Chapter 12. Psychopathology: The Biology of Behavioral Disorders

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By Sandra Lamb Each night before “Greg” goes to bed he brushes and flosses his teeth. Then he double-checks the instructions on the dark brown bottle his nurse gave him before he unscrews the cap and tips five drops of a light-amber, oily liquid onto a spoon. The brew, glistening from the light of the bathroom fixture, is tasteless and has no odor he can detect. But it’s chock-full of bacteria. He sloshes the substance around in his mouth and swallows. Greg hopes that while he sleeps the foreign microbes will wage war with other organisms in his gut, changing that environment to ultimately help him manage some of the post-traumatic stress disorder (PTSD) symptoms that cloud his mind and riddle his days and nights with nightmares, flashbacks, thoughts of suicide and irrational responses to stressful events. The bacteria he is swallowing, his doctors tell him, “may help reduce symptoms of stress.” Each drop of Greg's brew is filled with millions of Lactobacillus reuteri, a bacterium isolated and derived from human breast milk. The Denver VA Hospital orders the substance and prescribes it as part of a PTSD clinical trial involving 40 veterans who either receive the bacteria or a placebo mix of sunflower oil and other inactive substances. (The bacterium is also currently used to treat a dental condition called chronic periodontitis because it has been shown to help fight inflammation.) © 2017 Scientific American

Keyword: Stress; Obesity
Link ID: 23600 - Posted: 05.10.2017

Sara Reardon Tom Insel, former director of the US National Institute of Mental Health, is searching for new ways of addressing mental illness. Sixteen months after leaving the US National Institute of Mental Health (NIMH) for Google’s health sciences division, psychiatrist Tom Insel is on the move again. The former NIMH director, who left Google on 5 May, is starting his own company. Insel’s group, called Mindstrong, will try to infer a person’s mental-health status by analysing the way they use smartphones. Insel stepped down as NIMH director in December 2015 in order to start a mental-health program called Verily within Google’s Life Sciences group. One of the division’s goals overlaps with that of Mindstrong's: Verily intends to build tools, which could include smartphone apps or computer programs, that can recognize characteristics of mental illness using a method known as “digital phenotyping”. The method analyses factors such as a user’s word choice in communication, voice patterns when talking to digital assistants, their physical movements and location data to determine their state of mind. If a smartphone could recognize when its owner was feeling suicidal, for instance, it could potentially intervene by providing resources or alerting others. © 2017 Macmillan Publishers Limited

Keyword: Depression; Schizophrenia
Link ID: 23597 - Posted: 05.10.2017

By CASEY SCHWARTZ OAKLAND, Calif. — In a packed, cavernous space one weekend late in April, a crowd of thousands was becoming increasingly amped up. Rainbow hair was commonplace, purple silk pants were sighted, and the smell of marijuana drifted in from a designated smoking area nearby. Audience members watched the stage with avid interest, leaping to occasionally shoeless feet to applaud and cheer. This wasn’t Coachella, taking place the same weekend some 500 miles south, or any other music festival, but a five-day convention of the Multidisciplinary Association for Psychedelic Studies (MAPS), its first in four years. Rather than rock stars, scientists from schools like Johns Hopkins and N.Y.U. were the main attraction, bringing evidence to the medical case for psychedelics like psilocybin (the active ingredient in magic mushrooms) to assuage end-of-life anxiety, to help deepen meditation practices, to search for the shared underpinnings of spiritual life, and — in a new study — to explore a possible treatment for severe depression. Paul Austin, 26, of Grand Rapids, Mich., a so-called social entrepreneur who runs a website called The Third Wave devoted to getting out information on psychedelic substances, had come to meet other members of the pro-psychedelic community and share with them his vision for how the next generation must proceed. “A lot of the people who are leading the movement now are 60 or 70 years old, based in academia or research,” Mr. Austin said. “But to catalyze change, you have to speak to people, get to them on an emotional level.” The conference was taking place just over the Bay Bridge from the city that introduced psychedelics to the American imagination in the early 1960s, when LSD was relatively new, legal and regarded by those who used it as a portal to expanded consciousness, a deeper life and an enlightened, humane society. (Cary Grant and other Hollywood stars were among those who experimented with it as part of their psychotherapeutic process.) © 2017 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 23589 - Posted: 05.08.2017

A U.S.-based drug researcher who led a team that hunted through a massive database of patient records says the anesthetic ketamine shows potential as an antidepressant and should be further studied for its potential as a psychiatric drug. Doctors currently use ketamine to relieve pain during surgery and it is approved for that purpose. The drug's potential to relieve suicidal depression is also well known, but that information is based on anecdotes and small studies rather than a large clinical trial. Ruben Abagyan, a professor in the school of pharmaceutical sciences at the University of California San Diego, said ketamine is a "possible alternative treatment and definitely in particularly difficult cases." Those cases could include suicidal depression, where the weeks of treatment that traditional antidepressants require to take effect might be too long, Abagyan said. Search for beneficial signal Abagyan is the senior author of a study published in Wednesday's issue of the journal Scientific Reports, based on an analysis of a large U.S. database of adverse effect reports that were made for any reason. The U.S. Food and Drug Administration's adverse effects database, which contains over 8 million patient records of reports made for a wide range of reasons, is normally used to look for potentially harmful side-effects. But in a twist, the researchers turned this on its head, looking for reduction in depression symptoms among patients who took ketamine. "If we can look at the reduction of their complaints about depression that can be a signal for the beneficial effect of ketamine," Abagyan said. ©2017 CBC/Radio-Canada.

Keyword: Depression; Drug Abuse
Link ID: 23569 - Posted: 05.04.2017

Miriam E. Tucker In July 2012, a science reporter for The Washington Post, Brian Vastag, was in Wisconsin visiting his family when a high fever hit. He became instantly bedridden with flu-like symptoms that never went away. "It didn't feel like anything I'd ever had before. ... The things that distinguished it were the dizziness and the feeling of unreality in the head," Vastag says. Now, nearly five years later, the 45-year-old can no longer concentrate or read even a few sentences without becoming exhausted. A short walk to the mailbox means lying down for the rest of the day. In September, he'll qualify for Medicare due to his disability. That level of severity isn't the picture most people — including physicians — think of when they hear the term "chronic fatigue syndrome." But that was the diagnosis Vastag finally received after 18 months of visiting numerous doctors, submitting countless vials of blood and initially being misdiagnosed with West Nile virus. Actually, Vastag's condition is now termed "myalgic encephalomyelitis/chronic fatigue syndrome," or ME/CFS for short, and is estimated to affect at least 1 million people in the U.S. alone. Many with the condition dislike the name "chronic fatigue syndrome" because they feel it's trivializing and misleading, giving the impression that they're simply tired or depressed when in fact many are quite ill. Nailing down the cause — or, more likely, causes — of the illness has proven exceptionally difficult, since patients' symptoms vary tremendously. © 2017 npr

Keyword: Depression
Link ID: 23561 - Posted: 05.02.2017

By Dave A. Chokshi, In medicine, we speak of “seeing patients” when we are rounding in the hospital or caring for those who come to our clinics. But what about those people who may be sick but do not seek care? What is our responsibility to the patients we do not see? This question takes on greater urgency in the current political climate, as patients face the threat of losing health insurance. Renewed efforts to repeal and replace the Affordable Care Act leave millions wondering whether they will be covered. For me, as a physician practicing in the safety net, abstract numbers evoke the very real stories of my uninsured patients. One of my patients, whom I’ll call Elsa, had not seen a doctor since immigrating to the United States 15 years ago. That abruptly changed one morning: She awoke to find the room spinning around her and, terrifyingly, she could not articulate the words to explain to her husband what was going on. She was having a stroke. There are many reasons that patients like Elsa may not seek care – until they have no choice. Although she felt no symptoms before her stroke, Elsa was one of about 13 million U.S. adults with undiagnosed high blood pressure. I wondered if making her aware of her blood pressure would have been enough to avoid her suffering. But even if high blood pressure may sit atop the list of problems I write out, from his or her perspective it may not crack the top five. Food security, job stability, child care and affordable housing understandably feel more urgent. Time and again, I have learned that taking care of my patients starts by trying to walk a mile in their shoes. © 2017 Scientific American

Keyword: Stroke; Schizophrenia
Link ID: 23555 - Posted: 05.01.2017

Amy Maxmen Psychedelic drugs could soon help people, including soldiers, who suffer from post-traumatic stress disorder with the pain of recalling traumatic memories. Psychologists have occasionally given people psychedelic drugs such as LSD or magic mushrooms to induce altered states, in an attempt to treat mental illness. Today, many of those drugs are illegal, but if clinical trials testing their efficacy yield positive results, a handful could become prescription medicines in the next decade. The furthest along in this process is MDMA — a drug sold illegally as ecstasy or Molly — which is showing promise in the treatment of post-traumatic stress disorder (PTSD). Last week, at the Psychedelic Science 2017 conference in Oakland, California, researchers presented unpublished results from phase II trials involving a total of 107 people diagnosed with PTSD. The trial treatment involved a combination of psychotherapy and MDMA (3,4-methylenedioxymethamphetamine). The US Food and Drug Administration (FDA) reviewed these data in November, which were not released to the public at the time. The agency recommended that the researchers move forward with phase III trials, the final stage before potential approval of the drug. At the conference, researchers affiliated with the non-profit organization that is sponsoring the trials, the Multidisciplinary Association for Psychedelic Studies (MAPS) in Santa Cruz, California, presented some of their latest resutls. They used a cinically validated scale that assesses PTSD symptoms such as frequency of nightmares and anxiety levels. More than one year after two or three sessions of MDMA-assisted therapy, about 67% of participants no longer had the illness, according to that scale. About 23% of the control group — who received psychotherapy and a placebo drug — experienced the same benefit. © 2017 Macmillan Publishers Limited,

Keyword: Drug Abuse; Stress
Link ID: 23554 - Posted: 04.29.2017

Elizabeth Eaton Researchers have pinpointed a gene that keeps important brain cells in mice from crossing their wires, providing a possible link between brain wiring and mood disorders like depression. Without the gene, called Pcdhαc2, mice acted more depressed, researchers report April 28 in Science. Nerve cells, or neurons, that produce the chemical messenger molecule serotonin extend long projections called axons to various parts of the brain. Serotonin released from the tips of the axons signal other neurons in these target areas to influence mood and other aspects of behavior. For efficient signaling, the axon tips must be properly spaced. In the new work, scientists from New York City, St. Louis and China found that such spacing is disrupted in mice lacking the Pcdhαc2 gene. As a result, serotonin-signaling circuits are not properly assembled and the mice exhibited behaviors indicating depression. Pcdhαc2 is found in a cluster of genes that contain the blueprints for proteins that protrude from the surface of cells. These proteins work like ID cards, says study coauthor Joseph Dougherty, a neurogeneticist at Washington University School of Medicine in St. Louis. As serotonin neuron axons branch out through the brain, they can recognize other axons carrying identical IDs and spread out to keep out of each other’s paths. This process, called tiling, evenly spaces the axons in their target areas within the brain. |© Society for Science & the Public 2000 - 2017

Keyword: Depression; Brain imaging
Link ID: 23553 - Posted: 04.29.2017

New research from the National Institutes of Health found that pairing the antidepressant amitriptyline with drugs designed to treat central nervous system diseases, enhances drug delivery to the brain by inhibiting the blood-brain barrier in rats. The blood-brain barrier serves as a natural, protective boundary, preventing most drugs from entering the brain. The research, performed in rats, appeared online April 27 in the Journal of Cerebral Blood Flow and Metabolism. Although researchers caution that more studies are needed to determine whether people will benefit from the discovery, the new finding has the potential to revolutionize treatment for a whole host of brain-centered conditions, including epilepsy, stroke,human amyotrophic lateral sclerosis (ALS), depression, and others. The results are so promising that a provisional patent application has been filed for methods of co-administration of amitriptyline with central nervous system drugs. According to Ronald Cannon, Ph.D., staff scientist at NIH’s National Institute of Environmental Health Sciences (NIEHS), the biggest obstacle to efficiently delivering drugs to the brain is a protein pump called P-glycoprotein. Located along the inner lining of brain blood vessels, P-glycoprotein directs toxins and pharmaceuticals back into the body’s circulation before they pass into the brain. To get an idea of how P-glycoprotein works, Cannon said to think of the protein as a hotel doorman, standing in front of a revolving door at a lobby entrance. A person who is not authorized to enter would get turned away, being ushered back around the revolving door and out into the street.

Keyword: Depression
Link ID: 23548 - Posted: 04.28.2017

By Daniel Barron Earlier this month, JAMA Psychiatry published a land-breaking editorial. A group of psychiatrists led by David Ross described how and why post-traumatic stress disorder (PTSD) should be clinically evaluated from a neuroscience framework. The fact that this editorial was published in one of psychiatry’s leading journals is no small feat. Psychiatry houses a large and powerful contingency that argues neuroscience has little clinical relevance. The relevance of neuroscience to psychiatry was the subject of a recent Op-Ed debate in the New York Times: “There’s Such a Thing as Too Much Neuroscience” was rebutted with “More Neuroscience, Not Less.” This specific debate—and the dense politics as a whole—exists because competing frameworks are vying for competing funding, a conflict that pre-dates Freud’s departure from neurology. That the relevance of neuroscience to psychiatry is still questioned is blatantly outlandish: what organ do psychiatrists treat if not the brain? And what framework could possibly be more relevant than neuroscience to understanding brain dysfunction? In his editorial, Ross tactfully presented his case for neuroscience, describing the obvious choice for a clinical framework as one “perspective,” making a delicate intellectual curtsey while supporting his case with data. Ross discussed five “key neuroscience themes” (read: lines of evidence from burgeoning sub-fields) relevant to understanding and treating PTSD: fear conditioning, dysregulated circuits, memory reconsolidation, and epigenetic and genetic considerations. Each theme accounts for the diverse biological, psychological and social factors involved in PTSD—which is to say, these factors all have some affect on the brain mechanisms. Most importantly, Ross describes how a mechanistic approach allows clinicians to trace the specific causes of PTSD to specific treatments that can target those causes. © 2017 Scientific American,

Keyword: Schizophrenia; Depression
Link ID: 23536 - Posted: 04.26.2017

By TANYA FRANK It begins in the laundry room in the early hours of the morning. I find him alone, tracing the wires of the telephone circuit board. “This is how they are monitoring us,” my son whispers. “We have to cut some stuff out, change the receiver, I can do it.” “Who?” I ask. “Who is monitoring us? And why?” He puts a finger to his lips to quiet me, and begins rifling through the tool kit. He doesn’t seem quite sure what he is looking for. He has never rerouted wires in his life, and besides, it is 2009 and we have suspended our landline. These wires that my 19-year-old is obsessing over are part of a defunct apparatus from a bygone age. I shiver in this damp afterthought of a room, but not from the concrete floor under my bare feet. I’m a Londoner with a tolerance for winter. It’s nerves that have me shaking. I am scared of my own child. My partner is in San Francisco, and we are in Los Angeles. There is no national health system here. We are unmoored, just my boy and me above a twinkling metropolis of strangers. “We can’t trust anybody,” he writes. “Our computers and phones are bugged. Listen, hear that?” I shake my head, unable to detect anything. “It’s a helicopter spying on us.” When it sinks in that this is not a delirium that can be eased with Advil and a good night’s sleep, and when I stop denying that my son is armed, I take him to the closest psychiatric hospital, where he is involuntarily held for 72 hours, considered a danger to himself or others. His symptomology is examined and classified as if he is some rare and delicate butterfly, and he emerges with a label: schizoaffective disorder. It is a complex condition with traits of both schizophrenia (a thought disorder) and bipolar (a mood disorder). Basically, my son had a psychotic break. That’s what they call it when someone disintegrates from his psyche. © 2017 The New York Times Company

Keyword: Schizophrenia
Link ID: 23518 - Posted: 04.21.2017

Ian Sample Science editor Brain scans have revealed the first evidence for what appears to be a heightened state of consciousness in people who took psychedelic drugs in the name of science. Healthy volunteers who received LSD, ketamine or psilocybin, a compound found in magic mushrooms, were found to have more random brain activity than normal while under the influence, according to a study into the effects of the drugs. The shift in brain activity accompanied a host of peculiar sensations that the participants said ranged from floating and finding inner peace, to distortions in time and a conviction that the self was disintegrating. Researchers at the University of Sussex and Imperial College, London, measured the activity of neurons in people’s brains as the drugs took hold. Similar measurements have shown that when people are asleep or under anaesthetic, their neurons tend to fire in a more predictable way than when they are awake. “What we find is that under each of these psychedelic compounds, this specific measure of global conscious level goes up, so it moves in the other direction. The neural activity becomes more unpredictable,” said Anil Seth, a professor of neuroscience at the University of Sussex. “Until now, we’ve only ever seen decreases compared to the baseline of the normal waking state.”

Keyword: Drug Abuse; Brain imaging
Link ID: 23511 - Posted: 04.19.2017

Aimee Cunningham Taking antidepressants during pregnancy does not increase the risk of autism or attention-deficit/hyperactivity disorder, two new large studies suggest. Genetic or environmental influences, rather than prenatal exposure to the drugs, may have a greater influence on whether a child will develop these disorders. The studies are published online April 18 in JAMA. Clinically, the message is “quite reassuring for practitioners and for mothers needing to make a decision about antidepressant use during pregnancy,” says psychiatrist Simone Vigod, a coauthor of one of the studies. Past research has questioned the safety of expectant moms taking antidepressants (SN: 6/5/10, p. 22). “A mother’s mood disturbances during pregnancy are a big public health issue — they impact the health of mothers and their children,” says Tim Oberlander, a developmental pediatrician at the University of British Columbia in Vancouver. About one in 10 women develop a major depressive episode during pregnancy. “All treatment options should be explored. Nontreatment is never an option,” says Oberlander, who coauthored a commentary, also published in JAMA. Untreated depression during pregnancy creates risks for the child, including poor fetal growth, preterm birth and developmental problems. Some women may benefit from psychotherapy alone. A more serious illness may require antidepressants. “Many of us have started to look at longer term child outcomes related to antidepressant exposure because mothers want to know about that in the decision-making process,” says Vigod, of Women’s College Hospital in Toronto. |© Society for Science & the Public 2000 - 2017.

Keyword: Depression; Autism
Link ID: 23510 - Posted: 04.19.2017

By CLYDE HABERMAN In America’s most storied political family, Rosemary Kennedy was the first in her generation to die of natural causes. Before then, a brother had been killed in war, a sister in a plane crash and two other brothers in assassinations. Not much of Ms. Kennedy’s life qualified as natural, though. Intellectually challenged from birth, she became increasingly erratic after entering womanhood. Her tempestuous mood swings troubled the family patriarch so much that he approved controversial surgery, which he was led to believe would calm her. In 1941, at age 23, Ms. Kennedy underwent a prefrontal lobotomy. It went badly. For her remaining 63 years, she led an institutionalized existence, out of public view, unable to speak clearly or walk without a limp. Retro Report, a series of video documentaries exploring major news stories of the past, harks back to that botched lobotomy and the neurologist who effectively sealed the young woman’s fate, Dr. Walter J. Freeman. The purpose is to show how the past informs the present. Psychosurgery endures, as with a procedure called a cingulotomy, which is used to treat depression and obsessive-compulsive disorder and involves severing fibers deep in the frontal lobe. But attention these days is keenly focused on stimulating discrete areas of the brain with electrical charges in the hope of easing torments like Parkinson’s disease, O.C.D. and depression. “What Walter Freeman was doing was crude and barbaric and harmful in many cases,” said Jack El-Hai, who wrote a 2005 biography of him, “The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness.” Referring to cingulotomies, Mr. El-Hai told Retro Report, “But what does remain is the idea that the brain can be physically manipulated, surgically manipulated, to help treat psychiatric illnesses.” The New York Times Company

Keyword: Schizophrenia
Link ID: 23505 - Posted: 04.18.2017

Emily Corwin Michael Treadwell sat at the back of a courtroom in New Hampshire. He wore a windbreaker and khaki pants and leaned over his work boots with his elbows on his knees. At first it looked like he was chewing gum — a bold choice in a courtroom. But when he spoke it was clear: He wasn't chewing gum, he was chewing his own gums. Michael doesn't have any teeth. Taxpayers in Hillsborough County, N.H., have spent $63,000 over the last six years keeping Treadwell in jail for little more than trespassing. Law Investigation Into Private Prisons Reveals Crowding, Under-Staffing And Inmate Deaths For years now, his life has looked like this: Trespass in an apartment building, spend 30 days in jail; bother restaurant customers, spend 42 days in jail; panhandle aggressively, spend 30 days in jail. "When you live in a town like Nashua, there's not a lot of homelessness there, and it kinda like focuses, puts you in the spotlight," Treadwell says. "Especially if you drink alcohol and stuff." His charges all come from some combination of being homeless and getting drunk. Still, he says, jail is no worse than the streets. "People kill homeless people, violence and everything else," Treadwell says. "It can be a very dangerous life to live in. I don't suggest jail as an alternative. Ain't no kinda life." © 2017 npr

Keyword: Schizophrenia
Link ID: 23497 - Posted: 04.17.2017

By Andy Coghlan It tastes foul and makes people vomit. But ayahuasca, a hallucinogenic concoction that has been drunk in South America for centuries in religious rituals, may help people with depression that is resistant to antidepressants. Tourists are increasingly trying ayahuasca during holidays to countries such as Brazil and Peru, where the psychedelic drug is legal. Now the world’s first randomised clinical trial of ayahuasca for treating depression has found that it can rapidly improve mood. The trial, which took place in Brazil, involved administering a single dose to 14 people with treatment-resistant depression, while 15 people with the same condition received a placebo drink. A week later, those given ayahuasca showed dramatic improvements, with their mood shifting from severe to mild on a standard scale of depression. “The main evidence is that the antidepressant effect of ayahuasca is superior to the placebo effect,” says Dráulio de Araújo of the Brain Institute at the Federal University of Rio Grande do Norte in Natal, who led the trial. Shamans traditionally prepare the bitter, deep-brown brew of ayahuasca using two plants native to South America. The first, Psychotria viridis, is packed with the mind-altering compound dimetheyltryptamine (DMT). The second, the ayahuasca vine (Banisteriopsis caapi), contains substances that stop DMT from being broken down before it crosses the gut and reaches the brain. © Copyright Reed Business Information Ltd.

Keyword: Depression; Drug Abuse
Link ID: 23494 - Posted: 04.15.2017

Doctors trialling the use of ketamine to treat depression are calling for the treatment to be rolled out. Ketamine is licensed to be used as an anaesthetic but has a reputation as an illegal party drug. Writing in The Lancet Psychiatry, Dr Rupert McShane, who has led a trial in Oxford, since 2011 says ketamine can work on patients with depression "where nothing has helped before". However, he is calling for a national registry to monitor its use. Dr McShane says tens of thousands of people who have not responded to other treatment could be helped by the drug. But he adds there should be a national registry for those who prescribe the treatment to monitor the results and avoid misuse of the Class B substance. Of the 101 people taking part who had failed to find a successful depression treatment, 42 of them responded to the ketamine. "The first ketamine infusion literally saved my life," says one patient. "I had felt so desperate I was going to end it all. "Subsequent ketamine treatment has enabled me to return to my job full-time. I still struggle at times but being able to work again has given me such a boost." Dr McShane hopes more doctors will use it to treat depression but fears that the UK could follow the US where there are private ketamine clinics that vary in their clinical checks. © 2017 BB

Keyword: Depression; Drug Abuse
Link ID: 23469 - Posted: 04.10.2017

By Jia Naqvi An experimental technique reduces the tics, or involuntary movements and vocal outbursts, associated with severe Tourette's syndrome in young adults, a study published Friday found. The surgical technique, called thalamic deep brain stimulation (DBS), sends electrical impulses to a specific area of the brain that reduces the tics, according to the study published in the Journal of Neurosurgery. The finding adds to the growing body of evidence about the safety and effectiveness of deep brain stimulation, which might eventually lead the Food and Drug Administration to approve the treatment for Tourette's syndrome, according to the researchers. “Our study shows that deep brain stimulation is a safe, effective treatment for young adults with severe Tourette syndrome that cannot be managed with current therapies,” said Alon Mogilner, an associate professor in the departments of neurosurgery and anesthesiology at New York University Langone and director of its Center for Neuromodulation, in a news release. “This treatment has the potential to improve the quality of life for patients who are debilitated through their teenage years and young adulthood.” Tourette's syndrome, a type of neurological disorder, according to various studies afflicts from 0.3 to 0.6 percent of children in the United States, with around 138,000 ages 6 to 17 being diagnosed with the condition. The causes for the syndrome are not well known and are thought to be largely genetic, with unidentified environmental factors increasing the likelihood of the condition. Usually the syndrome begins in childhood and the condition improves with age for some people, but for others the symptoms become more severe to the point that people become socially isolated and unable to work or attend school. © 1996-2017 The Washington Post

Keyword: Tourettes
Link ID: 23468 - Posted: 04.08.2017

MaryCatherine McDonald, Marisa Brandt, Robyn Bluhm In the wake of World War I, some veterans returned wounded, but not with obvious physical injuries. Instead, their symptoms were similar to those that had previously been associated with hysterical women – most commonly amnesia, or some kind of paralysis or inability to communicate with no clear physical cause. English physician Charles Myers, who wrote the first paper on “shell-shock” in 1915, theorized that these symptoms actually did stem from a physical injury. He posited that repetitive exposure to concussive blasts caused brain trauma that resulted in this strange grouping of symptoms. But once put to the test, his hypothesis didn’t hold up. There were plenty of veterans who had not been exposed to the concussive blasts of trench warfare, for example, who were still experiencing the symptoms of shell-shock. (And certainly not all veterans who had seen this kind of battle returned with symptoms.) We now know that what these combat veterans were facing was likely what today we call post-traumatic stress disorder, or PTSD. We are now better able to recognize it, and treatments have certainly advanced, but we still don’t have a full understanding of just what PTSD is. The medical community and society at large are accustomed to looking for the most simple cause and cure for any given ailment. This results in a system where symptoms are discovered and cataloged and then matched with therapies that will alleviate them. Though this method works in many cases, for the past 100 years, PTSD has been resisting. © 2010–2017, The Conversation US, Inc.

Keyword: Stress
Link ID: 23442 - Posted: 04.04.2017

Aaron E. Carroll One of the biggest American public health victories of the last decade has been the record low reached in the teenage birthrate. Along with that have been lows in rates for teenage pregnancy and abortion. Most researchers believe that improved access to contraception is a large part of this success. But news continues to focus on the concern that hormone-based contraception — like the pill or the patch — causes depression, and that this should lead us to question its wider use. A more nuanced discussion would consider both the benefits and the harms. This issue drew widespread coverage at the end of last year with a large study published in JAMA Psychiatry. Researchers tracked all women and adolescent females (ages 15 to 34) living in Denmark from 2000 through 2014. The study found that those who used hormonal contraception had significantly higher risks of also taking an antidepressant. The study broke down the increased relative risk for each hormonal method this way: combined oral contraceptives (23 percent), progestogen-only pills (34 percent), the patch (100 percent), vaginal ring (60 percent) and levonorgestrel intrauterine system (40 percent). The risks were highest in adolescents and decreased as women aged. The risks also peaked six months after the start of contraception. Needless to say, many news outlets covered this finding widely. Some portrayed it as shocking new information that should change the way we think about hormonal birth control. Others saw it as a vindication of many women who said for years that birth control had triggered their depression while scientists and doctors ignored them. But we have to acknowledge the limitations of this type of research. It’s not a controlled trial, and it’s impossible to establish causality. Women who choose to have sex could also be more likely to consider antidepressant use. © 2017 The New York Times Company

Keyword: Depression; Sexual Behavior
Link ID: 23439 - Posted: 04.03.2017