November 21, 200812:17 pm
posted by Aric Thorpe, MHR

Religious feelings have an association with greater likelihood of survival

According to findings from a large study (92,000 female participants), religious feelings have an association with greater likelihood of survival. The study, which was published in Psychology and Health online, found that women who reported certain types of religious feelings had hazard ratios of 0.80 to 0.89 (P<0.05) for all causes of mortality. According to Eliezer Schnall, Ph.D., of Yeshiva University, and colleagues, "In an effort to assess which pathways may be relevant to the decreased mortality found for those with religious affiliation and more frequent religious service attendance, causes of death were compared across groups… however, no significant differences were found." The group concluded that while the association between religious feelings and lengthier survival seems real the reasons for it are still unknown. The following is an excerpt of an article from Medpage Today that discusses the study more:

At baseline in the study, women were asked whether they had a religious affiliation; how frequently they attended worship services; and whether religion provided a great deal of strength and comfort, a little, or none.

The hazard ratios for all-cause death during follow-up associated with these variables, relative to participants expressing the lowest level of religious attachment, were:

* Having a religious affiliation: HR 0.84 (95% CI 0.75 to 0.93)
* Attending services less than weekly: HR 0.85 (95% CI 0.79 to 0.92)
* Attending services weekly: HR 0.80 (95% CI 0.75 to 0.86)
* Attending services more often than weekly: HR 0.80 (95% CI 0.73 to 0.87)
* Religion provides a little comfort: HR 0.95 (95% CI 0.86 to 1.05)
* Religion provides a great deal of comfort: HR 0.89 (95% CI 0.82 to 0.98)

These hazard ratios reflected adjustments for age, ethnicity, income, education, body mass index, and current morbidities.

The apparent benefits of deriving substantial strength and comfort from religion disappeared when the researchers also controlled for smoking and alcohol consumption.

And having a religious affiliation was no longer a protective factor when these health behaviors and psychosocial variables, such as self-reported social support and life satisfaction, were included in the analysis.

But the protective effect of attendance at religious services at least weekly remained significant in these enhanced models, with hazard ratios of 0.87 to 0.90 (P<0.05).

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

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November 20, 200812:14 pm
posted by Aric Thorpe, MHR

Second suicide attempts are more likely to be successful in individuals where psychiatric disorders are present

According to findings from a recent study, second suicide attempts are more likely to be successful in individuals where psychiatric disorders are present. Individuals with schizophrenia, bipolar disorder, or unipolar depression who had previously attempted suicide had the highest risk of completing suicide the second time. The risk was highest during the first year following hospitalization for a suicide attempt. In bipolar and unipolar disorder, 63.8% of men and 42.3% of women committed suicide the first year following an unsuccessful attempt. Researchers conducting the study, commenting, stated, “The present results suggest that attempted suicide in those with schizophrenia or bipolar and unipolar disorder is particularly worrying and underlines the need for more focused care during at least the first two years after a suicide attempt.” The following is an excerpt of an article from Medpage Today that takes a closer look at the study’s results:

So the investigators took a cohort of 39,685 patients ages 10 and older (53% female; mean age 38.4 for men and 37.0 for women) who were hospitalized for a suicide attempt in Sweden from 1973 through 1982 and followed them until 2003.

Most (68%) were not diagnosed with a psychiatric disorder at hospital discharge.

The rest were diagnosed with one of the following disorders: bipolar and unipolar disorder (1,043), other depressive disorder (5,082), schizophrenia (713), anxiety disorder (1,328), adjustment disorder or posttraumatic stress disorder (764), alcohol abuse or dependence (2,702), drug abuse or dependence (385), or personality disorder (664).

In all diagnostic categories, a high percentage of the suicides during follow-up (13.5% to 63.8% in men and 14.3% to 53.9% in women) occurred during the first year.

The proportion of suicides occurring in the first year was high in the group free from psychiatric disorders as well (45.1% for men and 39.6% in women), although the completed suicide rate was low (5.1% in men and 2.8% in women).

Over the entire follow-up period, patients with bipolar and unipolar disorder (HR for men 3.5, 95% CI 3.0 to 4.2; HR for women 2.5, 95% CI 2.1 to 3.0) and schizophrenia (HR for men 4.1, 95% CI 3.5 to 4.8; HR for women 3.5, 95% CI 2.8 to 4.4) had the highest risk of successfully committing suicide.

Among patients with schizophrenia, 4.6% of the suicides in men and 2.8% in women were attributed to the disorder.

For those with unipolar and bipolar disorder, the corresponding percentages were 4% and 4.1%, respectively.

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

Click here to learn more about depression and suicide

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November 18, 20085:02 pm
posted by Aric Thorpe, MHR

A few tips on how to keep your holiday glee as well as your wallet

It’s that time of the year again, time for the holidays. Respectively, this year will be more monetarily challenging for many families due to the current state of financial affairs in our country than any in many decades past. The stock market is on a continuous roller coaster ride; gas prices, until recently, have been astronomical; real estate prices have plummeted and many mortgages have been called in on unprepared, ill equipped families. No doubt, these are tumultuous times but that does not mean that financial stress has to overwhelm you this season, snuffing out the joy of family and the holiday spirit. Here are a few tips on how to keep your holiday glee as well as your wallet this year:

• Buy in bulk: Stocking stuffers and greeting cards can be bought in bulk and save you time and cash. Holiday greeting cards can be purchased in assortment packages so that it doesn’t appear as though you are buying everyone the same greeting card. Stocking stuffers for children and or grandchildren are filled quickly and inexpensively when buying multi-packs of gum, combs, tic-tacs, candy, chapstick, disposable shaving razors, pens, pencils, erasers, toy cars, and so on.

• Brake out the board games: Board games are great fun and they reinforce interaction. Why pay for the entire extended family to go watch the latest Tim Allen Christmas movie when there is plenty of fun and savings waiting for you at home?

• Mail your gifts early: Don’t wait until the last minute to send out gifts to family that you won’t see in person this year. First class and priority mail is expensive and can add up fast. Watch the calendar and mail out gifts early enough so that you can utilize ground shipping.

• Utilize the dollar store: There are many things that can be bought at the dollar store, items that really don’t necessitate quality, annual throw away items. Most dollar stores have an abundance of Christmas decorations, cards, signs, batteries (big one), balloons, ribbons, plastic table clothes, candy cans / tins, etc. For those of you that are feeling lucky, you can even purchase a variety of nuts at the dollar store for your finger food assortments.

• Black Friday Sales: You can purchase some big ticket items at a considerable discount at Black Friday sales (the day after Thanksgiving). Granted, insane crowds and primal human behavior may not be your cup of tea. However, if you’re the type of person that likes the thrill of the hunt, Black Friday sales can help you to obtain those excessively priced Christmas wish list items.

• Get a used artificial tree: Browse Craigslist for a plastic tree and put the money you saved toward gifts.

• Set a holiday spending limit and pay cash: Setting a limit and paying with cash will help you to keep track of your spending. It is very easy to slide that credit card through, not keeping a total of your spending. Additionally, setting a holiday spending limit helps one to evaluate items of the greatest importance and to cut out excess.

• Redeem your points: You’ve been piling up those credit card points for awhile now… just in case you forgot. Redeem your credit card points for just about anything, anywhere. Many credit card company point programs are versatile; you may be surprised what you can put those American Airlines points toward, for instance. Give your credit card company a call and find out more.

• Surf the web for better prices: You can always find products online cheaper than in department stores. Granted, shopping online requires shopping in advance but if you are willing to do so this is much advised. There are a variety of websites where consumers can find gifts at prices “far below” what you can find at bricks and mortar locations, especially the mall. Froogle.com (Google’s shopping search engine), Amazon.com, Buy.com, and Walmart.com (more selection and often lower prices than what you find in store with a no shipping-cost option for in-store delivery) are some reputable places to look where you can find most any brand and product. If you prefer to shop in person, go to your department store of choice and write down the item name, brand, and corresponding item number for products you would like to purchase; look up those products online and you will be amazed at the savings you can realize.

Big spending doesn’t equate to holiday happiness. Incorporate some holiday spending strategies and take a pass on undue financial burden and stress this year!

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November 17, 20085:11 pm
posted by Aric Thorpe, MHR

Nightmarish temptations and sensations of guilt

Obviously, for many, if not most individuals, the holidays are a difficult time when dealing with the temptation of food. During the holidays it is socially accepted and expected that all will eat, drink, and be merry. However, it is a much more difficult time of the year for individuals who have an eating disorder. Individuals with eating disorders encounter nightmarish temptations and sensations of guilt if they “give in” to their disorder specific behaviors. The UNC School of Medicine eating disorders team has some good suggestions for individuals coping with eating disorders during the holidays:

– Have a “wing man” someone you trust to help run interference at family get-togethers or office parties. This should be someone who knows your triggers and can help distract you from temptations (or someone pushing your buttons), change the subject or assist you while you handle the stress.

– Make up a code signal or phrase with the wingman before going to the holiday party. If you start to feel overwhelmed give your friend the signal so that you can both step out of the room and they can offer you some support.

– Keep your support team on speed dial and call them at any time during or after a party. Talking relieves the pressure. You’re not overburdening them. They will undoubtedly have stories to share, too.

– Potlucks are your friends. Don’t hesitate to take a food you prepared that feels safe enough to you so that you will have at least one manageable entrée.

– Lavish holiday spreads don’t have to be the enemy. If faced with one, channel your inner Boy Scout or Girl Scout skills and be prepared! Before stepping in line, and before getting a plate, evaluate the options. Mindfully consider which foods you’ll sample, portion sizes and whether you feel comfortable trying a “feared food.” Make a decision and stick with it!

– If your treatment team has given you a meal plan stay on track so you aren’t starving when you get there.

– Listen with your heart, not your head. Hear the happiness and caring in a person’s tone when they tell you that you look “so much better.” They are saying they care about you. Don’t let the eating disorder lead you to misinterpret those words in a way that deprives you of hearing that people really care about you.

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

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November 14, 20088:35 am
posted by Aric Thorpe, MHR

Survival odds lessened for individuals who develop PTSD after a major cardiac event

Survival odds are lessened for individuals who develop PTSD after a major cardiac event. According to researchers at the Technical University of Munich, individuals who received a cardioverter-defibrillator implant after cardiac arrest possessed a mortality rate 3.45 times higher if they developed strong PTSD symptoms. “Symptoms of PTSD, particularly intrusive recollections of adverse aspects of the disease course, have a substantial effect on survival in patients with implantable cardioverter-defibrillators,” the researchers wrote. The findings, which were published in the Archives of General Psychiatry, indicate the need for “… routinely applied comprehensive and interdisciplinary psychosocial aftercare” among patients in this population. The following is an excerpt of an article from Medpage Today that reviews the study:

The study involved 147 patients who were followed for a mean of 5.1 years (SD 2.2) after receiving the devices. Thirty-eight of these patients scored in the top quartile on a standard PTSD symptom scale.

Dr. Ladwig and colleagues calculated an event rate of 55 deaths per 1,000 person-years among those with low to moderate PTSD scores, compared with 80 deaths per 1,000 person-years among those with high PTSD scores.

The findings reflect adjustments for age, sex, diabetes status, scores on depression and anxiety scales, and several measures of cardiovascular disease severity.

The researchers said that, according to previous studies, some 27% to 38% of patients surviving an out-of-hospital cardiac arrest develop PTSD. The rate of PTSD following heart attacks appears somewhat lower, but may still top 30%.

Because many patients receiving cardioverter-defibrillators are survivors of such events, they are likely at risk for PTSD, the researchers said.

“Treatment with [the device] may act as a constant reminder of the underlying disease condition,” they noted.

All the patients in their sample had survived some type of life-threatening, sudden-onset cardiac condition. That met one of the main criteria for PTSD, but only the 38 scoring in the highest quartile on the revised Impact of Event Scale were categorized as PTSD index cases.

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

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November 12, 20085:49 pm
posted by Aric Thorpe, MHR

Domestic violence among veterans increasing

Domestic violence has long been a problem associated with veterans due to the population’s high instance of posttraumatic stress disorder (PTSD); recently, and due to an increasing number of veterans from two wars, the problem has been widely recognized as worsening. “The increasing number of veterans with PSTD… raises the risk of domestic violence and its consequences on families and children in communities across the United States,” says Monica Matthieu, Ph.D., an expert on veteran mental health.

One of the issues surrounding aid for veterans in this regard is that treatment for domestic violence is currently much different than treatment for PTSD. “Treatments for domestic violence are very different than those for PTSD. The Department of Veterans Affairs (VA) has mental health services and treatments for PTSD, yet these services need to be combined with the specialized domestic violence intervention programs offered by community agencies for those veterans engaging in battering behavior against intimate partners and families,” Dr. Matthieu explains. An integrated approach of therapies to address domestic violence and PTSD among veterans is desperately needed. The following is an excerpt of an article from Medical News Today that discusses this issue further:

Matthieu and Peter Hovmand, Ph.D., domestic violence expert and assistant professor of social work at Washington University, are merging their research interests and are working to design community prevention strategies to address this emerging public health problem.

“The increasing prevalence of traumatic brain injury and substance use disorders along with PTSD among veterans poses some unique challenges to existing community responses to domestic violence” says Hovmand.

“Community responses to domestic violence must be adapted to respond to the increasing number of veterans with PTSD. This includes veterans with young families and older veterans with chronic mental health issues.”

Even as the demographic of the veteran population changes as World War II veterans reach their 80s and 90s and young veterans completing tours of duty in Iraq and Afghanistan, the numbers of living veterans who have served in the United States military is staggering. Current estimates indicate that there are 23,816,000 veterans.

Matthieu says there are evidence-based psychological treatment programs that can be a great resource for clinicians to learn how to identify and treat PTSD symptoms. However, identifying battering behaviors among veterans with active PTSD symptoms may be difficult and may require consultation and referral to domestic violence experts.

Research in the VA shows that male veterans with PTSD are two to three times more likely than veterans without PTSD to engage in intimate partner violence and more likely to be involved in the legal system.

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

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November 11, 20084:01 pm
posted by Aric Thorpe, MHR

Behavioral therapy significantly improves the quality of life for kidney disease patients with depression

Depression is extremely common among kidney disease patients who frequently need dialysis. 20 to 30% of patients who are on dialysis because of kidney disease become depressed. However, the first study of its kind proves that there is hope for individuals suffering from depression in this population. According to a paper presented at the American Society of Nephrology’s 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania, behavioral therapy, a relatively cheap and accessible option, significantly improves the quality of life for kidney disease patients with depression. The following is an excerpt of an article from Medical News Today that discusses the details:

Researchers now report the results of the first clinical trial of a psychological intervention in hemodialysis patients who are depressed. Ricardo Sesso, MD and his colleagues at the Federal University of Sao Paulo in Sao Paulo, Brazil studied 85 patients with end-stage renal disease who were on chronic hemodialysis and had been diagnosed with depression. Half of the patients underwent three months of weekly 90-minute sessions of cognitive-behavioral therapy led by a trained psychologist. Sessions focused on issues related to kidney disease treatment and its effects on daily life, depression and coping techniques, thinking and cognitive remodeling techniques, relaxation activities, social behavior abilities, etc.

The other half of patients in the study received usual treatment offered in the dialysis clinic, without behavioral interventions. All patients filled out quality-of-life questionnaires at the start of the study and again after three and nine months of follow up.

The investigators found that after three months of intervention, the group receiving cognitive-behavioral therapy had a significant improvement in depressive symptoms, cognitive function, and quality-of-life scores when compared to the control group. These differences also persisted after six months of intervention. During this period, patients received once a month maintenance sessions. The authors concluded that cognitive-behavioral therapy - a relatively cheap, harmless, and practical intervention - is an effective strategy to treat depression in patients with kidney disease. “No other randomized trial using psychological or medical intervention with drugs has shown to be effective or has been published in this regard,” said Sesso.

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

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November 7, 200812:11 pm
posted by Aric Thorpe, MHR

Do depressed patients process pain abnormally?

Over 75% of patients with depression experience chronic pain and 30% to 60% of those who experience chronic pain also have symptoms of depression; however, despite the major overlapping of these two conditions very little is know about the nerobiological basis of how the brain processes pain among patients with major depressive disorder. A study reported in the November issue of Archives of General Psychiatry has shed new light on the subject, however. According to the study, patients with depression had decreased activity in areas of the brain responsible for pain modulation during painful heat stimulus. Conversely, these same patients experienced increased activity in the right anterior insular region, dorsal anterior cingulate, and right amygdala (emotion-processing areas of the brain) while anticipating pain. According to the researchers, “The anticipatory brain response may indicate hypervigilance to impending threat, which may lead to increased helplessness and maladaptive modulation during the experience of heat pain… this mechanism could in part explain the high comorbidity of pain and depression when these conditions become chronic.” The following is an excerpt of an article from Medpage Today that reviews this fascinating study:

So they recruited 15 patients with major depressive disorder (12 females; mean age 24.5) and 15 healthy controls with no history of psychiatric disorders (10 females; mean age 24.3) to undergo functional magnetic resonance imaging before and during painful stimulation.

The depressed patients completed the Pain Catastrophizing Scale, which assesses magnification, rumination, and helplessness related to pain.

Both painful and non-painful levels of heat were applied to the participants’ forearms as they viewed images that signaled the intensity of heat to come.

The temperatures did not differ significantly between the groups; the painful stimulus was 115.5° F in the depressed patients and 116.4° F for the controls (P=0.08), and the non-painful stimulus was 102.2° F for both groups (P=0.59).

Both groups reported similar subjective ratings of the unpleasantness and intensity of the painful heat.

The depressed patients rated the non-painful heat as significantly more unpleasant (P=0.04), “a finding that is consistent with our previous observations of the increased affective bias in major depressive disorder at non-painful temperatures,” the researchers said.

During the anticipation of pain, the depressed patients had increased activation in the right anterior insular region, left anterior insular/inferior frontal gyrus, bilateral dorsal anterior cingulate cortex, right dorsolateral prefrontal cortex, several clusters in the left dorsolateral prefrontal cortex, clusters in the temporal and occipital lobes, and right amygdala.

The increased activity in the amygdala during anticipation was associated with greater levels of perceived helplessness toward pain (P=0.01) and rumination (P=0.02) in the depressed patients only.

During painful stimulation, the depressed patients had increased activity in the left parahippocampal gyrus and occipital cortex and the right amygdala, and decreased activity in the periaqueductal gray matter and the rostral anterior cingulate and prefrontal cortices.

The increased activity in the amygdala during painful stimulation was associated with perceived levels of helplessness (P=0.02) and rumination (P=0.03).

“These findings suggest that increased emotional reactivity during the anticipation of heat pain may lead to an impaired ability to modulate pain experience in major depressive disorder,” the researchers said.

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

Click here for general information on depression

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November 6, 20084:43 pm
posted by Aric Thorpe, MHR

Careless eating habits and couch potato pastimes

The holiday season is upon us and so is the temptation to adopt careless eating habits and couch potato pastimes. During the holiday’s parents can be an example of healthy eating and an active lifestyle. It is easy for children to snack around, skip meals, and stay inside this time of year. “Focus on being with family, friends and loved ones, rather than ‘what’s to eat,’” suggests Richard E. Kreipe, M.D., professor of pediatrics in the Adolescent Medicine Division of Pediatrics at Golisano Children’s Hospital at Strong. The following are a few tips for parents who desire to model an active lifestyle and healthy eating habits this winter:

Model Healthy Eating

Healthy eating is a lifestyle. “Kids who are taught from a young age to eat well and note their hunger level are much more prepared to make healthy choices later in life,” said Stephen R. Cook, M.D., M.P.H., assistant professor for the Department of Pediatrics at Golisano Children’s Hospital at Strong.

Bring the kids into the kitchen while preparing healthy holiday meals. By watching adults prepare foods, kids can get some tips on healthy eating and engage in a family activity.

At the dinner table, adults should encourage small portions of a variety of foods and lots of fruits and vegetables. “Encourage water as the beverage of choice between meals,” said Kreipe. Milk is another nutrient-rich beverage.

Express Excitement

It is important not to overemphasize healthy habits. Pressuring kids to eat things they do not like and prohibiting certain foods can be frustrating and stressful to kids. “Talk with children ahead of time about taking small portions, eating single-servings and sharing desserts,” advised Cook.

“The single most important thing that parents can do is lead by example,” stressed Kreipe. “Listen twice as much as you talk and don’t talk about food in the same breath as calories, guilt, or ‘paying the price.’” Turn healthy eating into a positive experience by showing excitement about trying a variety of healthy foods in small portions.

Be Active

Cold weather doesn’t have to limit activity during holiday seasons. There is plenty that families can do to get off the couch and enjoy one another’s company. “Going for a nice brisk walk, especially after eating a heavy meal, can be refreshing and relaxing,” Kreipe said.

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

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November 5, 20083:44 pm
posted by Aric Thorpe, MHR

Alcohol advisement should be included in talks surrounding sex education

According to a recent study conducted by researchers at the University of Sheffield, UK, alcohol advisement should be included in talks surrounding sex education. According to the study, which divided groups of boys and groups of girls in to various focus groups, girls are more likely to be aware of the social complexities surrounding sex whereas boys are not, to be expected; surprisingly, however, some boys that participated in the focus groups found aggressive attitudes, the use of alcohol, and even physical persuasion to be appropriate in order to gain the opportunity to engage in sexual relations. Some boys in the focus groups described alcohol as a useful tactic to persuade a girl to have sex.

Traditional talks surrounding sexual education do not include the subject of alcohol. However, considering these findings, it would appear that not including advice about alcohol during sexual education talks could hold serious consequences. The following is an excerpt of an article from Medical News Today that discusses the study more:

Alcohol and attitudes are two of the key factors that health professionals need to be aware of when they are dealing with sexually active teenagers.

Researchers from the University of Sheffield, UK, found considerable differences between the way that boys and girls aged 14 to 16 viewed a series of sexual scenarios.

“The girls who took part in our focus groups were more likely to see their partner’s point of view and were more aware of the complex nature of relationships than the boys” says nurse researcher Dr Mark Hayter.

Ten focus groups were held with 35 teenagers who had accessed nurse-led sexual health outreach clinics for contraception. These clinics are often held in conjunction with youth clubs in areas where teenage pregnancy rates are high.

The participants were presented with a series of scenarios - a girl and a boy both reluctant to have sex, a girl who had had a numbers of partners and a girl who felt pressured to have sex because her friends had paired off with two boys leaving her with a third.

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

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