New survey shows recession's toll on youngsters' mental health

Nearly a million 16-24 year-olds in the U.K. are unemployed and a new survey by the Prince's Trust charity shows the toll that this is taking on youngsters' mental health. The survey of 2,170 people aged between 16 and 25 found that young people were twice as likely to self-harm or suffer from panic attacks if they had been jobless for more than a year. Almost half of the sample had problems such as self-harm or insomnia. About one in six respondents to the survey said being out of work was as stressful as a family breakdown, and one in eight said unemployment gave them nightmares. Half of young people seeking work said visits to a job centre made them feel ashamed, and more than half said that job-searching had left them feeling disillusioned or desperate.

Overweight mums not linked to children's intellectual and behaviour problems

Previous studies have shown that women who are overweight before becoming pregnant are more likely to have children with behavioural and learning problems. However, a new study by researchers at the University of Bristol suggests that there is not a direct link between mothers being too fat and their children being badly behaved or doing poorly at school. The researchers studied 7,500 British and Dutch children. The British children were born between 1991 and 1992 and the Dutch children were born between 2002 and 2006. Overall there was no connection between the mothers' pre-pregnancy weights and their children's performance on tests of language and other skills. Children born to overweight women did do less well on language tests but once the fact that fatter mothers tended to be less well-educated and have lower incomes was taken into account the link disappeared.

Mediterranean diet may lead to fewer senior moments

Researchers from Rush University Medical Centre in Chicago have been adding to the evidence which suggests that a Mediterranean diet can prevent cognitive decline in older people. The researchers studied 4,000 people aged 65 and over and gave their diets scores based on how closely they matched a traditional Mediterranean diet - high in wine, fruit, vegetables, legumes, olive oil and fish and low in saturated fat and red meat. The study found that those participants who adhered most closely to a Mediterranean diet had a slower cognitive decline even after taking into account the influence of other factors such as education.

Steps to respect shuts up malicious gossip

Despite proverbs about sticks and stones malicious gossip can be hurtful to children and adults alike, and, in the playground at least, can often lead on to physical bullying. Researchers from the University of Washington in Seattle studied the effectiveness of a programme called Steps to Respect at reducing spiteful gossip. The programme encourages empathy, teaches assertiveness, emphasises that bullying is not a social norm and teaches children not to retaliate as this can make matters worse. Researchers used Palm Pilots to electronically record 610  Year 3 to Year 6 students' behaviour for five minutes, once a week, while they were in the playground. After the programme the children who had taken part in the Steps to Respect programme showed a 72% decrease in malicious gossip.

Alcoholism and obesity

People with a family history of alcoholism may be more likely to become obese. Researchers from Washington University in St Louis studied 80,000 people taking part in a national survey in 2001 and 2002. They found that women with a family history of alcoholism were 49% more likely to be obese than those without. Men who had a family history of alcoholism were also at a greater risk of becoming too fat but to a lesser extent. The researchers think that the link might be due to the fact that the high levels of fat and sugar in junk food affect the same 'reward' centres in the brain that alcohol does.

Sibling age differences and autism

Children who are born closer in age to their older siblings may have an increased risk of being diagnosed with autism. Researchers from Columbia University in New York studied more than 600,000 pairs of siblings born in California between 1992 and 2002. In 3,000 of these pairs the older child had not been diagnosed with autism while the younger one had. In sibling pairs where the mother became pregnant with her second child less than a year after giving birth to her first 7.5 out of 1,000 younger children were diagnosed with autism but where the gap was three years or more only 2.5 out of every 1,000 were. The shorter the age gap between children the greater the risk of developing autism. The researchers thought that this could either be because women's nutrition and stress levels had not recovered properly after giving birth to their first child by the time they became pregnant again or because, having seen normal childhood development relatively recently, the parents were quicker to spot abnormal development in their younger child.

Light boxes might help with non-seasonal depression too

Light boxes are often used to help people suffering from seasonal affective disorder (SAD). However, a new study by researchers from the VU University Medical Centre in Amsterdam suggests that it may also be helpful for people suffering from non-seasonal depression too. In the study 89 men and women aged 60 and over were assigned to two groups. One group got genuine light therapy while the other group sat in front of a dimmer light which has no known effects on the body. After three weeks of treatment the group receiving the genuine light therapy showed an improvement in their depression symptoms - an improvement which was still maintained three weeks later. The people in the light-therapy group showed increases of the hormone melatonin - which promotes sleep - in the evening and decreases in their levels of the stress hormone cortisol, and the lamps were effective for people already taking anti-depressants. However, this was quite a small trial and there is a need for evidence that the lamps produce an improvement in symptoms over a period longer than three weeks.

Even second-hand TV can increase the risk of eating disorders

The mixed blessings of broadcast television only arrived in Fiji in 1995 which makes it an ideal place to research its effects. Researchers from Harvard Medical School have been looking into the effects of media consumption on eating disorders in adolescent girls there and found that the girls participating in the study did not even need to have a TV at home themselves in order to see a raised risk of eating-disorder symptoms. In fact, by far the biggest factor for eating disorders was how many of a subject's friends and schoolmates had access to TV. By contrast, researchers found that direct forms of exposure, like personal or parental viewing, did not have an independent impact, when factors like urban location, body shape and other influences were taken into account. Higher exposure to TV among a girl's peer group was linked to a 60% increase in the odds of having a high level of eating-disorder symptoms. The study is particularly interesting as Fijian culture traditionally prizes a fuller-figure among women.

New blood test for Alzheimer's could be new breakthrough

Researchers from the Florida campus of the Scripps Research Institute have developed a new blood test for Alzheimer's disease which could detect the condition much earlier than current methods. The test is based on the body's immune system which produces antibodies in response to proteins on viruses and bacteria and those produced in Alzheimer's disease. The team used 15,000 synthetic proteins as 'bait' to 'fish' for antibodies in blood samples taken from six patients with Alzheimer's disease, six with Parkinson's and six healthy individuals. The test proved successful in this small sample but lots more research is needed before it can be fully established.

More evidence on overuse of antipsychotics

So-called 'second-generation,' antipsychotic drugs were originally developed to tackle psychoses and schizophrenia but are increasingly being used to tackle unrelated conditions where cheaper and more effective alternatives exist. Researchers from the University of Chicago and IMS Health used data from a survey of U.S. physicians. They found that 16.7 million prescriptions for antipsychotic drugs were written in 2008, accounting for $10 bn, or nearly 5% of U.S. spending on prescription drugs. 9 million of the prescriptions - about $6bn across the U.S. - were for conditions where the use of the drug does not have approval from the U.S.'s Food and Drug Administration. There were particular concerns about the use of antipsychotic drugs to treat bipolar disorder and depression where cheaper and more evidence-based alternatives exist. The drugs can have a number of different side effects including weight gain, diabetes and heart disease.

ADHD and the daydreaming brain

The default mode network (DMN) connects various parts of the brain; it is active when we are daydreaming or staring into space and gives rise to spontaneous thought but is suppressed when we are concentrating on a particular task. New research from the University of Nottingham suggests that children with attention-deficit hyperactivity disorder (ADHD) could have difficulty in switching their DMNs off which could explain why they have problems concentrating. The researchers compared 18 children between nine and 15 who had been diagnosed with ADHD against a similar number of unaffected controls scanning their brains as they played a video game. The researchers found that the control group were better at switching off their DMNs when they needed to than the children with ADHD.

Deaf people, seclusion and restraint

It is widely believed that people who are deaf or who have hearing problems are more often subject to restraint and seclusion in mental-health services than other people but there is little hard evidence to back this up. Researchers from Oregon State Hospital and Pacific University in Oregon compared 22 deaf or hard of hearing people committed to a large state hospital with 22 similar people who had also been committed but who did not have hearing problems. They found that the people with hearing problems were more likely to be subject to seclusion and restraint although the people with good hearing were, on average, secluded for longer.

Hartman, Brian and Blalock, Ann - Comparison of Seclusion and Restraint Prevalence between Hearing Patients and Deaf or Hard of Hearing Patients in a State Hospital Setting Issues in Mental Health Nursing, 32: 42–45, 2011

Iraq - the long-term toll of PTSD

Nearly 2 million U.S. troops have served in Iraq since 2001. Researchers from the University of Minnesota Medical School studied 953 National Guard soldiers who answered questions in Iraq a month before returning home and then again a year later. In the first survey 7.6% of the soldiers were thought to have post-traumatic stress disorder (PTSD) whereas in the second survey 18.2% were. The troops who had had PTSD in the first survey were more likely to suffer from memory and balance problems, concentration difficulties and irritability a year later than those who had suffered concussion without PTSD.

Schizophrenia and impulsivity

Being over-impulsive is one of the hallmarks of schizophrenia and can lead to violence, drug abuse and suicide. However, it is not really known what happens in the brains of people suffering from schizophrenia that makes them more impulsive. Researchers from the Universite de la Mediterranee in Marseilles studied this issue by comparing 26 people with schizophrenia with 30 healthy controls. The participants filled out a questionnaire about their impulsiveness, took a 'Go/No go' test - in which not reacting to things is as important as reacting to them - and had MRI brain scans. The patients with schizophrenia were more impulsive than the controls and a region of their brains called the right ventrolateral prefrontal cortex was less efficient at processing 'inhibitory control.'

Kaladjian, A. ... [et al] - Impulsivity and neural correlates of response inhibition in schizophrenia Psychological Medicine (2011), 41, 291–299

What to do with people who fall through the gaps?

Unless people present a danger to themselves or others mental health services don't treat them until they voluntarily seek help. Psychologists now think that people might be at risk of developing psychosis for a while before they become severely ill. Developing psychosis can have a massive impact on people's lives but so can being labelled as mentally ill and the side effects of antipsychotic drugs so that intervening in the lives of people who are 'at risk' for psychosis is a vexed issue, both medically and ethically. Researchers from the Institute of Psychiatry, King's College London attempted to shed a little more light on this debate in a study of people who had been referred to mental-health services by their GP. The study found that 21.2% of people had not turned up for their appointment with mental-health services. Around half this group subsequently received a diagnosis of mental illness and over a fifth of the 'no-shows' were later given a diagnosis of psychosis with nearly 70% of them seeking help from other mental-health services. People who did go on to their appointments with mental-health services were more likely to be employed. The authors of the study argue that there is a case for mental-health services chasing up people who have been referred to them by GPs but who have not turned up for their appointments.

Green, C. E. L. ... [et al] - Outreach and Support in South London (OASIS). Outcomes of non-attenders to a service for people at high risk of psychosis: the case for a more assertive approach to assessment Psychological Medicine (2011), 41, 243–250

Seclusion and restraint in Canada

Patients in psychiatric hospitals are often put on their own - in seclusion - for a while until they calm down and stop being a danger to either themselves or others. However, researchers don't know that much about how often it happens or which people are most likely to be placed in seclusion. Researchers from Montreal University studied 2,721 psychiatric patients. They found that 23.2% of them had been placed in seclusion and that 17.5% of them had been secluded with (physical) restraint. Being young; suffering from schizophrenia or psychosis; suffering from bipolar or personality disorder and having to stay in hospital for a longer time were all associated with seclusion while being young, having bipolar or personality disorder and staying for a longer time in hospital were all associated with having to be physically restrained.

Dumais, A. ... [et al] - Prevalence and correlates of seclusion with or without restraint in a Canadian psychiatric hospital: a 2-year retrospective audit Journal of Psychiatric and Mental Health Nursing doi: 10.1111/j.1365-2850.2010.01679.x

Hospital art - is it really a waste of money?

In times of budget cutbacks hospital art is often the first thing to go, however, a new piece of research suggests that this might be a false economy. Upali Nanda from American Art Resources in Houston led a study based in a lounge for psychiatric patients in a hospital in East Alabama. On different days either a picture of nature or a landscape; a piece of abstract art or no art at all was hung up in the lounge. The researchers then noted how much medication was prescribed on a pro re nata (PRN) (over and above patients' normal prescriptions) basis to deal with patients who had become agitated or anxious. The study found that there was a significant reduction in PRN medication on the days when natural and landscape art was hung in the lounge although some abstract art was found to make patients more agitated. The reduction in PRN medication was found to be around $30,000 per annum - more than enough to buy a few halfway-decent prints for the lounge.

Nanda, U. ... [et al] - Effect of visual art on patient anxiety and agitation in a mental health facility and implications for the business case Journal of Psychiatric and Mental Health Nursing
doi: 10.1111/j.1365-2850.2010.01682.x

Mindfulness and stress. Who does it help?

Mindfulness - being aware in the present moment in an open and non-judgemental fashion - is used to help with a number of different psychological problems. Mindfulness-based stress reduction (MBSR) has been shown to be helpful to people but there has been little research into whether it is more effective in certain people or not. Researchers from Santa Clara University in California studied 30 people. 15 of them formed a control group while 15 of them received MBSR. MBSR was found to increase mindfulness, wellbeing and empathy in assessments carried out two and 12 months later. However, those participants who already had the highest levels of mindfulness before the MBSR treatment started showed the greatest levels of improvement.

Shapiro, Shauna L. - The Moderation of Mindfulness-Based Stress Reduction Effects by Trait Mindfulness: Results From a Randomized Controlled Trial Journal of Clinical Psychology doi: 10.1002/jclp.20761

Executive dysfunction, problem-solving and depression

People with executive dysfunction have problems setting goals, planning, initiating and sequencing behaviour. Executive dysfunction is often a symptom of depression and a team of researchers from Weill Cornell Medical College in New York studied the effectiveness of two different kinds of therapy in combating it in a study of 221 older adults with depression. Problem-solving therapy (PST) helps patients identify the most important problems in their lives, select solutions and make concrete plans for dealing with them while supportive therapy (ST) is more like counselling being based on 'active listening' and offering support in a non-judgemental environment. The participants were divided into two groups, each having either PST or ST, and received 12 weekly sessions of therapy. After six weeks both groups had shown comparable levels of improvement, however, the group receiving PST showed greater improvements after nine and 12 weeks and this difference was still there 24 weeks after the end of treatment. PST was particularly helpful for people who had cognitive problems and who had had more previous episodes of depression.

Alexopoulos, George S. ... [et al] - Problem-Solving Therapy and Supportive Therapy in Older Adults With Major Depression and Executive Dysfunction: effect on disability Archives of General Psychiatry January 2011, 68(1): 33-41

Bupropion and tobacco cravings

Bupropion hydrochloride was originally marketed as an antidepressant but it has also been found to be effective in helping people to give up smoking. It reduces people's cravings for cigarettes but noone knows quite how it works. A team of researchers from the University of California Los Angeles studied 30 people all of whom were hooked on cigarettes. Over an eight-week study half of them were given bupropion and half were given a placebo. The participants who had been given bupropion reported fewer cravings and less activation in the left ventral striatum, the right medial orbitofrontal cortex and the bilateral anterior cingulate cortex than those who were taking a placebo. All the participants showed reduced brain activity in the bilateral medial orbitofrontal cortex and the left anterior cingulate cortex when they were trying to resist tobacco cravings suggesting that bupropion works by dampening down these areas of the brain.

Culbertson, Christopher S. ... [et al] - Effect of Bupropion Treatment on Brain Activation Induced by Cigarette-Related Cues in Smokers Archives of General Psychiatry doi:10.1001/archgenpsychiatry.2010.193