October 29, 20082:30 pm
posted by Aric Thorpe, MHR

Persistence of childhood bipolar I disorder into adulthood

Findings from a study recently reviewed by Journal Watch (jwatch.org), a physician edited source focused on research and news, reported a significant rate of persistence of childhood bipolar I disorder into adulthood. The study, which examined 115 children with a mean age of 11 years, ultimately concluded that bipolar I disorder persisted into adulthood in 44% of participants. One weakness of the study, however, is that it did not report findings about participants beyond the age of 19. Additionally, the study is not reflective of subsyndromal and bipolar II disorder persistence into adulthood. Nonetheless, the study sheds light on the widely discussed topic of age at the time of mental illness onset. The following is an excerpt of the Journal Watch article:

The researchers used a stringent definition of childhood bipolar I disorder: Diagnosis of mania required elation, grandiosity, or both. Most subjects (94%) completed all assessments during the 8-year follow-up (every 6 months for 2 years, yearly for 4 years, and a final assessment 2 years later). About half of the participants were 18 or older at the final assessment.

Of the group, 88% recovered from the index manic episode (mean time to recovery, 55.6 weeks); 73% of these subjects relapsed to mania, on average 99 weeks later. Although significantly shorter than the index episode, later manic episodes were lengthy (mean duration: second episode, 55 weeks; third episode, 40 weeks) and were marked by psychosis and ultradian cycling. Participants younger than 18 years were ill 66% of the time; the percentage dropped to 49% among patients 18 or older. Low maternal warmth and earlier age at onset predicted longer time ill with manic episodes. At age 18 or older, 44% of participants had manic episodes, and 35% developed a substance-use disorder.

Click here to read the entire “free” article from jwatch.org

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October 27, 20087:27 am
posted by Aric Thorpe, MHR

Youths in thier late teens from poor neighborhoods are four times more likely to commit suicide

According to a study conducted at Canada’s Université de Montréal and Sainte-Justine Hospital Research Center, youths in their late teens from poor neighborhoods are four times more likely to commit suicide than those who are from more affluent neighborhoods. According to the study, in addition to higher risk for suicide, late teens from poor neighborhoods are also twice as likely to report suicidal thoughts and had higher levels of depressive symptoms. The researchers were not sure what the contributing factors were for increased suicide risk in this population. However, Véronique Dupéré, lead author and a post-doctoral fellow at Tufts University who completed the research at the Université de Montréal, surmised that, “They were more vulnerable because difficult events, such as personally knowing someone who has committed suicide or experiencing a painful breakup with a romantic partner, apparently led to increased suicidal thoughts or attempts… In other words, difficult events seemed to have a more dramatic impact on these teenagers.” The following is an excerpt of an article from Medical News Today that discusses the study more:

For this study, 2779 teens were surveyed as part of Canada’s National Longitudinal Survey of Children and Youth. Poverty levels in the neighbourhood were measured in early and mid adolescence based on Census data. Suicidal thoughts and attempts were assessed later, when participants were 18 or 19 years old. Participants were asked, “During the past 12 months, did you seriously consider attempting suicide?” Those who responded yes were then asked, “During the past 12 months how many times did you attempt suicide?”

Among teenagers from across all socioeconomic backgrounds, the research team found that hyperactivity and impulsivity, depression, substance use, low social support, exposure to suicide and negative life events increased vulnerability to suicide thoughts and attempts. “But among youth in disadvantaged neighbourhoods, hyperactivity and impulsivity was even more strongly associated with suicidal behaviours,” says Éric Lacourse, senior author of the study and a Université de Montréal sociology professor. “We observed that community adversity could amplify a young person’s vulnerability to consider suicide.”

Dr. Lacourse, who is also a scientist at the Research at the Sainte-Justine Hospital Research Center, says bolstering access to health or community services in disadvantaged neighbourhoods may help reduce suicidal behaviour among Youths. “This is the first study to examine the independent role of neighbourhood disadvantage as a risk factor in adolescent suicidal behaviours,” added Dr. Dupéré. “Our study suggests that to be effective, intervention and prevention efforts must reach vulnerable adolescents living in disadvantaged communities.”

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

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October 24, 20087:19 am
posted by Aric Thorpe, MHR

Rates Of Depression Vary By Occupational Industry and Gender

According to a study recently conducted by Gordian Health Solutions, Inc., a national personal health company, varying occupations and gender can contribute to differing instances of depression. The group examined 13 different occupational industries and found that the arts-entertainment-recreation, retail trade and utilities industries had the highest prevalence of depressed workers, citing depression for periods of up to two weeks at a time. Among women the percentage of depressed workers was on average 10% higher. The study also examined the lifetime prevalence of depression among the workers and found similar results. The following is an excerpt of an article from Medical News Today that reviews the study:

- Arts-entertainment-recreation: 29% of female employees self-reported depressive symptoms occurring for two weeks or more over the past year, compared to 18% of male employees
- Retail trade: 29% of females, 19% of males
- Utilities: 27% of females, 16% of males

The Gordian study found similar industry and gender patterns for self-reported lifetime prevalence of depressive symptoms, with the highest percentage of employees reporting feeling depressed for two years or more in their lifetime in the retail trade, public administration, arts-entertainment-recreation, finance-insurance and utilities industries. The lowest rates of lifetime prevalence of depressive symptoms were noted in the management consulting, educational services and food manufacturing industries.

“Depression among employees is extremely costly to employers, given its well-documented links to other health problems, increased medical expenditures, absenteeism, presenteeism and job turnover,” said Adam Long, Ph.D., vice president of research and informatics at Gordian. “Employers, particularly those in sectors showing the higher rates of employee depression, have a huge stake in helping their employees deal with depression and should consider devoting resources to address this issue.”

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

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October 23, 20087:43 am
posted by Aric Thorpe, MHR

The Lexicon: International Media Guide for Mental Health

By some estimates, mental illness affects one in four individuals at some point during life. However, even though mental illness is a common occurrence, stigma attached to it is still rampant. American and European societies have developed a great amount of sensitivity to a variety of issues surrounding discrimination; considering this “great sensitivity,” why is it that such great stigma is still attached to mental illness? This stigma not only affects an individual’s self-esteem but can prevent one from the basic functions needed to succeed in life. For instance, many employers ask questions regarding past mental health issues during the hiring process and, according to one advocacy group, fewer than 20 percent of those with serious mental illness are able to hold down a job.

Many of the improper ideas that the public has about mental illness are created by literary fiction, TV drama and film, even television news-reporting and news publications. For this reason, the World Federation for Mental Health (WFMH) has begun a publications program to target media leaders. “The Lexicon: International Media Guide for Mental Health” is a guide to be placed in the hands of senior journalists across the world that gives both information on different types of mental illness as well as examples of appropriate language for discussion. The Lexicon is one of many initiatives by WFMH to end the stigma associated with mental illness, stigma that, according to a recent survey conducted by AstraZeneca, a pharmaceutical company, is felt by 88 percent of individuals with bipolar disorder. The following is an excerpt of an article from Medical News Today that discusses the WFMH initiative more:

The WFMH and six other patient advocacy groups recently collaborated on a publishing initiative for journalists titled “The Lexicon: International Media guide for Mental Health” with the help of an educational grant from AstraZeneca. “The Lexicon” has been designed in consultation with people with first-hand experience of mental illness as well as senior journalists, to help journalists promote responsible and accurate coverage of mental health issues and to give a balanced perspective. Journalists can consult “The Lexicon” when writing news stories involving a mentally disturbed person to select appropriate terminology and to write with sensitivity instead of opting for pejorative labels. It includes expert contact details, facts and statistics about mental illness, the correct definition of much misused terms like “schizophrenic” and “split personality”, and gives examples of good and bad reporting.

Discussing “The Lexicon” at a recent AstraZeneca media event, WFMH immediate past president Dr Patt Franciosi said: “It shows journalists how to replace words that hurt with words that could help”. Instead of terms no better than playground insults such as “nutter”, “psycho”, “schizo” and “sicko”, The Lexicon suggests instead using the person’s correct diagnosis or a term such as “disturbed” which does not carry condemnation. Before publishing a story involving a mentally ill person, Dr Franciosi suggests journalists should ask themselves if mentioning a diagnostic label is relevant. She advises. “Read it through and ask yourself - is this offensive? If it involved a relative of yours, would you want someone to say that about them?” The Lexicon is available from the website www.forum4mentalhealth.com/lexicon.

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

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October 21, 20087:27 am
posted by Aric Thorpe, MHR

People struggling with obesity may gain less pleasure from eating

Findings from a study published in the October 17th issue of Science reveal that people struggling with obesity may receive less pleasure from eating, contributing to their weight. Eric Stice, psychology researcher at The University of Texas at Austin, and colleagues, found that individuals may have a predisposition to obesity due to their brain’s sluggish response to a sensation of fulfillment or pleasure from eating; these individuals compensate for the lack of reward from their brain by eating foods that are more calorie rich, this makes them gain weight. As Stice put it, “Obese people may have fewer dopamine receptors, so they overeat to compensate for this reward deficit… they need to take in more of a rewarding substance to experience the same level of pleasure as other people.” The following is an excerpt of an article from Medical News Today that discusses the study’s findings more:

For the study, Stice and colleagues used Functional Magnetic Resonance Imaging (fMRI) to watch activity in the dorsal striatum of female participants while they consumed a chocolate milkshake and then while they consumed a tasteless solution. They did this twice, once with 43 female students aged 18 to 22 and then also with 33 teenage girls aged 14 to 18.

They also tested both groups to find out which individuals had the Taq1A1 gene, which meant they had a lower number of dopamine D2 receptors.

Stice and colleagues then followed the participants for 12 months and monitored changes in their body mass index (BMI).

The results showed that participants whose striata were less active when they drank the milkshake and who also had the Taq1A1 gene were the ones most likely to put on weight over the follow up period.

Stice said understanding how the dopamine receptor deficit affects the brain’s reward circuits and their response to eating is important for the development of treatment options that could target this effect in people at higher risk of unhealthy weight gain.

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

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October 20, 20082:09 pm
posted by Aric Thorpe, MHR

Adolescents who use alcohol or marijuana before the age of 15 increase chances for poor outcomes

According to a recent study published online in Psychological Science, adolescents who use alcohol or marijuana before the age of 15 are more likely to develop a pattern of substance abuse, obtain criminal convictions, experience academic failure, and obtain sexually transmitted diseases, before the age of 32. Many public health officials have debated whether drug use produces conduct disorder or whether conduct disorder causes drug use; according to Avshalom Caspi, Ph.D., of Duke University, “In fact, drugs are bad for kids…” Dr. Caspi’s long running study in New Zealand observed no history of conduct problems in adolescents who experienced illicit drugs before the age of fifteen; however, this group had the same risk for poor outcomes as those that had a history of conduct disorder. The following is an excerpt of an article from Medpage Today that reviews the study’s findings:

Dr. Caspi and colleagues have been following 1,037 participants in the Dunedin Multidisciplinary Health and Development Study, which enrolled 91% of the children born between April 1972 and March 1973 in Dunedin, New Zealand.

The children were enrolled at age three and follow-up assessments were conducted when the cohort members were five, seven, nine, 11, 13, 15, 18, 21, 26, and 32. Almost all of the living study members (96%) took part in the assessment at age 32.

“We have history about these children from their birth,” Dr. Caspi said, “so we knowing an enormous amount about these kids up to the point they started using drugs” — mainly alcohol and cannabis.

That detailed information was combined with a statistical method called propensity matching — used to overcome the lack of randomization — to evaluate the risk of five negative outcomes at age 32: having a substance dependency, failing to finish school, acquiring herpes simplex, having a criminal conviction, and, in the case of females, being pregnant before the age of 21.

The researchers found that 17% of adolescents with a history of conduct problems were early drug users, compared with 9.1% of those with no such history. The odds ratio was 2.1, with a 95% confidence interval from 1.4 to 3.1.

On the other hand, 56 of the 114 early-exposed adolescents had no history of conduct problems.

Click here to read the rest of this article from Medpage Today

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October 14, 200811:02 am
posted by Aric Thorpe, MHR

Moderate alcohol intake is associated with a loss in total brain volume

There is an abundance of research supporting the idea that a small glass of wine in the evening promotes good heart health, but how does it affect your brain? According to a study published in the October issue of Archives of Neurology, moderate alcohol intake is associated with a loss in total brain volume, more volume loss than expected from aging alone (P<0.001). According to Carol Ann Paul, of Wellesley College, the cardiovascular benefits from low to moderate alcohol consumption supposedly come from an increase in blood flow, which would be thought to help the brain as well. However, low and moderate alcohol intake was closely related to the cognitive decline and brain atrophy associated with heavy drinking. Paul, summing things up, said, "The brain shrinkage that you see with Alzheimer's and dementia is of a much greater magnitude… however, any decrease in brain volume is probably not beneficial." The following is an excerpt of an article from Medpage Today that reviews the study:

They analyzed self-reported alcohol intake for 1,839 participants in the community-based Framingham Offspring Study who had an MRI between 1999 and 2001 but no clinically evident neurological disease, stroke, or dementia.

Most participants reported drinking one to seven alcoholic beverages a week, which is considered low intake. Men were more likely to report moderate or high — more than 14 drinks per week — alcohol consumption.

Increasing alcohol consumption was associated with decreasing total cerebral brain volume, which remained significant after adjustment for head circumference, age, sex, education, body mass index, and Framingham Stroke Risk Profile score (P<0.01).

The slope of this negative association (−0.25) was slightly greater than that for the average annual decline expected with aging.

Moderate drinking had a significantly worse impact on the brain than former drinking (P=0.03).

Heavy drinking was associated with significantly smaller brain volume compared with all other groups (P<0.01 versus abstinence, former drinking, and low intake, P=0.04 versus moderate intake).

Click here to read the rest of this article from Medpage Today

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October 13, 200810:33 am
posted by Aric Thorpe, MHR

Cocaine addiction and structural brain abnormalities

A new study published in the October 9th issue of Neuron has found that cocaine addicts have structural brain abnormalities due to drug use and predisposition toward addiction. The study examined how cocaine affects neural systems which mediate cognition and motivation. According to Dr. Hans Breiter of Massachusetts General Hospital, author of the study, “Human studies have shown differences in how addicts make judgments and decisions, but it is not well understood how these differences relate to alterations in the structure of the brains of addicts. Claims have been made that cocaine, potentially in connection with alcohol or other drugs, may be toxic to brain cells. We sought evidence supporting a hypothesis that brain thickness is reduced in some brain regions in addicts, is related to altered decision-making and cognition, and might to some limited degree, be connected to their exposure to cocaine.” The following is an excerpt of an article from Medical News Today that discusses the study’s findings:

Dr. Breiter and colleagues found that brain regions involved with regulation of attention and reward, specifically the dorsolateral prefrontal cortex (DLPFC) and insular cortices, were significantly thinner in cocaine addicts when compared with matched controls. Behavioral tests revealed that the thinner cortex was associated with restrictions in preference-based judgment and decision-making, and with less accurate effortful attention. A general reduction in the level of preference and in the range of decisions reflecting these preferences can be considered an example of a fundamental feature of addiction - the loss of interest in many things outside of drug use.

Some cortical thickness differences were associated with years of drug use, but the researchers also observed differences in the symmetry of DLPFC thickness between control subjects and cocaine addicts that suggested predisposition to drug abuse. “In human and animal studies, differences in the structure of the right and left sides of the brain are important for many behaviors, and when these normal differences in brain structure are altered, there may be a genetic basis for the change. We found an altered right/left relationship in a part of the frontal cortex that was also associated with altered judgment and decision-making in addicts. We further found that the overall brain thickness in the cocaine addicts was more uniform across the brain, which is quite different from what is observed in non-drug users. These differences did not correlate with any drug use measure. Together, this set of findings point to predisposing factors being a potential contributing factor to the addiction,” explains Dr. Breiter.

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

Click here for information on addiction

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October 10, 200810:39 am
posted by Aric Thorpe, MHR

“Manorexia”

Eating disorders are not usually associated with men. Typically, we think of eating disorders as being primarily associated with females. However, could this be because unhealthy relationships towards food are expressed differently for men, not meeting diagnostic criteria for an eating disorder? Take, for instance, the man who exercises excessively, but is not necessarily expressing a desire to change his body shape; he avoids certain needed foods developing an unhealthy perspective about eating. Dr Peter Rowan, consultant psychiatrist at Cygnet Hospital Ealing’s Eating Disorders Unit, describes men who are obsessed with fitness, who name their exercise as being for heart health or prolonged life, who “avoid certain types of food… and some may develop a very unhealthy relationship to food and eat restrictively. And by doing so, they maintain a low weight.”

The BBC2 recently hosted a spot called “Manorexia,” which discussed the different ways in which men may express eating disorders. The following is an excerpt of an article from Medical News Today that discusses these ideas more:

‘Eating disorders are still rare among men,’ explains Dr Peter Rowan, consultant psychiatrist at Cygnet Hospital Ealing’s Eating Disorders Unit. ‘The incidence in males over the age of puberty who suffer with anorexia, for instance, is around 10 percent or so.

‘But the longer we study all eating disorders, the more we discover variations of disorder that don’t quite fit the classical diagnoses For instance, among women there are not only bulimics but there are also those who suffer with binge eating disorder, and, of course EDNOS (eating disorders not otherwise specified).’

According to Dr Rowan, there are also many men who have an unhealthy relationship with food who don’t fit the diagnostic criteria - which are, of course, designed for women. For instance some men are obsessed with fitness, but not necessarily because they are trying to change their body shape. Some may, for example, become addicted to exercise in an attempt to live longer and avoid coronary heart disease.

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

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October 8, 20087:27 am
posted by Aric Thorpe, MHR

Childhood diagnosis of bipolar disorder may be more creditable then some have thought

According to findings published in the October issue of Archives of General Psychiatry, childhood diagnosis of bipolar disorder may be more creditable then some have thought. Findings from the study revealed that 44.4% of children diagnosed with bipolar disorder had manic episodes after the age of eighteen, a rate that was 13 to 44 times higher than population prevalence. Despite these findings, however, some psychiatrists continue to be skeptical about the presentation of bipolar I disorder in children because it presents differently in adults. However, in general, these findings establish a “…growing awareness that serious mental illnesses do not emerge de novo when individuals reach adulthood, but rather reflect early developmental processes,” said Ellen Leibenluft, M.D., of the National Institute of Mental Health, Bethesda, Md. The following is an excerpt of an article from Medpage Today that reviews the findings:

The prospective, controlled, blindly rated study followed 108 children — 93.9% of the initial cohort age seven to 16 in 1995 — with about yearly ascertainment of symptoms for eight years.

All participants were in their first episode of manic or mixed phase bipolar I at baseline.

Diagnosis was by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria with at least one cardinal symptom –elation or grandiosity — to avoid overlap with attention-deficit hyperactivity disorder (ADHD).

During follow-up, 87.8% of patients recovered but 73.3% of these went on to relapse into mania or mixed mania episodes with a mean of 2.0 episodes over eight years.

Children who got little emotional warmth from their mothers were significantly more likely to relapse after recovery independent of their parents’ mental health and other factors (hazard ratio 2.9, P=0.001).

Click here to read the rest of this article from Medpage Today

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