: more new evidence

Two studies from the U.S. have added to the evidence that exercise can help to stave off memory problems as we get older. In the first study researchers from the University of Washington School of Medicine compared two groups of 70-year-olds with mild memory problems. One group took an hour of high-intensity exercise with a trainer four days a week while the other group did gentle stretching. After six months the group doing the high-intensity exercise showed improvements in their thinking skills; something that was more marked among the women. In another study researchers from the Mayo Clinic in Rochester, Minnesota, found that older people who had exercised since middle age were 39% less likely to have memory problems while those who exercised into old age were almost a third less likely. Unfortunately light exercise such as bowling, slow dancing or golf with a buggy did not reduce the risk of memory problems.

Counting the cost of alcohol abuse in Scotland

A report by economists at York University has attempted to put a price on the cost of alcohol abuse in Scotland and has put the price of the nation's bar tab at a hefty £900 a year for every adult. The report estimated the cost of drinking at between £2.4bn and £4.6bn. The report's 'mid-point' estimate of £3.5bn was made up of £268.8m costs to the health service, £230.5m to social care, £727.1m in crime and £865.7m to the economy. The cost of premature death caused by alcohol was estimated at £1.46bn. The report comes as the ruling Scottish National Party attempts to impose a minimum price for alcohol in the teeth of opposition from the Labour and Conservative parties.

You can find out more about this story at

http://news.bbc.co.uk/1/hi/scotland/8453060.stm

Measuring the effects of respite care

Carers of people with mental illness often suffer from an increased burden, distress, health problems and lower life satisfaction. Respite care involves relieving carers of their duties by employing professional carers and volunteers for a short time. Researchers from Queensland University in Australia studied 20 carers, 10 of whom used respite care and 10 of whom did not. Over the course of the 3-month study the group receiving respite care showed a decrease in burden but an increase in stress while the other group did not change over time.

Jardim, Claudia and Pakenham, Kenneth I. - Pilot investigation of the effectiveness of respite care for carers of an adult with mental illness Clinical Psychologist November 2009, 13(3), 87-93

How effective are antidepressants?

Antidepressants could be little better than a placebo for all but the most severe depression. Researchers from the University of Pennsylvania in Philadelphia carried out a data analysis combining information from six different trials covering a total of 718 participants. They found that true advantages of antidepressants over placebos were 'non-existent to negligible' among depressed patients with mild, moderate and even severe symptoms. However, the drugs were very effective among patients with severe depression. The authors of the study pointed out that many studies used by drug companies to publicise the benefits of antidepressants only included severely-depressed people as participants.

You can find out more about this research at

http://www.sciencedaily.com/releases/2010/01/100105161538.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Reader

Self-perception and reflection

Some people have a more positive self-image than others. Researchers love playing around with brain scanners and scientists at the University of Texas studied 20 people as they were asked about how they compared to their peers in tact, modesty, likeability, maturity, materialism, messiness, unreliability and narrow-mindedness. Those participants who had a more positive view of themselves than others used their orbitofrontal cortex less than the other subjects. This is a region of the brain generally associated with reasoning, planning, decision-making and problem-solving. People with a more negative view of themselves showed four times more activity in this area than those with the rosiest view of themselves. In a separate, though related, study people who were given more time to think about their answers rated themselves more harshly than those who were asked for a snap judgment. Taken together the studies suggest that the more we think about ourselves the less we like what we find.

You can find out more about this study at

http://psychcentral.com/news/2010/01/07/high-self-perception-low-brain-activity/10606.html

U.K. M.P.s call for alcohol clampdown

The U.K. Parliament's Health Select Committee - which has an advisory but not executive role - has called for a steep rise in alcohol prices to tackle the country's drink problem. The report claims that a minimum price of 50p a unit would save 3,000 lives a year while one of 40p would save 1,100. The report says that in some shops alcohol can be bought for 10p a unit and that the average moderate drinker would pay just 11p a week more if a minimum price of 40p a unit was set. Three times as much alcohol a head is drunk now than in the mid 20th century and ten million adults drink more than the recommended limits. Around 30-40,000 deaths every year could be alcohol-related and the total cost of alcohol to society has been estimated at £55bn. Other recommendations of the Committee included

• mandatory labelling of cans and bottles with warning details of units
• restrictions on advertising where children can see it and a ban on advertising before the 9pm watershed
• incentives for GPs to detect more problem drinkers
• targets for hospitals to reduced alcohol-related admissions
• Stronger enforcement by the police against serving people who are drunk

You can see a full copy of the report at

http://www.publications.parliament.uk/pa/cm200910/cmselect/cmhealth/151/15102.htm

Milkshakes for memories

A milkshake to improve people's memories could be on the shelves within two years. The milkshake - produced by French company Danone who also make Shape and Actimel yogurts - was found to improve the memories of people with the early stages of the disease after just 12 weeks. The shake contains omega-3 fatty acids, uridine and choline and works by targeting the synapses that carry signals between brain cells. Large-scale trials are underway and Danone hope that the shake could be sold over the counter in pharmacies.

You can find out more about this story at

http://www.telegraph.co.uk/health/healthnews/6950206/Milkshake-promises-to-improve-memory-of-Alzheimers-sufferers.html

Comments on the Mental Health Update blog

I am changing the settings on my blog so that I can approve comments before they are added. This is to stop a number of people posting links to Viagra, car insurance, mobile phones and hot chicks etc. I am still very happy to receive comments about the posts themselves and on issues about mental health and won't be attempting to censor any such comments. But there may be a slight delay before your comments appear if the notifications about them get caught up in my email backlog.
Best Wishes,
John Gale,
Mental Health Update

Why We Stay In Emotionally Destructive Relationships - Guest Post by Susan White

When we think addiction, we associate the term with alcohol, drugs or cigarettes. But there is another thing that that most of us are addicted to – relationships. Think about it – you’ve fallen in love and you cannot do without your significant other; you think that he or she is the only one who can make you happy; you feel lost without them; you want to spend every minute together; and you can’t get enough of your lover no matter how much time you spend together – does this not count as addiction?
If you still don’t agree, try staying away from your loved one for a day or two, or go even a few hours without texting, calling or emailing them. If you feel withdrawal symptoms and crave a fix so badly that you break your resolution, there’s no other way to say this – you are addicted. Addiction to a relationship is not that bad a thing as long as it is reciprocated; if your partner feels the same way that you do, then there’s no need to press the panic button. But if your feelings become more intense and his/her feelings swing the opposite way, then you have a problem.
It’s a cruel twist of fate, but the more they withdraw from you, the more you seem to want them. You begin to stalk them, hound them, harass them, and even threaten them with dire consequences if they don’t respond the way you want them to. You don’t understand why and how this relationship deteriorated to this level. And you end up becoming a doormat and allow yourself to be used by your partner just because you’re scared that they might leave you.
When this happens over a period of time, you begin to lose a part of your soul; you become someone else, and your natural enthusiasm and zest for life come down by notches. You know in your heart that this relationship is destroying you emotionally and stressing you out, yet you persist, because it’s like a drug that you can’t get out of your system.
Just as an addiction ruins your life and leaves you a shell of your former self, emotionally destructive relationships too cause havoc in your life and drain your vitality and strength. So the sooner you get out, the better. But it’s easier said than done as most of us who have been there and done that know. It’s takes a great deal of determination and willpower to wrest control of your life and start afresh, but the first step to doing so is to recognize and admit that you do have a problem and that you need help.
Once you’re able to do that, it’s time to get your support network of family and friends (who have all been trying to get you out of this vicious rut you’re stuck in all this while) to help you become your former self, gain some self confidence and live life the way it should be lived. Because we’re human, we need relationships; but when relationships threaten to dehumanize us, it’s time to say goodbye to them.
By-line:
This post is written by Susan White, who writes on the topic of Becoming a Radiologist . She welcomes your comments at her email id: susan.white33@gmail.com .

Thrill-seeking, disruptive behaviour and cannabis use

High-intensity pleasure seeking refers to a tendency in teenagers to look for physical and social thrills. Broadly speaking it's what makes some kids go for raves and snowboarding while others go for hanging around in shopping centres and watching TV. A team of researchers from the Erasmus Medical Centre in Rotterdam looked into the links between high-intensity pleasure seeking, disruptive behaviour and the early onset of cannabis use. They found that both early-adolescent high-intensity pleasure seeking and disruptive behaviour (naughtiness and attention-deficity hyperactivity disorder (ADHD)) were linked to an early start smoking cannabis. However, there was little interaction between the two factors suggesting that thrill-seeking and disruptive behaviour lead on to cannabis use by different 'pathways.'

Creemers, Hanneke E. ... [et al] - Predicting onset of cannabis use in early adolescence: the interrelation between high-intensity pleasure and disruptive behavior: the TRAILS study Journal of Studies on Alcohol and Drugs November 2009, 70(6), 850-858

Older people and drink problems

Alcohol misuse by older adults is associated with poorer mental health, an increased risk of suicide and a greater chance of falls as well as an overall increase in the death rate of heavy drinkers. Researchers from Washington University in St Louis, Missouri, studied a sample of 4,646 people over 60. They found that nearly 90% of them could be classified as low-risk drinkers, nearly 10% were moderate-risk drinkers and just over 1% could be classified as genuine problem drinkers. Being a woman, older and African-American were associated with a decreased risk of alcohol problems whereas being the adult child of an alcoholic and being an ex- or current smoker were linked to an increased risk as was having major depression. People in the high-risk category had significantly worse mental and physical health than those people who drank less.

Sacco, Paul, Bucholz, Kathleen and Spitznagel, Edward L. - Alcohol use among older adults in the National Epidemiologic Survey on Alcohol and Related Conditions: a latent class analysis Journal of Studies on Alcohol and Drugs November 2009, 70(6), 829-838

Psychopathic children and antisocial adults

A number of studies have linked psychopathy with antisocial behaviour but there has been little research as to whether psychopathic tendencies in childhood and adolescence lead on to antisocial behaviour in adulthood. There has also been little research into whether the relationship might work in the other direction with antisocial behaviour such as rule-breaking and fighting leading on to the development of psychopathy. A team of researchers from the Karolinska Institute in Sweden studied 2,255 people involved in the Swedish twin study following them from childhood into adulthood. They found that psychopathic personality in mid-adolescence predicted antisocial behaviour in adulthood but not vice versa. However, persistent antisocial behaviour in childhood was associated with psychopathy. Psychopathic personality predicted both rule-breaking behaviour and aggressive behaviour. Genetic factors were also found to influence whether the children who were psychopathic earlier in the study went on to display antisocial behaviour later.

Forsman, Mats ... [et al] - A longitudinal twin study of the direction of effects between psychopathic personality and antisocial behaviour Journal of Child Psychology and Psychiatry January 2010, 51(1), 39-47

Mini people with mini bipolar disorder?

Bipolar disorder in children is a controversial topic. It has traditionally been thought to be very rare but the rate of diagnosis has increased dramatically over the last decade. There is a lot of heated debate as to whether this increase reflects past under-diagnosis or present over-diagnosis. The last large-scale study found a rate of 0.1% of mood disturbances in children under 13 but an official diagnosis requires lengthy periods of disturbance. If shorter periods of altered mood are included then the number of children affected by the condition could be much higher. One study found that 25% of children who had the shorter period of mood disturbance went on to develop bipolar disorder within the next two years. Researchers led by Argyris Stringaris from the Institute of Psychiatry, King's College London studied 5,326 8-19 year-olds from the general population. They found that while only 0.1% of the sample met the criteria for bipolar disorder, 1.1%-1.5% (depending on whether the parents or children respectively were asked about symptoms) had shorter episodes of mood disturbance. These mood disturbances were associated with social impairments over and above those caused by other mental-health problems but the researchers questioned whether, although they were superficially similar to bipolar disorder, they were actually part of the same condition with the same origin and potential treatments.

Stringaris, Argyris ... [et al] - Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry Journal of Child Psychology and Psychiatry January 2010, 51(1), 31-38

Burnout, nursing and trauma

Burnout syndrome is characterized by feeling overwhelmed by work, having impersonal feelings towards those one is providing services or care to, negative self-evaluation and a perception of reduced achievement. Burnout syndrome and post-traumatic stress disorder (PTSD) are common in hospital nurses and researchers from the University of Colorado and Emory University in Atlanta looked into this issue in a survey of 332 nurses. They found that 18% could be diagnosed with PTSD and 86% with burnout syndrome and that 98% of those with PTSD also had burnout syndrome. Nurses with burnout syndrome and PTSD were significantly more likely to have difficulty in their life outside work than those with burnout syndrome alone.

Mealer, Meredith ... [et al] - The prevalence and impact of post-traumatic stress disorder and burnout syndrome in nurses Depression and Anxiety December 2009, 26(12), 1118-1126

What works for PTSD?

Post-traumatic stress disorder (PTSD) is characterized by symptoms such as repeated, intrusive upsetting memories of the trauma; avoidance of similar situations and things which might remind one of them; a feeling of detachment from others; hypervigilance, and overarousal. It is associated with problems at work and at home and it is estimated that between 1% and 14% of people might suffer from it over the course of their lifetime. A team of researchers from New York reviewed 57 studies into treatments for PTSD and acute stress disorder which can often lead to it. They found that there was the strongest evidence for trauma-focused cognitive-behavioural therapy (CBT) and eye-movement desensitization and reprocessing (EMDR). There was some evidence that stress innoculation training, hypnotherapy, interpersonal psychotherapy and psychodynamic psychotherapy were effective for PTSD and that trauma-focused CBT was effective for acute stress disorder. The study also found evidence that trauma-focused CBT was effective for assault- and road-traffic-accident-related PTSD.

Ponniah, Kathryn and Hollon, Steven D. - Empirically supported psychological treatments for adult acute stress disorder and posttraumatic stress disorder: a review Depression and Anxiety December 2009, 26(12), 1086-1109

Early to bed, early to rise, makes a teenager much less miserable

Teenagers who go to bed early are more cheerful than ones who stay up late. Researchers from Columbia University Medical Center in New York studied data from 15,659 adolescents gleaned from the National Longitudinal Study of Adolescent Health which took place between 1994 and 1996. Those children who had a set bedtime of midnight or later were 24% more likely to suffer from depression and 20% more likely to have suicidal thoughts than those who had set bedtimes of 10 p.m. or earlier. Teenagers who slept for five or fewer hours per night were 71% more likely to suffer from depression and 48% more likely to think of committing suicide than those who said they got eight hours a night. Those who said they usually got enough sleep were significantly less likely to suffer from depression or suicidal thoughts. Perhaps the most surprising result of the survey is that 70% of the adolescents said that they complied with the bed times set by their parents. On average there was only a five minute difference between the teenagers' 'official' bed times and when they actually went to bed.

You can find out more about this research at

http://www.medicalnewstoday.com/articles/174948.php

Medics grappling with graphs

Graphs at the foot of patients' beds are a staple of cartoons, TV programmes and films but it might be more helpful if they were replaced with writing. Researchers at Edinburgh University presented 35 nurses and doctors from the neonatal intensive care unit in the city's Royal Infirmary with real data from 24 infant patients. The participants had to look at the data and decide what the next course of action should be. The data was presented in the form of a graph, text written by a medical expert and text generated by a computer from the information in the graph. The decisions made after looking at the graph and the computer-generated text were as good as each other but the medical staff made significantly better decisions after reading the text written by a medical expert. The text made no recommendations merely summarising the data on the graphs. It would be very expensive to write the written summaries for all patients but if the computer-generated texts could be improved that might be a cheaper way of improving patient care.

http://bps-research-digest.blogspot.com/2010/01/hospital-staff-make-better-decisions.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+BpsResearchDigest+%28BPS+Research+Digest%29&utm_content=Google+Reader

Unemployment hits mental health of U.K. youngsters

Unemployment is having a damaging effect on the mental health of young people. A poll carried out by YouGov for the U.K. charity the Prince's Trust found that among the 2,000 strong sample of 16-25 year-olds surveyed one in ten of those who had been out of work had turned to alcohol or drugs. Those not in education or training were twice as likely to feel down, depressed, isolated or rejected. 25% of unemployed youngsters believed that joblessness had caused arguments with their parents or other relatives and 15% said that their life lacked direction. The latest Government figures show that almost a million people aged between 16 and 25 are unemployed.

You can find out more about this story at

http://news.bbc.co.uk/1/hi/business/8438789.stm