Social capital and children's mental health

The last decade has seen a lot of research into the links between social capital and mental health. Social capital is a measure of the community spirit of a neighbourhood and looks at things like community activities, electoral turn out and levels of voluntary work. Most of these studies have focused on adults and very few have looked into the relationship between social capital and children and adolescents' mental health. A study of 3,340 11-16 year-olds spread out over 426 different postcodes collected information on the health and socio-economic status of the children, measures of social capital and neighbourhood prosperity and how safe the children felt in their neighbourhood and how trustworthy they felt people in their area were. The researchers found that the less safe the children felt and the less trustworthy they perceived their neighbours to be the more likely they were to suffer from mental-health problems and that this perception was more important than the socio-economic nature of the neighbourhood. However, there was no link between children's actual behaviour, e.g. going to the park or the shops on their own, and their levels of mental-health problems.

Meltzer, Howard ... [et al] - Children's perceptions of neighbourhood trustworthiness and safety and their mental health Journal of Child Psychology and Psychiatry December 2007, 48(12), 1208-1213

Anxiety disorders : from childhood to adolescence

Anxiety disorders occur frequently in childhood and adolescence, are associated with substantial impairment and disability and may have a chronic (lasting) course. Children with one type of anxiety disorder can often have other types as well and childhood anxiety can lead to depression and alcohol abuse in later life. However, there have been few long-term studies into anxiety disorders following people from childhood to adolescence and beyond. A study of 906 children in North Carolina, U.S. carried out by German and Australian researchers followed three sets of children aged 9, 11 and 13 through to the age of 19. They found that childhood separation anxiety disorder carried on into adolescence. Childhood over-anxious disorder also carried on into adolescence but also led on to panic attacks, depression and conduct disorder. General anxiety disorder in childhood was related only to conduct disorder in adolescence. Social phobia in childhood led on to adolescent over-anxious disorder, social phobia and attention deficit hyperactivity disorder.

Bittner, Antje ... [et al] - What do childhood anxiety disorders predict ? Journal of Child Psychology and Psychiatry December 2007, 48(12), 1174-1183

Eating disorders in minority ethnic groups

Most studies on eating disorders have focused on white, middle-class women who are usually seen as being at more risk than other groups. Our knowledge of how eating disorders affect other ethnic and socio-economic groups is limited. A U.S. study of 884 first-year students looked at the rates of eating disorders in an ethnically diverse, low-income group and at the risk factors of physical abuse and sexual abuse before and after the age of 13. The study found that 12.2% of the girls and 7.3% of the boys could be diagnosed with an eating disorder. For women child abuse and sexual abuse both contributed equally to the development of an eating disorder while for men only sexual abuse did so. The results show that ethnic minority populations can suffer from relatively high rates of self-reported eating disorders.

Gentile, Katie ... [et al] - It doesn't happen here : eating disorders in an ethnically diverse sample of economically disadvantaged, urban college students Eating Disorders October-December 2007, 15(5), 405-425

Costs of eating disorders vs costs of substance abuse

Surveys looking into the prevalence of drug abuse usually ask people about the costs associated with their drug or alcohol use. These can include problems with physical and mental health, friendships and social life, home life and marriage, work, studies, financial well-being and housing. However, these questions are not usually asked in studies about eating disorders. A Canadian study of 1,043 women, aged between 18 and 25 asked them about their dieting, bingeing, vomiting and laxative-using behaviour as well as their use of alcohol, cigarettes and cannabis. The women were all asked how they felt these activities impeded their friendships and social lives, their physical health,their family relationships, their studies, work or employment, their financial situation and their happiness. The researchers found that the percentages of women who reported adverse consequences relating to eating disordered behaviour were comparable, if not higher, than the percentages of women who reported adverse consequences related to their substance use suggesting that future surveys into the prevalence of eating disorders should include questions about their effects on people's lives.

Piran, Niva, Robinson, Shannon R. and Cormier, Holly C. - Disordered eating behaviors and substance use in women : a comparison of perceived adverse consequences Eating Disorders October-December 2007, 15(5), 391-403

Influences on adolescent drinking

Alcohol misuse among adolescents is a substantial problem throughout the Western world and has been linked to a wide range of problems such as school problems and aggression, alcohol-related injuries and deaths, suicidal ideation and even impaired brain development. There have been various studies examining the links between drinking by adolescents' parents, siblings and within their peer group and adolescent drinking. Most of the research has been inconclusive as far as the influence of parents' drinking is concerned but there seems to be a definite link between peer-group drinking and adolescent drinking. A study of 3,760 twins in Holland has confirmed this picture, showing that in each of the three age groups studied - 12-15, 16-20 and 21-25 - regular drinking of same-sex co-twins and friends posed the highest risk for regular drinking. As adolescents got older they became less susceptible to the influence of their siblings and peer groups. For all age groups regular drinking by fathers and mothers posed the lowest risk.

Scholte, Ron H. J. ... [et al] - Relative risks of adolescent and young adult alcohol use : the role of drinking fathers, mothers, siblings, and friends Addictive Behaviors 33(2008), 1-14

Drug deaths in Scotland

Drug-related deaths (DRDs) have been increasing in Scotland over the last ten years. A team of Scottish researchers looked at the coroner's records for all the drug-related deaths in Scotland in 2003 to see what trends emerged. 80% of the deaths were male and the mean age at death was 32.8. 51% of those who died injected drugs and those who injected drugs were more likely to be younger and male. 25-44-year-olds made up 79% of the deaths by drug injection but only 47% of the other drug deaths. Heroin was involved in 87% of the deaths but two-thirds of the DRDs also tested positive for benzodiazepines.

Zador, Deborah ... [et al] - Difference between injectors and non-injectors, and high prevalence of benzodiazepines among drug related deaths in Scotland 2003 Addiction Research and Theory December 2007, 15(6), 651-662

Drink early, drink often

Young people often consume alcohol at home before a night out. Alcohol is much cheaper from off-licences and supermarkets and drink brought in this way makes up an increasing proportion of total alcohol sales. A study of 380 young people in the North West of England asked them whether they drank before they went out, how much alcohol they drank and whether they had had bad experiences on a night out. The study found that over a quarter (26.5%) of female and 15.4% of male alcohol consumption occured before going out. Those who drank before going out drank significantly more alcohol, were four times as likely to drink 20 or more units of alcohol and 2.5 times as likely to have been involved in a fight in the last year.

Hughes, Karen ... [et al] - Alchohol, nightlife and violence : the relative contributions of drinking before and during nights out to negative health and criminal justice outcomes Addiction 103(1), 60-65

Danish suicide study shows surprising results

Studies dating back over a hundred years have highlighted the links between the risk of suicide and low income, unemployment, educational underachievement and singleness. However, a similar consistency between suicide and these factors has not been found among people with psychiatric disorders. This is important as nearly half the people who kill themselves have previously been admitted to hospital with a psychiatric disorder and more than 90% of people who commit suicide have a diagnosable psychiatric illness. A study of 96,369 patients admitted to hospital in Denmark with psychiatric problems found that higher income, employment, postgraduate education and marriage were all linked to a higher risk of suicide in this group. However, loss of earnings, employment and marriage among people who had previously had them was found to increase the risk of suicide.

Agerbo, Eshen - High income, employment, postgraduate education, and marriage : a suicidal cocktail among psychiatric patients Archives of General Psychiatry December 2007, 64(12), 1377-1384

Schizophrenia, bipolar disorder and cancer

There is a lot of speculation that people with schizophrenia have lower rates of cancer than the rest of the population. The results from the research are mixed with some studies finding lower rates, some higher and others little difference. The largest and most sophisticated study of the subject yet attempted looked at thousands of cases of six types of cancer and related them to schizophrenia and bipolar disorder. The results were adjusted to take into account the effects of smoking, body mass index, socio-economic status, other illnesses and prescribed medication. The researchers found that schizophrenia nearly doubled the risk of colon cancer and that schizophrenia patients who took antipsychotic medication had three times the risk of colon cancer. However, people with schizophrenia did have a 47% lower risk of lung cancer. People with bipolar disorder had the same risks for cancer as the rest of the population.

Hippisley-Cox, Julia ... [et al] - Risk of malignancy in patients with schizophrenia and bipolar disorder Archives of General Psychiatry December 2007, 64(12), 1368-1376

Hostility, drinking and death

Hostility - defined by psychologists as the willful refusal to accept that one's perceptions of the world are wrong not as anger or aggression - has been shown to predict the development of heart disease and raise the risk of death from other causes as well. Several studies have reported positive associations between hostility and alcohol consumption although they have only measured total alcohol intake rather than patterns of drinking. This is important as a pattern of heavy episodic drinking is worse for you than the same amount of alcohol spread out over a number of days. A study of 3,326 Vietnam veterans in the U.S. looked at their levels of hostility, their drinking patterns and their mortality and found that there was a link between hostility and total monthly intake of alcohol, drinks per drinking day and heavy episodic drinking and that hostility, drinks per drinking day, heavy episodic drinking and total monthly alcohol intake were all associated with an increased risk of death. The study concluded that high hostility was associated with elevated mortality and a deleterious drinking pattern characterized by relatively high intake per drinking session. The researchers suggested that this pattern of binge drinking among hostile people could help to explain why they tend to die earlier than other people.

Boyle, Stephen H. ... [et al] - Hostility, drinking pattern and mortality Addiction January 2008, 103(1), 54-59

Child rearing and suicide

Depressed people's perceptions of how they were brought up remain remarkably consistent over time regardless of the levels of depression they are experiencing. Studies have demonstrated links between suicidal thoughts and suicidal behaviour in individuals and their perception of rejecting, guilt-engendering and neglectful parents. Childhood abuse, and specifically childhood sexual abuse, have also been found to relate to suicidality. A ten-year study of 343 patients referred to a mood disorders unit in Sydney compared their perceptions of their childhood with the number of times they had tried to kill themselves. The researchers found that female patients who perceived themselves as rejected and/or neglected by either parent in childhood had a greater chance of making at least one suicide attempt in their life. However, there was no such link in male patients.

Ehnvall, A. ... [et al] - Perception of reglecting and neglectful parenting in childhood relates to lifetime suicide attempts for females - but not for males Acta Psychiatrica Scandinavica January 2008, 117, 50-56

Risk factors for post-partum psychosis

Post-partum psychosis is characterized by a rapid development of bizarre delusions, affective symptoms, sleeplessness and disorganized behaviour that jeopardizes the safety of the new-born baby and the mother as well as the long-term mental health of the infant. The incidence of psychosis within the first 3 months after delivery is 14 times higher than during the two years before pregnancy and leads to hospital admission in about one woman per 1,000 deliveries. A study of 1,133,368 first-time mothers in Sweden over a 29-year period found 1,413 hospitalized cases of post-partum psychosis. Breathing problems in the child, severe birth asphyxia, pre-term birth, caesarean section, perinatal death (of the infant) and small birthweight were all associated with an increased risk of postpartum psychosis. However, after adjustment for previous hospitalization for psychiatric problems only pre-term birth and caesarean section remained significant risk factors increasing risk by a factor of 1.2 and 1.3 respectively. Previous hospitalization for psychiatric problems increased the risk of postpartum psychosis more than a hundredfold.

A. Nager ... [et al] - Obstetric complications and postpartum psychosis : a follow-up study of 1.1 million first-time mothers between 1975 and 2003 in Sweden Acta Psychiatrica Scandinavica January 2008, 117, 12-19

High blood pressure and mild cognitive impairment

Mild cognitive impairment (MCI) - an age-related condition that involves difficulties with thinking and learning - has attracted increasing interest during the last few years as people with MCI have a five-to-six times greater than average risk of going on to develop Alzheimer's disease. There is also a link between high blood pressure and Alzheimer's disease. A study of 918 people over 65 in the U.S. checked their health and cognitive functioning over an average of 4.7 years. Over this period 334 of the participants developed MCI, 160 of them with memory problems and 174 without. High blood pressure was associated with MCI but not with memory problems or a decline in language abilities.

You can find out more about this research at

http://psychcentral.com/news/2007/12/12/hypertension-may-impair-cognition/1649.html

Mixed results for new schizophrenia drug

Schizophrenia is one of the most debilitating of the major psychiatric disorders and is also one of the most difficult to treat. Although a number of drugs are available to treat the condition they can cause significant side effects ; many patients experience only a partial improvement in their symptoms while up to 30% experience no relief at all. A study of 444 patients compared those taking a placebo with those taking an existing anti-psychotic drug, olanzapine and those taking a new anti-psychotic drug paliperidone. Although the new drug was found to be no more effective than olanzapine it can be taken in a long-acting, extended-release form and was found to be relatively safe.

You can find out more about this research at

http://psychcentral.com/news/2007/12/13/extended-release-medication-for-schizophrenia/1660.html

Big Brother methods add to workplace stress

A study by the Economic and Social Research Council has suggested that modern working practices can put as much strain on a woman's family relationships as working an extra 120 hours a year. Team-based forms of work organization, performance-related pay and policies that emphasize the development of individual potential all create a pressure to perform which can have a detrimental effect on employees' families. Women's family relationships are more likely to be adversely effected by these employment practices than men although both sexes can suffer stress over childcare arrangements. Women are also less likely to get help from men around the home when men are subject to modern working practices.

The study also looked at computerized surveillance in the workplace which now affects more than half of all British employees. This surveillance has led to a sharp increase in work strain and feelings of exhaustion, anxiety and worry which is particularly strong among administrative and white-collar staff in places such as call centres.

You can find out more about this research at

http://psychcentral.com/news/2007/12/14/women-face-increased-worksite-stress/1667.html

Stress, CBT and pregnancy

Stress can have many effects on the body, including on fertility. Stress can affect the pituitary gland which can slow the release of the luteinizing hormone which triggers ovulation. A shortage of luteinizing hormone can also lead to a lower level of progesterone, a hormone necessary to nourish and sustain an embryo's implantation and early development. However, researchers from Emory University in the U.S. have shown that psychotherapy can reduce stress-related infertility. The study of 16 women divided them into two groups, one receiving cognitive behaviour therapy and relaxation techniques, the other receiving no treatment. Six of the eight women in the CBT/relaxation group regained full fertility, compared to only one in the other group, and two of them became pregnant within two months.

You can find out more about this research at

http://psychcentral.com/news/2007/12/14/fertility-issues-can-trigger-seasonal-blues/1668.html

Psychotherapy for tics

People with tics are often given medication to help them with their problem but the drugs used can have limited effectiveness, unwanted side effects and poor adherence. However, a new review of the research has indicated that behavioural programmes and procedures can effectively reduce the symptoms of tic disorders. Habit-reversal training emphasizes sensitivity to tic sensations and replaces the tic behaviour with a more appropriate competing response while exposure prevention and response prevention focus on the process of habituation. All these psychological techniques were found to be effective at reducing symptoms.

You can find out more about this research at

http://psychcentral.com/news/2007/12/17/therapy-as-first-line-treatment-for-tics/1672.html

PTSD, cognition and trauma

Verbal memory is partially dependent on a region of the brain called the hippocampus. Studies have shown that, in animals, stress can lead to cells dying in this area and some studies have shown a decrease in the volume of the hippocampus, together with memory problems in people suffering from post-traumatic stress disorder (PTSD). PTSD can also involve dysfunctional cognition such as an overly negative appraisal of the traumatic event ('wasn't it dreadful' rather than 'thank goodness I survived'), intrusive thoughts, worry, self-punishment, loss of control and lack of self-confidence. A study of 89 people in Germany compared people who had suffered no trauma, those who had suffered a recent trauma but were yet to develop PTSD and those suffering from PTSD. The researchers found no differences in verbal memory between any of the groups. The recent trauma victims hardly differed from the controls in terms of dysfunctional thought processes but those suffering from PTSD showed more negative appraisal, worry, self-punishment and loss of control than the other groups. Within the group of people who had recently suffered a trauma negative appraisals grew the longer it had been since the original trauma.

Elsesser, Karin and Sartory, Gudrun - Memory performance and dysfunctional cognitions in recent trauma victims and patients with post-traumatic stress disorder Clinical Psychology and Psychiatry November-December 2007, 14(6), 464-474

Mindfulness and cognition

Mindfulness is a form of meditation with rooots in Buddhist spiritual practices that has been used in a number of ways in clinical psychology including mindfulness-based stress reduction (MBSR) and dialectical behaviour therapy. Mindfulness meditation is distinguished from concentration-based meditation which trains participants to focus their attention on a single stimulus such as an object or a word. By contrast mindfulness meditation involves a broader observation of one's present moment experience i.e. physical sensations, thoughts and feelings. There is a growing body of research suggesting that mindfulness-based techniques are effective for a wide variety of conditions including depression, stress, anxiety and pain but less research on the underlying mechanisms whereby mindfulness affects cognition. A team of researchers in Canada studied 72 people to compare how MBSR affected people's concentration, attention and cognition as well as their emotional well-being and mindfulness. Those people who had undertaken an MBSR course showed improvements in emotional well-being and mindfulness but no improvements in attention. However, those people who had improved their mindfulness were better at picking objects out of drawings when asked to do so.

Anderson, Nicole D. ... [et al] - Mindfulness-based stress reduction and attentional control Clinical Psychology and Psychotherapy November-December 2007, 14(6), 449-463

Newer antidepressants in pregnancy

There has been lots of research on the use of selective serotonin reuptake inhibitors (SSRIs) in pregnancy but much less is known about more recently-introduced anti-depressants such as venlafaxine, mirtazapine, mianserin and reboxetine. A study of 732 women in Sweden who used the new drugs in pregnancy looked at the kinds of people who took them and their effects on their pregnancies and babies. The study found that the women who used the new antidepressants were older, were more likely to have been having their first child, were heavier smokers, were heavier and were more likely to be native Swedes. They were more likely to have premature births and their children were more likely to suffer from symptoms such as breathing difficulties, poor health, hypoglycemia and convulsions.

Lennestal, Roland and Kallen, Bengt - Delivery outcome in relation to maternal use of some recently introduced antidepressants Journal of Clinical Psychopharmacology December 2007, 27(6), 607-613