Religion, depression and meaning in life

There has been a lot of research recently into the links between religion and mental health. Researchers at Temple University in the U.S. studied 918 people and looked into three aspects of religious belief: church attendance, religious well-being (the quality of a person's relationship with a higher power) and existential well-being, a person's sense of meaning and their purpose in life. People with high levels of religious well-being were 1.5 times more likely to have had depression than those with lower levels of religious well-being. However, people who attended church regularly were 30% less likely to have had depression in their lifetime and people who had a clear sense of meaning and purpose in their life were 70% less likely to have suffered from depression.

You can find out more about this research at

http://psychcentral.com/news/2008/10/24/spirituality-tops-religion-for-depression/3196.html

Poverty ups youth suicide risk

A study of 2,779 teenagers in Canada, carried out as part of the National Longitudinal Survey of Children and Youth looked into the risk factors for suicide attempts in this age group and in particular the impact of poverty. Poverty levels in the children's neighbourhoods were measured in early and mid-adolescence based on census data and at 18 or 19 the participants were asked whether they had seriously considered attempting suicide in the last 12 months. Among teenagers from all backgrounds hyperactivity and impulsivity, depression, substance use, low social support, exposure to suicide and negative life events all led to an increase in sucidality but in children from poorer neighbourhoods the effects of hyperactivity and impulsivity were accentuated. Youths from poorer neighbourhoods were twice as likely to report suicidal thoughts as their peers from more affluent neighbourhoods and four times as likely to actually make a suicide attempt.

You can find out more about this research at

http://psychcentral.com/news/2008/10/27/teens-in-poor-neighborhoods-at-greater-risk-for-suicide/3206.html

Earlier the better for child anxiety disorders

A study presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry has suggested that it may be more beneficial for children to confront and manage their fears rather than use other techniques to deal with them. The study found that children were able to complete exercises designed to expose them to and neutralise their fears much earlier than suggested in treatment manuals for childhood anxiety disorders and that treatment that was shorter and began exposure to the child's fear earlier than usual was more effective at improving children's functioning.

You can read more about this research at

http://psychcentral.com/news/2008/10/30/confront-fears-to-reduce-child-anxiety/3233.html

Breast is best for mental health

The health benefits of breast-feeding children are well established and a new study by the American Public Health Association suggests that it may also have benefits for children's mental health. Researchers used data from the 2003 National Survey of Children's Health made up of 102,353 interviews with parents and guardians about the health of their children. The study found that parents of breastfed children were less likely to report concern over their child's behaviour and their children were less likely to have been diagnosed by a health professional with behavioural or conduct problems or to have received mental health care. Parents of breastfed children were also less likely to report concern about their child's ability to learn.

You can find out more about this research at

http://psychcentral.com/news/2008/10/30/breastfed-children-have-less-mental-health-issues/3235.html

Risk factors for methamphetamine abuse

Methamphetamine is a stimulant, also known as 'meth' or 'speed' that can be smoked, snorted or injected and which produces sensations of euphoria, lowered inhibitions, feelings of invincibility, increased wakefulness and an increase in energy. An analysis of 12 studies into the risk factors for methamphetamine abuse, carried out by researchers at the University of Alberta, Canada looked at low-risk (those not involved in any other drug abuse) and high-risk (those who had taken other drugs or who had been in a juvenile detention centre) children. Within the low-risk group a history of engaging in behaviour such as sexual activity, particularly homosexual or bisexual activity, alchohol consumption and smoking was significantly associated with methamphetamine use. Among high-risk youth the risk factors identified were growing up in a family with a history of crime, alcohol and drug use; having received treatment for a psychiatric condition and being a girl.

You can find out more about this research at

http://psychcentral.com/news/2008/10/28/meth-abuse-among-teens/3214.html

The neuroscience of hate

A brain imaging study by researchers at University College London looked at the parts of the brain that are activated by hate. They found that this 'hate circuit' was distinct from those related to threat, fear and danger although it did share a part of the brain related to aggression. The circuit was distinct from that associated with romantic love although it did share at least two common structures with it. To generate hate seventeen people had their brains scanned while looking at a picture of someone they hated. The 'hate circuit' included structures in the cortex and the sub-cortex important in generating aggressive behaviour and translating this into physical action and a part of the frontal cortex involved in predicting the actions of others. Hate activated parts of the brain called the putamen and insula which are both also involved in romantic love although love de-activated the parts of the brain associated with judgement and reasoning more than hate.

You can find out more about this research at

http://psychcentral.com/news/2008/10/29/hate-area-of-brain-identified/3225.html

Older people, risk and stress

Researchers at the University of Southern California Davis School of Gerontology looked into the way that stress affects decision making and found that following a stressful experience older people were much more averse to stress than young ones. The study compared young adults (18-33) with older ones (65-89) and used a driving game to measure their approach to risk. Participants were given points for every second they spent driving on a yellow light but lost points if the light turned red while they were driving meaning they had to take risks to score any points at all. In a control group which had not been exposed to stress the older adults had a higher score but after the participants had been exposed to stress (by putting their hands in a bucket of ice-cold water for three minutes) the older people became much more cautious. They were also jerkier drivers, braking and restarting almost three times as much as older drivers in the control group. The differences in the effects of stress were consistent even when the researchers accounted for gender, level of education, mood and health.

You can read more about this research at

http://psychcentral.com/news/2008/10/29/stress-effect-more-exaggerated-in-older-adults/3226.html

Depression and premature birth

A study of 791 women in and around San Francisco has found that those of them who were suffering with symptoms of depression were much more likely to give birth prematurely. The women were interviewed around the 10th week of their pregnancy when 41% reported 'significant' symptoms of depression and 22% reported 'severe' symptoms. Those with 'severe' symptoms had almost twice the risk of an early birth while those with 'significant' symptoms had a 60% greater risk. Women who were more likely to report depressive symptoms tended to be younger than 25, unmarried, less educated, poorer, Black and have a history of pre-term delivery. But it may not necessarily be the depression itself that leads directly to premature birth. Depression at 10 weeks could itself be a symptom of another underlying process or problem that causes premature birth. At the same time depression is known to be linked with non-compliance with prenatal care, poor nutrition, inadequate sleep and self-medication with alcohol and drugs so it could be these factors that lead to premature birth rather than depressson per se

You can find out more about this research at

http://psychcentral.com/news/2008/10/27/depression-ups-pregnancy-risk/3204.html

Depression and COPD

Depression is already known to be linked to worse outcomes for people recovering from heart attacks or with other cardiovascular problems and now new research has shown that it is also linked to worse outcomes in the lung disease chronic obstructive pulmonary disease (COPD). The study of 491 people with COPD in China found that depression was associated with a 50% worsening of COPD symptoms while anxious patients had instances of worsening symptoms that were nearly twice as long as patients without anxiety.

You can find out more about this research at

http://www.mentalhelp.net/poc/view_doc.php?type=news&id=114118&cn=5

Mental health and employment

On Monday this week Incapacity Benefit was replaced with Employment Support and Allowance which aims to get as many claimants back to work as possible, including people with mental-health problems. But with unemployment forecast to rise over the coming months a poll by the mental-health charity MIND has revealed the vulnerability of employment for people with mental-health problems. Of the 279 people who responded to the poll on the charity's web site 58% had had to leave a job because of a lack of mental-health support, 31% had been sacked or forced out of a job after disclosing a mental-health problem and 1 in 4 had had job offers withdrawn when they told employers about their psychological problems. Over 200,000 people with mental distress lose their jobs and have to start claiming benefit each year.

Bipolar below the radar

Bipolar disorder, or manic depression, is a recurrent and long-term mental illness that can seriously affect the lives of sufferers and their relatives. It is characterized by the alternating occurence of manic, hypomanic, depressive and possibly mixed episodes and has been estimated to have a lifetime prevalence of 1.5-2% in the E.U. When service users are in remission they can still be suffering from subsyndromal symptoms which are not quite severe enough for a diagnosis of full-blown bipolar disorder. While subsyndromal manic symptoms can improve functioning subsyndroman depressive ones can lead to impairment and disability. A survey of 157 bipolar outpatients in the Netherlands found that they had fewer symptoms of psychopathology than psychiatric outpatients in general but a significantly lower quality of life than the rest of the population. The more bipolar symptoms they had the worse was their quality of life.

Goossens, Peter J.J. ... [et al] - Self-reported psychopathological symptoms and quality of life in outpatients with bipolar disorder Perspectives in Psychiatric Care October 2008, 44(4), 275-284

Older gamblers' other problems

There has been a steady increase in gambling over the last few years with a deregulation of betting shops, state lotteries and online gambling. The growth in gambling participation has included older adults who have more time on their hands and, if they are lucky, a good disposable income. 35% of older adults reported lifetime gambling in 1975, a figure that had increased to 80% by 1998. In 1975 23% reported having gambled in the past year compared to 50% in 1998. The increase in gambling behaviour among older adults was more dramatic than in all other age groups. While most older adults gamble for recreation and do so responsibly a minority develop problem gambling or pathological gambling. A survey of 40 older adults with lifetime pathological gambling in Illinois and Iowa used established mental-health screening tools to see what other mental-health problems they might have. The results indicated a high level of other mental illnesses including depression, alcohol dependence, panic disorder, anxiety, obsessive-compulsive and avoidant personality disorders.

Kerber, Cindy Sullivan, Black, Donald W. and Buckwater, Kathleen - Comorbid psychiatric disorders among older recovering pathological gamblers. Issues in Mental Health Nursing 2008, 29(9), 1018-1028

Compulsive hoarding and OCD

Compulsive hoarding is a problem that is characterized by excessive collecting and the failure to discard excessive amounts of collected items, in addition to the cluttering of living space and significant distress or impairment caused by the hoarding. Between 15-40% of OCD sufferers report saving and hoarding compulsions but there is some uncertainty about the relationship between hoarding and OCD. A study of 52 people by researchers at the Institute of Psychiatry in London compared 25 people with severe compulsive hoarding and OCD and 27 people with compulsive hoarding without OCD. Overall the nature of hoarding behaviour was similar between the two groups with the majority of the participants in both groups reporting hoarding common items as a result of their emotional and/or intrinsic value. However, about a quarter of the hoarders with OCD hoarded bizarre items and had other obsessions and compulsions related to their hoarding such as a fear of catastrophic consequences, the need to perform checking rituals and the need to perform mental compulsions before discarding any items and these people had a much more severe and disabling form of the disorder. The researchers concluded that in most individuals compulsive hoarding appeared to be a syndrome separate from OCD but that in otheer individuals it is a symptom of OCD and has unique clinical features.

Pertusa, Alberto ... [et al] - Compulsive hoarding: OCD symptom, distinct clinical syndrome or both? American Journal of Psychiatry October 2008, 165(10), 1289-1298

Olanzapine for anorexia

Olanzapine is an antipsychotic drug, mostly used to treat people suffering from psychosis or schizophrenia. However, there has recently been some research into the use of olanzapine in treating people with anorexia. One of the side effects of olanzapine is weight gain and it is also thought to have some effectiveness in combating obsessional thoughts and depression. People whose anorexia involves restricting their calorie intake tend to have obsessional traits while those who binge and then purge often suffer from dysphoric (depressed) mood. A small study of 34 people with anorexia compared a group taking olanzapine with another group taking a placebo. The group taking olanzapine was found to have a greater rate of increase in weight, an earlier achievement of their target body mass index and a greater rate of decrease of obsessive symptoms. No differences in adverse effects were observed between the two treatment conditions.

Bissada, Hany ... [et al] - Olanzapine in the treatment of low body weight and obsessive thinking in women with anorexia nervosa: a randomized, double-blind, placebo-controlled trial American Journal of Psychiatry October 2008, 165(10), 1281-1288

CBT and theories of depression

There is now a lot of evidence for the effectiveness of cognitive behaviour therapy (CBT) as a treatment for major depression but there is still some uncertainty as to how it actually works. The cognitive mediation model says that it works by changing people's dysfunctional attitudes; maladaptive, inflexible and extreme assumptions by which the self or the world is judged. Dysfunctional attitudes are more prevalent in depressed people and decline with treatment but the complication model holds that it is depression that produces dysfunctional attitudes and not vice versa. Other theories are that depression and dysfunctional attitudes contribute to one another or that there is a third, underlying factor, common to both. A study of 130 people with major depression in Canada divided them into three groups. One group received CBT, another group received interpersonal therapy and a third group received pharmacotherapy. A comparison of CBT with interpersonal therapy showed that a reduction in dysfunctional attitudes explained the effectiveness of CBT. However when CBT was compared to pharmacotherapy the complication model was found to fit the facts better.

Quilty, L.C., McBride, C. and Bagby, R.M. - Evidence for the cognitive mediational model of cognitive behavioural therapy for depression Psychological Medicine November 2008, 38(11), 1521-1530

Computerized CBT and patient satisfaction

Cognitive behaviour therapy (CBT) is used to treat a variety of mental-health problems including depression and anxiety. However, it is not always available to service users because of a shortage of therapists and long waiting times. Alternative methods of provision have been developed including group therapy, bibliotherapy and computerized CBT (CCBT). There is evidence about the clinical effectiveness of CCBT but little information about its acceptability to service users. A review of 16 studies on the use of CCBT for depression found that although drop-out rates from CCBT were comparable to other forms of treatment, take-up rates were much lower. Overall there was limited information on patient satisfaction with CCBT but when treatment was completed several studies reported positive expectancies and high satisfaction.

Kattenthaler, E. ... [et al] - The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review Psychological Medicine November 2008, 38(11), 1521-1530

Shame and eating disorders

Eating-disorder symptoms are associated both with negative emotionality in general and specific negative emotions, in particular chronic feelings of shame. Symptoms of eating disorders are also thought to be linked to problems with regulating emotions. A study of 154 undergraduates at Duke University in the U.S. looked at the relationship between shame, emotional regulation and eating disorder symptoms. The results showed that chronic shame predicted eating disorder symptoms over and above the general effects of negative emotions. Problems with emotional regulation were found to have an influence on the link between chronic shame and eating disorder symptoms; the worse people's emotional regulation the more their shame led on to eating disorder symptoms.

Gupta, Sumati ... [et al] - Emotion regulation skills mediate the effects of shame on eating disorder symptoms in women Eating Disorders October-December 2008, 16(5), 405-417

Eating disorders in the military

Elite athletes often develop eating disorders as they are under constant pressure to meet demanding weight and fitness standards. Members of the U.S. armed forces have also got to meet strict weight and fitness standards and can be placed on a remedial fitness programme and be denied promotion if they fail to match up to them. There have been a few surveys into this issue but because these are filled in by servicemen themselves they have produced unreliable results. The U.S. services' medical records are on a database and a survey of this database from 1998 to 2006 found that in any one year 0.3% of service personnel had an eating disorder. Eating disorders were diagnosed significantly more in 2006 than in 1998 and women were diagnosed significantly more than men. The majority of anorexia cases were in the Marines.

Antczak, Amanda J. and Brininger, Teresa L. - Diagnosed eating disorders in the U.S. military: a nine year review Eating Disorders October-December 2008, 16(5), 363-377

Dementia: out of the shadows

700,000 people are estimated to be suffering from dementia in the UK. The Alzheimer's Society has produced a report, Dementia: out of the shadows in which people with dementia speak out about the impact it has had on their lives and the stigma that goes with the condition. People report losing friends after their diagnosis, neighbours crossing the street to avoid them and professionals dismissing their symptoms as old age.

You can download a full copy of the report at

http://www.alzheimers.org.uk/downloads/Out_of_the_Shadows.pdf

Ethnicity and learning difficulties

It has long been recognised that people from different ethnic groups receive different levels of care from mental-health services. People from ethnic minorities have higher rates of compulsory admission, longer average lengths of stay and are more likely to be prescribed drugs or ECT rather than psychotherapy or counselling. They are also less likely to use mental-health services in the first place. Ethnicity and learning disability is an under-researched area although what research there is suggests that services often offer a 'tokenistic' approach in meeting individual needs, resulting in under usage of service and creating a general environment of 'lack of engagement'.

You can read more about the existing research on this topic and plans for future research at

http://www.library.nhs.uk/ethnicity/viewResource.aspx?resid=296479&code=13e349d0c83a1a920e3672f92df146f0