One-day communities for personality disorder

The U.K. Government and mental-health services have been making attempts to improve services for people with personality disorders. Sometimes these involve residential therapeutic communities but day therapeutic communities which people take part in once a week are more adaptable, local and cheaper. Researchers from the University of Liverpool studied four one-day therapeutic communities in Manchester and Liverpool between November 2005 and July 2008 looking at patients' mental health, social functioning, self-harm and use of services. The patients reported their own levels of health and were assessed by experts. The researchers found that the centres improved the patients' mental health and social functioning but made only slight improvements in their levels of self-harm and their use of services.

Barr, Wally ... [et al] - Quantitative findings from a mixed methods evaluation of once-weekly therapeutic community day services for people with personality disorder Journal of Mental Health, October 2010; 19(5): 412–421

How a pair of trainers could keep the college blues away

There is quite a lot of evidence to suggest that exercise improve one's mental health. However, most of the research done so far has concentrated on people who already suffer, to some extent at least, from depression and anxiety. A team of researchers from the University of Gloucestershire and the University of Hertfordshire investigated whether exercise could improve mental health in a sample of 100 students. Students are known to be at greater risk of developing mental health problems because of worries about their studies, finances and moving away from home and one study found that they were 64% more likely to experience symptoms of mental ill-health than other young people. The researchers found that those students who engaged in high levels of physical activity showed significantly lower levels of depression and anxiety than the medium- and low-physical-activity groups and the more the students exercised the less depressed and anxious they were.

Tyson, Philip ... [et al] - Physical activity and mental health in a student population Journal of Mental Health, 2010; 1–8, iFirst article

Why people do what the voices tell them to do

People who hear voices often report being given commands by them but not everyone obeys such commands. Researchers from the Adult Learning Disability Service in Prescot, Merseyside and the University of Manchester studied 49 people who were hearing voices. They classified the commands the participants had been given as benign, self-harm or harm-others. The study found that obeying their last self-harm command was associated with 'elevated voice malevolence,' worse symptoms and perceived negative consequences for non-compliance. Compliance with the last harm-others command was associated with more severe symptoms, worse perceived consequences for non-compliance and higher levels of social rank attributed to the voice.

Barrowcliff, Alastair L. and Haddock, Gillian - Factors affecting compliance and resistance to auditory command hallucinations: perceptions of a clinical population Journal of Mental Health, 2010; 1–11, iFirst article

Getting better slowly or gradually - does it make a difference?

People having psychotherapy quite often make sudden gains, displaying abrupt and substantial improvements in symptoms from one session to the next. Sudden gains have been investigated in the context of randomised controlled trials (RCTs), tightly-controlled studies designed to compare one treatment with another, and in therapy carried out by experts but researchers from American University in Washington D.C. looked to see whether these gains could occur in other contexts. They studied 106 outpatients being treated in a university-based psychotherapy training clinic. Overall sudden gains were identified in 29% of the patients, gains which tended to occur early in therapy. However, the gains were more likely to be reversed than in RCTs which usually involve more-experienced therapists. 54% of the sample showed gradual gains which tended to occur later in therapy. Those patients who had had sudden gains did significantly better by the end of therapy than those who showed more gradual gains.

Greenfield, M. F., Gunthert, K. C. and Haaga, D. A. - Sudden gains versus gradual gains in a psychotherapy training clinic Journal of Clinical Psychology n/a. doi: 10.1002/jclp.20748

Getting to the bottom of why people worry

Generalised anxiety disorder (GAD), or chronic worrying, is the most common anxiety disorder and, in any one year, is thought to affect around 2.7% of the population. Two thought processes that are believed to underly GAD are intolerance of uncertainty and what psychologists call negative metacognitive beliefs - worry about worry. Intolerance of uncertainty is a predisposition to react negatively to an uncertain event or situation - to assume that the worst is going to happen. People who are intolerant of uncertainty assess ambiguous situations as being stressful, disturbing and unacceptable and show increased perceptions of threat in situations that are relatively harmless. Worrying about worrying can lead to unhelpful behaviour and ways of controlling one's thoughts that actually lead to more worry in the long-term. Researchers from Swinburne University of Technology in Melbourne studied 119 people in an attempt to investigate these issues further. Their study also looked into the effects of 'parentification' - a situation in which children end up looking after people who are supposed to be looking after them. The idea behind this was that these children are asked to carry out tasks that they are not really capable of which makes them less confident, and more anxious about, their ability to handle difficult situations in the future. The researchers found that intolerance of uncertainty and negative metacognitive beliefs were both associated with an increase in GAD symptoms. However, once the researchers had taken into account the effects of depression parentification was not associated with an increased propensity to worry.

Tan, Shary ... [et al] (2010) Metacognitive, cognitive and developmental predictors of generalised anxiety disorder symptoms Clinical Psychologist 14 (3), 84 - 89

New study - Omega-3s no help with Alzheimer's

Omega-3 fish oils do not slow the cognitive decline of people with Alzheimer's disease. Researchers from Oregon Health and Science University studied 215 people with mild to moderate Alzheimer's disease. Over 18 months 171 of them took fish-oil tablets while the rest took a placebo. The researchers tested the participants' cognitive abilities and, in a smaller group of participants measured their brain volumes with an MRI scanner. The researchers found that taking the fish oil had no beneficial effects on the participants' cognition and no effect on total brain volume. The authors concluded that "in summary these results indicate that DHA (docosahexanoic acid, an Omega-3 found in fish oil) supplementation is not useful for the population of individuals with mild to moderate Alzheimer disease."

Could meditation help preserve your DNA?

A new study by researchers at the University of California, Davis and the University of California, San Francisco has provided more evidence of the links between meditation, psychological wellbeing and health by measuring the levels of an enzyme called telomerase. The researchers studied 60 people comparing 30 who received meditation training with 30 from similar backgrounds who acted as a control group. Telomerase helps to repair telomeres which are sequences of DNA at the end of chromosomes; they function a bit like the bits of plastic at the end of shoelaces helping to stop the chromosomes wearing out. The researchers compared the levels of telomerase in the white blood cells of the meditating and non-meditating participants and found that telomerase activity was about a third higher in the white blood cells of the meditating group. The meditating participants had a greater sense of purpose in life and more mindfulness this led them to feel a greater sense of control over their life and surroundings and less neuroticism which in turn led to the increase in telomerase activity.

Genes, autism and neural connections

Scientists at the Scripps Translational Science Institute in San Diego have been using cutting-edge neuroscience to look into the links between genetics and autism. They used MRI (magnetic resonance imaging) brain scans to study 32 children who had a variation in a gene called CNTNAP2 which is associated with an increased risk of autism, attention deficit hyperactivity disorder (ADHD), Tourette's syndrome and schizophrenia. Half of the children had been diagnosed with autism while half were unaffected. The researchers used the MRI scans to see what was going on in the children's brains while they carried out a language-learning task. Compared to children without the variation in the gene the children with it had a superfluity of connections in their prefrontal cortices and a lack of connections between the prefrontal cortex and the left side of the brain, which is connected with language.

Antiepileptic drugs and cognition

Women with epilepsy who take more than one drug to control their seizures may have children who perform less well at school. Researchers from Karolinska University Hospital and the University of Lund in Sweden studied 1,308,318 children born between 1973 and 1986; 1,235 of them were born to mothers with epilepsy who took more-than-one (429), one (641) or no (165) anti-epileptic drugs when they were pregnant. Those children who had been exposed to more than one anti-epileptic drug in the womb had an increase risk of not receiving a final grade upon completion of their schooling. However, those whose mothers had taken only one kind of anti-epileptic drug showed no decrease in performance.

The best way of learning something? Sleep on it.

Getting information into one's long-term memory has been compared to pouring water into a bottle with a narrow neck; it holds a lot but it is difficult to get it in in the first place. A new study by researchers at York University and Harvard Medical School suggests that one of the best ways of doing this could be to sleep on it. The researchers got two groups of volunteers to learn new words. One group learnt them in the evening and were tested in the evening. The group who slept on things, as it were, remembered more words and could recognise them faster. By studying these participants' brain waves the researchers found that it was deep sleep - rather than rapid-eye-movement (REM) or light sleep - that did most to consolidate memory. Sleep spindles, which are sharp bursts of activity reflecting information transfer between the neorcortex on the surface of the brain and the hippocampus deep within it, were particularly associated with memory consolidation.

Mental disorders and risk of suicide in veterans

Researchers from the Department of Veterans Affairs (VA) Healthcare System and the University of Michigan, Ann Arbor have been looking into the links between mental disorders and suicide in U.S. military veterans. They studied more than 3 million veterans who had received any type of care in a VA facility in 1999. They looked at their psychiatric diagnoses from their 1998 and 1999 treatment records and followed them over a seven-year period. By the end of the study 7,684 veterans had killed themselves. 46.8% of those who committed suicide had at least one psychiatric diagnosis and all of the diagnoses studied - depression, schizophrenia, bipolar disorder, drug abuse, post-traumatic stress disorder (PTSD) and anxiety - led to an increased risk of suicide. In men bipolar disorder was associated with the greatest risk of suicide while in the women drug abuse was - overall bipolar disorder led to the greatest increase in risk.

Child sex abuse and schizophrenia risk

Being sexually abused as a child is a risk factor for psychosis and schizophrenia. Researchers from Monash University in Australia studied 7,697 people, 2,759 of whom had - according to police and medical records - been sexuall abused as children. They found that over a 30-year period people who had suffered child abuse had double the rate of psychosis (2.8% vs 1.4%) and nearly treble the rate of schizophrenia (1.9% vs 0.7%). Those who had suffered penetration of an orifice by another person or an object were at an even greater risk of psychosis and schizophrenia - 3.4% and 2.4% respectively.

Faces, places and perception

A Canadian brain-scanning study has shed new light on the differences in the way older and younger people process visual information. Researchers from the University of Toronto used magnetic resonance imaging (MRI) to compare brain activity in younger and older adults. The participants in the study were asked to look at pictures of overlapping faces and places, although they were told only to pay attention to the face and its gender. In the young adults the area of the brain responsible for processing faces was active but the one responsible for processing places wasn't; however, in older adults both regions were active suggesting that they had difficulty screening out the relevant information. But, in a memory test 10 minutes later, the older adults were better at remembering which face went with which building, so, from a less ageist perspective one could say that older people were better at seeing the bigger picture.

Anorexia and abortion

Women with anorexia are more likely to have unplanned pregnancies and abortions. Researchers from the University of North Carolina at Chapel Hill, and from Norway, studied 62,060 women as part of the Norwegian Mother and Child Cohort Study. They found that 50% of the women with anorexia reported having an unplanned pregnancy, compared to 18.9% of the women without the eating disorder; for abortions the figures were 24.2% and 14.6% respectively. The researchers thought the difference could be due to the fact that the women with anorexia thought that their condition had rendered them - at least temporarily - infertile.

Brothers, sisters and bullying

Older brothers are more likely to bully their younger siblings than older sisters. Researchers from the Universita' degli Studi Di Firenze in Florence studied 195 children, aged between 10 and 12. They found that children with older brothers were more likely to report being bullied at home and that boys were more likely to bully if they had a younger brother or sister. Older sisters were only likely to bully if they had a bad relationship with their yonger siblings.

New study less hopeful on teenage depression

New research from Duke University in North Carolina has painted a gloomy picture of the recovery rates from adolescent depression. Their study involved 196 participants - 110 of whom were girls - aged between 12 and 17. Some were treated with fluoxetine (Prozac), others with cognitive behaviour therapy (CBT), others with a combination of the two, while a fourth group acted as a control group (i.e. had no psychotherapy and took a placebo instead of Prozac). Nearly 95% of the participants recovered and 88.3% recovered within two years. However, over the five-year period of the study 46.6% of the participants who recovered had another bout of major depression. 57% of the girls had a relapse, compared to 33% of the boys - perhaps, thought the researchers, because the girls were more inclined to chew things over and have feelings of inadequacy. None of the treatments was better at preventing relapse but those teenagers who recovered within two years were less likely to become ill again.

Misusing prescription drugs - the hidden rural drugs problem

Misuse of prescription drugs could be described as a hidden drug problem. One in eight U.S. teenagers abuse prescription opioids at some point, something which is associated with using cocaine and heroin as well as gambling, increased sexual activity and impulsivity. Researchers from the University of Kentucky analyzed data from 17,872 12 to 17-year-olds who took part in the 2008 National Survey on Drug Use and Health. Overall there was no difference in illegal drug use between urban and rural teenagers and the rates of usage were similar for cannabis, cocaine, heroin and hallucinogens. However, 13% of rural teenagers reported abusing prescription drugs compared to 10% of urban ones and they were more likely to have used pain relievers and tranquilizers non-medically. Even after taking other factors into account rural teenagers were 26% more likely to abuse prescription drugs. Poor health, episodes of depression and other substance abuse were all risk factors but children who lived with both parents were 32% less likely to misuse prescription drugs.

PTSD in Iraq troops - levels lower than expected

Researchers from the Institute of Psychiatry, King's College London have been carrying out the first major study into the mental health of the U.K.'s armed forces while they are on deployment. They studied 611 servicemen and women based in eight locations across Iraq. 92.6% rated their overall health as good, very good or excellent. Servicemen and women were more likely to report good health if they were officers, if they felt their unit was very cohesive and had supportive leadership and if they had taken a period of rest and recuperation outside the operational theatre. 20.5% showed signs of experiencing psychological distress and 3.4% were thought to have post-traumatic stress disorder (PTSD) - a rate similar to service personnel not on deployment and lower than in police officers, doctors in emergency departments and disaster workers. Psychological distress was more common among service personnel who were young, women, in the army and of junior rank. PTSD was more common among people of junior rank, those who felt themselves in danger of being killed and those who had been more exposed to combat.

Exercise and preventing depression - it works but only if you're having fun

Exercise can help to stave off depression but only if you do it in your spare time. Researchers from Norway and the Institute of Psychiatry, King's College London studied 40,401 Norwegians asking them about their physical activity and their levels of anxiety and depression. They found that people who took part in regular physical activity - no matter how intense - were less likely to have symptoms of depression. However, this relationship only held true for activity done during leisure time; those people whose work involved physical effort were as likely to be depressed as those people who worked in sedentary jobs. The more people engaged in physical activity during their spare time the less likely they were to be depressed and those who were not active outside work were almost twice as likely to suffer symptoms of depression as more active individuals.

Psychosis and socialising - investigating the connection

Psychosis symptoms are often preceded by a withdrawal from social relationships and a decline in social function. Researchers from Denmark set out to investigate this further in a study of 398 people. 11 of them had some symptoms of psychosis, 12 were defined as 'prodromal' - i.e. about to develop psychosis, 12 met the diagnostic criteria for psychosis and the remainder were an unaffected control group. The researchers used a questionnaire to measure people's interpersonal problems and found that there was an increase in them as their symptoms got worse. The research adds to other studies suggesting that addressing these problems in getting on with other people could be a useful way of helping people at risk of developing psychosis.

Mondrup, Lise and Rosenbaum, Bent - Interpersonal problems in the prodromal state of schizophrenia: an exploratory study Psychosis October 2010, 2(3), 238-247