Chapter 16. Psychopathology: Biological Basis of Behavior Disorders
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By Kelly Servick The “mad cow disease” epidemic that killed more than 200 people in Europe peaked more than a decade ago, but the threat it poses is still real. Eating meat contaminated with bovine spongiform encephalopathy and its hallmark misshapen proteins, called prions, can cause a fatal and untreatable brain disorder, variant Creutzfeldt-Jakob disease (vCJD). Thousands of Europeans are thought to be asymptomatic carriers, and they can spread prions through blood donations. So for years, researchers have sought a test to safeguard blood supplies. This week, two teams bring that goal closer. They describe methods for detecting prions in blood that proved highly accurate in small numbers of samples from infected people and controls. “There is new technology to go forward, and it looks promising,” says Jonathan Wadsworth, a biochemist who studies prion disease at University College London. “These are definitely very welcome papers.” Analyses of discarded appendix and tonsil samples suggest that as many as one in 2000 people in the United Kingdom carries abnormal prions—misfolded variations of a naturally abundant protein, which prompt surrounding healthy proteins to fold and clump abnormally. No one knows how many of these carriers will ever develop vCJD; incubation periods as long as 50 years have been reported. Once symptoms occur—first depression and hallucinations, and eventually dementia and loss of motor control—patients survive about a year. Four people are known to have contracted vCJD through a blood transfusion from an infected donor. © 2016 American Association for the Advancement of Science.
Link ID: 23007 - Posted: 12.22.2016
By STEVEN PETROW “So why did you stop drinking?” my friend Brad asked recently when we were out for dinner. “You never seemed to have a drinking problem.” The question surprised me, coming as it did a full two years after my decision to take a “break” from alcohol. He was scanning the wine list, and I sensed he was hoping I’d share a bottle of French rosé with him. So I decided to tell him the truth. “To get my depression back under control.” In my late 50s, my longstanding depression had started to deepen, albeit imperceptibly at first. I continued drinking moderately, a couple of glasses of wine most days of the week, along with a monthly Manhattan. Then two dark and stormy months really shook me up, leaving me in a black hole of despair as depression closed in. At my first therapy appointment, the psychopharmacologist listened to me attentively, then said bluntly: “Stop drinking for a month.” The shrink wanted to know whether I was in control of my drinking or my drinking was in control of me. He explained that we become more sensitive to the depressant effects of alcohol as we age, especially in midlife, when our body chemistry changes and we’re more likely to be taking various medications that can interact with alcohol and one another. On doctor’s orders, I went cold turkey off alcohol. When I returned a month later and volunteered that I hadn’t touched a drink since our last visit, he was satisfied that I didn’t have “an active alcohol problem” and told me I could drink in what he considered moderation: No more than two glasses of wine a day, and never two days in a row. He also suggested I keep a log. © 2016 The New York Times Company
Abby L. Wilkerson The new class I was teaching — “Composing Disability: Crip Ecologies” — was one of several first-year writing seminars offered at George Washington University. Given the focus, it was likely to be a challenge for at least some of the students. And it was presenting a particular challenge to me. Even before the class began, I was anxious. I have depression, and I wondered: Should I acknowledge it in the class? Would the students benefit if I did? I wanted to be sure I knew what I was doing, for everyone’s sake, before taking the leap. But I was not at all certain. The idea of disclosing in the classroom made me feel conflicted and vulnerable. Though the World Health Organization identifies depression as “the leading cause of disability,” not everyone with depression identifies herself as disabled. One of the central meanings of disability for me is “crip” pride — resistance to medical notions of disability as a defect and related social stigmas. My depression has given me unasked-for gifts, including a sensitivity to others’ suffering. But let’s face it — on some level, depression is suffering. How could I reconcile this with the fierce crip attitude in others that I’ve so admired? In class, how would the dull weight of depression sit with the “crip” in the course title? If I were going to do this, I needed to get it right. And I wasn’t sure how. Though I have suffered severe depression in the past, these days, my episodes tend to be milder and less frequent. Some days, I feel fine. But I might soon begin feeling melancholy — yet still able to laugh, think clearly, sleep at night and enjoy my life. Then one morning, for no discernible reason, I wake up mired in mud, my body now freight to be pushed through daily routines. The rhythm of life is suddenly ground down almost to nothing. I feel somehow both numb and raw, skin thin, laid open. Everything that matters is now far-off in the distance. Other people seem remote, existing in some parallel universe. © 2016 The New York Times Company
Link ID: 22985 - Posted: 12.14.2016
By BENEDICT CAREY About one in six American adults reported taking at least one psychiatric drug, usually an antidepressant or an anti-anxiety medication, and most had been doing so for a year or more, according to a new analysis. The report is based on 2013 government survey data on some 242 million adults and provides the most fine-grained snapshot of prescription drug use for psychological and sleep problems to date. “I follow this area, so I knew the numbers would be high,” said Thomas J. Moore, a researcher at the Institute for Safe Medication Practices, a nonprofit in Alexandria, Va., and the lead author of the analysis, which was published Monday in JAMA Internal Medicine. “But in some populations, the rates are extraordinary.” Mr. Moore and his co-author, Donald R. Mattison of Risk Sciences International in Ottawa, combed household survey and insurance data compiled by the federal Agency for Healthcare Research and Quality. They found that one in five women had reported filling at least one prescription that year — about two times the number of men who had — and that whites were about twice as likely to have done so than blacks or Hispanics. Nearly 85 percent of those who had gotten at least one drug had filled multiple prescriptions for that drug over the course of the year studied, which the authors considered long-term use. “To discover that eight in 10 adults who have taken psychiatric drugs are using them long term raises safety concerns, given that there’s reason to believe some of this continued use is due to dependence and withdrawal symptoms,” Mr. Moore said. Dr. Mark Olfson, a professor of psychiatry at Columbia University, who was not involved in the study, said the new analysis provided a clear, detailed picture of current usage: “It reflects a growing acceptance of and reliance on prescription medications” to manage common emotional problems, he said. © 2016 The New York Times Company
Ian Boldsworth If you deal with mental health issues of any sort, talking about them is often a struggle, especially with all the stigma around them. It turns out, putting them out there for the world to hear is even more tricky. Nonetheless, after years of producing podcasts that stretched idiocy to previously unchartered territories, I recently did precisely this and released my first semi-serious project, all about discussing and sharing personal experiences of dealing with mental health problems. Three days after it was released, I’d still not listened to the completed series myself. Despite being the presenter and producer, I’d slightly bottled it. Those closest to me will tell you that I was battling a real anxiety in the lead-up to releasing the full series of The Mental Podcast, and that I’d already made my excuses to them. Every time somebody said they were looking forward to it I told them not to, and my initial promotional tweets had a cautionary, apologetic feel of “you may like this, you may not”. For the record, I’ve never had any issues talking about mental health stuff, always more than happy to casually drop it into an interview or real-life conversation, but with this new series, as the release date loomed closer, I started to get worried about it. On a purely business level, I was concerned that it wouldn’t make its money back. Over the last 12 months or so I’ve financed my independent stuff up front and then, with a reward incentivised (not a word) donations drive at the end of the series, attempted to recoup the cost. It’s a very high risk/utterly idiotic business model as podcast listeners have “getting stuff free” in their DNA, but so far I’ve fluked a decent, if modest, return. The last two series of podcasts were called The ParaPod and consisted of me lambasting a ghost-believing-buffoon with the simple tools of logic and facts, a pretty easy concept to get on board with and you don’t need to be worrying that it will potentially take you to the darkest depths of depression (although the commitment of an adult to such a ludicrous supernatural premise should at least waver your faith in human intelligence). © 2016 Guardian News and Media Limited
Link ID: 22977 - Posted: 12.12.2016
by Tom Siegfried SAN DIEGO — Society’s record for protecting public health has been pretty good in the developed world, not so much in developing countries. That disparity has long been recognized. But there’s another disparity in society’s approach to public health — the divide between attention to traditional diseases and the resources devoted to mental disorders. “When it comes to mental health, all countries are developing countries,” says Shekhar Saxena, director of the World Health Organization’s department of Mental Health and Substance Abuse. Despite a breadth of scope and depth of impact exceeding that of many more highly publicized diseases, mental illness has long been regarded as a second-class medical concern. And modern medicine’s success at diagnosing, treating and curing many other diseases has not been duplicated for major mental disorders. Saxena thinks that neuroscience research can help. He sees an opportunity for progress through increased interdisciplinary collaboration between neuroscience and mental health researchers. “The collaboration seems to be improving, but much more is needed and not only in a few countries, but all countries,” he said November 12 at the annual meeting of the Society for Neuroscience. |© Society for Science & the Public 2000 - 2016.
By Alice Klein How can you stop old anxieties from resurfacing? An injection of new neurons may help, a study in mice suggests. Post-traumatic stress disorder (PTSD), anxiety and other fear-related disorders are difficult to treat, and many people who seem to get better later relapse. A similar phenomenon occurs in rodents. Adult mice can be conditioned to fear a sound by giving them an electric shock every time they hear it. Playing the sound repeatedly without the shock gradually wipes out the fear – a process known as extinction training. However, the fear often returns spontaneously if the mouse hears the sound later on. Baby mice, on the other hand, do not seem to relapse as much. Yong-Chun Yu at Fudan University in China and his colleagues wanted to know if they could treat fearful adult mice with brain cells from mouse embryos. The transplants did not prevent the mice developing new fears, nor help them overcome existing ones – at least not by themselves. But coupled with extinction training, the embryonic cells did help wipe out existing fears and prevent the mice relapsing. First, the researchers injected live brain cells from mouse embryos into the amygdalae of adult mice – the parts of the brain involved in fear. Other mice were implanted with dead embryonic brain cells as a comparison. © Copyright Reed Business Information Ltd.
Maanvi Singh "I lost more than 80 percent of my university friends," recalls Jagannath Lamichhane. After silently struggling with depression for two decades, Lamichhane published an essay in Nepal Times about his mental illness. "I could have hid my problem — like millions of people around the world," he says, but "if we hide our mental health, it may remain a problem forever." Many of his friends and family didn't agree with that logic. In Nepal — as in most parts of the world — there's quite a lot of stigma around mental illness. That was eight years ago. Now 35-year-old Lamichhane is a mental health advocate, working to challenge the stigma around depression. "People believe that depression is the result of personal weaknesses and the result of bad karma in a past life," he says. Even worse, they don't believe they can be helped, he says — so they don't seek treatment. The problem isn't unique to Lamichhane's community. An estimated 350 million people are affected by depression, and the vast majority of them don't get treatment for their condition either due to stigma or a lack of knowledge, according to a study of more than 50,000 people in 21 countries. The study was led by Graham Thornicroft, a professor of psychiatry at King's College London. He and his team of researchers from King's College London, Harvard Medical School and the World Health Organization found that in the poorest countries, one in 27 people with depression received minimally adequate care for their condition. Even in the richest countries, only one in five people with depression sought care. The data was published Thursday in The British Journal of Psychiatry. © 2016 npr
Link ID: 22945 - Posted: 12.03.2016
Sarah Boseley Health editor A single dose of psilocybin, the active ingredient of magic mushrooms, can lift the anxiety and depression experienced by people with advanced cancer for six months or even longer, two new studies show. Researchers involved in the two trials in the United States say the results are remarkable. The volunteers had “profoundly meaningful and spiritual experiences” which made most of them rethink life and death, ended their despair and brought about lasting improvement in the quality of their lives. The results of the research are published in the Journal of Psychopharmacology together with no less than ten commentaries from leading scientists in the fields of psychiatry and palliative care, who all back further research. While the effects of magic mushrooms have been of interest to psychiatry since the 1950s, the classification of all psychedelics in the US as schedule 1 drugs in the 1970s, in the wake of the Vietnam war and the rise of recreational drug use in the hippy counter-culture, has erected daunting legal and financial obstacles to running trials. “I think it is a big deal both in terms of the findings and in terms of the history and what it represents. It was part of psychiatry and vanished and now it’s been brought back,” said Dr Stephen Ross, director of addiction psychiatry at NYU Langone Medical Center and lead investigator of the study that was based there. © 2016 Guardian News and Media Limited
By DAVE PHILIPPS CHARLESTON, S.C. — After three tours in Iraq and Afghanistan, C. J. Hardin wound up hiding from the world in a backwoods cabin in North Carolina. Divorced, alcoholic and at times suicidal, he had tried almost all the accepted treatments for post-traumatic stress disorder: psychotherapy, group therapy and nearly a dozen different medications. “Nothing worked for me, so I put aside the idea that I could get better,” said Mr. Hardin, 37. “I just pretty much became a hermit in my cabin and never went out.” Then, in 2013, he joined a small drug trial testing whether PTSD could be treated with MDMA, the illegal party drug better known as Ecstasy. “It changed my life,” he said in a recent interview in the bright, airy living room of the suburban ranch house here, where he now lives while going to college and working as an airplane mechanic. “It allowed me to see my trauma without fear or hesitation and finally process things and move forward.” Based on promising results like Mr. Hardin’s, the Food and Drug Administration gave permission Tuesday for large-scale, Phase 3 clinical trials of the drug — a final step before the possible approval of Ecstasy as a prescription drug. If successful, the trials could turn an illicit street substance into a potent treatment for PTSD. Through a spokeswoman, the F.D.A. declined to comment, citing regulations that prohibit disclosing information about drugs that are being developed. © 2016 The New York Times Company
By Louisa J. Steinberg “You've got to be kidding me, Doc. I can barely keep my eyes open as it is, and you want me to pull an all-nighter?” I smiled. “Yes, exactly that. Maybe even two or three.” It started out benignly enough. Jodi (not the patient's real name) had been feeling more stressed between meeting the growing demands of her high-stakes job in business management and shouldering more chores while her husband was away on business trips. Strapped for time, she started neglecting her usual self-care routines—eating healthy, exercising, taking time to relax. Not surprisingly, her mood was poor. Things soon grew worse. She no longer enjoyed activities that were usually the highlight of her day: story time with her children, chatting on the phone with her mom, reading a book. Although she was constantly exhausted, she could not get a good night's sleep; she would toss and turn and still feel tired even when she slept in. Her performance at work had also been suffering; she began missing days because she just couldn't get out of bed. Jodi knows she should have recognized these warning signs sooner. She had experienced major depression twice before, once in college and again in her late 20s after a breakup. Now in her late 30s, she had been off antidepressants for years. Yet she found herself back in that dark place, barely eating and unable to concentrate enough to read even a short paragraph. Her thoughts circled around the same unpleasant memories and nagging fears. She felt hopeless and guilty. © 2016 Scientific American
By Nicole Ireland, CBC News Ten years ago, litigation lawyer Michele Hollins was a "perpetually happy person," with twin daughters and a partnership in her Calgary law firm. Then, depression struck. For a while, Hollins was able to hide her illness at work, then go home and "become a complete automaton," she says, unable to eat or even muster the energy to get ready for bed. At its worst, the depression crippled her at work, to the point where Hollins would walk into her office, say hello to her assistant and then "close the door and lay on the floor and cry for hours." At her lowest point, she says she would "spend most of the day trying to figure out how to collect myself enough to get to my car and get home." That raw vulnerability doesn't match the general impression society has of lawyers as tough and ambitious. But research suggests that they are at much higher risk of depression, anxiety and substance abuse issues than people in the broader population — and may even be more susceptible than those in other high-stress professions, such as medicine. A U.S. study published in the Journal of Addiction Medicine last February found the rate of problem drinking among lawyers was between two and three times higher than among other highly educated professionals, including physicians. The study was funded by the American Bar Association and the Hazelden Betty Ford Foundation. The rate of depression was about three times higher than the general population in the U.S., according to lead researcher Patrick Krill, who will be presenting his research to lawyers and law students in Toronto on Monday at a professional development session hosted by the Law Society of Upper Canada. ©2016 CBC/Radio-Canada.
By Darryl Hol, Every year, thousands of Canadians sign up to participate in clinical trials, offering their bodies to further the development of important medical advances like new drugs or devices. But the results of many of those trials never see the light of day. A new online tool aims to put pressure on some of the companies and institutions behind the problem. TrialsTracker maintains a list of all the trials registered on the world's leading clinical trials database and tracks how many of them are updated with results. Amid pharmaceutical companies and research bodies from around the world on ClinicalTrials.gov, maintained by the U.S. National Institutes of Health, nine Canadian universities and institutions rank in the top 100 organizations with the greatest proportion of registered trials without results. "It's well documented that academic trialists routinely fail to share results," says Ben Goldacre, who was part of the team from the University of Oxford that developed TrialsTracker. "Often they think, misguidedly, that a 'negative' result is uninteresting — when, in fact, it is extremely useful." The University of Toronto's David Henry says "publication bias," as it's called, is robbing the medical community and patients of important information. "We've been deceived about the truth about treatments that we've used widely over a long period, in very large numbers of individuals, because of the selective publication of results that are favourable to the product," says Henry, a professor of health systems data at U of T's Institute for Health Policy Management and Evaluation. ©2016 CBC/Radio-Canada.
Link ID: 22907 - Posted: 11.25.2016
Shane Fistell When I was 17, my father took me to a juvenile treatment clinic to see if doctors could figure out what was wrong with me. I entered a room. I sat on a chair. I waited for a long while. There was a video camera trained on me. Then I heard voices, the voices of doctors behind a two-way mirror. It was like being in a police interrogation room in the movies. A voice boomed: “So Shane, why do you think you’re acting this way? Do you know what you’re doing?” I didn’t know what to say. What were the right answers? I was born with a neurological disorder that causes involuntary movements, vocalizations and tics — sometimes mild, sometimes wildly disruptive: Tourette’s syndrome. Since my youth, I’ve often been stopped in public by the police and questioned because of my symptoms. Questioned: That sums it up in a single word. My whole life has been questioned. I’m 56 now. I’ve often led a life of self-imposed house arrest. Two months here, three months there. Summer gone, winter over. How many years have I wasted? If people know of Tourette’s, they will often say: “Oh, that’s that swearing disease!” A woman once said to me: ”At least you don’t swear! You would’ve been worse off!” Compulsive swearing is called coprolalia. Each person with Tourette’s is different, and only some swear compulsively. I don’t; but for most of my life I have had to put up with people swearing and cursing at me because of my symptoms. A few years ago a man argued: “There’s no way you have Tourette’s! If you don’t swear you don’t have it! Period. And I know you don’t have it because I’ve seen it on TV!” © 2016 The New York Times Company
Link ID: 22901 - Posted: 11.23.2016
By GRETCHEN REYNOLDS Exercise may be an effective treatment for depression and might even help prevent us from becoming depressed in the first place, according to three timely new studies. The studies pool outcomes from past research involving more than a million men and women and, taken together, strongly suggest that regular exercise alters our bodies and brains in ways that make us resistant to despair. Scientists have long questioned whether and how physical activity affects mental health. While we know that exercise alters the body, how physical activity affects moods and emotions is less well understood. Past studies have sometimes muddied rather than clarified the body and mind connections. Some randomized controlled trials have found that exercise programs, often involving walking, ease symptoms in people with major depression. But many of these studies have been relatively small in scale or had other scientific deficiencies. A major 2013 review of studies related to exercise and depression concluded that, based on the evidence then available, it was impossible to say whether exercise improved the condition. Other past reviews similarly have questioned whether the evidence was strong enough to say that exercise could stave off depression. A group of global public-health researchers, however, suspected that newer studies and a more rigorous review of the statistical evidence might bolster the case for exercise as a treatment of and block against depression. So for the new analyses, they first gathered all of the most recent and best-designed studies about depression and exercise. © 2016 The New York Times Company
Link ID: 22874 - Posted: 11.16.2016
By Arlene Karidis As a young teenager, Inshirah Aleem was sure she’d be heading to Harvard Law School in a few years. But the straight-A student went down another road. Within months of her 14th birthday, the quiet girl was telling outrageous lies, running away from home and stealing. She eventually landed in front of a judge and later was sent to foster care, where she lived in a basement, her belongings stuffed into a trash bag. It would be a year before Aleem, now a 38-year-old schoolteacher living in Greenbelt, was diagnosed with bipolar disorder. The brain condition is characterized by high (manic) moods and low (depressed) moods as well as by fluctuating energy levels. These unstable states are coupled with impaired judgment. The diagnosis explained her racing, disjointed thoughts and almost completely sleepless nights. And it explained her terrifying hallucinations, which were followed by a catatonic state where Aleem couldn’t move or talk. About 2.6 percent of adults and about 11.2 percent of 13- to-18-year-olds have bipolar disorder, according to the Substance Abuse and Mental Health Services Administration. The disorder can be hard to recognize and harder to treat. Combining medications often brings substantial improvement, but some patients experience side effects and show minimal improvement. Researchers, who have found that bipolar disorder is inherited more than 70 percent of the time, hope to identify drugs to target the 20 genetic variations known to be associated with the disorder. © 1996-2016 The Washington Post
Link ID: 22864 - Posted: 11.14.2016
By Esther Crawley We know almost nothing about chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME). And yet it causes misery and suffering for hundreds of thousands of people, including many children. One in a hundred teenagers in the UK miss a day a week or more of school because of it, and 2 per cent are probably missing out on the normal stuff that teenagers do. Those I see in my clinic are sick with disabling fatigue, memory and concentration problems, and terrible pain. On average, they miss a year of school, on top of which mothers give up work and siblings suffer. Yet progress on this illness is being hampered by controversy, with some people disputing both its cause and treatment. Some still dismiss it as a non-illness; others decry attempts to treat it with psychological therapy. The result is that few patients are offered treatment and there is almost no research on the condition. This illness is more common than leukaemia and more disabling than childhood arthritis, but few specialists treat it. How have we arrived at a position where the biggest reason for teenagers to miss school long-term is rarely studied and society allows so few to receive treatment? Part of the difficulty is that CFS/ME is not a single illness. Both children and adults have different clusters of symptoms that may represent different illnesses with different biology, requiring different treatments. This may explain why treatments only work for some – and is a problem for those trying to develop them and for people who don’t get better. © Copyright Reed Business Information Ltd.
Sarah Boseley Health editor Hundreds of children and young people are to get treatment for chronic fatigue syndrome for the first time, to see whether methods that have proved highly successful in the Netherlands can be adopted by the NHS. Up to 2% of young people are affected by CFS, also known as myalgic encephalopathy (ME). But few get any treatment, and attempts to help have sometimes stoked the row over the causes of the condition. Activists on social media frequently denounce doctors who suggest that psychological issues play any part in the disease. Treatment given to young people in the Netherlands has had remarkable results, helping 63% recover within six months and return to school and a normal life, compared with 8% of those who had other care. The children are given cognitive behavioural therapy to understand and overcome the debilitating exhaustion that neither sleep nor rest can help. The sessions are conducted with a therapist over the internet, using Skype, diaries and questionnaires. This means children will be able to get treatment in their own homes in parts of the country where there is nothing currently available to them. Esther Crawley, a professor of child health at Bristol University, said she would argue that the trial she is leading is not controversial. “Paediatric CFS/ME is really important and common,” she said. “One per cent of children at secondary school are missing a day a week because of CFS/ME. Probably 2% of children are affected. They are teenagers who can’t do the things teenagers are doing.” © 2016 Guardian News and Media Limited
Link ID: 22824 - Posted: 11.03.2016
Mo Costandi Stem cells obtained from patients with schizophrenia carry a genetic mutation that alters the ratio of the different type of nerve cells they produce, according to a new study by researchers in Japan. The findings, published today in the journal Translational Psychiatry, suggest that abnormal neural differentiation may contribute to the disease, such that fewer neurons and more non-neuronal cells are generated during the earliest stages of brain development. Schizophrenia is a debilitating mental illness that affects about 1 in 100 people. It is known to be highly heritable, but is genetically complex: so far, researchers have identified over 100 rare genetic variations and dozens of mutations associated with increased risk of developing the disease. One of the best characterised mutations associated with the disease is a microdeletion on chromosome 22, within a region containing dozens of genes known to be involved in the development, maturation, and function of brain circuits. This deletion is found in 1 in every 2,000 – 4,000 live births; all patients carrying it exhibit various psychiatric symptoms and conditions, with just under a third of them developing schizophrenia in adolescence or early adulthood. Manabu Toyoshima of the RIKEN Brain Science Institute and his colleagues obtained skin cells from two female schizophrenic patients diagnosed with the chromosome 22 deletion and two healthy individuals, then reprogrammed them to generate induced pluripotent stem cells (iPSCs), unspecialised cells which, like embryonic stem cells, retain the ability to differentiate into all the different cell types in the body. They then compared the properties of iPSCs obtained from the schizophrenic patients with those from the healthy controls. © 2016 Guardian News and Media Limited
Link ID: 22822 - Posted: 11.02.2016
Emily Sohn After a mother killed her four young children and then herself last month in rural China, onlookers quickly pointed to life circumstances. The family lived in extreme poverty, and bloggers speculated that her inability to escape adversity pushed her over the edge. Can poverty really cause mental illness? It's a complex question that is fairly new to science. Despite high rates of both poverty and mental disorders around the world, researchers only started probing the possible links about 25 years ago. Since then, evidence has piled up to make the case that, at the very least, there is a connection. People who live in poverty appear to be at higher risk for mental illnesses. They also report lower levels of happiness. That seems to be true all over the globe. In a 2010 review of 115 studies that spanned 33 countries across the developed and developing worlds, nearly 80 percent of the studies showed that poverty comes with higher rates of mental illness. Among people living in poverty, those studies also found, mental illnesses were more severe, lasted longer and had worse outcomes. And there's growing evidence that levels of depression are higher in poorer countries than in wealthier ones. Those kinds of findings challenge a long-held myth of the "poor but happy African sitting under a palm tree," says Johannes Haushofer, an economist and neurobiologist who studies interactions between poverty and mental health at Princeton University. © 2016 npr