Schizophrenia and the default network

Brain scans allow researchers to monitor people's brain activity as they complete different tasks and to examine the links between brain function and disease. Researchers at the Massachusetts Institute of Technology used brain scans to investigate the links between schizophrenia and a network of brain structures called the default network. The default network is involved in self-reflection and autobiographical memories and tends to become active when we are not engaged in any particular task. The study gave brain scans to 39 people. 13 of them had schizophrenia, 13 of them were relatives of people with schizophrenia and 13 were healthy controls. The participants' brains were scanned while they were resting and while they undertook easy and hard memory tasks. In the participants with schizophrenia there were very strong and active connections in the default network while they were at rest and - unlike the healthy controls - they were unable to suppress the activity in this network as they worked on the memory tasks. The more active this network was and the less able people were to suppress it the worse they performed on the memory task and the worse were their symptoms. The default system was overactive, but to a much lesser extent, in the brains of the relatives of people with schizophrenia.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/01/090120145316.htm

Rejection and aggression

Researchers at the University of Kentucky have been looking into the links between social rejection and aggression in a series of experiments involving a total of 190 college students. In one of the experiments 30 people were given a personality test and then bogus feedback about the results. A third of the participants were told their personalities would mean they would probably end up on their own later in life; these were the excluded group. The rest of the participants were either told they would have 'many lasting and meaningful relationships,' or were given no feedback at all. All the participants were then told to read an essay - supposedly by another participant - and rate their impression of the author's actions. They were also told that the authour was a candidate for a research position. Those participants who had been in the excluded group were far more likely to see the authour's actions as hostile and to give them a negative evaluation as suitable for the job. In anther experiment 32 participants were given the same personality test and again some of them were told that they would end up alone. The participants then 'played' a computer game in which they could inflict a blast of white noise on their opponents. Those participants from the excluded group inflicted a higher level of painful noise on their opponents than those participants in the control group.

You can read more about this research at

http://www.sciencedaily.com/releases/2009/01/090121122936.htm

Caregivers and elder abuse

A survey of 220 caregivers looking after a family member with dementia has found that abuse is more common than was previously thought. The survey was carried out by researchers from University College, London and surveyed people from a range of socio-economic and ethnic backgrounds. A third of caregivers said they frequently swore at or insulted their relative with dementia while half said that they occasionally screamed or yelled at them.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50M0G420090123?feedType=RSS&feedName=healthNews&sp=true

Time to Change campaign launched

England's biggest ever anti-stigma campaign, Time to Change, was launched yesterday. The three-year programme aims to reach 24m people at a cost of £18m. The campaign - financed by the Lottery and run by Mind, Rethink and Mental Health Media - will include adverts on television and radio, in newspapers and magazines and on the London Underground. Famous people such as Stephen Fry and Ruby Wax will also be taking part in the campaign.

You can find out more about the Time to Change campaign at

http://www.time-to-change.org.uk/

Migraines and mental health

As if they hadn't already got enough to contend with people who suffer from migraines are also at an increased risk of mood and anxiety disorders, according to a study of 7,124 adults by researchers at the University of Manitoba, Winnipeg. The study used data from the German Health Survey, which was carried out between 1997 and 1999. Among the whole sample 11.7% reported a history of migraine headaches and there was a significant association between having migraines in the past year and mood and anxiety disorders.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50K5N620090121?feedType=RSS&feedName=healthNews

Therapists ignore guideline on domestic violence

The following research relates to U.S. couple therapists only

Domestic violence is particularly common among couples seeking couples therapy with estimates of a half to two-thirds of couples seeking treatment reporting some incident of aggression in the previous year. There are guidelines as to how marital therapists treat the issue of domestic violence but little is known about whether therapists stick to them or not. A survey of 620 couples therapists by the American Association for Marriage and Family Therapy found that less than 4% of them consistently followed important published guidelines for domestic-violence screening. Only a minority indicated that they considered the victim's safety as a factor in choosing the course of treatment. The authors of the study concluded that domestic violence may be under-identified by couples therapists and that therapists could be using conjoint (both together) therapy with couples for whom this was not suitable because of relationship violence.

Schacht, Rebecca L. ... [et al] - Domestic violence assessment procedures among couple therapists Journal of Marital and Family Therapy January 2009, 35(1), 47-59

What people do to help marriages in trouble

Being in a bad relationship can cause distress to individuals (including thoughts of suicide), poorer perceived health and problems with one's work and social life. Marital dysfunction also takes a toll on children leading to bad behaviour, depression and anxiety, poor academic achievement and health problems. Approximately a fifth of marriages are distressed at any one time and 40% of marriages end in divorce so the cumulative toll of marital dysfunction is enormous. However, most distressed couples do not seek marital therapy. Only 37% of divorcing couples report seeking any type of counselling or therapy and only 19% of currently-married couples have. People that seek marital therapy tend to be upper-middle-class, White and college-educated. A study of 213 couples over the first five years of their marriage by U.S. researchers found that 36% of couples sought some form of outside help during this period. Individual and relationship difficulties led to an increased use of relationship books and marital therapy in the following year. Attending a marriage retreat or workshop was more closely linked to being religious.

Doss, Brian D. ... [et al] - Marital therapy, retreats, and books: the who, what, when and why of relationship help-seeking Journal of Marital and Family Therapy January 2009, 35(1), 18-29

Autism rise could be real - at least in California

The recent rise in the rates of autism has often been explained as a result of better diagnosis and an increased awareness of the condition. However, a review of data from the California Department of Development Services has found that there could be an increase in the actual incidence of the condition. The cumulative incidence of autism per 10,000 births climbed from 6.2 in 1990 to 42.5 in 2001. A change in the age at diagnosis could explain 12% of the increase, while the inclusion of milder cases could explain 56% but the researchers - from the University of California, Davis - concluded that "the possibility of a true increase in incidence deserves serious consideration."

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50D52U20090114?feedType=RSS&feedName=healthNews

Heart risk for antipsychotics

One of the main advantages of newer, 'atypical,' drugs for schizophrenia is that they are thought to have less of a risk of serious side effects such as heart attacks. However, a study of 277,000 people in Tennesee by researchers at the Vanderbilt University School of Medicine found that the newer drugs actually led to a greater risk of a heart attack than older medication. The study used files from the Tennesee Medicaid system which is aimed at providing health insurance for people on lower incomes. It found that users of the drugs had twice the rate of fatal heart attacks of non-users and the higher the dose of the drugs the greater the risk. Once patients stopped taking the drugs the risk of a heart attack faded. Although the risks may be outweighed by the benefits for people suffering from schizophrenia the drugs are also prescribed for people with dementia, attention-deficity hyperactivity disorder (ADHD), bipolar disorder and depression where - despite equal risks - there is much less evidence about their effectiveness.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50E04O20090115?feedType=RSS&feedName=healthNews&pageNumber=2&virtualBrandChannel=0&sp=true

Sleep medication use rises in the U.S.

A survey by the Reuters news agency has found that younger people in the U.S. are using an increasing amount of sleep medication. The survey found a 50% increase in the use of the drugs among all adults under 45 from 1998 to 2006. The drugs were also being taken for longer periods of time with the average length of use over the same period rising from 64 to 93 days. There was also a near trebling in the use of sleep medication by 18-24-year-olds; up from 599 users per 100,000 in 1998 to 1,524 users per 100,000 in 2004.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50E85Y20090115?feedType=RSS&feedName=healthNews&pageNumber=2&virtualBrandChannel=0&sp=true

Extra support keeps postnatal depression at bay

Two studies aimed at looking into ways of preventing women developing postnatal depression have had encouraging results. The first study, by researchers at the University of Huddersfield, compared 2,749 women who were supported by health visitors trained in cognitive behaviour therapy (CBT) or person-centred therapy to 1335 women who received conventional health-visitor care. After six months the women who had received extra support from the health visitors had lower scores for depression and these benefits were maintained after a year. In another study researchers from the University of Toronto looked at the benefits of telephone support provided by volunteers who had experienced and recovered from postnatal depression. 701 women at high risk of developing postnatal depression were divided into two groups. One group received telephone support while the other group received the usual care given to vulnerable new mothers. By the end of the 12-week study only 14% of people in the peer support group were showing symptoms of depression compared to 25% in the care-as-usual group.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50I3CI20090119?feedType=RSS&feedName=healthNews&sp=true

Childhood adversity, anxiety and asthma

Psychological factors, like stress and anxiety, can make people's asthma worse. However, a new study of 18,000 adults in the Americas, Europe and Asia has suggested that childhood adversity - such as the death of a parent or physical abuse - and mental-health problems could lead to the development of the condition in adulthood. The study used interviews carried out between 2001 and 2004 as part of the World Mental Health surveys and was analysed by researchers at the University of Otago in Wellington, New Zealand. It found that childhood adversity predicted adult-onset asthma. The more 'adversities,' such as child abuse, parental neglect, parental divorce, parental mental disorder and family violence that a child experienced the greater the risk of developing asthma as an adult. Anxiety and depression in childhood was also a strong predictor of asthma later in life. Stress is known to have an effect on the immune system so this could be the mechanism that leads to the increased risk of asthma.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50J6U520090120?feedType=RSS&feedName=healthNews&pageNumber=2&virtualBrandChannel=0

Calmness, sociability and dementia

Calm, sociable people might be less at risk of developing dementia than isolated, anxious ones according to a study of 506 older people by researchers at the Karolinska Institute, in Sweden. None of the participants in the study had dementia when they were first examined. The participants were given questionnaires to assess their personality traits and lifestyles and their health was assessed over a six-year period. The more socially active and less-stressed participants were 50% less likely to be diagnosed with dementia over the course of the study.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50I50920090119?feedType=RSS&feedName=healthNews

Emotional eating in children

Loss of control over eating is prevalent among overweight children and adolescents but what makes children binge eat is unknown. Recent studies have shown a relationship between negative emotions and binge eating and found that the experience of a loss of control over eating is significantly related to symptoms of anxiety and depression in children seeking treatment for obesity. A Belgian study of 188 overweight children included those who were seeking treatment (115) and those who were not (73). The study found that those seeking treatment for their obesity were twice as likely to lose control over their eating than those who were not seeking treatment. Increased anxiety was associated with emotional eating (eating too much but not in an uncontrolled fashion) and binge eating whereas increased depression was only associated with emotional eating. Very fat children were more at risk for loss of control over eating.

Goossens, Lien ... [et al] - Loss of control over eating in overweight youngsters: the role of anxiety, depression and emotional eating European Eating Disorders Revies January-February 2009, 17(1), 68-78

Compulsory detention for eating disorders

The compulsory treatment of people with severe eating disorders is considered controversial. The motivation to change is seen as an essential requirement for successful treatment and only a few places are prepared to treat people against their will. There is concern that compulsory treatment can undermine patients' independence and lead to worse outcomes to their treatment. A three-year study of 50 people with anorexia, admitted to the Wedgwood Unit in Stafford, compared detained patients with those being treated voluntarily. The detained patients had become ill at an earlier age and had been hospitalised more often. When admitted they were doing worse than voluntary patients, were more depressed and had more suicidal thoughts. However, both groups improved significantly once they had been admitted to the unit and by the time they were discharged there was no significant difference between them. Two of the voluntary patients died within a year of discharge; none of those who were compulsorily detained did.

Ayton, Agnes, Keen, Catherine, Lask, Bryan - Pros and cons of using the Mental Health Act for severe eating disorders in adolescents European Eating Disorder Review, 17(1), 14-24

Amygdalas and conduct disorders

Bad behaviour in childhood can predict both mental- and physical-health problems later in life. Among children with behaviour problems those with so-called callous-unemotional traits are a particular cause for concern. They show a lack of guilt and empathy for other people similar to that shown by adult psychopaths and tests have shown that they have difficulty recognising fear and sadness in others. Similar problems have been found among neuropsychological patients with damage to a part of the brain called the amygdala leading to suggestions that problems in this area could also exist in children with conduct problems. A brain-scan study of 30 boys - average age 11 - by researchers at the Institute of Psychiatry in London showed them pictures of fearful and neutral faces. Those boys with conduct problems and a higher level of callous-unemotional traits had less activity in the right amygdala when shown the fearful faces.

Jones, Alice P. ... [et al] - Amygdala hypoactivity to fearful faces in boys with conduct problems and callous-unemotional traits American Journal of Psychiatry January 2009, 166(1), 95-102

IQ and mental health

Cognitive reserve refers to differences in the way people's brains are made up with some people's brains having a denser network of links between brain cells and a higher processing efficiency than others. This difference in brain capacity can be measured, very roughly, by IQ tests and there is evidence to show that a higher IQ is linked to a lower risk of mental-health problems. A study of 1,037 people born between 1972 and 1973 in Dunedin, New Zealand measured their IQ at 7,9 and 11 and assessed them for mental-health problems at 18, 21, 26 and 32. The researchers found that a lower childhood IQ was associated with an increased risk of developing schizophrenia, depression and anxiety and people with lower childhood IQs tended to have more persistent mental-health problems. Higher childhood IQ was associated with an increased risk of mania in adulthood.

Koenen, Karestan C. ... [et al] - Childhood IQ and adult mental disorders: a test of the cognitive reserve hypothesis American Journal of Psychiatry January 2009, 166(1), 50-57

Cannabis and anxiety

Taking cannabis can affect people's anxiety levels. Long-term use has been associated with anxiety symptoms, panic attacks and an increased risk of anxiety disorders and sudden and severe increases in anxiety can also occur following cannabis use. However, cannabis use can also lead to sedation and relaxation and many people who take the drug say it makes them feel less anxious. A team of researchers at the Institute of Psychiatry in London gave 15 healthy volunteers (none of whom were regular cannabis users) two chemicals found in cannabis, 9-THC and cannabidiol. They then showed them faces, some of which looked frightened and distressed, designed to make them feel anxious. The participants' anxiety levels were measured by changes in their skin using the same techniques as lie-detectors, and they also underwent a brain scan. 9-THC was found to increase anxiety as well as levels of intoxication, sedation and psychotic symptoms. Cannabidiol reduced anxiety. The two chemicals were also found to affect different parts of the brain. 9-THC affected the frontal and parietal parts of the brain whereas cannabidiol affected the amygdala and the anterior and posterior cingulate cortex.

Fusar-Poli, Paolo ... [et al] - Distinct effects of 9-tetrahydrocannabinol and cannabidiol on neural activation during emotional processing Archives of General Psychiatry January 2009, 66(1), 95-105

Dopamine and schizophrenia

No-one really knows what causes schizophrenia. One theory is that too much activity involving the neurotransmitter dopamine in a part of the brain called the striatum causes the delusions associated with psychosis but it is unclear when the excess dopamine activity starts to occur in the course of the illness. A brain-imaging study of 43 people by researchers at the Institute of Psychiatry in London compared people with schizophrenia, people with prodromal symptoms of schizophrenia (who show certain symptoms and have a high risk of going on to develop full-blown schizophrenia) and a healthy control group. The researchers found that people with schizophrenia had the highest levels of dopamine activity but that those people with prodromal symptoms also had a raised level of dopamine activity compared to the control group. The higher levels of dopamine activity were found in a region of the striatum called the associative striatum.

Howes, Oliver D. ... [et al] - Elevated striatal dopamine function linked to prodromal signs of schizophrenia Archives of General Psychiatry January 2009, 66(1), 13-20

Guilt and PTSD in children

Although guilt is not one of the 'core' symptoms of post-traumatic stress disorder (PTSD) it often goes hand-in-hand with it. There can be guilt at surviving a trauma while others did not and a feeling of responsibility for not preventing the event in the first place. People can also feel guilty about how they behaved during and after the trauma and about how they deal with its consequences. Guilt has been found to be prevalent in about a third of children experiencing acute or non-abusive trauma such as floods, fires and car accidents and among children exposed to recurring trauma or child abuse nearly 60% felt guilt. A study of 87 Californian children between the ages of 5 and 16, all of whom had been exposed to interpersonal violence, found that guilt over things done and not done was highly associated with the severity of the child's PTSD. Feelings of unreality and separation anxiety were also significantly related to PTSD symptoms.

Kletter, Hilit, Weems, Carl F. and Carrion, Victor G. - Guilt and posttraumatic stress symptoms in child victims of interpersonal violence Clinical Child Psychology and Psychiatry January 2009, 14(1), 71-83