Chapter 16. Psychopathology: Biological Basis of Behavior Disorders

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Alison Abbott Arrival in a foreign, hostile country causes many refugees great stress. On an ice-cold day in January, clinical psychologist Emily Holmes picked up a stack of empty diaries and went down to Stockholm’s central train station in search of refugees. She didn’t have to look hard. Crowds of lost-looking young people were milling around the concourse, in clothes too flimsy for the freezing air. “It struck me hard to see how thin some of the young men were,” she says. Holmes, who works at Stockholm’s Karolinska Institute, was seeking help with her research — a pilot project on post-traumatic stress disorder (PTSD), which is all too common in refugees. She wanted to see whether they would be willing to spend a week noting down any flashbacks — fragmented memories of a trauma that rush unbidden into the mind and torment those with PTSD. She easily found volunteers. And when they returned the diaries, Holmes was shocked to see that they reported an average of two a day — many more than the PTSD sufferers she routinely dealt with. “My heart went out to them,” she says. “They managed to travel thousands of kilometres to find their way to safety with this level of symptoms.” Europe is experiencing the largest movement of people since the Second World War. Last year, more than 1.2 million people applied for asylum in the European Union — and those numbers underestimate the scale of the problem. Germany, which has taken in the lion’s share of people, reckons that it received more than a million refugees in 2015, tens of thousands of whom have yet to officially apply for asylum. Most came from Syria, Afghanistan and Iraq. Many have experienced war, shock, upheaval and terrible journeys, and they often have poor physical health. The crisis has attracted global attention and sparked political tension as countries struggle to accommodate and integrate the influx. © 2016 Macmillan Publishers Limited

Keyword: Stress; Depression
Link ID: 22740 - Posted: 10.11.2016

By NICHOLAS BAKALAR Hormonal contraceptives are associated with an increased risk for depression, a large study has found. Danish researchers studied more than a million women ages 15 to 34, tracking their contraceptive and antidepressant use from 2000 to 2013. The study excluded women who before 2000 had used antidepressants or had another psychiatric diagnosis. Over all, compared with nonusers, users of hormonal contraception had an 80 percent increased risk of depression. Some types of contraceptives carried even greater risk. Women who used progestin-only pills more than doubled their risk, for example, while those who used those who used the levonorgestrel IUD (brand name Mirena) tripled their risk. The risk persisted after adjusting for age, age of first intercourse, educational level and other factors. The study, in JAMA Psychiatry, also found that the risk was greater in adolescent girls, but this may be because adolescent girls are especially susceptible to depression. “Even though the risk of depression increases substantially with these drugs — an 80 percent increase is not trivial — most women who use them will not get depressed,” said the senior author, Dr. Oejvind Lidegaard, a clinical professor of obstetrics and gynecology at the University of Copenhagen. “Still, it is important that we tell women that there is this possibility. And there are effective nonhormonal methods of birth control.” © 2016 The New York Times Company

Keyword: Depression; Hormones & Behavior
Link ID: 22718 - Posted: 10.02.2016

Jon Hamilton There's growing evidence that a physical injury to the brain can make people susceptible to post-traumatic stress disorder. Studies of troops deployed to Iraq and Afghanistan have found that service members who suffer a concussion or mild traumatic brain injury are far more likely to develop PTSD, a condition that can cause flashbacks, nightmares and severe anxiety for years after a traumatic event. And research on both people and animals suggest the reason is that a brain injury can disrupt circuits that normally dampen the response to a frightening event. The result is like "driving a car and the brake's not fully functioning," says Minxiong Huang, a biomedical physicist at the University of California, San Diego. Scientists have suspected a link between traumatic brain injury (TBI) and PTSD for many years. But the evidence was murky until researchers began studying troops returning from Iraq and Afghanistan. What they found was a lot of service members like Charles Mayer, an Army sniper from San Diego who developed PTSD after finishing a deployment in Iraq. In 2010, Mayer was on patrol in an Army Humvee near Baghdad when a roadside bomb went off. "I was unconscious for several minutes," he says. So he found out what happened from the people who dragged him out. The blast fractured Mayer's spine. It also affected his memory and thinking. That became painfully clear when Mayer got out of the Army in 2012. © 2016 npr

Keyword: Brain Injury/Concussion; Stress
Link ID: 22695 - Posted: 09.26.2016

By MICHAEL HEDRICK My father said on numerous occasions when I was growing up that he would see other families that had problems like divorce and drug use, and he would thank God that his family was so perfect. Things would change, though. They always do. And that perfect family would face just as much struggle as any other. Growing up in the mountains above Boulder, Colo., our life was good. My parents had left their life in Chicago behind for an ideal they saw in a piece of art they found at a flea market, a haphazardly painted picture of a cabin next to a river with the mountains towering in the background. Born in the early ‘80s, my brothers and I shared a bond as best friends in our small neighborhood, isolated from town, where we spent time outside sledding, building forts and making dams in the ditch that ran by our house. The biggest problems we seemed to face were bloody knees and the occasional broken bone from snowboarding and bike accidents. My dad, a subscriber to “Mother Earth News,” relished our family’s home in the mountains. There were backpacking trips to the national park 30 miles away, where he taught us how to build a fire and to hang our food from tree limbs to keep it out of reach of bears. Other times he would take us on long father-son road trips, where we would drive the long highways with nothing to look at but the passing fields and nothing to pay attention to but the books on tape from Focus on the Family that my father put on the car stereo. Those tapes provided a Christian look at what it meant to be a man, covering issues like lust, sex and puberty, and he’d answer our questions about girls and all manner of things relating to our growing into healthy young men. © 2016 The New York Times Company

Keyword: Schizophrenia; Drug Abuse
Link ID: 22686 - Posted: 09.23.2016

Researchers at the National Institutes of Health have discovered a two-way link between depression and gestational diabetes. Women who reported feeling depressed during the first two trimesters of pregnancy were nearly twice as likely to develop gestational diabetes, according to an analysis of pregnancy records. Conversely, a separate analysis found that women who developed gestational diabetes were more likely to report postpartum depression six weeks after giving birth, compared to a similar group of women who did not develop gestational diabetes. The study was published online in Diabetologia. Gestational diabetes is a form of diabetes (high blood sugar level) occurring only in pregnancy, which if untreated may cause serious health problems for mother and infant. “Our data suggest that depression and gestational diabetes may occur together,” said the study’s first author, Stefanie Hinkle, Ph.D., staff scientist in the Division of Intramural Population Health Research at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “Until we learn more, physicians may want to consider observing pregnant women with depressive symptoms for signs of gestational diabetes. They also may want to monitor women who have had gestational diabetes for signs of postpartum depression.” Although obesity is known to increase the risk for gestational diabetes, the likelihood of gestational diabetes was higher for non-obese women reporting depression than for obese women with depression.

Keyword: Depression; Obesity
Link ID: 22670 - Posted: 09.20.2016

By CATHERINE SAINT LOUIS Attention deficit disorder is the most common mental health diagnosis among children under 12 who die by suicide, a new study has found. Very few children aged 5 to 11 take their own lives, and little is known about these deaths. The new study, which included deaths in 17 states from 2003 to 2012, compared 87 children aged 5 to 11 who committed suicide with 606 adolescents aged 12 to 14 who did, to see how they differed. The research was published on Monday in the journal Pediatrics. About a third of the children of each group had a known mental health problem. The very young who died by suicide were most likely to have had attention deficit disorder, or A.D.D., with or without accompanying hyperactivity. By contrast, nearly two-thirds of early adolescents who took their lives struggled with depression. Suicide prevention has focused on identifying children struggling with depression; the new study provides an early hint that this strategy may not help the youngest suicide victims. “Maybe in young children, we need to look at behavioral markers,” said Jeffrey Bridge, the paper’s senior author and an epidemiologist at the Research Institute at Nationwide Children’s Hospital in Columbus, Ohio. Jill Harkavy-Friedman, the vice president of research at the American Foundation for Suicide Prevention, agreed. “Not everybody who is at risk for suicide has depression,” even among adults, said Dr. Harkavy-Friedman, who was not involved in the new research. Yet the new research does not definitively establish that attention deficit disorder and attention deficit hyperactivity disorder, or A.D.H.D., are causal risk factors for suicide in children, Dr. Bridge said. Instead, the findings suggest that “suicide is potentially a more impulsive act among children.” © 2016 The New York Times Company

Keyword: ADHD; Depression
Link ID: 22668 - Posted: 09.19.2016

Richard J. McNally The welcoming letter to the class of 2020 in which Jay Ellison, a dean at the University of Chicago, told incoming students not to expect trigger warnings on campus struck a nerve in a highly polarized debate that is embroiling academia. Trigger warnings are countertherapeutic because they encourage avoidance of reminders of trauma, and avoidance maintains P.T.S.D. Trigger warnings, critics claim, imperil academic freedom and further infantilize a cohort of young people accustomed to coddling by their helicopter parents. Proponents of trigger warnings point out that many students have suffered trauma, exemplified by alarming rates of sexual assault on campus. Accordingly, they urge professors to warn students about potentially upsetting course materials and to exempt distressed students from classes covering topics likely to trigger post-traumatic stress disorder, or P.T.S.D., symptoms, such as flashbacks, nightmares and intrusive thoughts about one’s personal trauma. Proponents of trigger warnings are deeply concerned about the emotional well-being of students, especially those with trauma histories. Yet lost in the debate are two key points: Trauma is common, but P.T.S.D. is rare. Epidemiological studies show that many people are exposed to trauma in their lives, and most have had transient stress symptoms. But only a minority fails to recover, thereby developing P.T.S.D. Students with P.T.S.D. are those most likely to have adverse emotional reactions to curricular material, not those with trauma histories whose acute stress responses have dissipated. However, trigger warnings are countertherapeutic because they encourage avoidance of reminders of trauma, and avoidance maintains P.T.S.D. Severe emotional reactions triggered by course material are a signal that students need to prioritize their mental health and obtain evidence-based, cognitive-behavioral therapies that will help them overcome P.T.S.D. These therapies involve gradual, systematic exposure to traumatic memories until their capacity to trigger distress diminishes. © 2015 The New York Times Company

Keyword: Stress; Learning & Memory
Link ID: 22658 - Posted: 09.15.2016

By Jessica Hamzelou After experiencing post-traumatic stress disorder after being raped, Karestan Koenen made it her career to study the condition. Now at Harvard University, Koenen is leading the largest ever genetic study of PTSD, by sifting through the genomes of tens of thousands of people (see Why women are more at risk of PTSD – and how to prevent it”). She tells New Scientist how her experiences shaped her career What was your idea of PTSD before you experienced it yourself? I would have associated it with men who served in the military – the stereotype of a Vietnam veteran who has experienced really horrible combat, and comes back and has nightmares about it. Do you think that is how PTSD is perceived by the public generally? Yes. People know that PTSD is related to trauma, and that people can have flashbacks and nightmares. But they tend to think it is associated with combat. A lot of popular images of PTSD come from war movies, and people tend to associate being a soldier with being a man. They are less aware that most PTSD is related to things that happen to civilians – things like rape, sexual assault and violence, which can affect women more than men. Is this misperception of PTSD problematic? It’s a problem in the sense that women or men who have PTSD from non-combat experiences might not recognise what they have as PTSD, and because of that, may not end up getting help. And if you saw it in a loved one, you may not understand what was going on with them. © Copyright Reed Business Information Ltd.

Keyword: Stress; Genes & Behavior
Link ID: 22657 - Posted: 09.15.2016

By Helen Thomson High levels of inflammation as a child may predict a higher risk of manic behaviour in later life, a finding that could lead to new ways of treating conditions like bipolar disorder. Hypomania involves spells of hyperactivity and is often a symptom of mood disorders, including bipolar disorder, seasonal affective disorder and some kinds of psychosis. People experiencing hypomania may take more risks, feel more confident and become impatient with others. After spells like this, they may “crash”, needing to sleep for long periods and sometimes remembering little about the previous few days. Earlier studies suggested a link between inflammation and mood disorders, prompting Joseph Hayes at University College London and his team to see if inflammation as a child might lead to mental health problems later. Analysing data from more than 1700 people, his team identified a significant link between high levels of a chemical involved in inflammation at age 9, and experiencing aspects of hypomania at age 22. The chemical, called IL-6, is normally secreted by white blood cells to stimulate an inflammatory immune response to infection or trauma. Hayes’s team says it is unclear how inflammation in childhood could induce symptoms of hypomania but IL-6 is known to affect the brain. A study that used injections to increase IL-6 in the blood of healthy volunteers found that this caused symptoms of anxiety, and reduced performance in memory tests. © Copyright Reed Business Information Ltd.

Keyword: Schizophrenia
Link ID: 22636 - Posted: 09.07.2016

By Andy Coghlan Antidepressants may be bad for your bones. People who take some selective serotonin reuptake inhibitors (SSRI) have been found to have a higher risk of fractures, but it wasn’t clear whether this was due to the drug or their depression. “It’s a puzzling question,” says Patricia Ducy at Columbia University, New York. But her team have now found that giving mice fluoxetine – the active ingredient in Prozac – for six weeks causes them to lose bone mass. The team identified a two-stage process by measuring bones, blood and gene activity. During the first three weeks, bones grew stronger as the fluoxetine impaired osteoclasts, cells that usually deplete bone tissue. But by six weeks, the higher levels of serotonin prompted by the drug disrupted the ability of the hypothalamus region of the brain to promote bone growth. “We see bone gain, but it’s not long-lasting, and is rapidly overwhelmed by the negative effects,” says Ducy. She says this two-phase pattern is also seen in people. In the short term, those who take fluoxetine are less likely to break a bone, but the risk of bone depletion and fractures rises when they have been taking the drug for a year or more. © Copyright Reed Business Information Ltd.

Keyword: Depression
Link ID: 22630 - Posted: 09.06.2016

By Laurie McGinley The Food and Drug Administration, alarmed that increasing numbers of Americans are combining opioid painkillers and benzodiazepines, said Wednesday that it will require tough new warnings on the product labels that spell out the serious dangers of mixing the drugs. The agency said it will require “boxed warnings” — its strongest category — on 389 separate products and will mandate the warning on opioid-containing cough medications. The new language will list the hazards of using the medications in tandem, which include extreme sleepiness, respiratory depression, coma and even death. The agency noted that the misuse of opioids, powerful pain medications such as prescription oxycodone, hydrocodone and morphine, has “increased significantly” in the United States over the past two decades. Benzodiazepines are used to treat anxiety, insomnia and seizure disorders. Both classes of drugs depress the central nervous system and together can raise the risk of adverse outcomes. FDA officials said the number of patients prescribed both an opioid and a benzodiazepine increased by 41 percent — about 2.5 million people — between 2002 and 2014. From 2004 to 2011, the rate of emergency-department visits involving the non-medical use of both drug classes increased significantly and overdose deaths nearly tripled, the FDA said.

Keyword: Drug Abuse; Stress
Link ID: 22620 - Posted: 09.01.2016

By Will Boggs MD NEW YORK (Reuters Health) - Most adults in the U.S. who screen positive for depression are not being treated for depression, according to results from Medical Expenditure Panel Surveys (MEPS). "With the recent increase in prescribing of antidepressant medications, many physicians might assume that undertreatment of depression is no longer a widespread problem," Dr. Mark Olfson from College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute in New York City told Reuters Health by email. "This study makes clear, however, that most American adults who screen positive for depression receive no treatment for their symptoms." Surveys from the early 2000s show that about half of U.S. adults with a lifetime medical history of major depressive disorder had never received treatment for depression. Still, little is known about the extent to which adults with depression in the U.S. receive depression care and the extent to which such patients are matched based on their illness severity to appropriate treatments and healthcare professionals. Dr. Olfson and colleagues used data from the 2012 and 2013 MEPS to examine the prevalence and treatment of adults with screen-positive depression (a Patient Health Questionnaire-2 score of 3 or less). They also assessed whether serious psychological distress was associated with more intensive treatment. © 2016 Scientific American

Keyword: Depression
Link ID: 22613 - Posted: 08.30.2016

By Nicholas Bakalar Taking antipsychotic medicines during pregnancy does not increase the risk for birth defects, a large new study has found. Antipsychotics are used to treat schizophrenia, bipolar disorder, depression and other psychiatric disorders. Previous studies of their use during pregnancy have been small and have had mixed results. This study, in JAMA Psychiatry, reviewed records of 1,341,715 pregnant women, of whom 9,258 filled prescriptions for the newer atypical antipsychotics like quetiapine (Seroquel) or aripiprazole (Abilify), and 733 for older typical antipsychotics such as haloperidol (Haldol). All prescriptions were filled in the first trimester of pregnancy. After controlling for race, number of pregnancies, smoking, alcohol use, psychiatric conditions, additional medications and other variables, there was no difference in the risk for birth defects between those who took the drugs and those who did not. One possible exception was a marginal increase in risk with one drug, risperidone (Risperdal), which the authors said will require further study. “These findings suggest that the use of antipsychotics during the first trimester does not seem to increase congenital malformation,” or birth defects, said the lead author, Krista F. Huybrechts, an assistant professor of medicine at Harvard. But, she added, “we only looked at congenital malformation, not other possible negative outcomes for women and their children.” © 2016 The New York Times Company

Keyword: Development of the Brain; Schizophrenia
Link ID: 22574 - Posted: 08.20.2016

By Jef Akst ANDRZEJ KRAUZEAs a psychiatrist at Western University in London, Ontario, Lena Palaniyappan regularly sees patients with schizophrenia, the chronic mental disorder that drastically affects how a person thinks, feels, and behaves. The disorder can be devastating, often involving hallucinations and delusions. But one thing Palaniyappan and other mental health professionals have noticed is that, unlike those with degenerative neurological disorders such as Alzheimer’s disease, Huntington’s, or Parkinson’s, sometimes schizophrenia patients eventually start to improve. “In the clinic we do actually see patients with schizophrenia having a very relentless progress in early years,” Palaniyappan says. “But a lot of them do get better over the years, or they don’t progress as [quickly].” So far, most research has focused on the neurological decline associated with schizophrenia—typically involving a loss of brain tissue. Palaniyappan and his colleagues wondered whether there might be “something happening in the brain [that] helps them come to a state of stability.” To get at this question, he and his colleagues performed MRI scans to assess the cortical thickness of 98 schizophrenia patients at various stages of illness. Sure enough, the researchers noted that, while patients who were less than two years removed from their diagnosis had significantly thinner tissue than healthy controls, those patients who’d had the disease for longer tended to show less deviation in some brain regions, suggesting some sort of cortical amelioration (Psychol Med, doi:10.1017/S0033291716000994, 2016). “Some brain regions are regaining or normalizing while other brain regions continue to show deficits,” Palaniyappan says. © 1986-2016 The Scientist

Keyword: Schizophrenia; Regeneration
Link ID: 22572 - Posted: 08.18.2016

By Jessica Hamzelou JACK NICHOLSON has a lot to answer for. One of the knock-on effects of hit 1975 movie One Flew Over the Cuckoo’s Nest was a public backlash against electroconvulsive therapy (ECT). The treatment, used since the 1930s for a wide range of mental health conditions, delivers a jolt of electricity to the brain big enough to trigger a seizure. The film’s brutal depiction of ECT and lobbying helped it fall out of favour in the 1980s and 1990s. But ECT may now be undergoing a revival, led by psychiatrists who champion it because of its success rate. “It’s the most effective treatment we have in psychiatry,” says George Kirov at Cardiff University, UK, who oversees ECT treatments in the area. A report from the UK Royal College of Psychiatrists last September showed that three-quarters of people with mental health problems felt improvement after having ECT. And psychiatrists say that a similar percentage of people who have schizophrenia that doesn’t respond to drug treatment find ECT effective. “I’ve never seen an ECT treatment that doesn’t work,” says Helen Farrell, a psychiatrist at the Beth Israel Deaconess Medical Center in Boston. “People have such a skewed view of electroconvulsive therapy. It is seen as primitive and horrific“ Mounting evidence has convinced the US Food and Drug Administration (FDA) to consider reclassifying ECT devices to make the technology more accessible for people with depression or bipolar disorder. The public will still take some convincing, however. In a 2005 survey in Switzerland, for example, 56 per cent were against ECT, while just 1 per cent said they were in favour. © Copyright Reed Business Information Ltd.

Keyword: Depression
Link ID: 22571 - Posted: 08.18.2016

By MIKE SACKS You’ve seen me. I know you have. I’m the guy wearing gloves on the subway in October. Or even into April. Perhaps I’m wearing just one glove, allowing my naked hand to turn the pages of a book. No big deal. Just another one-gloved commuter, heading home. If it’s crowded, you may have noticed me doing my best to “surf,” sans contact, until the car comes to a stop, in which case I may knock into a fellow passenger. Aboveground you may have seen me acting the gentleman, opening doors for others with a special paper towel I carry in my front left pocket for just such a momentous occasion. No? How about that guy walking quickly ahead of you, the one impishly avoiding sidewalk cracks? Or perhaps you’ve noticed a stranger who turns and makes eye contact with you for seemingly no reason. You may have asked, “You got a problem?” Oh, I definitely have a problem. But it has nothing to do with you, sir or madam. (And, yes, even in my thoughts I refer to you as “sir” and “madam.”) The problem here is what multiple doctors have diagnosed as obsessive-compulsive disorder. You may refer to it by its kicky abbreviation, O.C.D. I prefer to call it Da Beast. Da Beast is a creature I have lived with since I was 11, a typical age for O.C.D. to snarl into one’s life without invitation or warning. According to the International O.C.D. Foundation, roughly one in 100 adults suffers from the disorder. Each of us has his or her own obsessive thoughts and fears to contend with. My particular beast of burden is a fear of germs and sickness. It’s a popular one, perhaps the most common. © 2016 The New York Times Company

Keyword: OCD - Obsessive Compulsive Disorder
Link ID: 22541 - Posted: 08.11.2016

Laura Sanders A busy protein known for its role in aging may also have a hand in depression, a study on mice hints. Under certain circumstances, the aging-related SIRT1 protein seems to make mice despondent, scientists report August 10 in the Journal of Neuroscience. The results are preliminary, but they might ultimately help find new depression treatments. Today’s treatments aren’t always effective, and new approaches are sorely needed. “This is one potential new avenue,” says study coauthor Deveroux Ferguson of the University of Arizona College of Medicine in Phoenix. Ferguson and colleagues subjected mice to 10 days of stressful encounters with other mice. After their demoralizing ordeal, the mice showed signs of depression, such as eschewing sugar water and giving up attempts to swim. Along with these signs of rodent despair, the mice had more SIRT1 gene activity in the nucleus accumbens, a brain area that has been linked to motivation and depression. Resveratrol, a compound found in red grapes, supercharges the SIRT1 protein, making it more efficient at its job. When Ferguson and colleagues delivered resveratrol directly to the nucleus accumbens, mice displayed more signs of depression and anxiety. When the researchers used a different compound to hinder SIRT1 activity, the mice showed the opposite effect, appearing bolder in some tests than mice that didn’t receive the compound. |© Society for Science & the Public 2000 - 2016.

Keyword: Depression; Genes & Behavior
Link ID: 22537 - Posted: 08.10.2016

By Ann Griswold, Autism shares genetic roots with obsessive-compulsive disorder (OCD) andattention deficit hyperactivity disorder (ADHD). The three conditions have features in common, such as impulsivity. New findings suggest that they also share a brain signature. The first comparison of brain architecture across these conditions has found that all are associated with disruptions in the structure of the corpus callosum. The corpus callosum is a bundle of nerve fibers that links the brain’s left and right hemispheres. The results appeared July 1 in the American Journal of Psychiatry. Clinicians may find it difficult to distinguish autism from ADHD based on symptoms alone. But if the conditions are marked by similar structural problems in the brain, the same interventions might be useful no matter what the diagnosis is, says lead researcher Stephanie Ameis, assistant professor of psychiatry at the University of Toronto. The unique aspects of each condition might arise from other brain attributes, such as differences in the connections between neurons, says Thomas Frazier, director of research at the Cleveland Clinic Foundation. “A reasonable conclusion is that autism and ADHD don’t differ dramatically in a structural way, but could differ in connectivity,” says Frazier, who was not involved in the study. Ameis’ team examined the brains of 71 children with autism, 31 with ADHD, 36 with OCD and 62 typical children using diffusion tensor imaging. This method provides a picture of the brain’s white matter, the long fibers that connect nerve cells, by measuring the diffusion of water across these fibers. © 2016 Scientific American

Keyword: Autism; OCD - Obsessive Compulsive Disorder
Link ID: 22536 - Posted: 08.10.2016

By BENEDICT CAREY HOLYOKE, Mass. — Some of the voices inside Caroline White’s head have been a lifelong comfort, as protective as a favorite aunt. It was the others — “you’re nothing, they’re out to get you, to kill you” — that led her down a rabbit hole of failed treatments and over a decade of hospitalizations, therapy and medications, all aimed at silencing those internal threats. At a support group here for so-called voice-hearers, however, she tried something radically different. She allowed other members of the group to address the voice, directly: What is it you want? “After I thought about it, I realized that the voice valued my safety, wanted me to be respected and better supported by others,” said Ms. White, 34, who, since that session in late 2014, has become a leader in a growing alliance of such groups, called the Hearing Voices Network, or HVN. At a time when Congress is debating measures to extend the reach of mainstream psychiatry — particularly to the severely psychotic, who often end up in prison or homeless — an alternative kind of mental health care is taking root that is very much anti-mainstream. It is largely nonmedical, focused on holistic recovery rather than symptom treatment, and increasingly accessible through an assortment of in-home services, residential centers and groups like the voices network Ms. White turned to, in which members help one another understand each voice, as a metaphor, rather than try to extinguish it. For the first time in this country, experts say, psychiatry’s critics are mounting a sustained, broadly based effort to provide people with practical options, rather than solely alleging abuses like overmedication and involuntary restraint. “The reason these programs are proliferating now is society’s shameful neglect of the severely ill, which creates a vacuum of great need,” said Dr. Allen Frances, a professor emeritus of psychiatry at Duke University. © 2016 The New York Times Company

Keyword: Schizophrenia
Link ID: 22534 - Posted: 08.09.2016

Nicola Davis Scientists have discovered 17 separate genetic variations that increase the risk of a person developing depression. The findings, which came from analysing DNA data collected from more than 300,000 people, are the first genetics links to the disease found in people of European ancestry. The scientists say the research will contribute to a better understanding of the disease and could eventually lead to new treatments. They also hope it will reduce the stigma that can accompany depression. According to Nice, up to 10% of people seen by practitioners in primary care have clinical depression, with symptoms including a continuously low mood, low self-esteem, difficulties making decisions and lack of energy. Both environmental and genetic factors are thought to be behind depression, with the interaction between the two also thought to be important. But with a large number of genetic variants each thought to make a tiny contribution to the risk of developing the condition, unravelling their identity has proved challenging. While previous studies have turned up a couple of regions in the genome of Chinese women that might increase the risk of depression, the variants didn’t appear to play a role in depression for people of European ancestry. © 2016 Guardian News and Media Limited

Keyword: Depression; Genes & Behavior
Link ID: 22504 - Posted: 08.02.2016