February 29, 20088:44 am
posted by Aric Thorpe, MHR

The human desire for one to “keep options open”

Recently, some MIT students, under the direction of professor Dan Ariely, took a test to examine the unproductive human desire for one to “keep options open.” Holding on to relationships that you know won’t work, keeping that outdated shirt that you haven’t worn in years, purchasing that extra protection plan on the camera you just bought, are all examples of most likely unproductive, encumbering decisions that we choose to make just to keep our options open. One of the role models in Professor Ariely’s new book, “Predictably Irrational,” is Chinese general Xiang Yu who, after crossing the Yanntze River into enemy territory with his troops, destroyed all of his troops pots for cooking and ships. The general told them that it was to keep them focused on moving forward. The following is an excerpt of an article by the New York Times that discusses this oddity of human behavior:

In the M.I.T. experiments, the students should have known better. They played a computer game that paid real cash to look for money behind three doors on the screen. (You can play it yourself, without pay, at tierneylab.blogs.nytimes.com.) After they opened a door by clicking on it, each subsequent click earned a little money, with the sum varying each time.

As each player went through the 100 allotted clicks, he could switch rooms to search for higher payoffs, but each switch used up a click to open the new door. The best strategy was to quickly check out the three rooms and settle in the one with the highest rewards.

Even after students got the hang of the game by practicing it, they were flummoxed when a new visual feature was introduced. If they stayed out of any room, its door would start shrinking and eventually disappear.

They should have ignored those disappearing doors, but the students couldn’t. They wasted so many clicks rushing back to reopen doors that their earnings dropped 15 percent. Even when the penalties for switching grew stiffer — besides losing a click, the players had to pay a cash fee — the students kept losing money by frantically keeping all their doors open.

Click here to read the rest of this article from the New York Times

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February 27, 20088:32 am
posted by Aric Thorpe, MHR

It is beneficial for rheumatologists to ask their patients about depression

A recent study reveals that it may be beneficial for rheumatologists to ask their patients about depression. The study, a randomized trail of communication strategies between patient and doctor, is still underway. Its findings revealed that 80% of depressed patients failed to mention their state to their rheumatologists. According to Betsy Sleath, Ph.D., “Chronic diseases can greatly affect a patient’s psychosocial well-being, and depression can also affect a patient’s adherence to treatment regimens.” The following is an excerpt of an article from Medpage Today that reviews the study:

The study was part of a randomized trial of provider-patient communication strategies that is not yet completed. The new report is based on the baseline patient examinations by their rheumatologists, which were recorded and transcribed.

It included 200 patients and eight rheumatologists in four clinics. Most of the analysis focused on 21 patients with severe or moderately severe depression.

This level of depression was defined by scores of at least 15 on the Patient Health Questionnaire.

Patients had previously seen the rheumatologists, but the researchers did not determine for how long.

Dr. Sleath and colleagues found that only four of the encounters (19%) included discussion of patients’ depressive symptoms. All four were initiated by the patients, not the physician.

Their report included quotes from the recorded conversations. In one case, the patient described feelings of depression and day-long crying jags. The physician was supportive and sympathetic, but did not explore the issues. According to Dr. Sleath and colleagues, the only medically substantive discussion was about the patient’s drug regimen for arthritis and follow-up appointment.

Click here to read the entire article from Medpage Today

The key message here is that rheumatologists need to take initiative to discuss depression with their patients. However, the message is much more broadly applicable, in my opinion, to a variety of situations. Families need to be aware through open discourse of what their members are going through, feeling. Additionally, people in charitable roles, such as Pastors, should also be aware of the signs of depression and be willing to have a discourse with congregants about this. Pastors are actually in a unique position to reach out to people in this regard because of the appealing nature, the luring influence, of their message. This truth can clearly be seen in the mission statement of one local church: “love, acceptance, forgiveness…”

Click here to view Renewal Christian Care’s “depression information guide”

Click here to view Renewal Christian Care’s “Pastor’s Mental Health Evaluation Guide” (This guide is not for the diagnosis of depression but merely a guide to help open a forum of discussion between Pastors and congregants about mental health)

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February 26, 20088:19 am
posted by Aric Thorpe, MHR

Nation wide shifting in religious affiliations

A recent study by the Pew Forum on Religion and Public Life has obtained some interesting findings about religious affiliation. According to the report, there is a great deal of shifting in affiliations to new denominations, other religions, or those that choose to be unaffiliated in the United States. The study took a sampling from 35,000 adults to provide information about a diverse population of Americans. According to the findings, Protestant churches, traditionally the majority among Christian denominations, are loosing members. Non-denominational churches, on the other hand, are experiencing tremendous gain. According to Luis Lugo, director of the Pew Forum, “Everyone is losing, everyone is gaining. There are net winners and losers, but no one can stand still.” The Pew Forum reported that 78% of the United States population consider themselves to be Christian, but only 51% Protestant. “Right now, there is a dropping confidence in organized religion, especially in the traditional religious forums,” said Roger Finke, Penn State University sociologist. The following is an excerpt of an article from CNN.com that discusses the study more in-depth:

The U.S. religious marketplace is extremely volatile, with nearly half of American adults leaving the faith tradition of their upbringing to either switch allegiances or abandon religious affiliation altogether, a new survey finds.
The study released Monday by the Pew Forum on Religion and Public Life is unusual for it sheer scope, relying on interviews with more than 35,000 adults to document a diverse and dynamic U.S. religious population.

While much of the study confirms earlier findings — mainline Protestant churches are in decline, non-denominational churches are gaining and the ranks of the unaffiliated are growing — it also provides a deeper look behind those trends, and of smaller religious groups.

“The American religious economy is like a marketplace — very dynamic, very competitive,” said Luis Lugo, director of the Pew Forum. “Everyone is losing, everyone is gaining. There are net winners and losers, but no one can stand still. Those groups that are losing significant numbers have to recoup them to stay vibrant.”

The U.S. Religious Landscape Survey estimates the United States is 78 percent Christian and about to lose its status as a majority Protestant nation, at 51 percent and slipping.

Click here to read the rest of this article from CNN.com

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February 25, 200812:38 pm
posted by Aric Thorpe, MHR

Childhood abuse increases the cost of healthcare later in life

According to a recent study, childhood abuse increases the cost of healthcare later in life. According to Amy Bonomi, PhD, and colleagues, women who reported childhood abuse had an average of 35% higher costs of healthcare annually in their adult lives. Specifically, women who reported physical abuse had costs that were 22% and higher. Women who reported sexual abuse had costs that were 16% higher. “This study provides the strongest evidence to date about the impact of abuse well into adulthood,” Dr. Bonomi said. This study is different from previous studies in that it reports actual cost increases relative to childhood abuse in females. The follow is an excerpt of an article from Medpage Today the reviews the study:

Dr. Bonomi and colleagues randomly selected women between 18 and 64 who had been members of the health plan for at least three years and conducted a telephone survey to discover the extent of abuse.

Of 6,321 women who were called, 3,333 completed the interview, gave consent for their health records to be used in the study, and met other inclusion criteria.

Their mean age was 47 and on average there was 7.4 years of data for each participant.

The telephone survey found that 34% of the women (1,128) reported at least one form of childhood abuse. Sexual abuse was reported by 671 women, physical abuse by 216, and both by 214.

Combining that information with recorded use of healthcare services, the researchers found that women who suffered both types of abuse were significantly more likely to use mental health services, emergency departments, hospital outpatient departments, pharmacy services, primary care services, and specialty care than were women with no history of abuse.

For instance, they were twice as likely to use mental health services and nearly twice as likely to visit an emergency department. The relative risks were 2.07 and 1.86, with 95% confidence intervals from 1.67 to 2.57 and from 1.47 to 2.35, respectively.

Click here to read the entire article from Medpage Today

Click here for information on the treatment of PTSD

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February 22, 20088:31 am
posted by Aric Thorpe, MHR

Why some friends won’t take advice

Some friends simply won’t take any advice. In some, this may be simply because they are hard headed. However, in others compulsions or other mental health issues may be at the center of their dilemma. According to Angela Wurtzel, a Santa Barbara psychotherapist, “These compulsions serve a purpose as a self-soothing or coping mechanism for deep psychological pain.” The fact is that these kinds of coping mechanisms develop over lengthy periods of time and people cannot convince even the closest of their friends to change in these situations; in fact, you may alienate yourself from your friend in the process of overbearingly trying to do so. In situations like these, what a friend may see as a problem with a simple solution may be much more complex for the individual to overcome. “A friend can offer support, but finding the reasons behind the behavior, and breaking down resistance? That’s a therapist’s job,” said Wurtzel. The following is an excerpt of an article from CNN.com that discusses the complexities of this issue:

“I told her I thought it was a mistake,” says Theresa. “So she kicked me out of her wedding party. We didn’t speak for six months.”

And the happy couple?

“Within a year, her husband left her for another man,” said Theresa, who asked that her full name not be used.

For Theresa, a medical receptionist in the Adirondacks, this was one more incident that followed a familiar pattern: Her friend picks the wrong man, and Theresa is left to pick up the pieces.

The final straw came when Theresa’s friend gave a different boyfriend power of attorney even though Theresa begged her not to.

“I just felt powerless,” says Theresa.

Such hard-to-control impulses cause behavior that is not only self-destructive but prompts frustration and anger among friends and family trying to lend a hand.

Roots of self-destructive behavior

“Nobody wants to watch someone they love hurt themselves,” says Angela Wurtzel, a psychotherapist in Santa Barbara, California, specializing in “hunger diseases” like eating disorders, self-injury and compulsive shopping.

But in almost all cases, she warns, trying to help will backfire.

What a well-intentioned friend may see as a clear-cut problem with an obvious solution — an anorexic should eat more, for example, or a compulsive shopper should cut up the credit card — is something far more complex.

Click here to read the rest of this article from CNN.com

Click here for information on the treatment of compulsive behaviors

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February 21, 20088:24 am
posted by Aric Thorpe, MHR

Common antidepressants can help to treat obsessive-compulsive disorder

According to a recent review of 17 studies published in the Cochrane Library, common antidepressants such as Zoloft or Prozac can help to treat obsessive-compulsive disorder (OCD). The review, which included 3,097 individuals, found that SSRI’s (selective serotonin reuptake inhibitors), six to 13 weeks after initial use, were more effective than placebo. Patients that took SSRIs were twice as likely to have a level of relief from the symptoms of OCD. Current therapies for OCD encourage the individual to confront and tolerate the irrational fears that are created by the disorder. However, approximately 25 percent of people suffering from OCD refuse this type of therapy as a treatment option. SSRIs may offer some relief to this population. The following is an excerpt of an article from Medical News Today that summarizes the review:

Common antidepressant drugs such as Prozac and Zoloft can be effective treatment options for obsessive compulsive disorder (OCD), according to a new review of studies.

Patients who take selective serotonin reuptake inhibitors, or SSRIs, are twice as likely to get some relief from their OCD symptoms as those who take placebo pills are.

However, the drugs have a “modest” effect at best, said Dr. Ghulam Mustafa Soomro, lead review author and honorary research fellow at St. George’s Hospital Medical School in London.

“Although SSRIs should be considered potentially effective treatments for OCD patients, treatment decisions need to take account of the potential adverse effects of these drugs,” including nausea, insomnia and sexual dysfunction, he warned.

The review of studies appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Many people with OCD seek out therapy that teaches them to confront, tolerate and gradually wean themselves from obsessive and compulsive behaviors.

“This is the primary kind of therapy used for OCD. It teaches patients to pay attention to their internal experiences and tolerate scary thoughts without having to act on them,” said Sanjaya Saxena, M.D., director of the Obsessive-Compulsive Disorders Program at the University of California, San Diego School of Medicine. “They learn that nothing terrible happens if they refrain from their usual compulsive behaviors.”

Click here to read the rest of this article from Medical News Today

Click here for more information on obsessive compulsive disorder

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February 20, 20088:31 am
posted by Aric Thorpe, MHR

Obesity doubles the risk of developing several kinds of cancers

A recent large study published in the February 16th issue of The Lancet confirms the long time association between body-fat and cancer. The study found that obesity doubled a person’s chances of developing several kinds of cancers. Additionally, the researchers found that obesity may also play a role in some rare forms of cancer. The study has made a strong connection between obesity and colon, pancreas, breast, endometrium, and rectal cancer, as well as a particular kind of esophageal cancer. The main message that can be derived from this study, which the American Institute for Cancer Research has laid out in ten points, is exercise, eat your vegetables and leafy greens, and attempt to stay at a healthy weight. The following is an excerpt of an article from Medical New Today that reviews the findings of the study:

Experts at the American Institute for Cancer Research (AICR) welcomed new results from a British study that links excess body fat to several cancers.

“This new analysis falls closely in line with the conclusions of AICR’s comprehensive expert report, Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective,” said AICR Nutritionist Sarah Wally, RD. “The expert panel who wrote that report reviewed hundreds of studies and determined that staying lean may be the most important thing we can do to protect against cancer. Today’s results bear that conclusion out.”

The new study appears in the February 16 issue of the British medical journal The Lancet. Researchers found that obesity doubled the risk for several common cancers, and that excess body fat may play a role in some rare cancers as well.

Last November, the AICR expert panel concluded that carrying excess body fat is now convincingly linked to cancers of the colon, rectum, pancreas, kidney, endometrium, breast (post-menopausal) and a specific kind of esophageal cancer as well.

The metabolically active nature of body fat is thought to be a main reason for the cancer link. Fat cells constantly pump a variety of proteins and hormones into the bloodstream. Over time, these substances can raise risk for cancer.

Click here to read the entire article

Click here for information on compulsive overeating

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February 19, 20088:30 am
posted by Aric Thorpe, MHR

Changing the face of depression

73 year old Don Miles, who has been a Pastor at a Lutheran church and a psychologist, suffered from deep depression during his late twenties. As such, he has developed a support group at his church called “Overcoming despair through Christ.” Rev Miles’ deepest depression hit before his conversion to Christ. “I had no Christian background, but one thing I experienced was a deep sense of emptiness that I sensed was a spiritual emptiness,” he said.

Rev Miles acknowledges that Christians go through depression too. Rev Miles is also a part of a national ministry headed by Ruth Graham, daughter of Billy Graham, who herself suffered from severe depression. According to Rev Miles, “Graham… made it safe for Christians not to hide behind their Sunday smiles.” The following is an excerpt of an article from the Rocky Mountain News that discusses Rev Miles and his support group in greater detail:

What? A Christian depressed? God’s in his heaven, all’s right with the world - right?

Not always. Enter the Rev. Don Miles, possessed of a wide-ranging career as a Lutheran pastor, psychologist and mental health counselor. At 72, an age when many peers are practicing their golf and hammock swings, Miles keeps limber by counseling Christians with depression.

He’s been there. The difference is, his own depression hit before he became a Christian and lifted when he found Christ.

“I thought I was a defective person,” Miles says, recalling the dark days. Today, he runs group sessions at St John’s Lutheran Church, 700 S. Franklin St., where he’s pastor emeritus. Christian or not, all may attend, but note the sessions’ subtitle: “Overcoming despair through Christ.” Two rules: Nobody has to talk unless they want to, and confidentiality is absolute.

He’s also part of the national ministry of Ruth Graham, daughter of Billy, and herself a depression survivor. For details on her ministry, go to ruthgrahamand friends.com/.

Click here to read the entire article from the Rocky Mountain News

Click here for information on the treatment of depression

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February 18, 20081:13 pm
posted by Aric Thorpe, MHR

Cannabis use connected with decreased cognitive function in MS patients

A recent study has connected cannabis use with decreased cognitive function in MS patients. According to the study, published in the February 13th addition of Neurology, people with multiple sclerosis sometimes use marijuana in order to lessen the emotional difficulties of the disease; however, there is no scientific proof that the use of marijuana aids in reducing emotional difficulties in this population. Researchers relayed that the portion of MS patients that use marijuana is significant. According to Anthony Feinstein, MPhil, PhD, “this is the first study to show that smoking marijuana can have a harmful effect on the cognitive skills of people with MS.” The following is an excerpt of an article from Medical News Today that reviews the study:

“This is important information because a significant minority of people with MS smoke marijuana as a treatment for the disease, even though there are no scientific studies demonstrating that it is an effective treatment for emotional difficulties.”

Feinstein noted that MS itself can cause cognitive problems. “In addition, cognitive problems can greatly affect the quality of life for both patients and their caregivers,” he said.

For the study, researchers interviewed 140 Canadian people with MS. Of those, 10 people had smoked marijuana within the last month and were defined as current marijuana users. The marijuana users were then each matched by age, sex, the length of time they had MS, and other factors to four people with MS who did not smoke marijuana.

The researchers then evaluated the participants for emotional problems such as depression, anxiety and other psychiatric disorders. They also tested the participants’ thinking skills, speed at processing information, and memory.

Click here to read the rest of this article from Medical News Today

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February 15, 20088:28 am
posted by Aric Thorpe, MHR

Smoking cannabis is linked with periodotal disease in young adults

According to a recent study conducted by Murray Thomson, PhD, of Sir John Walsh Research Institute, and associates, smoking cannabis is linked with periodotal disease in young adults. It has been long known that tobacco is a risk factor for periodontal disease, but research on cannabis in this regard has been limited. The study was composed of 1015 individuals born at Queen Mary Hospital in Dunedin, New Zealand who received dental exams at ages 26 and 32. Each of the participants were administered questioners about their cannabis use and as a result were divided into three categories, those who had no exposure (32.3%), some exposure (47.4%), and high exposure (20.2%). The study found that those who were categorized as having high exposure to cannabis experienced 23.6% incident attachment loss. The researchers reported that there was “no interaction between cannabis use and tobacco in predicting the condition’s occurrence.” The following is an excerpt of the study from The Journal of the American Medical Association:

The study’s demonstration of a strong association between cannabis use and periodontitis experience by age 32 years indicates that long-term smoking of cannabis is detrimental to the periodontal tissues and that public health measures to reduce the prevalence of cannabis smoking may have periodontal benefits for the population. To our knowledge, no previous studies have examined this relationship, so there are no data with which to compare the findings. Determining whether the association exists in other populations should be a priority for periodontal epidemiological research. The nature of the biological mechanism for the observed association is currently unclear. The periodontal effects of tobacco smoke are thought to occur via the systemic effects of nicotine and other toxic constituents on immune function and the inflammatory response within the periodontal tissues. Cannabis contains more than 400 compounds, including more than 60 cannabinoids; the noncannabinoid constituents are similar to tobacco (except for nicotine), and those have been reported to carry systemic health risks and have histopathological effects that are similar to those of tobacco smoke.21-22

Although definitively establishing the periodontal effects of exposure to cannabis smoke should await confirmation in other populations and settings, health promoters and dental and medical practitioners should take steps to raise awareness of the strong probability that regular cannabis users may be doing damage to the tissues that support their teeth.

Click here to read the entire study from The Journal of the American Medical Association

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