Farewell!

Dear Blog followers,
I am moving to a new job on the 11th of April and will no longer be able to keep up my work on the Mental Health Update blog. I have really enjoyed writing for the blog over the last six years. Thank you all for your kind comments about it and I hope some of you have found it interesting and even helpful. I'd like to wish everyone who follows the blog all the best for the future.
Best Wishes,
John Gale,
Mental Health Update

Antipsychotics and older people - new evidence on health risks

There has been much criticism in the past about the overuse of newer, atypical antipsychotic drugs to manage problem behaviour in elderly people with dementia. However, a new study by researchers from Brigham and Women's Hospital in Boston has suggested that alternative drugs may be just as dangerous. The researchers studied 10,900 people who were admitted to nursing homes in British Columbia between 1996 and 2006 and who received a psychotropic drug within 90 days of admission. The study found that people taking conventional antipsychotics, antidepressants and benzodiazepines were at higher risk of death and fractures of the femur. Levels of pneumonia and heart failure did not differ between those taking atypical antipsychotics and those taking other drugs.

ADHD and creativity

Adults with Attention Deficit Hyperactivity Disorder (ADHD) could be more creative than other people. Holly A. White from the University of Memphis and Priti Shah from the University of Michigan in Ann Arbor studied 60 people, 30 of whom had ADHD. They found that the adults with ADHD had higher levels of real-world creative achievement and displayed higher levels of creative thinking on a test of creativity. People with ADHD showed an inclination towards idea generation while those without ADHD were stronger at problem clarification and developing ideas.

Body acceptance and social support

Women's acceptance of their bodies could have more to do with how other people see them than their actual weight. Researchers from Ohio State University studied 801 women between the ages of 18 and 65. They found that the most important influence on how women saw their bodies was how they thought important people in their life saw them and that the more women focused on how their bodies functioned and felt the more they appreciated them. In turn, the more women appreciated their bodies the more likely they were to eat intuitively, i.e. in response to hunger rather than emotions or the presence of food. The study also found that women who thought they had strong levels of social support were more likely to accept their bodies. For women aged between 26 and 65 those who weighed more were less likely to eat intuitively and more likely to think that others didn't accept their bodies if they weighed more. Women aged between 26 and 39 were most likely to achieve body appreciation by focusing more on how their bodies functioned.

Ecstasy research moves into the real world

Studies into the effects of ecstasy tend to be carried out in the laboratory and don't always reflect what goes on in real life. A team of researchers led by Dr Rod Irvine from the University of Adelaide tried to get round this by sending researchers to parties where they thought people might be taking the drug. The researchers managed to persuade 56 people to invite them to house parties where they collected samples of pills and measured the users' levels of MDMA - the active ingredient of ecstasy. The researchers found that only half of the pills consisted entirely of MDMA; some pills contained no MDMA at all while others contained methamphetamine or chemicals related to MDMA such as MDEA or MDA. The pills that did contain MDMA ranged in quantity from 25mg to ten times that amount. Most users took more than one pill while some took as many as five. In 14 people the amount of MDMA in the blood reached levels that had never been studied in humans in the laboratory although noone suffered any immediate health problems.

Why goody two-shoes isn't always top of the class

Better-behaved children don't always get better marks at school and naughtier ones don't always do worse. A team of researchers from the University of North Carolina studied 350 children in seven schools over a five-year period. They looked at teachers' assessments of children's behaviour and achievements and at the actual level of pupils' work. They found that teachers were more likely to report that well-behaved students did better academically and expected more of them - even when some of these students were struggling with school-work. At the same time, students who were naughty in school were seen as having more academic difficulties, even though this was not always the case.

New research shows how violence spreads through society

Being exposed to violence, either watching it on TV, seeing it in the flesh or suffering it oneself is more likely to make children think it is normal and could lead to them behaving violently themselves. A team of researchers, led by Izaskun Orue from the University of Duesto in Spain, studied nearly 800 children aged between eight and twelve. They asked them if they had witnessed violence in their own lives or on TV and if they had been a victim of violence. They were also asked about their attitudes to violence by being asked whether they agreed with statements such as 'sometimes you have to hit others because they deserve it.' The children were asked about their own levels of violence and their classmates rated how violent they were. Six months later the children were surveyed again. The schoolchildren who had witnessed or been a victim of violence were more aggressive and observing violence at the first phase of the study was associated with increased aggression six months later. The increased aggression was caused in part by a change in how the children thought that violence was normal. Seeing violence -- at home, school, on TV, or as its victim -- made it seem common, normal, and acceptable and thinking that aggression was normal led to more of it.

Psychosis, insight and hearing voices

People with psychosis are said to lack insight when they have a poor awareness that they are mentally ill and don't think they need to get help. Lack of insight is associated with poorer outcomes and worse adherence to treatment while improved insight has been linked to better treatment compliance and less hostility. A team of researchers led by Guillem Lera from the Hospital de la Ribera in Valencia looked into the links between insight and auditory hallucinations in a study of 168 psychotic patients. They found that patients with persistent auditory hallucinations had significantly less insight than patients with occasional or no hallucinations. The further away the hallucinations were thought to come from the less insight people had. The patients who heard voices 'in their head' showed better insight than those who heard voices coming from outside themselves.

Lera, Guillem ... [et al] - Insight among psychotic patients with auditory hallucinations
Journal of Clinical Psychology, 67(7), 1-8

Anxiety sensitivity and cannabis use

Anxiety sensitivity can be defined as being anxious about being anxious. People with anxiety sensitivity are anxious about the physical symptoms of being anxious (an upset tummy, sweaty palms, pounding heart), mental incapacitation (losing control and not being able to think properly) and social concerns such as other people seeing them with a red face or in a panic. Some researchers think anxiety sensitivity plays a part in cannabis use and a team of researchers led by Julia D. Buckner from Louisiana State University looked into this in a study of 49 current cannabis users who were asked to fill in assessments about their mood at random times over a two-week period. The researchers found that at the start of the study fears about mental incapacitation were significantly related to more severe cannabis problems. Over the course of the study fears about mental incapacitation and social concerns were linked to subsequent cannabis use.

Buckner, Julia D. ... [et al] - Anxiety sensitivity and marijuana use: an analysis from ecological momentary assessment Depression and Anxiety DOI 10.1002/da.20816

Genetic link to suicide risk

Researchers from Johns Hopkins University in Baltimore have identified a gene that could be linked to an increased risk of attempting suicide. The researchers studied 2,698 people with bipolar disorder, 1,201 of whom had a history of suicide attempts. Those with one copy of a genetic variation on chromosome 2 were 1.4x as likely to have attempted suicide while those with two variations were almost three times as likely. The gene involved - ACP1 - leads to increased levels of a protein called ACP1 in the brains of people who had committed suicide. The protein is thought to influence the same biological pathway - albeit in a different direction - as lithium, a drug known to reduce the rate of suicidal behaviour.

Childhood problems and adult happiness

Psychological problems in people's childhoods could reduce their earnings later in life and their chances of forming a lasting relationship. A team of researchers led by Alissa Goodman from the U.K.'s Institute for Fiscal Studies looked at data from the National Child Development Study which followed 17,634 children born in Britain during the first week of March 1958 over a fifty-year period. The researchers found that family income was about a quarter lower, on average, among those who experienced serious psychological problems in childhood. Childhood psychological problems were also associated with being less conscientious, being less likely to marry and having less stable personal relationships later in life. By contrast major physical health problems in childhood only reduced income by an average of 9%.

For the very paranoid everyone is a threat

Previous research has shown that even neutral social contact can trigger paranoid thinking in people with paranoia. Social contact can have a wide variety of different contexts from complete strangers to friends and family and a team of researchers led by Dina Collip from Maastricht University studied 154 people assessing their paranoia and asking them to record their feelings in everyday life. People with low and medium levels of paranoia reported higher levels of perceived social threat when they were with less familiar people, however, people with high levels of paranoia showed no difference in the level of perceived threat between familiar and unfamiliar people.

Collip, D. ... [et al] - Social world interactions: how company connects to paranoia Psychological Medicine (2011), 41: 911-921

Immigration and psychosis

Migration is an accepted risk factor for schizophrenia but the level of risk in second-generation immigrants in unclear. A team of researchers from McGill University in Canada reviewed 21 studies into psychosis among immigrants. They found that while first-generation immigrants were 2.3x as likely to develop psychosis as other people second-generation immigrants were 2.1x as likely. While there was no significant difference in risk between the generations there were wide variations in levels of psychosis between different ethnic groups and different host countries.

Bourque, F., van der Ven, E. and Malla, A. - A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants Psychological Medicine (2011), 41: 897-910

Elder abuse - who suffers most?

Researchers from the University of Illinois at Chicago have been looking into the issue of older abuse. They used data from two trauma units in Chicago to compare people over 60 admitted after suffering from elder abuse to people of the same age admitted for different reasons. The researchers found that patients admitted after elder abuse were more likely to be women, to suffer from a neurological or mental disorder and to use drugs and were more than twice as likely to have a drink problem. The people who had suffered elder abuse had more severe injuries and worse outcomes. 85% of the perpetrators were family members or partners and 17% of the victims expressed a desire to return to the perpetrator and not to press charges.

Neglectful parents and mental-health problems

Emotional neglect can be defined as 'emotional unresponsiveness, unavailability and neglect characterised by a lack of interaction between parent and child.' It has been linked to children developing more mental-health problems but most research so far has been based on adults' memories of their childhood not how children feel at the time. A team of researchers from the University of Glasgow and the Medical Research Council in Glasgow studied 1,694 children. The children filled out a questionnaire called the Parental Bonding Instrument at 11 to assess their relationship with their parents and then had a computerised psychiatric interview at 15 to assess any mental-health problems. 3% of the children perceived their parents as almost always emotionally neglectful and controlling and this group had more than twice the risk of developing mental-health problems at 15.

Young, Robert, Lennie, Susan and Minnis, Helen - Children’s perceptions of parental emotional

neglect and control and psychopathology Journal of Child Psychology and Psychiatry
doi:10.1111/j.1469-7610.2011.02390.x

Even moderate stress can cause long-term problems

A study of more than 17,000 working adults by researchers from the University of Bristol and the Karolinska Institute in Sweden has found that even mild psychological stress can have an effect on people's health. The study followed the participants between 2002 and 2007 and found that higher levels of stress at the start of the study were associated with a significantly greater likelihood of subsequently being awarded long-term disability benefits. However, even those with mild stress were up to 70% more likely to receive disability benefits. One in four of the benefits awarded for physical illnesses such as high blood pressure, angina and stroke and almost two-thirds of those awarded for mental illness were attributable to stress.

Childhood epilepsy and mental-health problems

Children with epilepsy are more likely to have mental-health problems. A team of researchers led by Dr Kristin Alfstad from the National Centre for Epilepsy at Oslo University Hospital in Norway, studied information collected from 14,699 parents by the Norwegian Health Services Research Centre. 110 of the children in the survey had epilepsy and they were over twice as likely to have psychiatric symptoms as other children (38% vs 17%). Girls with epilepsy were more likely to have emotional problems while boys were more likely to have hyperactivity, inattention and problems with relationships. Having epilepsy was a much stronger risk factor for developing mental-health problems in boys than in girls.

Prematurity, poverty and child development

In 2006 12.8% of births in the U.S. were premature. Premature births are linked to delays in motor/neurologic function, intellectual and academic development, language problems, poorer executive functioning and worse behaviour. Premature births are more common in poorer people. Being poor also has an effect on child development and children who are both premature and have poor parents are at an even greater risk of developmental problems. A team of researchers from the University of Maryland and Pennsylvania State University looked into some of these problems in a study of 122 African-American women with premature babies. They found that psychosocial risk (mothers' depression, stress and self-efficacy) and sociodemographic risk (poverty, mothers' education and marital status) were linked to maternal sensitivity which in turn affected the strength of the attachment between the mothers and their children at 12 months. However, the health of the children did not affect maternal sensitivity or later attachment.

Candelaria, Margo,  Teti, Douglas M. and Black, Maureen M. - Multi-risk infants: predicting attachment

security from sociodemographic, psychosocial, and health risk among African-American preterm infants Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2011.02361.x

Hippocampal size and PTSD

The hippocampus is a region of the brain involved in memory and how we interpret the world around us. MRI (magnetic resonance imaging) studies have shown that the hippocampus shrinks in people with chronic post-traumatic stress disorder (PTSD) and that a smaller hippocampus could make people more vulnerable to the condition. A team of researchers, led by Brigitte A. Apfel from the San Francisco Veterans Affairs Medical Center, compared hippocampal volumes in veterans from the Gulf War. Some had developed PTSD and recovered from it, others had chronic PTSD and others had never had it. The study found that those veterans who had recovered from PTSD had larger hippocampi than those who had not recovered and were similar in size to those who had never had it. The study supports the idea that a smaller hippocampi is a risk factor for PTSD. This could be because common biological factors make people have smaller hippocampi and be more vulnerable to stress or that stress early in life makes people's hippocampi smaller and increases their vulnerability to stress later on.

Sickies - skiving or strategic problem avoidance?

The same levels of illness can lead different people - or the same person at different times - to either take a sickie or struggle into work. A team of researchers, led by Hanna Hultin from the Karolinska Institutet in Sweden, interviewed more than 400 people from six different workplaces within a few days of them taking sick leave. They found that problems in relationships with colleagues and superiors were more frequent in the days before people took sick leave and that people with a minor ailment were more likely to report sick when they expected that the following workday would be particularly stressful.