Expressed emotion, cognition and schizophrenia

Expressed emotion is a measure of how much emotion is displayed in the family of someone with a mental-health problem. High expressed emotion is made up of hostility (blaming the sufferer for their problem), emotional overinvolvement (blaming oneself) and critical attitudes and is often thought to be a risk factor for the development of schizophrenia. The cognitive problems that go along with schizophrenia are thought to make people more vulnerable to the negative effects of expressed emotion. Researchers from Semmelweis University in Hungary studied 80 people with schizophrenia, testing their cognition, counting the number of harsh comments made to them by relatives and recording their unusual thoughts. They found that the links between criticism and unusual thoughts were strongest in patients who had problems with attention and immediate memory.

Keri, Szabolcs and Kelemen, Oguz - The role of attention and immediate memory in vulnerability to interpersonal criticism during family transactions British Journal of Clinical Psychology March 2009, 48(1), 21-29

Attachment, genes and parenting

Attachment refers to the way in which children bond with their primary caregiver - usually their mother - and is thought to affect the way children develop and form relationships later in life. One of the ways in which psychologists assess children's 'attachment style' is by seeing how they react when their mothers leave the room. Children with secure attachment can tolerate brief separations and are easily comforted when their mothers return. Children with insecure attachment react differently; they may snub the returning caregiver or go to them but resist being picked up. A small group of children exhibit disorganized attachment. When they are reunited with their caregivers they can look dazed or frightened, freeze in place, back towards the caregiver or approach with their head sharply averted. Disorganized attachment is seen as a major risk factor for childhood mental-health problems and aggressive behaviour. Researchers in Germany and Hungary looked into the links between genes, upbringing and disorganized attachment in a sample of 106 one-year-olds. They found that there was a significant association between disorganized attachment and a variation in a gene called DRD4. However, this genetic link was only activated in children whose mothers showed low responsiveness to them.

Spangler, Gottfried ... [et al] - Genetic and environmental influence on attachment disorganization Journal of Child Psychology and Psychiatry August 2009, 50(8), 952-961

Infant stress and brain structure

Maltreatment, neglect or other stressful experiences early in life are known to produce impairments in social, behavioural and cognitive functioning. The brain is also known to be vulnerable to stress and the hippocampus, amygdala and corpus callosum are all known to be affected by early exposure to negative or stressful experiences. Researchers from the Institute of Psychiatry in London looked into the effects of early stress on the brain by comparing a group of children brought up in state orphanages in Romania and subsequently adopted to a control group of children brought up in families in the U.K. The conditions of care in the orphanages were pretty grim with the children remaining in cots all day, with few playthings, little interaction with adults and being fed gruel through a bottle. The study found that the Romanian children had significantly smaller grey and white matter volumes. The Romanian children had larger amygdalas, relative to the size of their brains, although this was because the right amygdala was larger as the left amygdala was actually smaller in the Romanian children. There were no differences in the hippocampus and the corpus callosum between the two groups.

Mehta, Mitul A. ... [et al] - Amygdala, hippocampal and corpus callosum size following severe early institutional deprivation: the English and Romanian adoptees study pilot Journal of Child Psychology and Psychiatry August 2009, 50(8), 943-951

Meal support and anorexia

People with very severe eating disorders can sometimes be fed, via a tube, through their nose. This is only recommended as a treatment of last resort and is, hardly surprisingly, very unpopular with those who receive it. Meal-support therapy is often used to help people with anorexia. Meals and snacks are given under the supervision of trained staff members who show empathy and understanding while setting firm limits about what they must consume. Researchers at McMaster University and the University of Western Ontario reviewed the medical records of 21 adolescents who had been treated for anorexia. They found that the incidence of nasogastric feeding was substantially reduced after the implementation of meal-support therapy. However, meal-support was found to produce no difference in length of stay, change in weight or readmission rates. The nasogastric feeding was associated with a number of problems including nausea, nose bleeds, anxiety, self-harm and throat pain.

Couturier, Jennifer, Mahmood, Adeel - Meal support therapy reduces the use of nasogastric feeding for adolescents with anorexia nervose Eating Disorder July-September 2009, 17(4), 327-332

Female athletes and eating disorders

Female athletes are known to be at a greater risk of suffering from disordered eating attitudes and behaviour. It is thought that up to 2% of female athletes have anorexia and 6% have bulimia compared to 0.9% and 1.5% respectively of the general population. Researchers from the University of North Texas, the University of Utah and the Center for Balanced Living in Ohio studied 204 female college athletes in an attempt to find the psychological factors behind eating disorders in athletes. They found that 27.5% of the sample showed at least some symptoms of disordered eating. There was no difference between the girls with and without eating disorders in terms of perfectionism or optimism and both groups were as motivated as each other to exercise for fitness and health. However, the girls with disordered eating were more likely to have low self esteem and to exercise to improve their mood and their appearance.

Petrie, Trent A. ... [et al] - Personality and psychological factors as predictors of disordered eating among female collegiate athletes Eating Disorders July-September 2009, 17(4), 302-321

Depression, anxiety and death

Depression is often linked to increased mortality but the strength of this link is controversial and even less is known about how anxiety affects mortality. Norwegian researchers studied 61,349 people over a 3-6-year period. They found that depression was associated with a 52% increase in mortality, on a par with smoking. This could only be partially explained by physical illness among the depressed people. The relationship between anxiety and mortality was more complex with depressed people who were also anxious being less likely to die. Anxiety had a 'U-shaped' relationship to mortality with moderately-anxious people living longer than those with low and high levels of anxiety.

Mykletun, Arnstein ... [et al] - Levels of anxiety and depression as predictors of mortality: the HUNT study British Journal of Psychiatry August 2009, 195(2), 118-125

Residential alternatives to hospital

Inpatient mental-health services are unpopular with patients. They often fail to address individuals' needs or provide a safe or therapeutic environment. However, home treatment is not always appropriate, either because of the levels of risk to patients and others involved, or because people's domestic circumstances are part of the problem not part of the solution. Researchers at University College London and the Institute of Psychiatry looked at research into residential alternatives to psychiatric hospitals. One was Soteria houses, developed by Loren Mosher in California in the 1970s. In these houses primary staff are not clinically-trained but work long shifts designed to help them attune to, and engage with, residents. Staff and service users share responsibility for household tasks and there is minimal reliance on antipsychotic medication. Other studies looked at crisis houses and schemes where service users are placed with individual families. In these schemes the host family support one or two acutely-ill people with training and assistance from local crisis services. Individuals are involved in a normal family environment with participation in meals and other domestic tasks and activities, a model which has been used on a small scale in Powys, Wales. The review found that there was no evidence to suggest these schemes were harmful and some preliminary evidence to suggest that they were cheaper than hospital and that service users were more satisfied. The researchers concluded that 'residential crisis services may provide a feasible and acceptable alternative to hospital admission for some people with acute mental illness.'

Lloyd-Evans, Brynmor ... [et al] - Residential alternatives to acute psychiatric hospital admission: systematic review British Journal of Psychiatry August 2009, 195(2), 109-117

Mothers' mental health - how does it affect their children?

Dr Belinda Lloyd from the University of Queensland has been looking into the links between mothers' mental health and their children's. She used data from the Mater-University Study of Pregnancy - a long-term study of more than 7,000 mothers and their children born at Brisbane's Mater Hospital between 1981 and 1983. Dr Lloyd found that children whose mothers experienced mental-health problems as their children went through adolescence were more likely to have behavioural and mental-health problems themselves. Children whose mothers had recurrent mental-health problems were also at greater risk of behavioural and psychological difficulties. However, the study found that antenatal and postnatal depression alone had no negative impact on children.

You can find out more about this research at

http://www.medicalnewstoday.com/articles/159191.php

Learning and dopamine

Researchers at the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig and at University College London have been looking into the ways the brain 'rewards' itself for getting answers right. People who are rewarded for making correct decisions learn quickly. Previous research has shown that when a correct decision is made the brain's reward system is activated and a reward stimulus is sent back to the area of the brain responsible for making the decision. The researchers thought that the neurotransmitter dopamine played a part in this. In their experiment they attached electrodes to both index fingers of the participants. Two electric currents, each with a different frequency, were applied via the electrodes and the participants had to decide which current had the higher frequency. If they guessed right a monetary reward was flashed on a screen. The higher the reward that was displayed the more accurate the participants' guesses were. To look into the effects of dopamine on this process a third of the participants were given Levopoda (which increases dopamine), a third were given Haloperidol (which decreases it) and a third were given a placebo. The 'reward effect' was greatest in the group taking Levopoda and completely absent in the group taking Haloperidol. However, dopamine is implicated in psychosis and schizophrenia so for any dopamine-boosting learning drug the side effects might end up being worse than the original problem.


You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090727203624.htm

Teenage pregnancy and depression

Researchers from the Institute of Behavioural Sciences at the University of Colorado, Boulder looked into the psychology of teenage pregnancy. They used data from two large, long-term U.S. surveys that followed thousands of teenaged girls and women. The researchers measured psychological distress by asking the participants how often they found things bothersome that would not normally affect them; how easily they could shake off feeling down and whether they had trouble concentrating. They found that poverty and psychological distress were good predictors of teenage pregnancy i.e. they already existed before the girls became pregnant. Other studies have shown high levels of depression among teenage mothers but this is the first to show that they may be suffering psychologically before they become pregnant.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090727204829.htm

GPs not great at diagnosing depression

Researchers from the University of Leicester looked at how accurate GPs were at diagnosing depression. They combined the results of 41 studies in nine countries and found that GPs were only able to spot 50% of people with clinical depression. One in five people who did not have depression were told they had it. The researchers recommended that in cases where the diagnosis was not clear GPs make a second appointment for the patient.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090729132113.htm

Over-diagnosing bipolar disorder

A year ago researchers at Rhode Island Hospital and Brown University found that fewer than half of the patients previously diagnosed with bipolar disorder actually met the strict criteria for the condition. In a study of 700 patients 145 reported that they had previously been diagnosed with bipolar disorder. However, when they were assessed with the Structured Clinical Interview for DSM-IV (SCID) it was found that only 43.4% could be diagnosed as bipolar. Over-diagnosing bipolar disorder can unnecessarily expose people to serious side effects affecting kidneys, hormones, livers, immune systems and metabolisms. A year later the researchers tried to give a more accurate diagnosis to the patients misdiagnosed with bipolar disorder. A quarter of them had borderline personality disorder while others had major depression, antisocial personality disorder, post-traumatic stress disorder (PTSD) and eating and impulse disorders.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090729100936.htm

Antipsychotics, dementia and diabetes

An increasing number of older adults with dementia are being prescribed antipsychotic drugs to regulate their behaviour; something that has been linked with Parkinson's-like symptoms, stroke and diabetes. Researchers from the University of Toronto studied 13,817 people with diabetes who started treatment with antipsychotics between 2002 and 2006. 11% were hospitalized for hyperglycaemia (high blood sugar) over the course of the study. Those who were currently taking antipsychotics had a higher risk of hospitalization and the risk was highest among those who were just starting antipsychotic treatment. Some previous studies have suggested that the neurotransmitter dopamine has a role in regulating blood sugar so it could be the antipsychotic's effects on dopamine within the body that leads to the increased risk.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090727191722.htm

Alzheimer's: brains change before symptoms show

Researchers from Harvard Medical School have found that people's brains can start to go bad ways even before they have any symptoms of Alzheimer's disease. One of the main characteristics of Alzheimer's disease is the accumulation and deposition of clumps of damaging amyloid protein in the brain. Using brain scans the researchers found that a significant number of older people without dementia showed amyloid deposition and abnormal neural activity in important areas of the brain network thought to be involved in memory.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090729121548.htm

Confidence and comprehension

Teenagers who are overconfident about their reading abilities may actually have worse reading skills than those who are less sure of themselves. Researchers from the University of Buffalo in New York and the University of Alberta studied 160,000 children in 34 countries. They found that overconfident children were more likely to be below-average readers while underconfident ones were more likely to be above-average. This finding held true in all 34 countries and was particularly marked in more individualistic cultures such as the U.S. and Switzerland. The study found that the underconfident students were better able to accurately assess and evaluate their own reading levels; those who can accurately gauge their strengths and weaknesses are usually in a better position to identify realistic goals and to achieve them. In practice this might mean that an overconfident child choses a more difficult book and then abandons it while an underconfident one choses an easier one, finishes it and then moves on to the more difficult book later.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090729140923.htm

Report finds murders up (but still rare) and suicides down

The latest annual report from the National Confidential Inquiry into Suicide and Homicide by people with mental illness has found that the number of murders by mentally-ill people rose between 1997 and 2005 but that less mentally-ill people killed themselves. The University of Manchester carries out the research for the report with funding from the National Patient Safety Agency. The study found that murders by mentally-ill people rose from 54 in 1997 to over 70 in 2004 and 2005. People with schizophrenia killed 25 people in 1997 and 46 in 2004. The risk of being killed by someone who has schizophrenia is still very small though - about 1 in 20,000. The number of inpatients killing themselves fell from 219 in 1997 to 141 in 2006, however, in the ten years up to 2006 there were 469 suicides by patients who had left a ward without permission. There was also an increase in the number of sudden unexplained deaths among inpatients - 338 in the eight years up to 2006.

http://www.medicine.manchester.ac.uk/psychiatry/research/suicide/prevention/nci/inquiryannualreports/AnnualReportJuly2009.pdf

Depressed people take a weight off their mind

New research has shown that losing weight might not only help depressed people become healthier it could also help improve their mood as well. Researchers at the University of Pennsylvania compared people with and without depression as they followed a weight-loss programme including lifestyle modification and meal replacements. Both groups lost significant amounts of weight and improved their levels of blood sugar, insulin and cholesterol but the depressed participants also showed a significant improvement in their depressive symptoms.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090727102028.htm

Dreams, delusions and psychosis

Researchers at the European Science Foundation have been discussing the latest research on dreams. They looked into a phenomenon called lucid dreaming in which people are aware that they are dreaming. They found it creates distinct patterns of electrical activity in the brain similar to the patterns made by psychosis. In lucid dreaming the brain is said to be in a dissociated state having lost conscious control over mental processes such as logical thinking and emotional reaction - again something that also occurs in psychosis. People suffering from nightmares can sometimes be treated by training them to dream lucidly so that they can consciously wake up, something it is hoped could be applied to people with psychosis. Dreaming is thought to have emerged to enable early humans to rehearse responses to the many dangerous events they faced in real life and some researchers think that paranoid delusions might occur because of a replay of this "threat response rehearsal," during waking life. However, not all dreams are threatening and other scientists see them as part of a learning process consolidating information acquired during the day. This theory is supported by the fact that people often remember things better the day after they learnt them i.e. after a night's sleep, than shortly afterwards.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090728184831.htm

New blood test for Alzheimer's

Researchers from MP Biomedicals and the University of California, Los Angeles have moved a step closer to a blood test for Alzheimer's disease. Although there is no cure for the condition early diagnosis is considered crucial so that people can get drugs which slow the progress of the disease. The test relies on taking cells called monocytes from the bloodstream and measuring how well they are 'mopping up' a protein called amyloid beta that forms the plaques and tangles in the brain characteristic of Alzheimer's disease. The more amyloid beta the cells are mopping up the less chance people have of having Alzheimer's and vice versa. In a study including 18 Alzheimer's patients and 14 university professors the test proved 94% accurate in saying that the patients had the disease and 100% accurate in giving the professors a clean bill of health. The results were also found to give a positive diagnosis in 60% of a further group of participants with mild cognitive impairment which is often a precursor to full-blown Alzheimer's. The test was also accurate over time with the amyloid levels of the Alzheimer's patients declining as their condition worsened.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090713124714.htm

Darkness, depression and dimming brainpower

It is known that lack of sunlight can contribute to depression but new research suggests that it might also have an effect on brainpower - at least for people suffering from depression. Shia Kent from the University of Birmingham in Alabama used data from another study covering 14,474 people to look at the links between depression, cognitive power and sunlight. They found that among the participants with depression low exposure to sunlight was associated with a significantly higher probability of cognitive impairment as assessed by short-term recall and temporal orientation. As well as regulating the hormones serotonin and melatonin light has also been shown to affect the flow of blood to the brain, something that has been linked with cognitive functioning.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/07/090727191728.htm