Chapter 16. Psychopathology: Biological Basis of Behavior Disorders
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By NICHOLAS BAKALAR “Insanity Treated By Electric Shock” read the headline of an article published on July 6, 1940, in The New York Times. The article described “a new method, introduced in Italy, of treating certain types of mental disorders by sending an electric shock through the brain.” It was the first time that what is now called electroconvulsive therapy, or ECT, had been mentioned in The Times. The electric shock, the article said, “is produced by a small portable electric box which was invented in Italy by Professor Ugo Cerletti of the Rome University Clinic.” Dr. S. Eugene Barrera, the principal researcher on the project, “emphasized that hope for any ‘miracle cure’ must not be pinned on the new method.” On April 29, 1941, the subject came up again, this time in an article about a scientific meeting at which a professor of psychiatry at Northwestern reported “ ‘very promising instantaneous results’ in the recently developed electric shock method of relieving schizophrenic patients of their malady.” The treatment entered clinical practice fairly quickly. In October 1941, The Times reported on the opening of several new buildings at Hillside Hospital in Queens (today called Zucker Hillside Hospital). “The hospital has pioneered in the use of insulin and metrazol, and also in the electric shock treatment, which has proved useful in shortening the average stay of patients,” the article read. Over the years, ECT has had its ups and downs in the public imagination and in the pages of The Times. In an article on Nov. 25, 1980, the reporter Dava Sobel seemed to relegate it to another age. © 2015 The New York Times Company
Link ID: 21304 - Posted: 08.18.2015
There may finally be a way to stop people progressing beyond the first signs of schizophrenia – fish oil. When people with early-stage symptoms took omega-3 supplements for three months, they had much lower rates of progression than those who did not, according to one small-scale trial. People with schizophrenia are usually diagnosed in their teens or 20s, but may experience symptoms for years beforehand, such as minor delusions or paranoid thoughts. Only about a third of people with such symptoms do go on to develop psychosis, however, and antipsychotic drugs can cause nasty side effects, so these are rarely given as a preventative. Fish oil supplements, which contain polyunsaturated fatty acids like omega-3, may be a benign alternative. These fatty acids may normally help dampen inflammation in the brain and protect neurons from damage, and lower levels in the brain have been implicated in several mental illnesses. Tests have found that people with schizophrenia have lower levels of these fatty acids in their blood cells, suggesting the same could be true for their brain cells. Fish oil supplements have been investigated as a treatment for adults with schizophrenia, but so far results have been mixed – four trials found no benefit while another four found a small reduction in symptoms. But a study that gave omega-3 fish oil pills to younger people suggests that what matters is catching the condition in time. The trial followed 81 people aged 13 to 25 with early signs of schizophrenia. Roughly half took fish oil pills and half took placebo tablets for three months. A year later, those given fish oils were less likely to have developed psychosis. © Copyright Reed Business Information Ltd.
Link ID: 21288 - Posted: 08.12.2015
By Ariana Eunjung Cha Everyone knows that a diet full of white bread, pasta and rice is bad for your waistline. Now scientists say these types of refined carbs could also impact your mind — putting post-menopausal women at higher risk for depression. In a new study published in the the American Journal of Clinical Nutrition, researchers looked at data from more than 70,000 women who participated in the National Institutes of Health's women's health initiative between 1994 and 1998. They found that the more women consumed added sugars and refined grains and the higher their score on the glycemic index (GI) — a measure of the rate carbohydrates are broken down and absorbed by the body — the more they were at risk of new-onset depression. Those who had a different sort of diet — one with more dietary fiber, whole grains, vegetables and non-juice fruits — had a decreased risk. "This suggests that dietary interventions could serve as treatments and preventive measures for depression," wrote James Gangswisch, an assistant professor of psychiatry at Columbia University Medical Center, and his co-authors. The researchers explained that refined foods trigger a hormonal response in the body to reduce blood sugar levels. That is believed to lead to the "sugar high" and subsequent "crash" some people say they feel after eating such foods. This can lead to mood changes, fatigue and other symptoms of depression.
Susanne Ahmari Some 40 million people worldwide have been diagnosed with anxiety disorders. In Anxious, Joseph LeDoux presents a rigorous, in-depth guide to the history, philosophy and scientific exploration of this widespread emotional state. An eminent neuroscientist and author of The Emotional Brain (Simon & Schuster, 1996) and The Synaptic Self (Viking, 2002), he offers a magisterial review of the role of mind and brain in the generation of both unconscious defensive responses and consciously expressed anxiety. LeDoux looks first at how our understanding of anxiety has evolved. He starts with ancient etymology (the Greek angh signified constriction) and moves on to Sigmund Freud's view of anxiety as the “root of most if not all mental maladies”, and philosopher Søren Kierkegaard's perspective on it as existential, evolving from the dread that stems from freedom of choice. He then lays out the core distinction between fear and anxiety. Fear he defines as anticipation of danger from a physically present threat (a grizzly bear in front of you); anxiety, as anticipation of an uncertain threat (potential predators roaming outside your tent). But although 'fear' and 'anxiety' are excellent descriptors of conscious feelings, LeDoux shows, they should not be used to describe the unconscious mental processes and neural circuits associated with these emotions. Instead of thinking of those processes as “fear stimuli activate a fear system to produce fear responses”, he proposes conceptualizing them as “threat stimuli elicit defense responses via activation of a defensive system”. This is a subtle distinction, and LeDoux makes an excellent case that it is an important foundation for rigorous research into the neural underpinnings of the conscious and unconscious processes that subserve anxiety. © 2015 Macmillan Publishers Limited.
Link ID: 21274 - Posted: 08.08.2015
By Kristin Leutwyler Ozelli Researchers are just now beginning to discover how different biological malfunctions can give rise to symptoms of post-traumatic stress disorder (PTSD)—insight that might one day lead to more targeted treatments. In the meantime they are also exploring the use of biomarkers—hallmark variations in hormones, genes, enzymes and brain function—to apply existing therapies more effectively. “Trauma exposure can result in enduring biological changes that depend on an individual’s life history, age, gender and a host of other factors,” says Rachel Yehuda, a neuroscientist at Mount Sinai Hospital in New York City. “We must capitalize on this heterogeneity in the service of individualizing treatment approaches rather than insisting that one size fits all.” Indeed, not all patients get well by way of the most popular forms of therapy. One widely recommended treatment, cognitive behavioral therapy (CBT), typically helps only half of the patients who try it. In 2008 Richard Bryant, a professor of psychology at the University of New South Wales in Australia, and his colleagues attempted to identify that half up front. Before CBT they took brain scans using functional MRI of 14 subjects while showing them photographs of frightening faces. Seven people—the same who later failed to improve—showed greater than normal activity in brain regions associated with experiencing fear: the amygdala and the ventral anterior cingulate cortex. In another study Bryant found that the people who did benefit from CBT began treatment with larger rostral anterior cingulate cortices. Both animal and human studies have linked this brain area to “extinction,” the psychological process by which we unlearn conditioned responses, including fear. © 2015 Scientific American
By Christian Jarrett One of the saddest things about loneliness is that it leads to what psychologists call a “negative spiral.” People who feel isolated come to dread bad social experiences and they lose faith that it’s possible to enjoy good company. The usual result, as Melissa Dahl recently noted, is more loneliness. This hardly seems adaptive, but experts say it’s because we’ve evolved to enter a self-preservation mode when we’re alone. Without the backup of friends and family, our brains become alert to threat, especially the potential danger posed by strangers. Until now, much of the evidence to support this account has come from behavioral studies. For example, when shown a video depicting a social scene, lonely people spend more time than others looking at signs of social threat, such as a person being ignored by their friends or one person turning their back on another. Unpublished work also shows that lonely people’s attention seems to be grabbed more quickly by words that pertain to social threat, such as rejected or unwanted. Now the University of Chicago’s husband-and-wife research team of Stephanie and John Cacioppo — leading authorities on the psychology and neuroscience of loneliness — have teamed up with their colleague, Stephen Balogh, to provide the first evidence that lonely people’s brains, compared to the non-lonely, are exquisitely alert to the difference between social and nonsocial threats. The finding, reported online in the journal Cortex, supports their broader theory that, for evolutionary reasons, loneliness triggers a cascade of brain-related changes that put us into a socially nervous, vigilant mode. The researchers used a loneliness questionnaire to recruit 38 very lonely people and 32 people who didn’t feel lonely (note that loneliness was defined here as the subjective feeling of isolation, as opposed to the number of friends or close relatives one has). Next, the researchers placed an electrode array of 128 sensors on each of the participants’ heads, allowing them to record the participants’ brain waves using an established technique known as electro-encephalography (EEG) that’s particularly suited to measuring brain activity changes over very short time periods. © 2015, New York Media LLC.
By Julie Scelfo This week, I wrote about the pressures college students face and the related risk for depression and suicide. The article, “Suicide on Campus and the Pressure for Perfection,” generated numerous comments, and readers also raised important questions about other aspects of mental health. Q.Your story seemed to focus on women. Do boys and men experience the same kinds of pressure? A.Yes, male college students experience the same kind of pressure and commit suicide at significantly higher rates than their female counterparts. The rate of suicide among 15 to 24-year-old males in the United States was 17.3 per 100,000 in 2013, compared with 4.5 among females of the same age, according to the Centers for Disease Control and Prevention. In fact, men of all ages are far more likely to commit suicide than women. Q.If men are more likely to commit suicide, why did the story focus on a female student? A. There is still tremendous stigma surrounding mental illness, and not everyone who experiences depression is willing to talk about it. The young woman I profiled, Kathryn DeWitt, offered a rare opportunity to hear from someone who had gone all the way down to the depths of despair but — thankfully — was still alive to talk about it (and could do so articulately). Male depression is a significant concern, and a topic I have written about in the past. More information and resources are available from The National Alliance on Mental Illness. Q.Why didn’t you talk about high rates of suicide among Asian-American students? A.While suicide among Asian-American students is a significant concern, data from the C.D.C. shows the racial/ethnic group with the highest suicide rate is actually American-Indian/Alaskan Native. According to the C.D.C, the rate of suicide in that group for 15 to 24-year-olds is 9.4 for females and a staggering 29.1 for males. Q.Are parents to blame for suicide? A. The cause of any individual suicide is complex, and it would be a mistake to assume parents are to blame if a child attempts suicide. Gregory Eels, the director of Counseling and Psychological Services at Cornell, who has worked in higher education for 20 years and says he has seen “too many” student deaths, describes it this way: “The causes of a completed suicide are never a single thing. It’s a combination of thousands of things.” © 2015 The New York Times Company
Link ID: 21266 - Posted: 08.05.2015
Richard Harris One of the frequent trials of parenthood is dealing with a picky eater. About 20 percent of children ages 2 to 6 have such a narrow idea of what they want to eat that it can make mealtime a battleground. A study published Monday in the journal Pediatrics shows that, in extreme cases, picky eating can be associated with deeper trouble, such as depression or social anxiety. The study followed a broad spectrum of children who had come to Duke University for routine medical care. Most kids dislike some foods (broccoli is a common villain), but the researchers counted a child as a severely picky eater if his or her food choices were so limited that it made meals at home difficult, and meals out all but impossible. Those extreme cases were rare — just 3 percent of all kids. But, as a group, they were twice as likely as the children who weren't picky to have a diagnosis of depression, and seven times as likely to have been diagnosed with social anxiety, according to the study. Nancy Zucker, director of the Duke Center for Eating Disorders, says parents of children who are extremely finicky may find it useful to seek help, because the kids may not simply outgrow the behavior on their own. And even if they eventually do, it can be disruptive to child and family alike in the meantime. A big question is what to do about less extreme cases, which in the Duke study made up 17 percent of all children. These children have a list of foods that they are reluctant to stray beyond. © 2015 NPR
By Nancy Szokan “This is a story of a family who made mistakes.” Thus Janet Sternburg begins her memoir of a close-knit Jewish family living in Boston. Her grandfather, Philip, was a cold, angry man who abandoned his wife and six children not long after the only son in the family, Bennie, was diagnosed as schizophrenic. As Bennie became increasingly violent and untreatable, the family — advised by a Harvard professor of psychiatry — agreed to submit him to a prefrontal lobotomy. More than a decade later, one of Bennie’s sisters, Francie, sank into a debilitating depression — relentlessly weeping, attempting suicide — and again, the solution was seen to be a lobotomy. While she was growing up, Sternburg accepted the lobotomies as her family’s normalcy. It was decades later, when she was an adult living in California, that it occurred to her to question why such terrible measures had been taken. “The years came back to me when my aunt and uncle were driven to our house” for a regular visit, she writes. As the grandmother cooked and the aunts and uncles talked and played cards, the two lobotomized siblings “sat blankly on the couch — Bennie at one end, virtually unmoving, my aunt crumpled into the far corner. . . . With the sharp return of memories came the realization that even as a child I had a slight awareness . . . that something wrong had been done.” But she also knew her relatives as good and generous people. So she set out to learn what happened, and why. “White Matter: A Memoir of Family and Medicine” is Sternburg’s tale of what she discovered, put in the context of her family’s history.
Steve Connor A computer game designed by neuroscientists has helped patients with schizophrenia to recover their ability to carry out everyday tasks that rely on having good memory, a study has found. Patients who played the game regularly for a month were four times better than non-players at remembering the kind of things that are critical for normal, day-to-day life, researchers said. The computer game was based on scientific principles that are known to “train” the brain in episodic memory, which helps people to remember events such as where they parked a car or placed a set of keys, said Professor Barbara Sahakian of Cambridge University, the lead author of the study. People recovering from schizophrenia suffer serious lapses in episodic memory which prevent them from returning to work or studying at university, so anything that can improve the ability of the brain to remember everyday events will help them to lead a normal life, Professor Sahakian said. Schizophrenia affects about one in every hundred people and results in hallucinations and delusions (Rex) Schizophrenia affects about one in every hundred people and results in hallucinations and delusions (Rex) “This kind of memory is essential for everyday learning and everything we do really both at home and at work. We have formulated an iPad game that could drive the neural circuitry behind episodic memory by stimulating the ability to remember where things were on the screen,” Professor Sahakian said. © independent.co.uk
By JULIE SCELFO Kathryn DeWitt conquered high school like a gold-medal decathlete. She ran track, represented her school at a statewide girls’ leadership program and took eight Advanced Placement tests, including one for which she independently prepared, forgoing the class. Expectations were high. Every day at 5 p.m. test scores and updated grades were posted online. Her mother would be the first to comment should her grade go down. “I would get home from track and she would say, ‘I see your grade dropped.’ I would say, ‘Mom, I think it’s a mistake.’ And she would say, ‘That’s what I thought.’ ” (The reason turned out to be typing errors. Ms. DeWitt graduated with straight A’s.) In her first two weeks on the University of Pennsylvania campus, she hustled. She joined a coed fraternity, signed up to tutor elementary school students and joined the same Christian group her parents had joined at their alma mater, Stanford. But having gained admittance off the wait list and surrounded by people with seemingly greater drive and ability, she had her first taste of self-doubt. “One friend was a world-class figure skater. Another was a winner of the Intel science competition. Everyone around me was so spectacular and so amazing and I wanted to be just as amazing as they are.” Classmates seemed to have it all together. Every morning, the administration sent out an email blast highlighting faculty and student accomplishments. Some women attended class wearing full makeup. Ms. DeWitt had acne. They talked about their fantastic internships. She was still focused on the week’s homework. Friends’ lives, as told through selfies, showed them having more fun, making more friends and going to better parties. Even the meals they posted to Instagram looked more delicious. Her confidence took another hit when she glanced at the cellphone screen of a male student sitting next to her who was texting that he would “rather jump out of a plane” than talk to his seatmate. © 2015 The New York Times Company
Steve Connor Anxiety and depression could be linked to the presence of bacteria in the intestines, scientists have found. A study on laboratory mice has shown that anxious and depressive behaviour brought on by exposure to stress in early life appears only to be triggered if microbes are present in the gut. The study, published in Nature Communications, demonstrates a clear link between gut microbiota – the microbes living naturally in the intestines – and the triggering of the behavioural signs of stress. “We have shown for the first time in an established mouse model of anxiety and depression that bacteria play a crucial role in inducing this abnormal behaviour,” said Premysl Bercik of McMaster University in Hamilton, Canada, the lead author of the study. The scientists called for further research to see if the conclusions applied to humans, and whether therapies that that target intestinal microbes can benefit patients with psychiatric disorders. Previous research on mice has indicated that gut microbes play an important role in behaviour. For instance, mice with no gut bacteria – called “germ-free” mice – are less likely to show anxiety-like behaviour than normal mice. The latest study looked at mice that had been exposed to a stressful experience in early life, such as being separated from their mothers. When these mice grow up they display anxiety and depression-like behaviour and have abnormal levels of the stress hormone corticosterone in their blood, as well as suffering from gut dysfunction based on the release of the neurotransmitter acetylcholine.
Link ID: 21232 - Posted: 07.29.2015
By C. CLAIBORNE RAY Q. Are men more likely to be claustrophobic than women? A. The opposite seems to be true, as is the case in almost all anxiety disorders, large epidemiological studies have found. The reasons for such a gender difference are not clear, and claustrophobia, the feeling of extreme panic when faced with being in a confined or enclosed space, is not as well studied as some other phobias. One situation that has been comparatively well researched is what happens when people need magnetic resonance imaging, which often involves a prolonged period of confinement in a small enclosure, the perfect storm of claustrophobia triggers. A recent study found that certain factors seem to correlate with an increase in claustrophobic reactions, including being female, going into the scanner head first and having a previous negative experience with the test. Another large study involving scanners with a shorter chamber and noise reduction found a significant reduction in claustrophobic reactions, but being female and middle-aged were still associated with a higher rate of claustrophobia. It has often been assumed that claustrophobia develops as a response to a traumatic experience, like being trapped in a closet as a child, but newer research suggests a genetic component. In one study in mice, a single defective gene was associated with claustrophobia. email@example.com © 2015 The New York Times Company
Jessie Rack If you've ever had hiccups in a quiet room, you know how embarrassing and completely uncontrollable they can feel. What if, instead of the hiccups, your body jerked involuntarily or you blurted out words without meaning to? That's a rough idea of what living with Tourette syndrome can be like. Designers of a new computer program called TicHelper hope that they will be able to help children recognize and control these impulses themselves. People with Tourette's perform repetitive movements or vocalizations called tics. A simple tic might be something like head jerking, eye blinking, or throat clearing, and a complex tic might involve patterns of movement or saying multiple words or phrases. We don't know exactly what causes Tourette's, says Douglas Woods, a psychologist at Texas A&M University. Woods, who is also co-chair of the Tourette Association of America Medical Advisory Board, is one of the minds behind TicHelper. "Sometimes kids will grow out of [Tourette's]," Woods says. But if the wait-and-see approach isn't working, and the tics are interfering with daily life, there are a few treatment options. One option is medication. Woods says there are a few different antipsychotic drugs that are used to manage Tourette syndrome, but they have side effects and don't always work. An alternative to pharmaceutical treatment is behavioral therapy. A form of behavioral therapy called comprehensive behavioral intervention for tics, or CBIT for short, is commonly used. CBIT training teaches people with Tourette's to recognize the onset of a tic and to perform a different behavior when they feel one coming on. © 2015 NPR
Link ID: 21208 - Posted: 07.23.2015
By Andrea Alfano Unexpectedly losing a loved one launched 18-year-old Debra* into an episode of major depression, triggering dangerous delusions that landed her in a hospital. Her doctor immediately started her on an antidepressant and on risperidone (Risperdal), an antipsychotic. In little more than a month, her weight shot up by 15 pounds. “Gaining weight made it even more difficult for me to want to leave my house because I felt self-conscious,” Debra says. In the medical community, antipsychotics are well known to cause significant weight gain. Gains of 20 to 35 pounds or more over the course of a year or two are not unusual. Debra's doctor never warned her, though, leaving her feeling like she was losing herself both mentally and physically. The situation is not uncommon, according to psychiatrist Matthew Rudorfer, chief of the somatic treatments program at the National Institute of Mental Health, who points out that although the U.S. Food and Drug Administration carefully tracks acute side effects such as seizures, it pays less attention to longer-term complications such as weight change. Perhaps taking their cue from the FDA, doctors tend to downplay weight-related risks that accompany many psychiatric drugs, Rudorfer says. But for Debra and many others, these side effects are not trivial. The three types of psychiatric drugs that can seriously affect body weight are reviewed below. According to a 2014 review of eight studies, as many as 55 percent of patients who take modern antipsychotics experience weight gain—a side effect that appears to be caused by a disruption of the chemical signals controlling appetite. Olanzapine (Zyprexa) and clozapine (Clozaril) are the top two offenders; studies have shown that on average these drugs cause patients to gain more than eight pounds in just 10 weeks. These two drugs also bear the highest risk of metabolic syndrome, which encompasses weight gain and other related disorders, including type 2 diabetes, according to a 2011 study of 90 people with schizophrenia. Although most antipsychotics are associated with weight gain, aripiprazole (Abilify) and ziprasidone (Geodon) stand out for their lower risk. © 2015 Scientific American
T. M. Luhrmann AMERICANS are a pretty anxious people. Nearly one in five of us — 18 percent — has an anxiety disorder. We spend over $2 billion a year on anti-anxiety medications. College students are often described as more stressed than ever before. There are many explanations for these nerves: a bad job market, less cohesive communities, the constant self-comparison that is social media. In 2002 the World Mental Health Survey found that Americans were the most anxious people in the 14 countries studied, with more clinically significant levels of anxiety than people in Nigeria, Lebanon and Ukraine. To be clear, research suggests that anxiety is at least partially temperamental. A recent study of 592 rhesus monkeys found that some of them responded more anxiously than others and that as much as 30 percent of early anxiety may be inherited. Yet what is inherited is the potential for anxiety, not anxiety itself. Life events obviously play a role. Another, less obvious factor may be the way we think about the mind: as an interior place that demands careful, constant attention. Humans seem to distinguish between mind and body in all cultures, but the sharp awareness of mind as a possession, distinct from soul and body, comes from the Enlightenment. It was then, in the aftermath of the crisis of religious authority and the scientific revolution, that there were intense debates about the nature of mental events. Between 1600 and 1815, the place where mental stuff happened — the “thing that thinks,” to use Descartes’s phrase — came to seem more and more important, as George Makari, a psychiatrist and psychoanalyst, explains in his forthcoming book, “Soul Machine: The Invention of the Modern Mind.” From this, Mr. Makari writes, was developed the psychological mind and psychoanalysis and an expectation that personal thoughts and feelings are the central drivers of human action — not roles, not values, not personal sensation, not God. In the United States, the enormous psychotherapeutic and self-help industry teaches us that we must pay scrupulous attention to inner experience. To succeed and be happy, we are taught, we need to know what we feel. © 2015 The New York Times Company
Link ID: 21189 - Posted: 07.20.2015
By Tori Rodriguez Many studies have examined the effects of sufficient versus insufficient sleep on mental health. A new study, published in February in the Journal of Youth and Adolescence, takes a more nuanced look, attempting to determine just how much each hour less per night really costs—where teenagers are concerned. The researchers surveyed an ethnically diverse sample of 27,939 suburban high school students in Virginia. Although teenagers need about nine hours of sleep a night on average, according to the National Institutes of Health, only 3 percent of students reported getting that amount, and 20 percent of participants indicated that they got five hours or less. The average amount reported was 6.5 hours every weekday night. After controlling for background variables such as family status and income, the researchers determined that each hour of lost sleep was associated with a 38 percent increase in the odds of feeling sad and hopeless, a 42 percent increase in considering suicide, a 58 percent increase in suicide attempts and a 23 percent increase in substance abuse. These correlational findings do not prove that lack of sleep is causing these problems. Certainly the reverse can be true: depression and anxiety can cause insomnia. “But the majority of the research evidence supports the causal direction being lack of sleep leading to problems rather than the other way around,” says study co-author Adam Winsler, a psychology professor at George Mason University. © 2015 Scientific American
Allison Aubrey The idea that fermented foods — including yogurt and kefir — are good for us goes way back. But could the benefits of "good bacteria" extend beyond our guts to our brains? Nobel prize-winning scientist Elie Metchnikoff (also known as Ilya Ilich Mechnikov) first observed a connection between fermented milk and longevity among Bulgarian peasants more than a century ago. "Metchnikoff is regarded by many as the father of probiotics," says Gregor Reid of the University of Western Ontario, who published a look back at Metchnikoff's contributions. Metchnikoff came up with "the scientific rationale for the use of live microbes in the prevention and treatment of infections," according to Reid. And back in 1907, he says, Metchnikoff hypothesized that replacing or diminishing the number of bad bacteria in the gut with lactic acid bacteria — like the kind found in yogurt and kefir — "could normalize bowel health and prolong life." But Metchnikoff's ideas were ignored for decades. Reid says after the discovery of penicillin, science focused on the use of antibiotics to kill off harmful bacteria. It's only recently, Reid says, that the importance of beneficial bacteria has come into the limelight. More than a century ago, Élie Metchnikoff, a Nobel prize-winning microbiologist, hypothesized that lactic acid bacteria — like the kind found in our yogurt — was important to gut health and longevity. More than a century ago, Élie Metchnikoff, a Nobel prize-winning microbiologist, hypothesized that lactic acid bacteria — like the kind found in our yogurt — was important to gut health and longevity. © 2015 NPR
Link ID: 21166 - Posted: 07.14.2015
By James Gallagher Health editor, BBC News website Smoking could play a direct role in the development of schizophrenia and needs to be investigated, researchers say. The team at King's College London say smokers are more likely to develop the disorder and at a younger age. Published in the Lancet Psychiatry, their analysis of 61 separate studies suggests nicotine in cigarette smoke may be altering the brain. Experts said it was a "pretty strong case" but needed more research. Smoking has long been associated with psychosis, but it has often been believed that schizophrenia patients are more likely to smoke because they use cigarettes as a form of self-medication to ease the distress of hearing voices or having hallucinations. The team at King's looked at data involving 14,555 smokers and 273,162 non-smokers. It indicated: 57% of people with psychosis were already smokers when they had their first psychotic episode Daily smokers were twice as likely to develop schizophrenia as non-smokers Smokers developed schizophrenia a year earlier on average The argument is that if there is a higher rate of smoking before schizophrenia is diagnosed, then smoking is not simply a case of self-medication. Dr James MacCabe, from the Institute of Psychiatry, Psychology and Neuroscience at King's, said: "It's very difficult to establish causation [with this style of study], what we're hoping that this does is really open our eyes to the possibility that tobacco could be a causative agent in psychosis, and we hope this will then lead to other research and clinical trials that would help to provide firmer evidence." Clearly most smokers do not develop schizophrenia, but the researchers believe it is increasing the risk. The overall incidence of the condition is one in every 100 people normally, which may be increased to two per 100 by smoking. © 2015 BBC
Patricia Neighmond Some antidepressants may increase the risk of birth defects if taken early in pregnancy, while others don't seem to pose the same risks, a study finds. The question of whether antidepressants can cause birth defects has been debated for years, and studies have been all over the map. That makes it hard for women and their doctors to make decisions on managing depression during pregnancy. To try to untangle the question, researchers at the Centers for Disease Control and Prevention analyzed federal data on more than 38,000 women who gave birth between 1997 and 2009. They looked at the number of birth defects among babies and asked women whether they took any antidepressants in the month before getting pregnant or during the first three months of pregnancy. The study, published Wednesday in The BMJ, found no association between the most commonly used antidepressant, sertraline (Zoloft), and birth defects. Forty percent of the women who took antidepressants took sertraline. They also found no increased risk of birth defects with the antidepressants citalopram (Celexa) and escitalopram (Lexapro). But the analysis did find an association between birth defects and the antidepressants fluoxetine (Prozac) or paroxetine (Paxil). That included heart defects, abdominal wall defects, and missing brain and skull defects with paroxetine, and heart wall defects and irregular skull shape with fluoxetine. The relative risk increased 2 to 3.5 times, depending on the defect and the medication. That may sound like a lot, but Jennita Reefhuis, an epidemiologist and lead researcher in the study, says "the overall risk is still small." © 2015 NPR