Self portraits and eating disorders

Women who suffer from anorexia and bulimia draw themselves differently from other women. Researchers from the University of Haifa in Israel studied 76 women. 36 had been diagnosed with anorexia or bulimia, 20 had no eating disorders but were overweight and 20 were normal weight. The women with eating disorders drew themselves either with a lager neck, a disconnected neck or no neck at all, they emphasized the mouth more and drew themselves with wider thighs. They also drew themselves either without feet or with disconnected feet. Compared to the women with bulimia the women with anorexia tended to omit breasts from their drawings, draw less defined body lines and draw smaller figures relative to the size of the page.

Ecstasy and cognition

A new study led by John Halpern of Maclean Hospital in Belmont, Massachussetts has found no evidence that ecstasy affects people's cognitive abilities. The study of 111 people compared 52 ecstasy users with 59 non-users. The non-users were also members of the "rave" scene and had also taken part in all-night raves where they suffered from fluid and sleep deprivation. The participants were screened for drug and alcohol use to make sure they were unaffected on the day of testing and the ecstasy users did not habitually use other drugs that might impair their cognition. The study found no signs that ecstasy impaired people's cognitive ability but the study's authors point out that there are still a number of other risks to taking ecstasy including other side effects and the risk of overdosing and contamination.

Review gives thumbs up to peer support

Peer support programmes for depression involve patients and volunteers supporting each other by talking and sharing information with one another. They have been found to decrease isolation, reduce stress, increase the sharing of health information and provide role models, and, because they rely on volunteers and non-professionals they are also cost effective. Researchers from the University of Michigan Medical School reviewed 10 studies into the effectiveness of peer support carried out between 1987 and 2009. They found that the programmes reduced symptoms of depression better than traditional care alone and were about as effective as cognitive behaviour therapy.

Why teenage drinking should be taken seriously

People who are drinking heavily at 18 are more likely to develop an alcohol problem by the time they are 25. Researchers from Indiana University studied 597 Finnish twins assessing them for drinking problems at age 18 and again at 25. The researchers used a questionnaire called the Rutgers Alcohol Problem Index which asks about 23 different negative consequences of alcohol drinking such as getting into a fight with a friend or family member. The more drink-related problems experienced by an adolescent at 18 the likelier it was that they would be diagnosed with alcoholism at 25. The study shows that teenage heavy drinking is something that needs to be taken seriously not just a phase that kids go through.

Deafness and dementia

Losing your hearing could increase your risk of developing dementia. Researchers from Johns Hopkins University in Baltimore studied more than 600 men and women over an average of 12 years and all the participants had a hearing test done at the start of the study. Overall 9% of the participants developed dementia over the course of the study. Those with mild hearing loss had twice the risk of developing dementia, while those with moderate hearing loss had three times the risk. People with severe hearing loss had five times the risk of developing dementia.

Suicide and depression - why the greatest risk is on the way back up

Paradoxically people being treated for major depression often experience more suicidal thoughts after they start treatment as they move from a state of complete passivity and acquire enough energy to think about suicide while still being profoundly depressed. A team of researchers led by Paola Rucci from the University of Pittsburgh School of Medicine studied this effect in 291 patients taking part in a trial comparing the effectiveness of interpersonal psychotherapy and treatment with serotonin-specific reuptake inhibitors (SSRIs). Of the 231 patients who weren't thinking of killing themselves at the start of the study 13.8% of them did think about ending it all at some point in the study. The participants taking SSRIs took longer to start thinking about killing themselves than those having psychotherapy. Of the 60 patients who were thinking about killing themselves at the start of the study seven showed more suicidal ideation after starting treatment. Overall though all the patients in the study managed their suicidal ideation successfully within the context of the study.

Rucci, P. ... [et al] - Treatment emergent suicidal ideation during 4 months of acute management of unipolar major depression with SSRI pharmacotherapy or interpersonal psychotherapy in a randomized clinical trial Depression and Anxiety DOI 10.1002/da.20758

Valued action and anxiety

'Valued action' is defined as 'the degree to which one engages in behaviours that are consistent with personally-held values.' A team of researchers from Suffolk University in Massachussetts studied how valued action affected quality of life in people with generalised anxiety disorder (GAD). They compared 30 people with GAD to 30 unaffected people and found that those participants with GAD reported significantly less valued action; something not explained by the depression that often goes alongside GAD. Valued action had a significant association with quality of life and was also associated with less 'experiential avoidance' - avoiding potentially-stressful situations - and distress about emotions. An acceptance-based behavioural therapy, which encourages patients to accept their uncomfortable emotions but still change their behaviour was found to increase valued action in the participants with GAD with 40% achieving clinically-significant change in this area.

Michelson, Susan E. ... [et al] - The role of values-consistent behaviour in generalized anxiety disorder Depression and Anxiety DOI 10.1002/da.20793

Cleft lip/palate and child development

Cleft lip and palate is one of the most common congenital malformations affecting around one in 650 children. Despite the fact that in the developed world surgery is usually carried out for the condition at between three and four months people affected by it have been found to be at an increased risk of psychological difficulties including cognitive problems in infancy and early school, particularly with verbal IQ. Researchers have previously found an association with the quality of mother-child interaction at two months and cognitive development at 18 months; the theory being that shock, worries about forthcoming surgery, feeding problems and the difficulty of engaging with a disfigured child affect the relationship between a mother and her child, in turn affecting children's development. The same team of researchers, led by Francoise Hentges from the University of Reading, followed up a group of 170 children seven years later. 44 had early cleft-palate surgery, 49 late surgery and 77 were unaffected 'controls.' The study found that the children who had had cleft palate scored significantly lower on tests of cognitive development. This was mostly mediated  by 'maternal sensitivity' at two months, even after allowing for the later effects of mother-child interaction. The study shows both how parents of children with cleft lip/palate need support from day one and how crucial the first few months are in a child's development.

Hentges, Francoise ... [et al] - The effect of cleft lip on cognitive development in school-aged children: a paradigm for examining sensitive period effects Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2011.02375.x

Is there such a thing as passive drinking?

People who are in close contact with someone with an alcohol problem could end up suffering from something analogous to passive drinking. Researchers from Massey University in Auckland, New Zealand studied 3,068 people aged between 12 and 80. The participants were asked whether they had any heavy drinkers in their life and one in three said they had. People who lived with a heavy drinker had the lowest scores on measures of general health and personal well-being - defined as people's satisfaction with their relationships, work, health and what they were achieving in life. However, even people with a relatively low exposure to heavy drinkers, such as a colleague or a more distant relative with a drink problem, generally reported lower satisfaction with life compared to those who knew no heavy drinkers. The study is interesting but doesn't show which direction the link goes in. It could be the case, for instance, that unhappy people are more attracted to heavy drinkers or that unhappy people drink more but it is their unhappiness not their drinking that affects other people. And of course the fact that two things - heavy drinking and unhappiness - happen together does not meant that they are linked any more than riots in Egypt and Green Bay Packers' Superbowl triumphs are. But the study does add some weight to the commonsense idea that heavy drinking isn't good either for oneself or the people around one.

New gene linked to depression

Everyone experiences some stress in their day-to-day lives but some people calm down after it more quickly than others. A chemical in the brain called neuropeptide Y (NPY) is thought to play a role in this and some variations in people's genes can cause them to produce lower levels of this chemical. Researchers from the University of Michigan Medical School studied 181 people. They analyzed their genes to see how effective they were at producing NPY and studied how they reacted to negative stimuli and whether they suffered from depression. The study found that people whose genes led them to produce low levels of NPY were more responsive to negative stimuli, less resilient to stress and more likely to develop major depression.

Schizophrenia and shrinking brains

Schizophrenia is associated with a decrease in the volume of people's brains. Researchers from the University of Iowa in Iowa City looked further into this topic in a study of 211 schizophrenia patients who underwent regular brain scans over a period of just over seven years. The study examined four factors: how long people had been ill; how severe their illness was; whether they used illegal drugs and whether they had been treated with antipsychotic drugs. Being ill for longer and being treated with antipsychotic drugs were both linked to loss of brain tissue. Higher doses of antipsychotics were linked to overall brain tissue loss, reduced grey matter and progressive declines in white matter. However, illness severity and substance abuse had little or no association with brain tissue changes.

Less use of 'chemical cosh' for dementia patients

Elderly people in the U.S. are being prescribed fewer antipsychotics - which can have side effects including an increased risk of stroke, weight gain and diabetes - to manage their behaviour. The change comes after the Food and Drug Administration issued a 'black-box warning' about using the drugs in this way. Researchers from the University of Michigan in Ann Arbor analyzed data on more than 250,000 veterans from the national Veterans Affairs registers. They found that the overall use of antipsychotics in elderly dementia patients fell from nearly 18% in 1999 to 12% in 2007.

Children's IQ and diet

A healthy diet could boost children's IQ. Researchers from Bristol University studied the eating habits of 3,966 children taking part in the long-term Avon Longitudinal Study of Parents and Children. The children's eating habits were recorded at three, four, seven and eight-and-a-half years old. The researchers found three main types of diet: processed diets, high in fat, sugar and convenience foods; traditional diets of meat, potato and vegetables and 'health-conscious' diets of salad, fruit and fish. The children all took IQ tests when they were eight-and-a-half years old and those who ate a diet high in processed foods at the age of three had slightly lower IQs. The researchers took into account the effects of mothers' level of education, social class and duration of breastfeeding.

Childhood behaviour and adult health

Childhood behaviour problems are associated with premature death. To look into this link a little further a team of researchers, led by Sophie von Stumm from the University of Chichester, used information from a study of 12,500 people in Aberdeen. The children's behaviour and psychological problems were assessed by teachers when they were between six and 12 and they were followed up and asked about their health between 2001 and 2003 when they were between 46 and 51. People who had been badly behaved when they were children were 15% more likely to be suffering from a long-term disease in middle age. Bad behaviour in childhood was also associated with a 16% greater risk of obesity and a 20% greater risk of smoking. Childhood hyperactivity was associated with starting to smoke earlier and, in women, smoking more as well as binge drinking for both men and women and having more hangovers in men. Being depressed or anxious as a child was related to a decreased risk of smoking and a later age of starting for those who did smoke.

von Stumm, Sophie ... [et al] - Childhood behavior problems and health at midlife: 35-year follow-up of a Scottish birth cohort Journal of child psychology and psychiatry doi:10.1111/j.1469-7610.2011.02373.x

Cannabis use and psychosis

The extent and nature of the link between cannabis use and psychosis is one of the most controversial areas of psychiatry. A team of researchers, led by Matthew Large from the Prince of Wales Hospital in New South Wales reviewed 83 studies into the relationship between cannabis use and the age at which people become ill with psychosis. They found that people who used cannabis became ill, on average, 2.7 years earlier than those who didn't with people who used any illegal drugs becoming ill 2 years earlier. Alcohol use was not associated with an earlier onset of psychosis.

Large, Matthew - Cannabis use and earlier onset of psychosis Archives of General Psychiatry
doi:10.1001/archgenpsychiatry.2011.5

Suicide risk and criminal justice

Previous studies have shown that prisoners are substantially more likely to kill themselves but little is known about increased risk among other people who have a brush with the law. Researchers from the University of Manchester and the University of Aarhus in Denmark studied 552,118 people in Denmark 27,219 of whom committed suicide. More than a third of all the men who killed themselves had a criminal-justice history although the relative risk was higher among women with a criminal-justice history. Suicide risk was markedly increased among people who had been in jail but the risk was even greater among people who had been sentenced to psychiatric treatment and who had had charges conditionally withdrawn. The risk of suicide was greater even in people who had not been sent to jail or who had been found innocent and was especially high in people who had had recent or frequent contact with the law or who had been charged with violent offences.

Webb, Roger T. ... [et al] - National study of suicide in all people with a criminal justice history Archives of General Psychiatry doi:10.1001/archgenpsychiatry.2011.7

Depression, anxiety, inequality and ageing

Although research often demonstrates associations between being less well-off and having worse mental health there is less clarity about how age affects things and researchers often lump depression and anxiety together in their analyses. Researchers from the Public Health Sciences Unit in Glasgow studied 3,846 people over a 20-year period and found that social-class differences in anxiety and depression widened with age. The prevalence of anxiety decreased as people aged but decreased less slowly among manual workers. By contrast the prevalence of depression increased with age and increased more in manual workers than in white-collar one.

Green, M.J. and Benzeval, M. - Ageing, social class and common mental disorders: longitudinal evidence from three cohorts in the West of Scotland Psychological Medicine (2011), 41, 565–574

Sense of coherence and depression

Sense of coherence (SOC) is a positive way of looking at life and an ability to successfully manage stressful situations. People with a strong SOC are thought to cope better with stress because they consider stressors to be more predictable, have confidence in their own ability to deal with them and view pressures as meaningful challenges. A strong SOC has been associated with good subjective health, a lower frequency of sickness absence in women and a reduced risk of heart disease in male, white-collar workers. Researchers from the University of Turku in Finland looked into the links between SOC and depression in a study of 1,645 people. They found that people who had a strong SOC at the start of the study were less likely to suffer from depression, both a year and nine years later.

Luutonen, Sinikka ... [et al] - Weak sense of coherence predicts depression: 1-year and 9-year follow-ups of the Finnish Outcomes of Depression International Network (ODIN) sample Journal of Mental Health,
February 2011; 20(1): 43–51

Theory of Mind and eating disorders

Theory of Mind - how we interpret our own and other people's thoughts and emotions - has become one of the most influential ideas in psychology. It is thought to be deficient in people with autism and some psychologists think that people with eating disorders could also have problems in telling what other people are thinking. Researchers from Oxford University looked into this a bit more in a study of 145 women recruited from among university students and local workplaces. The women were asked aobut four different situations: having an argument with a family member, being on one's own at the end of the day, coming back from a date which didn't go well and moving to a new area. As well as writing about their own reactions to these situations the participants were also asked how an attachment figure (usually their mother) and an acquaintance would have reacted. Those women who had a higher number of eating-disorder symptoms had a 'concretised' understanding of their own emotions, i.e. they were more likely to mention food in their responses even though there was no mention of food in the original vignettes, although they did have a sophisticated understanding of a same-sex acquaintance's emotions. Eating-disorder symptoms were also associated with fewer positive thoughts about oneself but also fewer negative emotions about one's own behaviour. People with eating-disorder symptoms were also more likely to mention food when discussing how a same-sex acquaintance would react.

Warren, Louis and Cooper, Myra J. - Understanding Your Own and Other’s Minds: The Relationship to Eating Disorder Related Symptoms European Eating Disorders Review DOI: 10.1002/erv.1079

Spirituality and PTSD

Most psychotherapy for post-traumatic stress disorder (PTSD) involves making new meaning of the traumatic experience but very few talk about spirituality. Nearly equal numbers of trauma survivors describe their spirituality as helpful, hurtful or neutral in their recovery. Those who view their spirituality, church and God as sources of support, validation and acceptance are more able to make healthy meanings and recover while those who see these things as sources of judgment, punishment and rejection were less likely to. Researchers from the Veterans Affairs Medical Center in Minneapolis, Minnesota studied the effectiveness of a programme called Building Spiritual Strength. The programme is not designed to convert people or change their religious affiliation but to help them to recognise and resolve spiritual concerns that can contribute to distress and maintain and enhance areas of spiritual functioning that are contributing to positive adjustment. The researchers compared 26 people going through the programme with 28 on a waiting list - the people taking part in the programme showed a statistically-significant reduction in PTSD symptoms.

Harris, J. Irene ... [et al] - The Effectiveness of a Trauma Focused Spiritually Integrated Intervention

for Veterans Exposed to Trauma Journal of Clinical Psychology January 2011, 67(1), 1-14