RxPG News : Mental Health

Prevalence of personality traits disputed

Wed, 09 Jan 2013 14:26:06 PST

( from http://www.rxpgnews.com ) Washington, Jan 9 - US psychologists have disputed the long-held notion that a group of five personality traits or their variations are a universal feature of human psychology.

However, University of California Santa Barbara - anthropologists have questioned the veracity of that five-factor model - of personality structure, bearing on indigenous populations.

Studying the Tsimane, an indigenous group in central Bolivia, Michael Gurven, professor of anthropology at UCSB, found they did not necessarily exhibit the FFM model, comprising openness, conscientiousness, extraversion, agreeableness, and neuroticism, according to the Journal of Personality and Social Psychology.

The Tsimane live in communities ranging from 30 to 500 people dispersed among approximately 90 villages.

Since the mid-20th century, they have come into greater contact with the modern world although fertility and mortality rates remain high, the study noted.

Previous research has found strong support for what experts refer to as the Big Five in more developed countries and across some cultures, according to an UCSB statement.

But Gurven and his team, which includes Christopher Von Rueden, postdoctoral scholar in anthropology, discovered more evidence of a Tsimane Big Two -- prosociality and industriousness.

These combine elements of the traditional Big Five and may represent unique aspects of highly social, subsistence societies.

Similar to the conscientiousness portion of the Big Five, several traits that bundle together among the Tsimane included efficiency, perseverance, and thoroughness. These traits reflect the industriousness of a society of subsistence farmers, said Gurven.

However, Gurven continued, other industrious traits included being energetic, relaxed, and helpful. In small-scale societies, individuals have fewer choices for social or sexual partners, and limited domains of opportunity for cultural success and proficiency. This may require abilities that link aspects of different traits, resulting in a trait structure other than the Big Five.

Mind-body programme helps women cope better with cancer

Sat, 16 May 2009 12:15:46 PST

( from http://www.rxpgnews.com ) Pathfinders, a mind-body-spirit programme, helps women cope with terminal cancer and improves their quality of life, according to a new study.

'The program helped improve distress and despair during the initial three months and up to six months after diagnosis among women with metastatic breast cancer and a six-month life expectancy,' said Amy Abernethy.

Abernethy, oncologist at Duke University Medical Centre - and lead investigator of the study, obseved that 'though the women were getting sicker and experiencing more symptoms..., they reported... less distress and despair.'

Pathfinders focuses on the seven pillars of personal recovery: hope, balance, inner strengths, self care, support, spirit and life review.

The program provides patient navigation, counselling, coping skills training, mind and body techniques and lifestyle advice.

'The goal... is to teach patients coping skills for dealing with their cancer,' said Tina Staley, director of Pathfinders. 'To reach this goal, we have created a common language between patients, nurses, physicians and Pathfinders for communicating coping skills.'

Researchers enrolled 50 adult breast cancer patients with a prognosis of less than six months survival.

The women met with a Pathfinder, one social worker at least monthly, plus phone conversations and e-mail exchanges, said a DUMC release.

They helped the women identify inner strength, taught them coping skills and encouraged them to engage in complementary and alternative medical services.

The researchers will be presenting their findings at the American Society of

Clinical Oncology in Orlando, on May 31.

'Brain music' can lull your anxieties, sharpen reflexes

Sun, 26 Apr 2009 12:42:20 PST

( from http://www.rxpgnews.com ) Washington, April 25 - Every brain has a sound track, which when recorded and played back to an emergency responder, such as a fire fighter, may sharpen their reflexes during a crisis, and calm their nerves afterward.

The concept of 'brain music' is to use the frequency, amplitude and duration of musical sounds to move the brain from an anxious state to a more relaxed one.

Over the past decade, the influence of music on cognitive development, learning, and emotional well-being has emerged as a hot field of scientific study.

Department of Homeland Security's Science & Technology Directorate - has begun a study into a form of neuro-training called 'brain music' that uses music created in advance from listeners' own brain waves to help them deal with common ailments like insomnia, fatigue, and headaches stemming from stressful environments.

'Strain comes with an emergency response job, so we are interested in finding ways to help these workers remain at the top of their game when working and get quality rest when they go off a shift,' said S&T programme manager Robert Burns.

'Our goal is to find new ways to help first responders perform at the highest level possible, without increasing tasks, training, or stress levels.'

If the brain 'composes' the music, the first job of scientists is to take down the notes.

Each recording is converted into two unique musical compositions designed to trigger the body's natural responses.

The compositions are clinically shown to promote one of two mental states in each individual: relaxation - for reduced stress and improved sleep; and alertness - for improved concentration and decision-making.

Each two to six minute track is a composition performed on a single instrument, usually a piano. The relaxation track may sound like a 'melodic, subdued Chopin sonata', while the alertness track may have 'more of a Mozart sound', says Burns.

After their brain waves are set to music, each person is given a specific listening schedule, personalised to their work environment and needs. If used properly, the music can boost productivity and energy levels, or trigger a body's natural responses to stress.

The music created by Human Bionics LLC is being tested as part of the S&T Readiness Optimization Programme -, a wellness programme that combines nutrition education and Neuro-training to evaluate a cross population of first responders, including federal agents, police, and fire fighters.

Incubator care at birth reduces depression risk in adult life

Sat, 15 Nov 2008 11:12:16 PST

( from http://www.rxpgnews.com ) Toronto, Nov 12 - A Canadian study says babies who receive incubator care after birth are two to three times less likely to suffer depression in their adult life.

The study was conducted by scientists from Montreal University, in collaboration with researchers from Montreal-based Sainte Justine Hospital Research Center, McGill University and Douglas Hospital Research Centre and the Britain-based Institute of Psychiatry at King's College over a period of many years.

The research was undertaken following observations about mammal behaviour where separation between mother and child after birth can lead to behavioural problems in adulthood.

'Our hypothesis was that mother-baby separation resulting from incubator care could heighten depression in adolescence or adulthood,' said study co-author and psychiatrist Richard E. Tremblay of Montreal University Monday.

'Instead, we found that incubator care could decrease the risk of depression two-to-three fold by the age of 21,' he added. It was close to three times for girls.

As part of the study, 1,212 children were recruited from kindergartens. These children had been picked up for another study in 1986.

The researchers obtained reports on their birth condition, obstetrical complications and incubator care from medical records.

After subjecting these participants to psychiatric assessments at the ages of 15 and 21, the researchers found that out of the 16.5 percent babies placed in incubators, only five percent suffered major depression by age 21.

Among those who were not placed in incubators, nine percent developed depression, which is the average rate in society.

The researchers found correlation between decreased depression and incubator care after factoring participant age, weight at birth, family adversity or maternal depression.

They also found that girls were three times less likely to experience depression by the age of 15 if they had received incubator care at birth.

'This difference was due to the fact that more girls experience depression than boys during adolescence and how boys suffer depression in later adolescent years,' said study co-author Frank Vitaro of Montreal University.

According to the researchers, children who received incubator care as babies, received more emotional support from their mothers throughout childhood because they were perceived as more vulnerable.

'Incubator care was not the sole factor that shielded participants from future depression,' said psychiatrist David Gourion of Montreal University.

'We believe that incubator care is a trigger for a complex chain of biological and emotional factors that helped decrease depression,' he said.

The study has been published in the journal Pyschiatry Research.

Shed tears to stay healthy

Wed, 12 Nov 2008 12:21:02 PST

( from http://www.rxpgnews.com ) London, Nov 11 - Are you alexithymic or anhedonic? You may profit from therapeutic interventions to stimulate your lacrimal apparatus. In other words, if you can't feel emotions or are unable to derive pleasure from good experiences, make yourself weep with medical help, scientists across the world advise.

And if you don't suffer from either symptom, carry on weeping still, for good health, they suggest.

Why we cry and what happens when we do is still a mystery, but that hasn't stopped researchers from studying its effects. Their latest research suggests that crying is not only a stress-buster, but is good at healing too.

A clue to the purpose of crying perhaps lies in the experimental finding that emotional tears contain different compounds from regular eye watering, such as that triggered by chopping onions.

Tears associated with emotion have higher levels of some proteins, and of manganese and potassium, and hormones, including prolactin, than mere eye watering. Manganese is an essential nutrient. Too little of it can lead to slowed blood clotting, skin problems, and lowered cholesterol levels.

Potassium is involved in nerve working, muscle control and blood pressure. Prolactin is a hormone involved in stress and plays a role in the immune system and other body functions.

William Frey, professor of pharmaceutics at the University of Minnesota, is quoted by The Independent as saying: 'Because unalleviated stress can increase our risk for heart attack and damage certain areas of our brain, the human ability to cry has survival value.'

New research shows that crying increases arousal of certain body functions to ward off some physiological threats. In support of this theory, some research shows that skin sensitivity increases during and after crying, and that breathing deepens - both considered healthy signs.

'It is possible that crying is both an arousing distress signal and a means to restore psychological and physiological balance,' say researchers at the University of South Florida. Others suggest that emotional tears signal distress and encourage group behaviour, as well as improve social support and inhibit aggression.

Researchers at the University of South Florida found that almost everyone feels better after a cry and that personality has a big effect on how often we cry.

'The overwhelming majority of our participants reported mood improvement after crying. Our results may have also implications for clinical interventions,' the researchers said.

Currently research is underway in several countries on the therapeutic effects of crying. Psychologists at the University of Florida are using scans to locate the areas of the brain involved in crying.

The Tilberg University in The Netherlands is studying the social impact of crying. Researchers at Bunka Women's University and Nagano College in Japan are simulating crying experiences to understand their health values.

The increasing research into crying and its beneficial health effects may also make shedding tears less of a taboo behaviour.

William Frey, author of 'Crying: The Mystery of Tears', says: 'It is no accident that crying has survived evolutionary pressures. Humans are the only animals to evolve this ability to shed tears in response to emotional stress, and it is likely that crying survived the pressures of natural selection because it has some survival value.'

Weeping by numbers:

20 percent of bouts of crying last longer than 30 minutes

8 percent go on for longer than one hour

70 percent of criers make no attempt to hide their crying

77 percent of crying takes place at home

15 percent at work or in the car

40 percent of people weep alone

39 percent of crying occurs in the evening, the most popular time compared with morning, afternoon, and night -

6-8 p.m. is the most common time for crying

88.8 percent feel better after a cry

47: average number of times a woman cries each year

7: average annual number of crying episodes for a man

Depression during pregnancy doubles risk of premature delivery

Fri, 24 Oct 2008 13:33:39 PST

( from http://www.rxpgnews.com ) Washington, Oct 23 - Depressed pregnant women face twice the risk of premature delivery than their counterparts with no such symptoms, according to a new study.

Besides the increased risk of premature delivery, the study found that the risk grows with the severity of the depressive symptoms, among pregnant women.

These findings also provide preliminary evidence that social and reproductive risk factors, obesity, and stressful events may aggravate depression-premature delivery link, according to researchers.

'Premature delivery is the leading cause of infant mortality, and yet we don't know what causes it,' said co-author De-Kun Li, a reproductive and perinatal epidemiologist at Kaiser Permanente's Division of Research in Oakland.

'This study adds to emerging evidence that depression during early pregnancy may interfere with the neuroendocrine pathways and subsequently placental function,' Li said.

'The placenta and neuroendocrine functions play an important role in maintaining the health of a pregnancy and determining the onset of labour,' Li explained.

Because the majority of the women in the study did not use anti-depressants, the study provides a clear look at the link between depression and preterm delivery.

The study, among the first to examine depression and premature delivery in a representative and diverse population in the US, looked at 791 pregnant Kaiser Permanente members in San Francisco city and county from October 1996 through October 1998.

Researchers interviewed the women around their 10th week of pregnancy and found that 41 percent of the women reported significant or severe depressive symptoms, according to a Kaiser Permanente press release.

The women with less severe depressive symptoms had a 60 percent higher risk of premature delivery -- defined as delivery at less than 37 completed weeks of gestation -- compared with women without significant depressive symptoms, and the women with severe depressive symptoms had more than twice the risk.

In addition to being the leading cause of infant mortality and morbidity, preterm delivery is also the leading medical expenditure for infants, with estimated annual cost of about $26 billion in the US alone.

The study is published online in the Oxford University Press' journal Human Reproduction.

Depressed older people risk losing their minds

Tue, 09 Oct 2007 14:30:35 PST

( from http://www.rxpgnews.com ) New York, Oct 9 - Older people who suffer from depression face higher risk of losing intellectual ability, the results of a study conducted in the US show.

Depression is a disorder that affects the functioning of a person in day-to-day life. It is a strong mood involving sadness, discouragement, despair or hopelessness that lasts for weeks, months or even longer.

The study by University of Rochester Medical Centre researchers looked into 700 patients aged 65 years and over for more than two years. The findings of the study suggest that older people who are depressed may be intellectually impaired and lose executive functions, reports science portal EurekAlert.

Researchers looked at loss of executive functions of the participants that involve high-level mental processes such a making decisions, organising, planning and doing a series of things in sequence.

Trained interviewers reviewed each patient's primary care medical chart, recording information about mood and cognitive symptoms, disorders or treatments as well as active and past medical problems and current medications. Psychiatrists and researchers also assessed their levels of cognition, functional status and depression.

The study published in the American Journal of Psychiatry found that depression increased the risk of subsequent mental impairment. The scientists said the depression symptoms could act as predictors of future intellectual decline.

High-quality child care for low-income children offset the risk of later depression

Sun, 20 May 2007 04:00:00 PST

( from http://www.rxpgnews.com ) Young adults from low-income families who were in full-time early educational child care from infancy to age 5 reported fewer symptoms of depression than their peers who were not in this type of care, according to a new report. The early educational intervention also appears to have protected the children to some extent against the negative effects of their home environments.

The report, from the FPG Child Development Institute (FPG) at the University of North Carolina at Chapel Hill, uses data from the Abecedarian Project, a longitudinal study begun in 1972 in which 111 high-risk children were randomly assigned to early educational child care from infancy to age 5 or to a control group that received various other forms of child care. The study is published in the May/June 2007 issue of the journal Child Development.

Research has shown a relationship between poverty in early childhood and an increased risk for mental health problems in adulthood. A number of early intervention programs have been found to enhance the cognitive development and academic outcomes of children living in poverty, but less is known about the long-term effects of these programs on children's mental health.

In the Abecedarian Project, 98 percent of the children were black and all came from low-income families with demographic factors known to predict developmental delays or academic problems. As part of the study, developmental and demographic data were collected regularly during the early childhood years with follow-up assessments in adolescence and young adulthood.

The study followed up with 104 study participants when they were 21 and found that those who had participated in the child care program had fewer symptoms of depression than those who did not.

Early child care also moderated the effects of the children's home environments on subsequent feelings of depression. For children in the control group, the more negative the early home environment, the greater the likelihood of signs of depression.

The early intervention does not appear to have changed home environments, according to Frances A. Campbell, a senior scientist at FPG and one of the authors of the study. Rather, it buffered, or protected, the children from the adverse effects of less-optimal early home environments. This evidence, indicating that good early childhood experiences can make a positive difference in the mental health of individuals born into poverty, underscores the importance of investing in high-quality early childhood experiences for poor children.

Light therapy fights doldrums with sun substitute

Tue, 19 Dec 2006 09:05:18 PST

( from http://www.rxpgnews.com ) Berlin, Dec 19 - It starts when the days get shorter in late autumn and often does not disappear until March: winter depression.

It not only causes sufferers long periods of feeling down, but also is accompanied by other aggravations such as restless sleep, loss of drive and a state of anxiety. Experts say one of the best ways of alleviating the problem is light therapy.

The problem occurs because when the days get shorter and there is less daylight, the body produces more melatonin, a hormone that causes drowsiness.

'A slightly depressed mood during the dark months of the year is nothing unusual,' said Jürgen Zulley, a sleep therapist at the University of Regensburg in southeastern Germany.

As opposed to a normal feeling of melancholy, winter depression is characterised by an added need to sleep, ongoing lack of energy and strength, trouble concentrating and overall diminished vitality.

Malek Bajbouj, psychiatrist at Berlin's Charité university hospital, said a person is said to be suffering winter depression when the depressive state occurs every day, lasts two weeks or longer and when the episodes occur in at least two consecutive years.

Light therapy is the most practical solution, an expert says.

A special lamp is used to provide the sensation of bright sunlight. The therapy can take place at a doctor's office or at home. The lamp's white rays of light shine into the retina, stimulating areas of the brain, which in turn produce the hormone serotonin. A filter blocks out harmful UV rays.

The length of time spent looking at the lamp depends on its strength. Stronger light require just 30 minutes daily, while those with less strength require as much as two hours.

'The best time to use the light is in the morning so that the body recognises that the day has begun,' said Bajbouj. Properly used, the lamp's bright light helps the inner clock regain its timing. The result is clearer thinking, better sleep and the ability to enjoy life to the fullest again.

Thomas Schluepfer, deputy director of the Clinic for Psychiatry and Psychology at the University Hospital in Bonn, recommends that people who suffer winter depression buy their own lamp.

'The whiter the light, the more effective it is,' said Bajbouj, adding that taking a 'light shower' in a solarium can improve someone's mood, but it does not have the hormonal effect of a prescribed light therapy. 'Aside from that the UV rays in solarium light can damage the skin.'

Basically, any natural light source can improve mood. Zulley also recommends moderate exercise in fresh air, preferably for an hour during midday when the sunlight is strongest. Even when it is cloudy, the sunlight is strong enough to make a difference, he added.

Over 50 Vietnamese girls faint due to mass 'hysteria'

Sat, 16 Dec 2006 19:58:33 PST

( from http://www.rxpgnews.com ) Hanoi, Dec 16 - Over 50 Vietnamese girls were hospitalised after they fainted at school, and officials Saturday blamed the incident on an episode of 'mass hysteria'.

'This is the first time such a thing has happened here in the district,' said Luong Thanh Nhan, a policeman in Vietnam's southern An Giang province. 'It was not the food or the environment which caused the incident.'

The director of the medical centre in Thoai Son district said the 51 girls who fainted suffered from 'hysteria', reported the Thanh Nien newspaper. He added that the 'syndrome is commonly found among young, sensitive school girls'.

School and medical officials said the first girl to faint was brought to the Vong Dong Senior Secondary School's nurse Thursday. The five girls that accompanied the 13-year-old to the nurse's office then fell unconscious.

Emergency medical personnel arrived to take the children to hospital. Dozens of students in their classrooms, who saw the girls being carried away, also suddenly collapsed.

Most of the girls were released from the medical centre the same day. But according to Nhan, four students remain in the hospital in stable condition.

'Everyone was so worried about the case,' said Nhan. 'We still don't know what the cause was.'

Feeling poor may be better predictor of mental illness than being poor

Thu, 23 Nov 2006 22:57:00 PST

( from http://www.rxpgnews.com ) More subjective measures of socio-economic position may be needed in order to predict the likelihood of people developing common mental illnesses, such as depression, a UK study has found.

There is a higher prevalence of common mental disorders among people in lower socio-economic groups. However, it is unclear whether low socio-economic position is associated with increased risk of a new episode of mental disorder, or with a worse outcome.

This longitudinal study, published in the August issue of the British Journal of Psychiatry, set out to investigate the issue among the general population. 2406 participants were interviewed at two time points 18 months apart. The sample was divided into two groups, according to whether they had a mental illness at the start of the study or not.

The mental illnesses studied were those most commonly found in general practice and in the community â€“ depression, anxiety, and mixed anxiety and depression.

The measurement of socio-economic position took into account social class, education and standard of living, as well as other variables such as marital status, type of family unit and employment status.

None of the socio-economic indicators studied was found to be significantly associated with an episode of common mental disorder at follow-up, after baseline psychiatric illness was taken into account.

The analysis of separate diagnostic categories showed that subjective financial difficulties at baseline were independently associated with depression at follow-up in both groups.

These findings are consistent with research suggesting that subjective measures of standard of living may be equally important in the relationship between socio-economic position and common mental disorders, compared with more objective measures of income or wealth.

The effects on mental health of objective measures of socio-economic position, such as income or occupational social class, may have been overestimated.

Mental health problems threaten the knowledge economy

Sat, 04 Nov 2006 20:54:00 PST

( from http://www.rxpgnews.com ) In a knowledge economy, people work increasingly with their heads instead of their hands. This makes mental health a crucial component of economic growth. However, the knowledge economy leads to high levels of stress and mental health problems. By damaging its mental capital the knowledge economy undermines the basis for its own success. These are some of the conclusions of the report Mental Capital by Rifka Weehuizen, researcher at UNU-MERIT - a joint research and training centre of United Nations University, and Maastricht University in the Netherlands.

The study: Mental Capital: a preliminary study into the psychological dimension of economic development, was commissioned by the Dutch Council for Health Research.
Weehuizen notes that while this report deals with the situation in the Netherlands, the same is happening in all modern economies.

My research focuses on the Netherlands, but all modern knowledge economies are damaging their human capital to some extent. It is a result of the pressure to be ever more productive. In the industrial sector you can achieve that by putting in more and better machines, but in the service economy the main way to achieve this is by making people work more and more intensely. By giving workers autonomy they have to effectively self-manage and self-regulate, which is much more efficient from the firms perspective, but which adds substantially to the load and pressure of the worker.

In the modern knowledge economy in which increasing numbers of people are working in the services sector - workers need to be autonomous, flexible, adaptive, and able to continuously deal with new circumstances, tasks and knowledge. The increased interaction with customers and colleagues that this requires means that workers need to regulate their emotions and feelings. Research shows that this is difficult for many workers, and it is leading to greater levels of stress and mental health problems.
Mental health is also a major problem in economic terms. In the Netherlands stress and work pressure are the cause of 29 % of sick leave and of 30 % of work disability. Thirty percent of the cost of health care in the Netherlands is directly or indirectly related to metal health problems like work related stress, burn out, depression and other ailments. According to the World Health Organisation (WHO) about 4 % of gross national product (GNP) in countries such as the Netherlands is lost due to the direct and indirect costs of mental health problems.

This may help to explain why ever growing numbers of people in the leading economies appear to be less happy in spite of their increased wealth (the happiness paradox). The study found that what drives economic growth is not necessarily good for the mental health of people. But mental health is essential for further growth, which leads to the question of what the net result will be of our attempts to grow even more. Even from an economic perspective this may not be the optimal strategy.

Policy measures Governments should therefore invest more in the mental capital of their economies by putting more money into treatment of mental health related problems and, even more important, into prevention.

Weehuizens research shows that even in a small country like the Netherlands this would result in savings of billions of euros.

Each euro spent on treatment of mental health related problems saves 20 to 30 Euros in future costs, that would occur without effective treatment. Prevention is even more cost effective. Research shows that currently 45 to 70 % of people with mental health related problems in European countries do not receive effective treatment.

She outlines a long list of needed measures: Parents and education should be teaching young people more coping skills. Self-awareness and cognitive, social and emotional skills have to be increased to make workers better able to function in the knowledge economy. The human resource departments of companies should extend their policies to prevent mental health problems. Quite often they only react, after the problems have arisen. Mental resilience of workers is a critical success factor of an organisation.
Weehuizen also points out that this is not only an issue for rich countries such as the Netherlands. Many developing countries are facing poverty and conflict - major stress factors that are leading to mental health problems and a lack of self-efficacy.

People learn that they do not control their own fate, and this does not give them the optimal psychological profile for economic development which requires optimism, trust and taking risks. The mental capital of developing countries is something we should think more about.

More generally, if the development strategies adopted by rich countries have not resulted in healthy economic development, meaning maximally contributing to the well-being of people, then developing countries should be wise to find out why this is so, before blindly trying to follow the same path.

Raine Study: Breastfeeding boosts mental health

Sat, 28 Oct 2006 05:41:00 PST

( from http://www.rxpgnews.com ) A new study has found that babies that are breastfed for longer than six months have significantly better mental health in childhood.

The findings are based on data from the ground-breaking Raine Study at the Telethon Institute for Child Health Research, that has tracked the growth and development of more than 2500 West Australian children over the past 16 years.

Researcher Dr Wendy Oddy said there was growing evidence that bioactive factors in breast milk played an important role in the rapid early brain development that occurs in the first year of life.

"Even when we adjust the results to take into account other factors such as the parents' socio-economic situation, their education, their happiness and family functioning, we see that children that were breastfed for at least six months are at lower risk of mental health problems," Dr Oddy said.

The study found that children who were breastfed for less than six months compared to six months or longer had a 52% increased risk of a mental health problem at 2 years of age, a 55% increased risk at age 6, at age 8 the increased risk was 61% while at age 10 the increased risk was 37%.

The analysis is based on a scientifically recognised checklist of child behaviour that assessed the study children's behaviour at 2, 6, 8 and 10 years of age.

Dr Oddy said that children that were breastfed had particularly lower rates of delinquent, aggressive and anti-social behaviour, and overall were less depressed, anxious or withdrawn.

"These results are powerful evidence for more support to be given to mothers to help them breastfeed for longer," she said.

Online video games found to promote sociability

Sat, 19 Aug 2006 21:39:00 PST

( from http://www.rxpgnews.com ) Hang in there, parents. There is some hopeful news on the video-gaming front. Researchers have found that some of the large and hugely popular online video games although condemned by many as time-gobbling, people-isolating monsters actually have socially redeeming qualities.

In theory, anyway. After examining the form and function of what's known in the trade as MMOs massively multiplayer online video games an interdisciplinary team of researchers concludes that some games "promote sociability and new worldviews."

The researchers, Constance Steinkuehler and Dmitri Williams, claim that MMOs function not like solitary dungeon cells, but more like virtual coffee shops or pubs where something called "social bridging" takes place. They even liken playing such games as "Asheron's Call" and "Lineage" to dropping in at "Cheers," the fictional TV bar "where everybody knows your name." "By providing places for social interaction and relationships beyond the workplace and home, MMOs have the capacity to function much like the hangouts of old," they said. And they take it one step further by suggesting that the lack of real-world hangouts "is what is driving the MMO phenomenon" in the first place.

Steinkuehler is a professor of education at the University of Wisconsin at Madison, and Williams is a professor of speech communication at the University of Illinois at Urbana-Champaign. The term "third places" was coined in 1999 by sociologist Ray Oldenburg to describe the physical places outside the home and workplace that people use for informal social interaction. Steinkuehler and Williams argue that online spaces, such as those found in MMOs, should also count as third places for informal sociability, "albeit new and virtual places." MMOs are graphical 2- or 3-D videogames that allow players, through their self-created digital characters or avatars, to interact with the gaming software and with other players, to build "relationships of status and solidarity." While still in-game, players can hold multiple real-time conversations with fellow players through text or voice.

The games the researchers studied "Asheron's Call I and II" and "Lineage I and II" represent "a fairly mainstream portion of the fantasy-based MMO market," the authors wrote, where rewarding players for cooperation and the formation of long-term player groups or "guilds" is part of the game. Game play in MMOs is not a "single solitary interaction between an individual and a technology," the researchers wrote, "but rather, is more akin to playing five-person poker in a neighborhood tavern that is accessible from your own living room." Steinkuehler and Williams also found that participation in such virtual third places "appears particularly well suited to the formation of bridging social capital social relationships that, while not usually providing deep emotional support, typically function to expose the individual to a diversity of worldviews," they wrote. "In other words," Williams said, "spending time in these social games helps people meet others not like them, even if it doesn't always lead to strong friendships. That kind of social horizon-broadening has been sorely lacking in American society for decades."

Over the last few years, Williams has published a number of studies that have challenged the common and mostly negative beliefs about game playing. For his work on online games as third places, Williams drew on an earlier study of "Asheron's Call," for which he combined survey research and experimental design and focused on "issues of social capital and real-life community," he said. He even played the game and conducted 30 random interviews, asking players about their motivations for playing, their in-game social networks and their life outside the game. "There were both positive and negative outcomes," he said.

In her earlier study of cognition and learning in MMOs, Steinkuehler conducted a two-year ethnography of the "Lineage" games, her goal being to explore the kinds of social and intellectual activities in which gamers routinely participate, including individual and collaborative problem solving, identity construction, apprenticeship and literary practices. She conducted repeated interviews of 16 key informants throughout the study. Their overall conclusion in this newest study: "Virtual worlds appear to function best as bridging mechanisms, rather than as bonding ones, although they do not entirely preclude social ties of the latter type."

While they continue to draw fire from many critics, MMOs attract more than 9 million subscribers worldwide, who spend on average 20 hours a week "in-game."

"To argue that their MMO game play is isolated and passive media consumption that takes the place of informal social engagement is to ignore the nature of what participants actually do behind the computer screen," the authors wrote. Still, they suggest that heavy game play might not be healthy in the short term for people who need strong connections, since it could take the place of strong offline relationships. "It's really a question of what kind of balance the person has in their life," Williams said. "For that reason, online spaces are not a one-size-fits-all phenomenon that can simply be labeled 'good' or 'bad.' " The authors suggest that now may be a good time to reconsider how new media are affecting people. "Perhaps it is not that contemporary media use has led to a decline in civic and social engagement, as many have argued, but rather, that a decline in civic and social engagement has led to a 'retribalization' through contemporary media."

Drug approval processes may have delayed warnings about safety of Paroxetine

Mon, 10 Jul 2006 07:24:00 PST

( from http://www.rxpgnews.com ) Drug approval processes may have delayed warnings about the safety of antidepressants, argues a senior doctor in this weeks BMJ.

Following GlaxoSmithKlines recent letter to doctors pointing to a sixfold increase in the risk of suicidal behaviour in adults taking paroxetine, Professor David Healy examines the regulation of selective serotonin reuptake inhibitors (SSRIs) and asks were mistakes made and could they have been avoided?

In February 1990 an article raised concerns that the recently licensed fluoxetine might trigger suicide acts in depressed patients. Subsequent trials showed a doubling of rates of suicidal acts between active treatment and placebo, but it was only in a recent study reviewing over 700 trials that this difference became significant.

This trend should have been seen by both companies and regulators as something that required investigation, writes the author.

Trials in children conducted from the mid-1990s also show a doubling of the risks of suicidal acts with SSRIs. These results have recently formed the basis of warnings about the use of SSRIs in children. Trials in adults show a similar risk ratio yet, until May 2006, no warnings were issued for adults.

Although data submitted to the FDA show an excess of suicides with every antidepressant licensed since 1987 compared with placebo, this simple but crucial finding continues to be obscured, he says.

He also examines the way in which the data were presented to regulators by manufacturers, and suggests that inappropriate inclusion of suicidal acts in the placebo group biased estimates of suicide risk. Subsequent rigid interpretation of these data by the regulators may have delayed warnings of dangers of suicidal acts, he adds.

Having re-analysed the evidence, he suggests that the best estimate for the likely risk of suicide on SSRIs over placebo is 2.6 (more than double the risk) and he calls for suitably powered studies to settle the issue.

He also believes that greater data transparency and statistical sophistication might lead to earlier research to discriminate between those who do well on new drugs and those who do not.

The regulators seem stuck in a world where balancing evidence of potential benefit against actual risk causes real problems, he writes. The SSRI and rofecoxib disasters have harmed public confidence in drugs. We urgently need to learn how to regulate both the risks and benefits of new treatments more effectively.

BMJ Editor, Fiona Godlee also touches on this issue in her Editor's choice column. She talks of "an overpowerful under-regulated drug industry and a research establishment and publishing industry in its thrall." A radical solution would be to stop allowing drug companies to evaluate their own products. Is this feasible? Is it the answer? she asks.

Living in the past indicates dissatisfaction with present

Sat, 01 Apr 2006 19:14:00 PST

( from http://www.rxpgnews.com ) It might seem quite natural for the elderly to often slip happily into reminiscence but living in the past could indicate dissatisfaction with the present, says psychologists.

This phenomenon becomes a problem when an elderly relative starts living completely in the past and ignores the present. While some might welcome a break from older relatives repeating boring old yarns, it is not a normal symptom of ageing.

People who are unhappy with their surroundings might find it easier to retreat into the past. Studies have shown that older people with a positive self-image and perception of others enjoy the present more.

Indeed, there are many reasons why the past is so important to many senior citizens.

"As one ages, one is more physically limited, not as mobile and has problems seeing and hearing," says Jochen Tenter, specialist in clinical geriatry.

For many, life becomes less exciting. Lacking stimulus, people tend to focus on their inner life. "They can rely on that. It is dependable and no one can take it away," explains Tenter.

Society also often contributes to the problem.

"Elderly people are often marginalised because they cannot participate in life as actively as young people," observes Georg Adler, director of the Central Institute of Mental Health in Mannheim, Germany.

"If older people are fully valued and taken seriously, then they go about their lives and the present day much more positively. Memories and old stories are not necessarily bad," states Ursula Lehr, gerontologist and honorary chairwoman of the Federal Working Group on Seniors' Organisations (BAGSO) in Bonn.

"Many people begin to take account of their lives as they get old, and that dredges up a lot of memories," explains Lehr. It only becomes problematic for children and grandchildren when the same stories are told over and over again and only a proactive approach will help.

"If you are really interested in the stories, ask for details. That makes it more interesting for the storyteller," suggests Tenter.

"A person repeats everything if he gets no feedback," explains Lehr. Instead, annoyed relatives should make it clear whether they already know the stories.

It would be better to say, "You have told me that so often already," advises Tenter.

Instead of living silently in the past, older people should seek contact with the younger generation. "Inter-generational contacts are advisable to put a stop to the past-oriented thinking," said Tenter. Additionally, it has been shown that contacts with unfamiliar people are also helpful.

"That way you get new impressions and maybe get to play a new role."

Psychologists and gerontologists also recommend that middle-aged people should be sure to maintain contacts and keep their spirits up. "That can mean games, dancing, sports or advanced crossword puzzles," recommends Tenter.

Further, Lehr says that elderly should keep themselves abreast of current affairs. "Old people should read a newspaper, watch the news, make dates and then discuss it all."

However, old stories should not be lost under any circumstances. "Young people should ask older people to write down their experiences and impressions," advises Lehr.

After all, telling old stories from old times is not just an expression of boredom or dissatisfaction.

So young, so sad, so listen - Relaunched

Fri, 02 Sep 2005 02:33:00 PST

( from http://www.rxpgnews.com ) The Royal College of Psychiatrists is relaunching this highly popular cartoon-illustrated* book, first published in 1995, with a new Foreword by Philip Pullman, acclaimed author of the trilogy His Dark Materials and other works.

So Young, So Sad, So Listen was written for parents and teachers of young people with depression. The authors hope that social workers, health visitors and family doctors will also find it useful, as well as some teenagers themselves.

The aim of the book is to help those involved to recognise the signs of depression in the young and to understand the possible causes. The authors, psychiatrist Philip Graham and psychotherapist Carol Hughes, provide practical advice and information about the wide range of help and support available.

In his Foreword Philip Pullman describes depression as "a savage and merciless disease". "Whatever the cause and wherever it comes from, if depression strikes you when you're young it strikes very hard indeed."

Around 5 in 100 teenagers in the UK are seriously depressed, and at least twice that number show significant distress. In troubled inner-city areas, the level of depression among the young may be twice this. As many as 2 or 3 girls in every 100 make a suicide attempt at some time during their teenage years.

Carol Hughes underlines the importance of listening to the young person with depression. "Try listening with the heart and not just the ears... Behind every attention-seeker is a real problem that perhaps the child needs to dramatise in order to ensure an audience."

She gives some basic ideas on how to be emotionally available to young people (which is a surprisingly difficult task), and advises on how to access further specialist help if home, school and GP support prove not to be enough.

Carol Hughes also highlights the difficult area of 'secrets' or 'confidentiality', where for instance a young person begs a well-meaning friend to keep quiet about their depression. This can be a potentially very dangerous position to be in, with the confidante becoming isolated, out of their depth and overwhelmed perhaps with secret details of suicidal intentions.

So Young, So Sad, So Listen reviews the range of talking treatments available, from cognitive-behavioural therapy to family or group therapy, and individual psychoanalytic psychotherapy. Although physical treatments are usually less important than talking treatments, they are sometimes helpful and can occasionally turn out to be the most important part of the treatment.

There have been a number of concerns aired publicly about giving young people antidepressant tablets or other drugs used to treat depression in adults. Prof. Graham outlines the limited but definite place of medication in treating depression in the young, always taking into account the need for very careful monitoring.

What happens to depressed children and young people? Some, with milder forms of depression, will improve over weeks or months, especially if their problems are recognised and they receive sympathetic help. More serious forms of depression may not fare as well, and perhaps as many of half of those will go into adult life with a high likelihood of recurrence.

But the authors conclude that there is always much that can be done to help a depressed child or teenager, as well as other members of the family.

Mental health charity warns of consequences of online gambling

Mon, 27 Jun 2005 21:35:00 PST

( from http://www.rxpgnews.com ) Poker websites and other online gambling services may be exciting investors at the moment, but there may be dangers for online gamblers, warns a mental health charity.

The Mental Health Foundation is concerned that online gambling could create problems for some individuals, with potentially serious consequences. In light of this, the charity has created new on-line resources for people who may be experiencing problems with gambling.

Andrew McCulloch, Chief Executive of the Mental Health Foundation says:

"Many, many people, including young people, are gambling from the comfort of their own homes, or from work. For some, occasional gambling that becomes an addiction can lead to problems -: not just debt, but relationship breakdowns and problems at work."

"Players can become isolated, avoiding social contact with family members, friends and colleagues, and lose interest in other activities. Compounded with financial worries, the mental health implications are serious, and charities like the Mental Health Foundation need to offer their support."

Patients may be just as happy as those without major medical conditions

Thu, 10 Feb 2005 18:17:00 PST

( from http://www.rxpgnews.com ) Despite what able-bodied healthy people might think, people with severe illnesses and disabilities don't wallow in misery and self-pity all the time.

In fact, a new study finds, such patients on the whole may be just as happy as those without major medical conditions.

The finding adds to the growing body of evidence that ill and disabled people adapt to their condition and show a resilience of spirit that many healthy people can't imagine. It's published in the new issue of the Journal of Experimental Psychology: General by a team led by University of Michigan Health System researchers.

The researchers made their surprising finding by having 49 pairs of dialysis patients and healthy people report their mood every few hours for a week, using a handheld personal digital assistant (PDA) such as a Palm. The patients had all been in dialysis for at least three months, visiting a hemodialysis center three or more times a week for hours at a time to have their blood cleaned because their kidneys had failed.

Lead author Jason Riis, a former U-M graduate student now at Princeton University, programmed the PDAs to beep randomly during each two-hour period of an entire week, and prompt participants to report their mood at those random moments by completing a quick series of ratings.

"The big advantage of using PDAs is that you can get representative snapshots of a person's experience, rather than just relying on their overall impressions of their lives," says Riis, adding that several studies have shown such overall impressions to be biased in a variety of ways. "Our snapshots revealed that the patients were in good moods the vast majority of the time, and that their moods were not substantially worse than those of the healthy people."

"This is further evidence that people adapt emotionally to serious adversity, such as end-stage kidney failure," says senior author Peter Ubel, M.D., a U-M professor of internal medicine and psychology, and a staff physician at the VA Ann Arbor Healthcare System. "People who haven't experienced such adversity assume that it would destroy their happiness when in truth it probably would not."

In fact, the researchers found that the healthy participants grossly underestimated the extent to which patients can adapt to dialysis. When asked to imagine that they were themselves dialysis patients, and to estimate the percentage of time that they would experience various positive and negative mood levels, the healthy participants assumed that they would be miserable.

They thought they would experience negative moods most of the time, and on average have moods that were much lower than what the real patients actually experienced.

Interestingly, the patients themselves seemed to underestimate their own adaptation. When asked to imagine the moods they would experience if they had never experienced kidney failure, the patients estimated that they would experience much better moods than those actually experienced by the healthy study participants.

The study involved healthy participants whose age, gender, race and education were similar to the patients. In all, 60 participants were white, 36 were black, and one was Hispanic.

The study does more than just give the first-ever glimpse into the hour-by-hour happiness of seriously ill and healthy people, Ubel notes. It may also help influence policy-level and personal decisions about treatments for serious illnesses.

For instance, someone who has been healthy but who is facing a decision about whether or not to have a colostomy, an amputation or a risky operation might worry that the procedure would make his or her life miserable. But in fact, it probably wouldn't.

That's not to say that a major health catastrophe doesn't change a person's life, nor that going on dialysis, losing a limb or using a wheelchair doesn't change a person's experience of life, Ubel says. It's also not to say that such a major change wouldn't come without periods of frustration and difficulty, risk of depression or effects on a person's social or economic situation.

But the evidence from the new study, and from studies before it, suggests that people who have gone through such changes tend to adapt their emotional response to their new life. In the words of some of Ubel's patients, "What use is there in complaining?"

"People are more resilient than they think they can be, and can get through things that they probably would have never thought they could," says Ubel. "The fact that people seem to be so poor at estimating the effect of illness on mood calls into question some of the ways we use such quality-of-life estimates in policy making and research."

In addition to recording the "snapshots" of mood, and the predictions of what life would be like in the other group's shoes, the researchers also had the patients and healthy controls recall the moods they had experienced during the week they had carried the PDA. While healthy people slightly underestimated their previous week's average mood, the patients were quite accurate in recalling theirs. The researchers speculate that the patients' recall accuracy may be involved in the adaptation process, but say that further research is needed on this area.

The researchers now hope to expand the use of moment-based well-being measures to assess people with a range of health conditions, including those associated with pain and mental illness, where the adaptation story many be quite different.

There was no difference between the 49 patients and the 49 healthy participants in the average hour-by-hour rating of their overall mood, which on the whole tended to be on the positive side. There was also no difference between the two groups in the average measures of specific momentary moods, such as "depressed," "pleased" or "worried/anxious." Even questions about pain, tiredness and overall life satisfaction showed no significant differences.

Royal College of Psychiatrists welcomes nice guidelines and MHRA advice on prescribing of SSRI medication in adults

Tue, 07 Dec 2004 06:04:00 PST

( from http://www.rxpgnews.com ) The Royal College of Psychiatrists welcomes the much-awaited publication of the National Institute for Clinical Excellence (NICE) guidelines for Depression and Anxiety, and are pleased that the Medicines and Healthcare products Regulatory Body (MHRA) are now able to communicate its verdict on the safety of Selective Serotonin Reuptake Inhibitors (SSRIs) and newer antidepressant drugs for adults.

BACKGROUND
Large numbers of people have gained benefit from the use of SSRIs and related drugs, and for most people they appear to be free from the more serious side-effects. In recent years, there has been a great deal of uncertainty and concern amongst large groups of patients about the use of SSRIs, and clarity about the evidence for efficacy and safety has been needed.

It is essential that people with depression, their carers, and clinicians, are able to make treatment decisions on the basis of a full appraisal of all the evidence about efficacy and safety. This is a crucial step in improving confidence in clinical decision-making and the development of evidence-based guidelines.

NICE GUIDELINES
The NICE guideline on depression, based upon the published evidence, suggests that SSRIs are effective treatments for moderate to severe depression. The guidelines developers have not, however, been able to access all unpublished trials.

The new NICE guidelines, incorporating the advice from the MHRA, now recommend greater caution in the use of SSRIs, including more intensive monitoring, especially when prescribing these and related drugs for younger adults (18 - 30 years), who may be at higher risk of developing suicidal thoughts, particularly in the first month or so of treatment.

The College welcomes the recommendation that patients will also need to know of the risks of withdrawal/discontinuation, as these may occur on stopping these drugs or when reducing the dose.

With these (and other) cautions in place, we believe that patients and clinicians will feel more confident about the safe use of these drugs.

MHRA ADVICE
The College considers it is very important that the MHRA has based its report upon both published and unpublished trials, and has made considerable effort to procure all the unpublished trials held by some of the pharmaceutical industry.

We therefore have some concerns that the MHRA has not been able to examine all the evidence upon which this guidance should be based, at least for some of the drugs considered.

It is also unclear whether there has been an adequate examination of the efficacy of the SSRIs and related newer drugs.

The Royal College of Psychiatrists stands by its evidence to the Parliamentary Health Select Committee last month on the role of the pharmaceutical industry, which began:

'The decision to give/receive treatment should be based upon the balance of risks and benefits. If the benefits outweigh the risks, the treatment is worth considering. If the risks outweigh the benefits, alternative treatments should be sought. To make a decision to give/receive a treatment, the doctor and patient should know about ALL the risks and potential benefits of the treatment.

Most of our knowledge about the benefit and harm associated with any drug comes from clinical research undertaken by drug companies. If pharmaceutical companies only publish clinical research that is positive, and hold back on publishing clinical research which is negative (selective reporting), then patients may well be given treatments which, unknown to either the patient or the doctor, are likely to do more harm than good.'

The Royal College of Psychiatrists is particularly pleased that the MHRA, NICE and the National Collaborating Centre for Mental Health1 will be meeting in the new year to review the current problems in accessing full safety and efficacy data, and to address the uncertainty this creates for patients, for carers, and for guideline developers.

We look forward to working with these organisations, in whatever way we can, to improve current uncertainties and to support these organisations in their efforts in strengthening confidence in the evidence base upon which clinical decisions and guidelines are currently developed.

Internet therapy for depression

Mon, 04 Oct 2004 15:40:00 PST

( from http://www.rxpgnews.com ) Little is known about the effectiveness of educational interventions for reducing the stigma associated with depression. A new study from Australia has found that the internet can offer an opportunity for people with depression to access programmes that reduce personal stigma.

Published in the October issue of the British Journal of Psychiatry, the study set out to investigate the effects on stigma of two internet depression sites.

A sample of 525 people with raised scores on a depression assessment scale were randomly allocated to a depression information site (BluePages), a cognitive-behavioural skills training website (MoodGYM), or an attention control condition.

The BluePages website provided information about depression, symptoms, sources of help, treatments and prevention. It stated that depression is as disabling as multiple sclerosis, can and should be treated, and stressed the importance of seeking help. The site included biographies of famous people with depression.

The MoodGYM website consisted of five interactive modules covering cognitive therapy, behavioural methods for overcoming negative thinking, relaxation, problem solving, assertiveness and self-esteem training, and strategies for coping with relationship break-up.

Participants were directed to read a different specified module of both sites each week for five weeks, and were in weekly telephone contact of ten minutes with an interviewer who monitored their progress.

The control intervention involved five weekly telephone contacts of 10 minutes with an interviewer, who asked open-ended questions about factors that might influence depression, including physical and artistic activities, hobbies and educational activities, relationships, social support, financial management, work stress and relationships, health and nutrition and alcohol intake.

Personal stigma (personal stigmatising attitudes to depression) and perceived stigma (perception of what most other people believe) were assessed before and after the intervention.

It was found that, relative to the control, the internet sites significantly reduced personal stigma, although the effects were small. BluePages had no effect on perceived stigma, but MoodGYM was associated with an increase in perceived stigma relative to the control.

The authors of the study comment that whatever mechanism led to increased perceived stigma in the MoodGYM group, it did not influence their personal views. It may be advisable for clinicians delivering cognitive-behavioural therapy to consider strategies for reducing perceived stigma.

Interestingly, the control group showed a decrease in perceived stigma. Whereas interviews with the internet participants focused on programme activities and feedback, questions asked of control participants related to their own personal experiences. Perhaps the experience of talking to another, non-judgemental person affected participants' perceptions about the attitudes of others.

Changes in personal stigma were not related to changes in depressive symptoms. Controlling for intervention, neither were theses changes connected to depression literacy nor to cognitive-behavioural therapy literacy.

The authors of the study conclude that depression literacy and cognitive behavioural therapy programmes can be helpful in decreasing personal stigma in people with depression. The internet offers an opportunity to disseminate such programmes widely and at low cost, but further research is needed.

Reference:
Griffiths KM, Christensen H, Jorm AF, Evans K and Groves C (2004) Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: Randomised controlled trial, British Journal of Psychiatry, 185, 342-349.

Assessment following self-harm in adults

Thu, 30 Sep 2004 21:03:00 PST

( from http://www.rxpgnews.com ) Assessment following self-harm in adults is a new report from the Council of the Royal College of Psychiatrists. It updates the College's 1994 report, The General Hospital Management of Adult Deliberate Self-Harm, modifying its recommendations in the light of developments that have occurred over the last ten years in national policies and research.

Mental illness is an important contributing factor to suicide and self-harm, and age and substance misuse also have an influence. Self-harm is a significant problem and requires the co-ordinated input of a number of agencies, including acute medical and psychiatric care. It is a common cause of admission to hospital.

Services for patients who have self-harmed have changed in the past decade. Fewer people are now admitted to hospital, and specialist mental health nurses increasingly have a primary role in assessment and management.

Good services for the treatment of self-harm potentially have an important role in suicide prevention. However, there are gaps between existing services and recommendations for best practice, despite a range of policy initiatives.

The new report identifies consensus standards for assessment following self-harm, as well as competencies that are expected of both generalist and specialist staff.

Standards are described for the organisation and planning of self-harm services, for procedures and facilities, and for training and supervision. These are specified for the accident and emergency department, the general hospital, the community setting and the psychiatric in-patient unit.

Detailed advice is given for particular patient groups: the intoxicated patient, the 'repeater', and the patient who is reluctant, or appearing, to refuse intervention. The specific risks associated with older people are also highlighted.

The report suggests managerial standards for a self-harm services planning group or co-ordinator. It is recommended that these standards, like the clinical standards, are used as a basis for audit and quality monitoring.

Suggested standard assessment tools, and an algorithm describing consent and capacity issues, are also included in the report.

New council report on psychiatric services for children and adolescents with learning disabilities

Thu, 30 Sep 2004 20:59:00 PST

( from http://www.rxpgnews.com ) The Royal College of Psychiatrists has issued a new report, Psychiatric services for children and adolescents with learning disabilities. It is a joint report between the Faculty of Child and Adolescent Psychiatry and the Faculty of the Psychiatry of Learning Disability.

The report is intended to inform the negotiations between service commissioners and the clinicians and general managers of psychiatric services that provide for these young people.

Changing circumstances across the UK, with an emphasis on comprehensive child and adolescent mental health services, have led to this revision of an earlier report. The shift in provision of care from hospital to the community has changed the pattern of service, encouraging young people to remain at home. Hospital places are often restricted to those over the age of eighteen.

As a result, other institutions have developed, particularly childrens homes and residential schools. At times, lack of clarity about management responsibilities has led to uncertainty and delay in the provision of mental health services for children in the care of (for example) the home authority and the institution.

Falling between the services provided by learning disability psychiatry and mainstream child and adolescent psychiatry, many children with learning disabilities have been dealt with by the community paediatrician.

The steady progress towards inclusion appears likely to lead to fewer specialised settings, a reduced tolerance for difficult behaviour and an increased demand on treatment services. Community services that have been based on special schools will need to extend and change their style to provide for a more diffusely scattered population.

This report is intended as a draft standard specification to be adapted for local need by those responsible for developing crucial local, specialised psychiatric services for young people with learning disabilities and their families. It complements a variety of recent policy initiatives across the UK and in Ireland.

The report reviews the resources required for a psychiatric service to young people aged under 18 and their families. Starting with an overview of their psychiatric needs, the nature of the disorders and the variety of forms of intervention, it describes the characteristics of a model service.

Whilst the report focuses on the psychiatric aspect of care, it recognises that such a service must be multidisciplinary and multi-agency, and therefore must be seen within the wider range of services supporting mental health. These include education, social services, community child health and other agencies, such as the employment support group Connexions.

The report is written for anyone involved in, or planning to develop, a psychiatric service for young people with learning disabilities.

SSRI "addiction is a myth"

Sat, 10 Jul 2004 22:51:00 PST

( from http://www.rxpgnews.com ) Up to two out of three people who come off modern anti-depressants suffer short-term withdrawal symptoms including dizziness, nausea and low mood. But it is impossible for anyone to become addicted to SSRIs, the Royal College of Psychiatrists heard today.

"Worries about addiction have arisen because doctors mistake these withdrawal symptoms for continuing depression and put people back on antidepressants, instead of reassuring them that the symptoms will soon go,' Dr Peter Haddad, a psychiatrist at the Community Mental Health Centre in Manchester, told the College's annual conference. "Typically the symptoms stop immediately the drug is restarted which gives people the impression that they are addicted.

But Dr Haddad said that dependency in the sense of having a powerful urge to continue a drug, often for more gratification, does not happen with SSRIs. Antidepressants do not have street value. People do not forge
prescriptions for fluoxetine. Nor do they register with multiple GPs, turn up at A&E departments to get more supplies or lie in bed craving an antidepressant,' he said. "As long as it is used widely, antidepressants have clear benefits, allowing people to get on with their lives.'

But he admitted there could be problems, perhaps explaining why thousands of people went on to websites to saying they were addicted to SSRIs. "I have seen people with apparently intractable withdrawal symptoms but I am always able to help them come off the drug eventually.' He said people needed reassurance that the symptoms were temporary. If necessary, the drug could be restarted and then doses could be reduced slowly.

Campaign Launched To Help Carers of People with Mental Health Problems and Learning Disabilities

Wed, 14 Jan 2004 00:14:00 PST

( from http://www.rxpgnews.com ) Carers are the invisible army that supports millions of relatives and friends who cannot look after themselves.
There are an estimated 6 million carers in the UK

13 million people can expect to become carers over the next decade

1 in 10 adults in the UK is a carer, and nearly half are men

80% of carers say that caring has had an adverse effect on their health
The Royal College of Psychiatrists and The Princess Royal Trust for Carers have joined together to mount a year-long campaign designed to help carers of people with mental health problems and learning disabilities.

The campaign will be launched on January 13th 2004 in the presence of Her Royal Highness The Princess Royal. It will highlight the problems faced by carers of all ages, including children and adolescents, and will aim to encourage constructive partnerships between carers, patients and professionals.

Carers play a vital role in looking after, and promoting the well-being of, people with mental health problems and learning disabilities, and the campaign will emphasise that carers responsibilities need greater recognition.

Unfortunately, carers themselves can suffer from mental health problems, often because of lack of support. They need to know that specialist help is available for them.

Partners in Care plans a number of campaign activities during 2004, including a booklet on confidentiality; leaflets on mental health problems aimed at carers and also at the professionals who deal with them; a training video and CD-ROM; a booklet for young carers; a Christmas debate for young people; checklists for carers, patients and professionals to let them know what questions they need to ask; training for professionals; and regional and local activities to generate interest and help promote the campaign across the country.

It is estimated that, overall, carers save the government £57 billion each year, says Dr. Mike Shooter, President of the Royal College of Psychiatrists and Co-Chair of the campaign. Yet they struggle for recognition and help for themselves.

Mental health professionals need to understand that carers carry the most intimate responsibility for the patients welfare. Their voice in decision making about

admission to hospital and discharge, for instance, is ignored at everyones peril and yet so often is.

Peter Tihanyi, Head of Policy at The Princess Royal Trust for Carers and the other Co-Chair of the campaign, believes that there is much to be done to improve communications between carers, those they care for, and professionals.

By making a concerted effort to work together to become true partners in care - we aim to make a real difference to the quality of life of carers, he says. It is our hope that this campaign will raise their profile and lead to better recognition and improved care for them.

The Nature of Panic a walk though fear in pictures & words

Sat, 10 Jan 2004 23:17:00 PST

( from http://www.rxpgnews.com ) A panic attack is a sudden rush of fear that comes out of the blue, often with no apparent trigger. Panic attacks are not uncommon: estimates range from one in four to one in 10 of us being affected at some time, with some developing chronic panic disorder. Fear of fear, apprehension about this apparently incomprehensible experience, can become crippling.

Patrick Olszowski has a different experience, as he desperately tries to conceal what he considers to be a shaming weakness. As he says Rocks fill my stomach, butterflies flit. Inside my head is torment. Im in front of you, and yet I wont let you see whats going on.

Panic attacks have been part of Patricks life since he was 15. In this exhibition, visitors are invited to walk through the physical symptoms of an attack and the emotions which surround them in a series of photographs taken from the natural world.

Patrick explains: Panic is a natural phenomenon which goes awry. If someone pulls a gun on you, a whole load of reactions help you protect yourself. Ive got used to having all these feelings with no stimulus. I carry a camera with me everywhere, and these photographs reflect a lot of the ways I feel. The fire at the beginning of an attack [see image accompanying this press release] a mesh of branches against a greying sky as the fears escalate until they feel huge and intractable, the calm after the storm.

Medical writer Sophie Petit-Zemans commentary accompanies the photographs, describing Patricks feelings at each stage of an attack, and their physiological basis is also explored. This writing challenges the belief that panic is incomprehensible and provokes thought about the diverse theories of cause and treatment for panic attacks.

As Sophie explains: Theres a lot of science out there about panic, but how does it all fit together? It seems to run in families, but is this due to genes or environment? It seems to be sometimes linked to major life events, but also stem from events in childhood. How come? Some people find medication helpful, while others swear by talking treatment, and researchers have suggested disruptions in a whole host of brain chemicals. Too many theories for something that really is incomprehensible, or can they be reconciled?

The exhibition is funded by a Wellcome Trust People Award. Admission free. Visitors will be invited to comment.

Exhibition details:

Dates: Friday 6th February Sunday 22nd February; 11am 6pm daily.
Sophie & Patrick will be at the gallery 5-6pm Tuesdays and Saturdays.

Address: the.gallery@oxo, Oxo Tower Wharf, Bargehouse Street, London SE1 9PH

For further information: