Chapter 16. Psychopathology: Biological Basis of Behavior Disorders

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by Peter Hess The mood-stabilizing drug lithium eases repetitive behaviors seen in mice missing SHANK3, an autism gene, according to a new study1. The findings suggest lithium merits further study as a treatment for some people with autism, even though the drug has troublesome side effects, including tremors and impaired memory. “Lithium is, of course, a rather difficult, non-ideal treatment,” says lead investigator Gina Turrigiano, professor of vision science at Brandeis University in Waltham, Massachusetts. “It’s really hard to get people on a lithium regimen that they can tolerate well.” But understanding why lithium works may set the stage for better treatments, she says. About 1 percent of people with autism have mutations in SHANK3. Deletion or mutation of the gene can also lead to Phelan-McDermid syndrome, which is characterized by intellectual disability, delayed speech and, often, autism. Case studies of people with Phelan-McDermid syndrome also suggest that lithium eases behavior problems associated with the condition2. Previous work has shown that SHANK3 helps stabilize neuronal circuits by adjusting excitatory and inhibitory signaling like a thermostat. This process, called homeostatic plasticity, allows neurons to respond to changes in sensory input. © 2020 Simons Foundation

Keyword: Autism
Link ID: 27215 - Posted: 04.27.2020

by Lauren Schenkman Mice with mutations in a gene called DLG2 are anxious and asocial; they also sleep poorly and overgroom themselves, according to a new study1. These characteristics resemble those seen in some people with autism. The results offer the first evidence that mutations in DLG2 may account for some of the condition’s behavioral traits. “This study is a baby step indicating DLG2’s implication in [autism’s] core behavioral symptoms,” says lead investigator Soo Young Kim, assistant professor of pharmacy at Yeungnam University in Gyeongsan, South Korea. A 2013 study reported that mice and people with DLG2 mutations have differences in learning, attention and other cognitive processes2. Last year, a study of nearly 500 families with two or more autistic children identified DLG2 as a candidate gene for autism3. The new work offers “a more full picture” of DLG2’s effect on behavior, says Seth Grant, professor of molecular neuroscience at the University of Edinburgh in Scotland. Grant led the 2013 work but was not involved in the new study. “It’s a useful contribution.” Kim and her colleagues bred male mice that have two mutant copies of DLG2. The animals lack the corresponding protein, which forms part of a neuron’s scaffolding. DLG4, another gene implicated in autism, has a similar role. © 2020 Simons Foundation

Keyword: Autism; Schizophrenia
Link ID: 27212 - Posted: 04.24.2020

By Kelly Servick For the first time in decades, researchers may have a new way to tweak brain signals to treat psychosis and other symptoms of schizophrenia. Results from a 245-person clinical trial hint that a compound called SEP-363856, which seems to act on neural receptors involved in dopamine signaling, might address a broader range of schizophrenia symptoms than currently available drugs do—and with fewer side effects. “If these results are confirmed, this will be big, big news,” says Jeffrey Lieberman, a psychiatrist at Columbia University. The drug’s developer, Sunovion Pharmaceuticals Inc., identified it through an unusual screening process not guided by the brain circuits and receptors already implicated in the disease, Lieberman says. “It was a big gamble on their part. This study suggests that it may pay off.” The biological basis of schizophrenia remains a puzzle, but researchers have linked patients’ hallucinations and delusions to an excess of the chemical messenger dopamine. To inhibit dopamine signaling, existing antipsychotic drugs bind to a type of dopamine receptor on neurons called D2. These drugs help control abnormal perceptions and thoughts—the “positive” symptoms of schizophrenia. But they don’t do much to address either cognitive impairments or the “negative” symptoms, including lack of motivation, dulled emotion, and social withdrawal. “Those negative symptoms are often the most devastating,” says Diana Perkins, a psychiatrist at the University of North Carolina, Chapel Hill. “A person can become, at the most extreme, robotlike.” © 2020 American Association for the Advancement of Science.

Keyword: Schizophrenia
Link ID: 27200 - Posted: 04.16.2020

Carl Sherman The world of neuroscience and psychiatry sat up and took notice last March when the Food and Drug Administration (FDA) approved brexanolone (Zulresso) for postpartum depression. It was the first drug specifically approved for the condition, which afflicts some 15 percent of women just before or shortly after childbirth. The event was a pivotal chapter in a neuroscience story that began three-quarters of a century ago with the 1941 discovery by Hans Selye (best known for his pioneering research into the nature of stress) that hormones including progesterone could affect the brain to induce deep anesthesia. Fast-forward 40 years to the discovery that a number of hormones—termed “neurosteroids” by the neuroscientist/endocrinologist Étienne-Émile Baulieu, a key figure in this work—are synthesized within the nervous system itself. In their National Institutes of Mental Health (NIMH) lab, Steven Paul and colleagues showed that several of these compounds work by binding to receptors on brain cells that are activated by GABA, the most plentiful inhibitory neurotransmitter in the brain. The GABA-A receptor is the site of action of several sedating central nervous system (CNS) drugs, including benzodiazepines (Valium, Librium), barbiturates, and many anesthetics. Neurosteroids can also bind to receptors for glutamate, the brain’s principal excitatory neurotransmitter. Paul and Robert Purdy proposed that, with its effect on both GABAergic and glutaminergic systems, neuroactive steroids (a term they coined to include synthetic analogues as well as the naturally-occurring hormones themselves) help regulate excitation throughout the brain. Excitation is a major factor in conditions such as epilepsy. Although there are many neuroactive steroids, the lion’s share of research has focused on allopregnanolone, a progesterone derivative. © 2020 The Dana Foundation.

Keyword: Depression; Stress
Link ID: 27197 - Posted: 04.16.2020

By Andrew Solomon For nearly 30 years — most of my adult life — I have struggled with depression and anxiety. While I’ve never felt alone in such commonplace afflictions — the family secret everyone shares — I now find I have more fellow sufferers than I could have ever imagined. Within weeks, the familiar symptoms of mental illness have become universal reality. A new poll from the Kaiser Family Foundation found nearly half of respondents said their mental health was being harmed by the coronavirus pandemic. Nearly everyone I know has been thrust in varying degrees into grief, panic, hopelessness and paralyzing fear. If you say, “I’m so terrified I can barely sleep,” people may reply, “What sensible person isn’t?” But that response can cause us to lose sight of the dangerous secondary crisis unfolding alongside the more obvious one: an escalation in both short-term and long-term clinical mental illness that may endure for decades after the pandemic recedes. When everyone else is experiencing depression and anxiety, real, clinical mental illness can get erased. While both the federal and local governments (some alarmingly slower than others) have responded to the spread of the coronavirus in critical ways, acknowledgment of the mental illness vulnerabilities has been cursory. Gov. Andrew Cuomo, who has so far enlisted more than 8,000 mental health providers to help New Yorkers in distress, is a fortunate exception. The Chinese government moved psychologists and psychiatrists to Wuhan during the first stage of self-quarantine. No comparable measures have been initiated by our federal government. The unequal treatment of the two kinds of health — physical over mental — is consonant with our society’s ongoing disregard for psychological stability. Insurance does not offer real parity of coverage, and treatment for mood disorders is generally deemed a luxury. But we are in a dual crisis of physical and mental health, and those facing psychiatric challenges deserve both acknowledgment and treatment. © 2020 The New York Times Company

Keyword: Depression; Stress
Link ID: 27183 - Posted: 04.13.2020

By Katherine Rosman The coronavirus outbreak has turned many of us into nervous germophobes, seeking to protect ourselves from infection by washing our hands methodically and frequently, avoiding unnecessary contact with so called high-touch surfaces and methodically sanitizing packages, our homes and our bodies. For people diagnosed with obsessive-compulsive disorder, or O.C.D., the worry created by the threat of coronavirus has the potential for more intense and longer-lasting implications. According to the International OCD Foundation, there are about three million Americans who have been diagnosed with O.C.D. It’s a condition characterized by unwanted thoughts or urges that generate high levels of anxiety and repetitive acts meant to neutralize the obsessional thought. The cleaning and sanitizing practices that help prevent coronavirus infection are bringing people with O.C.D. into closer orbit to behaviors that are a gateway to detrimental patterns that could interfere with their ability to engage meaningfully with the world outside their homes for years to come. Courtenay Patlin, a 28-year-old in Los Angeles, is trying to find balance between appropriate caution and overreaction. Several weeks ago, before the California shelter-in-place order, Ms. Patlin decided to mostly stay indoors. She had read enough about how quickly coronavirus had spread in China, Italy and then Seattle, and how very sick it was making so many. She felt she could rely on only herself and her Clorox to stay healthy. “I keep a very clean apartment, and I feel safe at home,” she said. Ms. Patlin, a graduate student studying clinical psychology, was diagnosed with O.C.D. about five years ago, she said, after years of being afraid of public toilets, refusing to eat off dishes that she hadn’t scrubbed herself or witnessed being sufficiently cleaned by others and being fearful of being hugged by basically anyone. ImageMs. Patlin’s hands. She used to clean her hands and apartment with pure bleach and cleaning solutions until the skin on her fingers started to peel off, which she would take as a sign that she was cleaning the proper amount. © 2020 The New York Times Company

Keyword: OCD - Obsessive Compulsive Disorder
Link ID: 27167 - Posted: 04.03.2020

By Jennifer Szalai Donald Galvin was a sophomore at Colorado State when he first checked into the campus health clinic to get treated for a cat bite, offering no further explanation of what had occurred. Two years and several visits later, he arrived at the clinic with another cat bite — only this time he told a doctor what happened to the cat. “He killed a cat slowly and painfully,” the doctor recorded in his notes. “Doesn’t know why he killed the cat nor why he tormented. Got emotionally upset as he discussed the behavior.” The oldest of 12 siblings, Donald was the first to be told he was schizophrenic. Five of his brothers would eventually get the same diagnosis. Even the healthy children in the Galvin family were beset in a sense, forced to live with an affliction that inevitably shaped their relationships to their parents and to one another. As the journalist Robert Kolker writes in “Hidden Valley Road,” having just one schizophrenic family member is bound to reorient the experiences of everyone else; having six made the Galvins extraordinary, not least to the medical researchers who eventually studied them. Kolker’s previous book, “Lost Girls,” traced the lives of five murdered women on Long Island and told a story of sex work and law enforcement during a time of technological change. His new book is a comparable feat of empathy and narrative journalism, as he coaxes out the struggles of the Galvin family, showing how they embodied the roiling debates over the science of schizophrenia — not just its causes, “but what it actually is.” The Galvin children were all born between 1945 and 1965, during the two decades of the baby boom. It was a time when the psychoanalytic approach to mental illness, with its theory of the cold and domineering “schizophrenogenic mother,” reigned supreme. What began as a more holistic rejoinder to the crude biological reductionism of the early 20th century soon hardened into its own orthodoxy. According to its proponents, mental illness was a disease of nurture, not nature; as one psychiatrist put it, the schizophrenic patient “is always one who is reared by a woman who suffers from a perversion of the maternal instinct.” © 2020 The New York Times Company

Keyword: Schizophrenia; Genes & Behavior
Link ID: 27161 - Posted: 04.02.2020

A first-of-its-kind trial has demonstrated that a receptor involved in the brain’s reward system may be a viable target for treating anhedonia (or lack of pleasure), a key symptom of several mood and anxiety disorders. This innovative fast-fail trial was funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, and the results of the trial are published in Nature Medicine. Mood and anxiety disorders are some of the most commonly diagnosed mental disorders, affecting millions of people each year. Despite this, available medications are not always effective in treating these disorders. The need for new treatments is clear, but developing psychiatric medications is often a resource-intensive process with a low success rate. To address this, NIMH established the Fast-Fail Trials program with the goal of enhancing the early phases of drug development. “The fast-fail approach aims to help researchers determine — quickly and efficiently — whether targeting a specific neurobiological mechanism has the hypothesized effect and is a potential candidate for further clinical trials,” explained Joshua A. Gordon, M.D., Ph.D., director of NIMH. “Positive results suggest that targeting a neurobiological mechanism affects brain function as expected, while negative results allow researchers to eliminate that target from further consideration. We hope this approach will pave the way towards the development of new and better treatments for individuals with mental illnesses.” In this study, researcher Andrew D. Krystal, M.D., who began the research while at the Duke University School of Medicine, Durham, North Carolina, and is now at the University of California, San Francisco, and colleagues report the first comprehensive application of this fast-fail approach. The researchers examined the kappa opioid receptor (KOR) as a possible neurobiological target for the treatment of anhedonia. Previous findings suggest that drugs that block the KOR, known as KOR antagonists, can affect reward-related brain circuits in ways that could improve reward processing and reverse anhedonia and associated symptoms.

Keyword: Depression
Link ID: 27152 - Posted: 03.31.2020

Jonathan Kanter and Adam Kuczynski To fight the spread of coronavirus, government officials have asked Americans to swallow a hard pill: Stay away from each other. In times of societal stress, such a demand runs counter to what evolution has hard-wired people to do: Seek out and support each other as families, friends and communities. We yearn to huddle together. The warmth of our breath and bodies, of holding hands and hugging, of talking and listening, is a primary source of soothing. These connections are pivotal for responding to and maximizing our survival in times of stress. Priority number one is to follow the recommended social distancing guidelines to control the virus. The cure is definitely not worse than the disease – experts’ projections of disease spread and mortality without strong intervention make this clear. But as with any pill, there are side effects. As psychological scientists at the University of Washington’s Center for the Science of Social Connection, our lab studies social connectedness, why it is important and how to maximize its benefits. Our clinical and research experiences help us understand the side effects of social distancing and suggest strategies for addressing them. In times of stress and illness, being deprived of social connection can create more stress and illness. People who are lonely have higher levels of the hormone cortisol, an indicator of stress; show weaker immune responses to pathogens; and are at increased risk for premature death. Isolation can lead to depression, suicidal thoughts and other clinical conditions. © 2010–2020, The Conversation US, Inc.

Keyword: Stress
Link ID: 27127 - Posted: 03.17.2020

By Alex Gatenby Victoria Derbyshire programme The mental health charity Mind says it is signposting people to street drug charities to help them withdraw from antidepressants because of the lack of alternatives available. Those affected can experience debilitating symptoms. "Within a couple of days of coming off, it was overwhelming - agitation, anxiety, akathisia [restlessness], just restlessness, can't sleep, suicidal ideations, all that stuff going on very quickly," Stuart Bryan tells the BBC's Victoria Derbyshire programme. The 48-year-old has been taking anti-depressants on and off for more than two decades. "The withdrawals are far worse than the original depression, for me and so many other people." Stuart has tried to stop more than 10 times, but has struggled with what he calls his withdrawal "hell" - and has now had to stop working. He says doctors have advised him to take anything between "a few weeks" to three months to slowly stop using the drugs. But he believes people coming off anti-depressants are being "abandoned by the system". Image caption Mind's Stephen Buckley says it is not fully understood how difficult a process coming off anti-depressants can be While antidepressants are not addictive, just over half of those who stop or reduce their dosage experience withdrawal symptoms, according to one review of 24 studies last year. The mental health charity Mind's head of information Stephen Buckley says it is having to signpost patients to street-drug charities, even though they have been prescribed the drugs on the NHS. Street-drug charities usually help those misusing alcohol and illegally-obtained drugs. © 2020 BBC

Keyword: Depression
Link ID: 27112 - Posted: 03.12.2020

By Heather Jones I knew early on that my normal didn’t feel like everyone else’s. Even as early as kindergarten, I could tell that my brain worked differently than others, and that I seemed more listless than other children my age. Other kids felt sadness when they experienced a loss or something upsetting. I always felt sad. I didn’t question the cloudy lens through which I viewed the world, because I had never seen clearly. When I was 16, my family doctor asked me the questions that would change my worldview. Having treated me since childhood, she had noticed patterns. She asked me whether I was experiencing the list of symptoms associated with persistent depressive disorder. I had all of them — feeling down, feeling hopeless, sleep problems, avoidance of social activities, low self-esteem and the rest of the laundry list of warning signs. My doctor explained to me that persistent depressive disorder, also called dysthymia, was a type of “functional depression” that lasts for years and often for a lifetime. I had probably had it since early childhood. I burst into tears, finally knowing there was a reason I felt this way. Knowing what I had didn’t take away my depression — more than 20 years later, I am still living with this condition — but getting a proper diagnosis started me on a path to better management of my symptoms. I am not alone. According to the National Institute of Mental Health, 1.3 percent of American adults will experience persistent depressive disorder at some time in their lives.

Keyword: Depression
Link ID: 27104 - Posted: 03.09.2020

By Michael Price Every Fourth of July, the thunderous crack of my neighbors’ fireworks is quickly followed by the wailing chorus of frightened dogs, including my own two mixed-breed pups. New research suggests Pico’s and Winnie’s sensitivity to noise, especially fireworks, is the most common form of anxiety in pet dogs. The study—the largest ever on canine temperaments—also finds that some breeds are prone to certain anxious behaviors, including aggression, separation anxiety, and fear. The results could help uncover new ways to tackle these traits. Anecdotes on dog behavior abound, but reliable scientific data are lacking, says Hannes Lohi, a canine geneticist at the University of Helsinki. That’s particularly an issue when looking at problem behaviors that can put dogs at higher risk of being euthanized or winding up in shelters. So Lohi and colleagues contacted Finnish dog breed clubs and reached out to dog owners around the world through social media, asking owners to rate their dogs’ behavior on seven different anxiety-related traits: noise sensitivity, general fear, fear of heights and surfaces (like reflective tiles), inattention, compulsive behaviors (like relentless chewing or tail chasing), aggression, and separation anxiety. They received more than 13,700 responses representing 264 breeds. To make reliable comparisons, the researchers limited themselves to the 14 breeds with 200 or more surveyed dogs. © 2020 American Association for the Advancement of Science.

Keyword: Emotions; Genes & Behavior
Link ID: 27099 - Posted: 03.06.2020

Eric Westervelt It's recreation time at a Los Angeles County jail known as the Twin Towers. Nearly a dozen disheveled young men stand docilely as they munch on sandwiches out of brown paper bags. They're half-naked except for sleeveless, thick, blanket-like restraints wrapped around them like medieval garments. All are chained and handcuffed to shiny metal tables bolted to the floor. "It's lunchtime and they're actually [in] programming right now," says a veteran guard, LA County Sheriff's Deputy Myron Trimble. Programming, in theory, means a treatment regimen. But it's difficult to determine what treatment they're actually receiving. A whiteboard nearby tracks how many days since guards on this floor had to forcibly restrain anyone: 54. These inmates haven't been violent, he says. So why are all of the men shackled to tables for recreation? "Just to make sure that they're not walking around," Trimble says. "If they don't take their medications, they could be deemed unpredictable." No one is under the illusion that shackles are helping mentally ill inmates get well. "I think everyone can agree that it's rather inhumane to have the inmate handcuffed while out," says LA Sheriff's Capt. Tania Plunkett, with the Twin Towers' Access to Care Bureau. "However, because of spacing and the lack of programming, we're not able to really focus on getting the inmate better to eventually lead to having them in a program without being handcuffed." New inmates with a mental illness arrive daily in the LA County jail system. It now holds more than 5,000 inmates with a mental illness who've had run-ins with the law. Some 3,000 are held in the jail's Twin Towers. © 2020 npr

Keyword: Schizophrenia
Link ID: 27073 - Posted: 02.26.2020

By Benedict Carey For years, Claire Bien, a research associate at Yale, strained to manage the gossipy, mocking voices in her head and the ominous sense that other people were plotting against her. Told she had a psychotic disorder, she learned over time to manage her voices and fears with a lot of psychotherapy and, periodically, medication. But sometime in late 1990, she tried something entirely different: She began generating her own voices, internal allies, to counter her internal abusers. “I truly felt I was channeling my father, my ancestors, a wise psychiatrist, giving me advice,” said Ms. Bien, who has written a book about her experience, “Hearing Voices, Living Fully.” She added: “Recovery for me means knowing that my mind is my own, and even when it doesn’t feel that way, I know it’s only temporary. Knowing that allows me to hold a job — a good job — and be productive, respected and even admired by the people with whom I work.” Mental-health researchers have numerous scales to track symptom relief, like the easing of depression during talk therapy, for instance, or the blunting of psychotic delusions on medication. But the field has a much harder time predicting, or even describing, what comes next. How do peoples’ lives change once they have learned to address their symptoms? Mental disorders are often recurrent, and treatment only partially effective. What does real recovery — if that’s the right word — actually look like, and how can it be assessed? This is what people in the thick of mental distress desperately want to know, and a pair of articles in a recent issue of the journal Psychiatric Services shows why good answers are so hard to come by. In one, the first study of its kind, Dutch researchers tested a standard life-quality measure, the Recovery Assessment Scale, that is typically used to rate an individual’s confidence, hope, sense of purpose, willingness to ask for help, and other features of a full, stable life. © 2020 The New York Times Company

Keyword: Schizophrenia; Depression
Link ID: 27071 - Posted: 02.25.2020

By Susanne Antonetta Last September, I believed my brain was on fire. Not in some metaphorical way. It was, as far as I was concerned, on fire. I am bipolar and I was hallucinating. My hallucinations can be sensory, like the brain burn, but many are auditory — I know hallucinations are coming when I hear birds speak. I can tell you what the birds say, but what matters is how intensely personal it is, being shouted at by a fierce small crowd: persist persist persist from one, six degrees yes yes yes from another. I couldn’t sleep in all the chatter. Then I heard whispering everywhere, semi trucks coming to a halt right under my bedroom window. A small part of me sensed all this was not really happening, but most of me thought it was. There’s another hallucinatory change that’s harder to describe, one that comes every time, mild episode or intense. The world feels malleable, like felt, or soft paper. Walls rock and steady themselves. What’s around me becomes alive, air itself humming and moving. As with the birds, these changes feel intensely personal — everything around me shifts as I watch. During the six months leading up to this brain-fire time, I’d been having milder hallucinations, on and off. I took a medication that controlled my psychotic symptoms until my cholesterol skyrocketed and kept going up. The drugs used to treat people like me — atypical antipsychotics like Zyprexa and the one I take, Seroquel — have metabolic side effects. These include soaring cholesterol and triglycerides, as well as diabetes. There may be no way out of these side effects except dropping the medication, going, as I did, from one that works to one that doesn’t. Doctors, and the occasional friend, kept telling me something meant to be cheering: “This is just a disease, the same as a broken bone or a bout of pneumonia.” As though my antipsychotic could just as easily be penicillin. I’ve heard this statement in one form or another for several decades, since my diagnosis at age 29. I don’t accept this mechanistic view of the brain, which suggests that if you pump in drugs (at levels often determined by drug company-funded research), the cogs will start working smoothly again. This model dismisses patients’ individual experience of medications, which vary wildly. © 2020 The New York Times Company

Keyword: Schizophrenia
Link ID: 27067 - Posted: 02.24.2020

Dominique Sisley Nothing is quite as shattering as a broken heart. A bad breakup has been known to trigger a range of psychological and physical symptoms, from nausea and insomnia to clinical depression. In more extreme scenarios, broken heart syndrome – when a person’s heart stops pumping blood properly after an emotional shock – can lead to death. Fortunately, recent breakthroughs suggest we may soon be able to beat it. In March, a Spanish study found propofol, a sedative used for anaesthesia, may also be able to mute the painful memories that come with heartbreak. Participants were injected with the drug immediately after recalling a distressing story and, when asked to recount it again 24 hours later, they found the memory to be less vivid. Advertisement The principal goal of the research was to relieve the symptoms of post-traumatic stress disorder (PTSD), but it seems there may be scope for the drug to be used to suppress other upsetting memories. An unexpected loss such as heartbreak can also be traumatic, and some people report similar symptoms. Dr Bryan Strange, who led the study, says: “Combining anaesthesia with evoking an emotionally charged memory impairs its subsequent recall. We will need to derive a set of criteria that identify people for whom it works well, and where the benefit justifies the risk of anaesthesia. There may well be those for whom heartbreak is so distressing that the criteria is fulfilled.” In the past year, a wave of apps such as Mend, Rx Breakup and Break-Up Boss have been released, promising guidance, advice and distracting activities to help soothe the pain of heartbreak. It is a lofty promise, but one that appears to be rooted in logic: a study in 2017 found similar brain-training style exercises could help curb embarrassing or impulsive post-breakup behaviour and strengthen self-control. © 2020 Guardian News & Media Limited

Keyword: Depression; Sexual Behavior
Link ID: 27066 - Posted: 02.24.2020

By Jade Wu 3 Anxiety-Related Disorders You Might Not Know About Person suffering from trichotillomania, an obsessive compulsive condition where sufferers can't resist pulling their hair out. Credit: Ryan Jackson Getty Images Most people know what it’s like to feel anxious. That tension in your muscles, those butterflies in your stomach, and the drumming of your heart tells you that you’re not calm. And this is totally normal. Where would we be if genuinely dangerous situations like dark alleys at night didn’t give us the heebie-jeebies? And would we take important tasks very seriously if we didn’t get nervous in the spotlight, like when giving a wedding toast? Sometimes, anxiety goes too far and gets in the way of our everyday functioning. It can mess up our health, relationships, work, and fun. It’s not hard to imagine the pain of being plagued by non-stop worries or feeling so shy as to have trouble with dating. But sometimes, anxiety and anxiety-related processes can show up in more unusual ways, even ways that don’t seem at first to have anything to do with emotions. The Diagnostic and Statistics Manual - 5th Edition is the official American Psychiatric Association’s list of psychological disorders. It’s a huge bible detailing everything that’s considered a disorder and how it’s categorized. It takes experts years to update it in response to ongoing scientific findings. Advertisement The Anxiety Disorders section got a big makeover in the last update, which came out in 2013. It’s now split into a few different sections, including Trauma and Stress-Related Disorders and Obsessive-Compulsive Disorders. Some of the less common disorders got shuffled around, some got new names, but experts still agree that the line between categories is blurry at best. Overlapping and related to some of the most common anxiety disorders, such as generalized anxiety disorder and social anxiety disorder, are some that are less well-known.

Keyword: Stress; Emotions
Link ID: 27041 - Posted: 02.14.2020

Jon Hamilton Scientists have taken a small step toward personalizing treatment for depression. A study of more than 300 people with major depression found that brain wave patterns predicted which ones were most likely to respond to the drug sertraline (Zoloft), a team reported Monday in the journal Nature Biotechnology. If the approach pans out, it could offer better care for the millions of people in the U.S. with major depression. "This is definitely a step forward," says Michele Ferrante, who directs the computational psychiatry and computational neuroscience programs at the National Institute of Mental Health. He was not a part of the study. Right now, "one of our great frustrations is that when a patient comes in with depression we have very little idea what the right treatment for them is," says Dr. Amit Etkin, an author of the study and a professor of psychiatry at Stanford University. "Essentially, the medications are chosen by trial and error." Etkin is also the CEO of Alto Neuroscience, a Stanford-backed start-up developing computer-based approaches to diagnosing mental illness and selecting treatments. In the study, researchers used artificial intelligence to analyze the brainwave patterns in more than 300 patients who'd been diagnosed with major depression. Then they looked to see what happened when these same patients started treatment with sertraline. And one pattern of electrical activity seemed to predict how well a patient would do. "If the person scores particularly high on that, the recommendation would be to get sertraline," Etkin says. © 2020 npr

Keyword: Depression
Link ID: 27034 - Posted: 02.11.2020

Catherine Offord The first time Kees van Heeringen met Valerie, the 16-year-old girl had just jumped from a bridge. It was the 1980s and van Heeringen was working as a trainee psychiatrist at the physical rehabilitation unit at Ghent University Hospital in Belgium. As he got to know Valerie, who’d lost both legs in the jump and spent several months at the hospital, he pieced together the events leading up to the moment the teenager tried to end her life, including stressful interactions with people around her and a steady accumulation of depression symptoms. Van Heeringen, who would later describe the experience in his 2018 book The Neuroscience of Suicidal Behavior, says Valerie’s story left a permanent impression on him. “I found it very difficult to understand,” he tells The Scientist. He asked himself why anyone would do “such a horrible thing,” he recalls. “It was the first stimulus for me to start studying suicidal behavior.” In 1996, van Heeringen founded the Ghent University Unit for Suicide Research. He’s been its director ever since, helping to drive scientific research into the many questions he and others have about suicide. Many of the answers remain as elusive as they seemed that day in the rehabilitation unit. Suicide rates are currently climbing in the US and many other countries, and suicide is now the second leading cause of death among young people globally, after traffic accidents. The World Health Organization recently estimated that, worldwide, one person ends their own life every 40 seconds. © 1986–2020 The Scientist.

Keyword: Depression
Link ID: 27032 - Posted: 02.11.2020

By Chris Woolston Sometimes it takes multitudes to reveal scientific truth. Researchers followed more than 7,000 subjects to show that a Mediterranean diet can lower the risk of heart disease. And the Women’s Health Initiative enlisted more than 160,000 women to show, among other findings, that postmenopausal hormone therapy put women at risk of breast cancer and stroke. But meaningful, scientifically valid insights don’t always have to come from studies of large groups. A growing number of researchers around the world are taking a singular approach to pain, nutrition, psychology and other highly personal health issues. Instead of looking for trends in many people, they’re designing studies for one person at a time. A study of one person — also called an N of 1 trial — can uncover subtle, important results that would be lost in a large-scale study, says geneticist Nicholas Schork of the Translational Genomics Research Institute in Phoenix. The results, he says, can be combined to provide insights for the population at large. But with N of 1 studies, the individual matters above all. “People differ at fundamental levels,” says Schork, who discussed the potential of N of 1 studies in a 2017 issue of the Annual Review of Nutrition. And the only way to understand individuals is to study them. Case studies of individuals in odd circumstances have a long history in medical literature. But the concept of a clinical medicine N of 1 study gathering the same level of information as a large study goes back to an article published in the New England Journal of Medicine in 1986. Hundreds of N of 1 studies have been published since then, and the approach is gaining momentum, says Suzanne McDonald, N of 1 research coordinator at the University of Queensland in Brisbane, Australia.

Keyword: Genes & Behavior; Schizophrenia
Link ID: 27027 - Posted: 02.10.2020