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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

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22824 - Posted: 11.03.2016

By David Tuller After living in Oklahoma for 40 years, Nita and Doug Thatcher retired in 2009 to the Rust Belt city of Lorain, Ohio, a Cleveland suburb that hugs Lake Erie. When Nita needed to find a new primary care doctor, a friend recommended someone from the Cleveland Clinic. Nita knew the institution’s reputation for cutting-edge research and superior medical services. But as a longtime patient grappling with chronic fatigue syndrome, a debilitating disorder that scientists still don’t fully understand, she was wary when she learned that the clinic was promoting a common but potentially dangerous treatment for the illness: a steady increase in activity known as graded exercise therapy. The notion that people with chronic fatigue syndrome should be able to exercise their way back to health has enjoyed longstanding and widespread support, and “graded exercise” has become the de facto standard of clinical care. This approach has obvious intuitive appeal. Exercise helps all kinds of illnesses, and it’s a great tool for boosting energy. How could it possibly hurt? British psychiatrists and psychologists developed the graded exercise strategy for treating chronic fatigue syndrome during the 1990s. They offered a straightforward rationale: These patients were not medically sick but severely out of shape (“deconditioned”) from prolonged avoidance of activity. And they avoided activity because they wrongly believed they had a biological disease that would get worse if they overexerted themselves. During treatment, patients were encouraged to question this “dysfunctional cognition,” view any resurgent symptoms as transient, and push through the exhaustion and pain to rebuild their strength. Copyright 2016 Undark

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22805 - Posted: 10.29.2016

Andrew Solomon A new virtual-reality attraction planned for Knott’s Berry Farm in Buena Park, Calif., was announced last month in advance of the peak haunted-house season. The name, “Fear VR 5150,” was significant. The number 5150 is the California psychiatric involuntary commitment code, used for a mentally ill person who is deemed a danger to himself or others. Upon arrival in an ersatz “psychiatric hospital exam room,” VR 5150 visitors would be strapped into a wheelchair and fitted with headphones. “The VR headset puts you in the middle of the action inside the hospital,” an article in The Orange County Register explained. “One patient seems agitated and attempts to get up from a bed. Security officers try to subdue him. A nurse gives you a shot (which you will feel), knocking you out. When you wake up in the next scene, all hell has broken loose. Look left, right and down, bloody bodies lie on the floor. You hear people whimpering in pain.” Knott’s Berry Farm is operated by Ohio-based Cedar Fair Entertainment Company, and Fear VR 5150 was to be featured at two other Cedar Fair parks as well. Almost simultaneously, two similar attractions were started at Six Flags. A news release for one explained: “Our new haunted house brings you face-to-face with the world’s worst psychiatric patients. Traverse the haunted hallways of Dark Oaks Asylum and try not to bump into any of the grunting inmates around every turn. Maniacal inmates yell out from their bloodstained rooms and deranged guards wander the corridors in search of those who have escaped.” The Orange County branch of the National Alliance on Mental Illness (NAMI) sprang into action, and Doris Schwartz, a Westchester, N.Y.-based mental-health professional, immediately emailed a roster of 130 grass-roots activists, including me, many of whom flooded Cedar Fair and Six Flags with phone calls, petitions and emails. After some heated back-and-forth, Fear VR 5150 was shelved, and Six Flags changed the mental patients in its maze into zombies. © 2016 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22789 - Posted: 10.26.2016

By Nathaniel P. Morris When meeting new people, I'm often asked what I do for work. Depending on how I phrase my answer, I receive very different reactions."I'm a doctor specializing in mental health" elicits fascination. People's faces brighten and they say, "Very cool!" But If I instead say, "I'm a psychiatrist," the conversation falls quiet. They get uncomfortable and change the subject. Mental health has made great strides in recent years. Every week, people across the country participate in walks to support mental health causes. The White House now designates May as National Mental Health Awareness Month. In the presidential race, Hillary Clinton released a comprehensive plan to invest in mental health care. Yet psychiatry—the medical specialty focused on mental health—remains looked down upon in nearly every corner of our society. The public often doesn’t regard psychiatrists as medical doctors. Many view psychiatric treatments as pseudoscience at best and harmful at worst. Even among health professionals, it’s one of the least respected medical specialties. The field is in serious decline. Academic papers abound with titles like “Is psychiatry dying?” and “Are psychiatrists an endangered species?” Despite growing mental health needs nationwide, fewer medical students are applying into the field, and the number of psychiatrists in the US is falling. Patients too often refuse treatment because of stigma related to the field. © 2016 Scientific American

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 1: Biological Psychology: Scope and Outlook
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 1: An Introduction to Brain and Behavior
Link ID: 22775 - Posted: 10.22.2016

By Jessica Hamzelou Is depression caused by an inflamed brain? A review of studies looking at inflammation and depression has found that a class of anti-inflammatory drugs can ease the condition’s symptoms. Golam Khandaker at the University of Cambridge and his colleagues analysed 20 clinical studies assessing the effects of anti-cytokine drugs in people with chronic inflammatory conditions. These drugs block the effects of cytokines – proteins that control the actions of the immune system. Anti-cytokines can dampen down inflammation, and are used to treat rheumatoid arthritis. Together, these trials involved over 5,000 volunteers, and provide significant evidence that anti-cytokine drugs can also improve the symptoms of depression, Khandaker’s team found. These drugs work about as well as commonly used antidepressants, they say. The most commonly used anti-depressant drugs, known as SSRIs, act to increase levels of serotonin in the brain, to improve a person’s mood. But depression might not always be linked to a lack of serotonin, and SSRIs don’t work for everyone. Recent research has found that around a third of people with depression appear to have higher levels of cytokines in their brains, while people with “overactive” immune systems seem more likely to develop depression. Khandaker’s team think that inflammation in the brain might be responsible for the fatigue experienced by people with depression. © Copyright Reed Business Information Ltd.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 22765 - Posted: 10.19.2016

Bruce Bower Scientists, politicians, clinicians, police officers and medical workers agree on one thing: The U.S. mental health system needs a big fix. Too few people get the help they need for mental ailments and emotional turmoil that can destroy livelihoods and lives. A report in the October JAMA Internal Medicine, for instance, concludes that more than 70 percent of U.S. adults who experience depression don’t receive treatment for it. Much attention focuses on developing better psychiatric medications and talk therapies. But those tactics may not be enough. New research suggests that the longstanding but understudied problem of stigma leaves many of those suffering mental ailments feeling alone, often unwilling to seek help and frustrated with treatment when they do. “Stigma about mental illness is widespread,” says sociologist Bernice Pescosolido of Indiana University in Bloomington. And the current emphasis on mental ills as diseases of individuals can unintentionally inflame that sense of shame. An effective mental health care system needs to address stigma’s suffocating social grip, investigators say. “If we want to explain problems such as depression and suicide, we have to see them in a social context, not just as individual issues,” Pescosolido says. |© Society for Science & the Public 2000 - 2016

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22758 - Posted: 10.15.2016

By JOHN C. MARKOWITZ The United States government recently announced its new director of the National Institute of Mental Health, Dr. Joshua Gordon. If you think that’s just bureaucracy as usual, think again. Mental health research, under the leadership of the previous director, Dr. Thomas Insel, underwent a quiet crisis, one with worrisome implications for the treatment of mental health. I hope Dr. Gordon will resolve it. For decades, the National Institute of Mental Health provided crucial funding for American clinical research to determine how well psychotherapies worked as treatments (on their own as well as when combined with medications). This research produced empirical evidence supporting the effectiveness of cognitive behavioral therapy, interpersonal psychotherapy and other talking treatments. But over the past 13 years, Dr. Insel increasingly shifted the institute’s focus to neuroscience, strangling its clinical research budget. Dr. Insel wasn’t wrong to be enthusiastic about the possibilities of neuroscientific research. Compared with the psychiatric diagnoses listed in the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.), which can be vague and flawed, brain-based research holds out the promise of a precise and truly scientific understanding of mental illness. Psychiatric diagnoses depend on clusters of signs and symptoms. For major depression, for example, some criteria are low mood; wanting to die; and sleep, appetite and energy changes. These diagnoses lack the specificity of the biological markers that neuroscience seeks to identify. If we could find a genetic, neuroimaging or brain-circuit explanation for a mental illness, it might even yield a cure, rather than just the treatment of what can be recurrent, chronic conditions. But where does that leave patients whom today’s treatments do not help? Can they wait for neuroscience developments that may take decades to appear, or prove illusory? Staking all your money on one bet, as the institute did under Dr. Insel, has consequences. © 2016 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 1: Biological Psychology: Scope and Outlook
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 1: An Introduction to Brain and Behavior
Link ID: 22757 - Posted: 10.15.2016

By Daisy Yuhas About 350 million people around the world suffer from depression. Therapists can use many different techniques to help, but none has more rigorous scientific evidence behind it than cognitive-behavioral therapy (CBT). This “inside-out” technique focuses primarily on thought patterns, training patients to recognize and reframe problematic thinking. Now, however, mental health professionals have another option: mounting evidence shows that a technique called behavioral-activation (BA) therapy is just as effective as CBT. BA is an outside-in technique in which therapists focus on modifying actions rather than thoughts. “The idea is that what you do and how you feel are linked,” says David Richards, a health services researcher at the University of Exeter in England. If a patient values nature and family, for example, a therapist might encourage him to schedule a daily walk in the park with his grandchildren. Doing so could increase the rewards of engaging more with the outside world, which can be a struggle for depressed people, and could create an alternative to more negative pastimes such as ruminating on loss. BA has existed for decades, and some of its elements are used in CBT, yet until now it had never been tested with the scale and rigor needed to assess its relative strength as a stand-alone approach. In one of the largest studies of its kind, Richards led a collaboration of 18 researchers working at three mental health centers in the U.K. who put BA and CBT head-to-head. They assigned 440 people with depression to about 16 weeks of one of the two approaches, then followed the patients' progress at six, 12 and 18 months after treatment began. As revealed in a paper, published online in July in the Lancet, the team found the treatments to be equally effective. A year on, about two thirds of the patients in both groups reported at least a 50 percent reduction in their symptoms. © 2016 Scientific American

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22741 - 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

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 12: Sex: Evolutionary, Hormonal, and Neural Bases
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 8: Hormones and Sex
Link ID: 22718 - Posted: 10.02.2016

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.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 22670 - Posted: 09.20.2016

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.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22630 - Posted: 09.06.2016

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

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22613 - Posted: 08.30.2016

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.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22571 - Posted: 08.18.2016

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.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 13: Memory, Learning, and Development
Link ID: 22537 - Posted: 08.10.2016

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

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 13: Memory, Learning, and Development
Link ID: 22504 - Posted: 08.02.2016

By David Levine Almost seven percent of U.S. adults—about 15.7 million people—are diagnosed with major depression disorder, according to the National Institute of Mental Health (NIMH). The Centers for Disease Control and Prevention report that depression causes 200 million lost workdays each year at a cost to employers of between $17 billion and $44 billion. The statistics for anxiety disorders are not great either. The most common mental illnesses in the U.S., they affect 40 million adults age 18 and older, costing the economy more than $42 billion a year. In my twenties, I developed panic disorder. I failed to get better on most medications and therapy. As I reported in an article earlier this year, it took me years to find a medication that worked. Because it took me so long to be diagnosed and treated properly, I have always been interested in alternative treatments for depression and anxiety. Two years ago I attended two sessions at the World Science Festival on the use of electrical therapy to treat depression and anxiety. The first event was Spark of Genius? Awakening a Better Brain, a panel discussion moderated by ABC News Chief Health & Medical Editor Richard Besser. The panel discussed what is known about treating the brain and the ethical and legal complications of brain enhancement. (You can watch it online at the World Science Festival website.) The second panel, "Electric Medicine and the Brain" was moderated by John Rennie, former editor in chief of Scientific American His panel focused on the use of "electroceuticals," a term coined by researchers at GlaxoSmithKline to refer to all implantable devices being used to treat mental illnesses and being explored in the treatment of metabolic, cardiovascular and inflammatory disorders. © 2016 Scientific American

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22462 - Posted: 07.20.2016

By Nicholas Bakalar A new study has identified a bacterial blueprint for chronic fatigue syndrome, offering further evidence that it is a physical disease with biological causes and not a psychological condition. Chronic fatigue syndrome is a condition that causes extreme and lasting fatigue, preventing people from taking part in even the most routine daily activities. There are no tests to confirm the diagnosis, which has prompted speculation that it is a psychological condition rather than a physical illness. In a study published in Microbiome, researchers recruited 48 people with C.F.S. and 39 healthy controls. Then they analyzed the quantity and variety of bacteria species in their stool. They also searched for markers of inflammation in their blood. The stool samples of those with C.F.S. had significantly lower diversity of species compared with the healthy people — a finding typical of inflammatory bowel disease as well. The scientists also discovered that people with C.F.S. had higher blood levels of lipopolysaccharides, inflammatory molecules that may indicate that bacteria have moved from the gut into the bloodstream, where they can produce various symptoms of disease. Using these criteria, the researchers were able to accurately identify more than 83 percent of C.F.S. cases based on the diversity of their gut bacteria and lipopolysaccharides in their blood. Finding a biomarker for C.F.S. has been an ongoing goal for researchers who hope to one day develop a diagnostic test for the condition. Still, the senior author of the study, Maureen R. Hanson, a professor of molecular biology at Cornell, said the bacteria blueprint in the new study is not yet a method of definitively diagnosing C.F.S. The importance of the finding, she said, is that it may offer new clues as to why people have these symptoms. © 2016 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22411 - Posted: 07.08.2016

Anthony Devlin/ Antidepressant use is at an all-time in high in England, where prescriptions filled for these drugs has doubled over the last decade. Figures from the Health and Social Care Information Centre show that in 2015, 61 million prescriptions were filled for antidepressant drugs, including citalopram and fluoxetine. This is up from 57.1 million in 2014, and 29.4 million back in 2005. “The reasons for this increase in antidepressant prescriptions could include a greater awareness of mental illness and more willingness to seek help,” says Gillian Connor of the charity Rethink Mental Illness. “However, with our overstretched and underfunded mental health services, too often antidepressants are the only treatment available.” UK guidelines suggest that people should be offered antidepressants as a first treatment option for moderate depression, but some critics argue that it would be better to steer people to talking therapies. In May, Andrew Green, a GP in East Riding and chairman of the British Medical Association’s Clinical and Prescribing Subcommittee, told a meeting of the UK’s All-Party Parliamentary Group for Prescribed Drug Dependence that one of the reasons doctors resort to prescribing antidepressants is because the waiting lists for talking therapies are so long. © Copyright Reed Business Information Ltd.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22399 - Posted: 07.06.2016

By Tara Parker-Pope About one in eight women take an antidepressant at some time during pregnancy, reports Roni Rabin in today’s Science Times. But is it safe? Some new research shows that antidepressant use during pregnancy may be linked to certain problems in newborns. A new review of the medical literature concludes that treatment decisions for depression during pregnancy must be made on a case-by-case basis. “There’s not a one-size-fits-all answer,” said Dr. Kimberly Yonkers, a professor of psychiatry and obstetrics and gynecology at Yale School of Medicine who was the report’s lead author, and who acknowledged receiving research support from antidepressant manufacturers. “You can’t say, ‘Stop medication for all women because it’s harmful,’ and you can’t put all women on medication either.” To learn more, read the full story, “Depression Is a Dilemma for Women in Pregnancy,” and then please join the discussion below. Did you experience depression during pregnancy? Did you take medication to treat it? © 2016 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 13: Memory, Learning, and Development
Link ID: 22386 - Posted: 07.01.2016

By Sara Chodosh Although scientists have learned a lot about the brain in the last few decades, approaches to treating mental illnesses have not kept up. As neuroscientists learn more about brain circuits, Stanford psychiatrist Amit Etkin foresees a time when diagnoses will be based on brain scans rather than symptoms. Etkin, who will be speaking at the World Economic Forum’s Annual Meeting of the New Champions in Tianjin, China, from June 26 to 28, spoke with Scientific American about his research on the neurological basis of emotional disorders and the future of mental health treatment. The high cost of treating mental illness doesn’t get talked about very much. Why is that? It’s a really interesting issue. The costs associated with mental illness are not just the care of people who have an illness, which often starts early in life and continues as a lifelong process, but also the cost to employers in decreased productivity and the cost to society in general. A report that came out recently in Health Affairs showed that spending within our health system in the U.S. is greater for mental illness than for any other area of medicine, and yet our understanding of these illnesses is incredibly backwards. Treatments are no different than they were 40 years ago, so that feels like a problem that is only getting bigger without an obvious solution. Why hasn’t there been much progress? It was really not until about 10 years ago that [mental health professionals] started realizing how little difference we have made. There are a few fundamental issues and mistakes we’ve made. One is that in the absence of knowing what the causes of the illnesses that we treat are, we focus on the symptoms, and that has already led us down the wrong path. If you go to another country and you ask somebody to tell you their symptoms, as a clinician you might have the sense that they have anxiety or depression. In Asian countries they express that in a somatic way: “I can’t sleep” or “I feel weak.” The biology cannot be that different, but the symptoms are different because they’re culturally bound. If you look at different parts of the U.S. you’ll see people expressing symptoms in different ways depending on their local culture. If that’s the case, then a symptom-based definition is problematic. The long and short of it is that people have named syndromes or disorders that they don’t actually know represent a valid entity that is distinct from another entity. © 2016 Scientific American

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 22364 - Posted: 06.27.2016