(HealthDay News) -- People worldwide subscribe to the belief that you are what you dream, concludes a new series of studies published in February's Journal of Personality and Social Psychology.
"Psychologists' interpretations of the meaning of dreams vary widely," lead author Carey Morewedge, an assistant professor at Carnegie Mellon University, said in an American Psychological Association news release. "But our research shows that people believe their dreams provide meaningful insight into themselves and their world."
For example, 149 university students in the United States, India and South Korea in one survey largely agreed that hidden truths present themselves in their dreams, a theory a nationally representative sample of Americans also supports.
Dreams also affect how people act when they awake, another study found. A survey of Boston train commuters found that when they dreamed of a plane crash the night before a scheduled air trip, they would be more likely to change their travel plans than if they had had a dream about an increased terrorist threat or consciously thought about their plane crashing. Dreaming about a plane crash also caused them as much anxiety as would a plane disaster actually occurring on their planned route shortly before their trip.
While most people said dreams rarely predict future events, they still found them meaningful, even if they were uneventful or plain bizarre, Morewedge said.
Not all dreams are equal, though. When asked to recall a dream about a person they knew, 270 Americans taking an online survey gave more significance to pleasant dreams about someone they liked than bad dreams about someone they didn't like.
"In other words, people attribute meaning to dreams when it corresponds with their pre-existing beliefs and desires," Morewedge said.
More information
The U.S. National Sleep Foundation has more about dreams.
Showing posts with label Mental Health. Show all posts
Showing posts with label Mental Health. Show all posts
Monday, March 02, 2009
Tuesday, February 03, 2009
Mental Illness Doesn't Predict Violent Behavior
(HealthDay News) -- Mental illness alone is not a predictor of future violent behavior, but mental illness combined with substance abuse or dependence does increase the risk, according to U.S. researchers who analyzed data collected from nearly 35,000 people.
People who have a severe mental illness but no substance abuse or a history of violence weren't any more likely than any other person in the general population to be violent over a period of three years, the study found. But the risk for future violence reached the level of statistical significance when mental illness was combined with substance abuse.
Still, the mental illness/substance abuse combination only ranked ninth on the study's list of the top 10 predictors of future violence. The predictors, listed from first to tenth, were: age (younger people are more likely to commit violence); history of violence; gender (males are more prone to violence); history of juvenile detention; divorce or separation in the past year; history of physical abuse; parental criminal history; unemployment in the past year; mental illness with substance abuse; and victimization in the past year.
The findings appear in the February issue of the Archives of General Psychiatry.
"Our study shows that a link between mental illness and violence does exist, but it's not as strong as most people think," said study author Eric B. Elbogen, an assistant professor in the forensic psychiatry program at the University of North Carolina (UNC) at Chapel Hill School of Medicine.
"We found that several other factors -- such as history of past violence or substance abuse or a recent divorce or loss of one's job -- are much more predictive of future violence than mental illness alone. Only when a person has both mental illness and substance abuse at the same time does that person's risk of future violence outweigh anyone else's," Elbogen said in a UNC news release.
Study co-author Dr. Sally C. Johnson said the "findings challenge the perception that some people have, and which you often see reflected in media coverage, that mental illness alone makes someone more dangerous. Our study shows that this perception is just not correct."
More information
The U.S. National Institutes of Mental Health has more about mental disorders.
People who have a severe mental illness but no substance abuse or a history of violence weren't any more likely than any other person in the general population to be violent over a period of three years, the study found. But the risk for future violence reached the level of statistical significance when mental illness was combined with substance abuse.
Still, the mental illness/substance abuse combination only ranked ninth on the study's list of the top 10 predictors of future violence. The predictors, listed from first to tenth, were: age (younger people are more likely to commit violence); history of violence; gender (males are more prone to violence); history of juvenile detention; divorce or separation in the past year; history of physical abuse; parental criminal history; unemployment in the past year; mental illness with substance abuse; and victimization in the past year.
The findings appear in the February issue of the Archives of General Psychiatry.
"Our study shows that a link between mental illness and violence does exist, but it's not as strong as most people think," said study author Eric B. Elbogen, an assistant professor in the forensic psychiatry program at the University of North Carolina (UNC) at Chapel Hill School of Medicine.
"We found that several other factors -- such as history of past violence or substance abuse or a recent divorce or loss of one's job -- are much more predictive of future violence than mental illness alone. Only when a person has both mental illness and substance abuse at the same time does that person's risk of future violence outweigh anyone else's," Elbogen said in a UNC news release.
Study co-author Dr. Sally C. Johnson said the "findings challenge the perception that some people have, and which you often see reflected in media coverage, that mental illness alone makes someone more dangerous. Our study shows that this perception is just not correct."
More information
The U.S. National Institutes of Mental Health has more about mental disorders.
Wednesday, November 26, 2008
Bad Bosses Are Hard on the Heart
(HealthDay News) -- Burdened by an overbearing boss? Your heart may pay the price, according to new research.
The Swedish study found that workers' risks for angina, heart attack and death rose along with the reported incompetence of their bosses.
"This study is the first to provide evidence of a prospective, dose-response relationship between concrete managerial behaviors and objectively assessed heart disease among employees," said lead researcher Anna Nyberg, from the department of public health sciences at the Karolinska Institute, and Stress Research Institute at Stockholm University.
"Enhancing managers' skills -- regarding providing employees with information, support, power in relation to responsibilities, clarity in expectations, and feedback -- could have important stress-reducing effects on employees and enhance the health at workplaces," Nyberg said.
The report was published in the Nov. 25 online edition of Occupational and Environmental Medicine.
According to the researchers, being a good boss includes consideration for employees, setting clear goals, setting realistic expectations, communicating and giving feedback, managing change, including people in decision-making and delegating authority.
For the study, Nyberg's team collected data on more than 3,100 Swedish men who participated in the Work, Lipids, and Fibrinogen Stockholm study. The men, 19 to 70 years of age, had their hearts checked at work between 1992 and 1995. The researchers then matched these men with hospital records for heart disease illness and death up to 2003.
During the follow-up period, there were 74 cases of fatal and nonfatal heart attacks or angina or death from heart disease, the researchers found.
Nyberg's group found that the more competent the men thought their bosses were, the lower their risk of developing heart disease. In contrast, the poorer men rated their boss's leadership ability, the higher the risk for heart disease. In fact, the risk increased the longer someone worked in the same stressful environment.
"Stress-related diseases are a large problem in our society," Nyberg said. "The workplace is one area in which stress occurs and thus can be reduced. This study suggests that managers have key roles in determining stress-related factors at work, which means that psychosocial work environment interventions could be directed towards managers in order to reduce stress in employees," she said.
Dr. Gregg C. Fonarow is a professor of cardiology at the University of California, Los Angeles. He said a number of studies have suggested that stressful work environments boost workers' risk for cardiovascular events.
"However, none of these studies have demonstrated causality, and it remains entirely unknown whether making these types of changes in the workplace would produce favorable effects on cardiovascular health," Fonarow said.
A related report -- this time in the Nov. 25 online edition of the Journal of Epidemiology and Community Health -- finds that taking sick leave from your job for mental health raises your risk of an early death.
"People who take medically certified absence spells of one week or more have a 60 percent excess risk of early death," said lead researcher Jane Ferrie, from the Department of Epidemiology and Public Health at University College London, U.K. "This excess risk is associated with some of the commonest diagnoses for sickness absence, in particular mental disorders," she said.
For the study, Ferrie's group collected data on more than 19,000 French public utility workers, aged 37 to 51, who took part in the GAZEL study.
The researchers found that from 1993 to 2007, 902 people died, 144 of them women. From 1990 to 1992, there were about 12,500 medically certified sick leaves lasting seven or more working days, involving 41 percent of the employees. These employees were 60 percent more likely to die early, Ferrie noted.
Women took sick leave more frequently than men. The data showed that, for both men and women, mental ill health and digestive and circulatory diseases in men were associated with the risk of dying early.
"Workers with medically certified absence for mental diagnoses should be considered a population at a higher risk of fatal disease," Ferrie concluded. "These diagnoses include mental health problems, often viewed as the diagnosis most likely to be used as an excuse for skiving."
But Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine noted again that this research did not prove causality.
"It may be that workers who are ill are less apt to be satisfied," Katz said. "But it is not unreasonable that dissatisfaction at work could translate into great risk for ill health, and even premature death," he said.
It stands to reason that how we interact with others in the workplace is important to our health and quality of life, Katz said. "Given how much time we spend at work, relationships there clearly count. Intervention studies that aim to optimize the interaction between employee and manager and test for health outcomes would clearly make sense," he said.
More information
For more on work stress, visit the U.S. Centers for Disease Control and Prevention .
The Swedish study found that workers' risks for angina, heart attack and death rose along with the reported incompetence of their bosses.
"This study is the first to provide evidence of a prospective, dose-response relationship between concrete managerial behaviors and objectively assessed heart disease among employees," said lead researcher Anna Nyberg, from the department of public health sciences at the Karolinska Institute, and Stress Research Institute at Stockholm University.
"Enhancing managers' skills -- regarding providing employees with information, support, power in relation to responsibilities, clarity in expectations, and feedback -- could have important stress-reducing effects on employees and enhance the health at workplaces," Nyberg said.
The report was published in the Nov. 25 online edition of Occupational and Environmental Medicine.
According to the researchers, being a good boss includes consideration for employees, setting clear goals, setting realistic expectations, communicating and giving feedback, managing change, including people in decision-making and delegating authority.
For the study, Nyberg's team collected data on more than 3,100 Swedish men who participated in the Work, Lipids, and Fibrinogen Stockholm study. The men, 19 to 70 years of age, had their hearts checked at work between 1992 and 1995. The researchers then matched these men with hospital records for heart disease illness and death up to 2003.
During the follow-up period, there were 74 cases of fatal and nonfatal heart attacks or angina or death from heart disease, the researchers found.
Nyberg's group found that the more competent the men thought their bosses were, the lower their risk of developing heart disease. In contrast, the poorer men rated their boss's leadership ability, the higher the risk for heart disease. In fact, the risk increased the longer someone worked in the same stressful environment.
"Stress-related diseases are a large problem in our society," Nyberg said. "The workplace is one area in which stress occurs and thus can be reduced. This study suggests that managers have key roles in determining stress-related factors at work, which means that psychosocial work environment interventions could be directed towards managers in order to reduce stress in employees," she said.
Dr. Gregg C. Fonarow is a professor of cardiology at the University of California, Los Angeles. He said a number of studies have suggested that stressful work environments boost workers' risk for cardiovascular events.
"However, none of these studies have demonstrated causality, and it remains entirely unknown whether making these types of changes in the workplace would produce favorable effects on cardiovascular health," Fonarow said.
A related report -- this time in the Nov. 25 online edition of the Journal of Epidemiology and Community Health -- finds that taking sick leave from your job for mental health raises your risk of an early death.
"People who take medically certified absence spells of one week or more have a 60 percent excess risk of early death," said lead researcher Jane Ferrie, from the Department of Epidemiology and Public Health at University College London, U.K. "This excess risk is associated with some of the commonest diagnoses for sickness absence, in particular mental disorders," she said.
For the study, Ferrie's group collected data on more than 19,000 French public utility workers, aged 37 to 51, who took part in the GAZEL study.
The researchers found that from 1993 to 2007, 902 people died, 144 of them women. From 1990 to 1992, there were about 12,500 medically certified sick leaves lasting seven or more working days, involving 41 percent of the employees. These employees were 60 percent more likely to die early, Ferrie noted.
Women took sick leave more frequently than men. The data showed that, for both men and women, mental ill health and digestive and circulatory diseases in men were associated with the risk of dying early.
"Workers with medically certified absence for mental diagnoses should be considered a population at a higher risk of fatal disease," Ferrie concluded. "These diagnoses include mental health problems, often viewed as the diagnosis most likely to be used as an excuse for skiving."
But Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine noted again that this research did not prove causality.
"It may be that workers who are ill are less apt to be satisfied," Katz said. "But it is not unreasonable that dissatisfaction at work could translate into great risk for ill health, and even premature death," he said.
It stands to reason that how we interact with others in the workplace is important to our health and quality of life, Katz said. "Given how much time we spend at work, relationships there clearly count. Intervention studies that aim to optimize the interaction between employee and manager and test for health outcomes would clearly make sense," he said.
More information
For more on work stress, visit the U.S. Centers for Disease Control and Prevention .
Tuesday, November 04, 2008
How to keep anger from bubbling over
Experts are predicting a record voter turnout for tomorrow's presidential election. That means long lines, and many people stewing over the amount of time they have to wait to cast their ballots. We all get angry at times, but it's what sets us off and how we manage that anger that set us apart. full story
Tuesday, October 28, 2008
Imaging Advances Map Brain Areas Affecting Mood
(HealthDay News) -- Recently developed types of imaging techniques enable researchers to map brain circuits and chemical systems believed to play a role in depression, bipolar disorder and other mood disorders, and may help lead to improved treatments.
Information about these techniques was expected to be presented Tuesday during a news conference by researchers taking part in U.S. National Institute of Mental Health symposiums at the American Psychiatric Association annual meeting, in Washington, D.C.
"These studies contribute new information about how the brain malfunctions in depression and bipolar disorder, what goes wrong with brain chemicals, and where in the brain the problems arise," Dr. Ellen Leibenluft, of the NIMH, said in a prepared statement. "We find that the brain systems involved and the exact nature of the difficulties differs among patients, even when those patients have similar symptoms. Eventually, data like these will allow us to develop more individualized and targeted treatments for depression."
In one study, University of Michigan researchers using molecular imaging with positron emission tomography (PET) found that patients with untreated major depression had an overall reduction in the concentration of serotonin 1A receptors in the hippocampus, a brain region that helps regulate stress.
"The reductions in these receptors were correlated with the functional impairment of the patients in work and with their families, with greater impairment being associated with lower receptor concentrations in this region," study author Dr. Jon-Kar Zubieta said in a prepared statement.
The patients responded to treatment with citalopram.
In another study, Zubieta and colleagues found that people with untreated major depression had reduced concentrations of "mu" opioid receptors in the thalamus, an area of the brain involved in the regulation of emotions. The mu receptors play a key role in regulating mood and triggering brain reward systems. A reduction in the receptors was associated with greater concentrations of stress hormones.
The researchers also found that depressed patients who didn't respond to the antidepressant fluoxetine (Prozac) had lower concentrations of mu receptors in the anterior cingulate, an area of the brain involved in the processing of emotional states.
In other studies, NIMH researchers used PET and functional MRI to identify abnormal patterns of neural activity and chemical function in the brain's reward pathway that underlie depressed patients' inability to experience pleasure.
"The identification of brain systems and circuits whose activity can be correlated with specific symptoms is a first step toward the development of more targeted and effective treatments for depression and other disorders of the brain," Dr. Wayne Drevets, of the NIMH, said in a prepared statement.
In another study, Yale School of Medicine researchers using specialized applications of MRI found that people with bipolar disorder have reduced volume of the brain's prefrontal cortex and its subcortical connections sites, including the amygdala.
Previous research found that patients with bipolar disorder have abnormal functioning of these brain structures, especially during the processing of emotional stimuli and during tasks that require inhibition of impulsive responses.
In other studies, scientists found that fMRI can help determine whether children have biploar disorder or severe irritability with attention-deficit hyperactivity disorder (ADHD). This suggests that brain imaging may prove useful in making a correct diagnosis.
"We're finding that these very irritable children with ADHD share some characteristics with children with bipolar disorder but also have significant differences," said Leibenluft.
Children with these conditions are easily frustrated, have difficulty reading facial emotional cues, and have social cognition deficits.
"Yet what's happening in the brain during frustration differed between the two groups. So these data indicate that, even when two groups of patients exhibit the same symptoms, the brain mechanisms underlying that symptom can differ. Data like these indicate how, eventually, psychiatric diagnosis will be based on brain mechanisms, in addition to symptoms," Leibenluft said.
More information
The U.S. Center for Mental Health Services has more about mood disorders.
Information about these techniques was expected to be presented Tuesday during a news conference by researchers taking part in U.S. National Institute of Mental Health symposiums at the American Psychiatric Association annual meeting, in Washington, D.C.
"These studies contribute new information about how the brain malfunctions in depression and bipolar disorder, what goes wrong with brain chemicals, and where in the brain the problems arise," Dr. Ellen Leibenluft, of the NIMH, said in a prepared statement. "We find that the brain systems involved and the exact nature of the difficulties differs among patients, even when those patients have similar symptoms. Eventually, data like these will allow us to develop more individualized and targeted treatments for depression."
In one study, University of Michigan researchers using molecular imaging with positron emission tomography (PET) found that patients with untreated major depression had an overall reduction in the concentration of serotonin 1A receptors in the hippocampus, a brain region that helps regulate stress.
"The reductions in these receptors were correlated with the functional impairment of the patients in work and with their families, with greater impairment being associated with lower receptor concentrations in this region," study author Dr. Jon-Kar Zubieta said in a prepared statement.
The patients responded to treatment with citalopram.
In another study, Zubieta and colleagues found that people with untreated major depression had reduced concentrations of "mu" opioid receptors in the thalamus, an area of the brain involved in the regulation of emotions. The mu receptors play a key role in regulating mood and triggering brain reward systems. A reduction in the receptors was associated with greater concentrations of stress hormones.
The researchers also found that depressed patients who didn't respond to the antidepressant fluoxetine (Prozac) had lower concentrations of mu receptors in the anterior cingulate, an area of the brain involved in the processing of emotional states.
In other studies, NIMH researchers used PET and functional MRI to identify abnormal patterns of neural activity and chemical function in the brain's reward pathway that underlie depressed patients' inability to experience pleasure.
"The identification of brain systems and circuits whose activity can be correlated with specific symptoms is a first step toward the development of more targeted and effective treatments for depression and other disorders of the brain," Dr. Wayne Drevets, of the NIMH, said in a prepared statement.
In another study, Yale School of Medicine researchers using specialized applications of MRI found that people with bipolar disorder have reduced volume of the brain's prefrontal cortex and its subcortical connections sites, including the amygdala.
Previous research found that patients with bipolar disorder have abnormal functioning of these brain structures, especially during the processing of emotional stimuli and during tasks that require inhibition of impulsive responses.
In other studies, scientists found that fMRI can help determine whether children have biploar disorder or severe irritability with attention-deficit hyperactivity disorder (ADHD). This suggests that brain imaging may prove useful in making a correct diagnosis.
"We're finding that these very irritable children with ADHD share some characteristics with children with bipolar disorder but also have significant differences," said Leibenluft.
Children with these conditions are easily frustrated, have difficulty reading facial emotional cues, and have social cognition deficits.
"Yet what's happening in the brain during frustration differed between the two groups. So these data indicate that, even when two groups of patients exhibit the same symptoms, the brain mechanisms underlying that symptom can differ. Data like these indicate how, eventually, psychiatric diagnosis will be based on brain mechanisms, in addition to symptoms," Leibenluft said.
More information
The U.S. Center for Mental Health Services has more about mood disorders.
Monday, June 30, 2008
Activity-Linked Heat Illness Needs Prompt Attention
(HealthDay News) -- As the mercury continues to rise, people of all ages should take precautions to ward off heat-related illness while exercising, playing or taking part in any kind of physical activity outside.
"Many cases of heat illness are preventable and can be successfully treated if such conditions are properly recognized and appropriate care is provided in a timely manner," Brendon McDermott, a certified athletic trainer with the University of Connecticut, said in a prepared statement. "We're hoping to educate athletes, coaches, parents and health care providers about what can be done to prevent and treat heat illnesses."
The National Athletic Trainers' Association (NATA) recently issued recommendations to help guard against illness related to warm-weather activity:
"Many cases of heat illness are preventable and can be successfully treated if such conditions are properly recognized and appropriate care is provided in a timely manner," Brendon McDermott, a certified athletic trainer with the University of Connecticut, said in a prepared statement. "We're hoping to educate athletes, coaches, parents and health care providers about what can be done to prevent and treat heat illnesses."
The National Athletic Trainers' Association (NATA) recently issued recommendations to help guard against illness related to warm-weather activity:
- Don't start at full tilt. Gradually increasing the intensity and duration of activity helps ready your body for the heat.
- Take rest breaks. Add them to the activity and get adequate rest between bouts of exercise. Good sleeping habits also cut your risk of heat-related trouble.
- Stay hydrated. Drink water or sports drinks well before and throughout physical activity in the heat. If your urine turns a darker color -- more like apple juice than lemonade - that's a quick indicator of dehydration.
- Timing helps. When possible, exercise during the cooler portions of the day -- early morning or late evening.
Back off at signs of trouble. If you don't feel well, reduce the intensity or length of your activity, for example, walk instead of run. If you have symptoms of an illness (e.g., fever, diarrhea, extreme fatigue, etc.) don't exercise at all. These conditions can decrease your body's tolerance for heat and increase your risk of a heat illness.
Even if you think you are prepared, always listen to your body. If you start to feel ill or strange, stop immediately and seek medical attention.
Here are some heat-related ailments to watch for in yourself and others when working or playing in the warm weather:
Exertional heat stroke can result in death unless quickly recognized and properly treated. Watch for an increase in core body temperature (usually above 104 degrees F/40 degrees C); altered consciousness, seizures, confusion, emotional instability, irrational behavior or decreased mental acuity, nausea, vomiting, or diarrhea; headache, dizziness, or weakness; increased heart rate; decreased blood pressure or fast breathing; dehydration; and combativeness. Seek emergency medical treatment immediately; if you are waiting for medical help to arrive try immediate whole-body cooling, preferably through immersion in cold water.
Heat exhaustion is moderately serious, usually resulting from fluid or sodium loss in the heat. Loss of coordination; dizziness or fainting; profuse sweating or pale skin; headache, nausea, vomiting or diarrhea; stomach/intestinal cramps or persistent muscle cramps are its signs. Heat exhaustion patients need to move to a cool, shaded environment, with feet elevated, and be given fluids. If their condition worsens or does not improve shortly, get them to an emergency room. Even if the patient does improve, NATA recommends having a doctor evaluate them.
Heat cramps often occur in people who perform strenuous exercise in the heat. Signs and symptoms include intense pain (not associated with pulling or straining a muscle) and persistent muscle contractions that continue during and after exercise. When heat cramps occur, stop activity immediately, eat salty food, consume a sports drink and stretch the affected muscle. If cramping getting worse or spreads, head to the emergency room.
Hyponatremia happens when a person's blood sodium levels decrease to a potentially fatal level. Over-hydration, inadequate sodium intake or both can cause it, with the result possibly being cerebral and/or pulmonary edema. Signs and symptoms include excessive fluid consumption to the point of weight gain during activity; increasing headache; nausea and vomiting; and swelling of the hands and feet. If the condition involves mental confusion and intense headache, see a doctor. A doctor should also be consulted before resuming outdoor activity in the heat.
More information
Sunday, June 08, 2008
Health Tip: Taking a Mental Status Test
(HealthDay News) -- Mental status tests are given to determine the state of a person's mental health. The test, for example, can help gauge the mental progression of a physical illness such as Alzheimer's disease.
Here's what may comprise a mental status test, courtesy of the U.S. National Library of Medicine:
Here's what may comprise a mental status test, courtesy of the U.S. National Library of Medicine:
- An examination of physical appearance, including dress and grooming.
- Orientation and awareness -- knowing one's own name, address, and phone, as well as the current date and season.
- Length of attention span, and short-term and long-term memory.
- Tests to determine abilities including problem solving and judgment.
- Ability to identify objects and recall words.
Thursday, February 14, 2008
Marijuana Use Among MS Patients Raises Risk for Cognitive, Mood Problems
(HealthDay News) -- Multiple sclerosis patients who smoke marijuana in search of symptom relief are more likely to suffer cognitive shortfalls and mood disorders, new Canadian research suggests.
A slowing down in the ability to process and remember information is one significant side effect, as is a rise in the rate of depression and anxiety.
"This is a small study, so our findings are preliminary, but the bottom line is that multiple sclerosis patients who smoke cannabis appear to be at an increased risk for cognitive issues, particularly with respect to the speed of their thinking," said study author Dr. Anthony Feinstein, a professor of psychiatry with the Sunnybrook Health Sciences Centre's department of psychiatry at the University of Toronto.
Feinstein's observations are published in the Feb. 13 online edition of Neurology and are focused exclusively on the impact of smoking marijuana illegally obtained by patients themselves. Medically prescribed marijuana was not studied.
The authors noted that a "significant minority" of multiple sclerosis patients smoke marijuana to combat the tingling, numbness, blindness and paralysis that can accompany the progressive and often disabling nervous system disease.
However, Feinstein's team stressed that scientists have yet to definitively prove that the psychoactive substance -- long linked to psychosis, anxiety and delirium among healthy users -- provides a measurable benefit to the more than 400,000 Americans and 2.5 million people worldwide who suffer from the disease.
The researchers therefore assessed the experience of 140 Toronto-based MS outpatients, 10 of whom had smoked the drug at least once in the previous month and were considered regular marijuana users.
All the patients -- three-quarters of them women -- underwent cognitive and mental health exams by a neurologist and a neuro-psychiatrist. Interviews were also conducted to assess disease severity and course, medications being used, and current disability.
Feinstein and his team observed that while pot smokers were younger, there were no differences between marijuana users and nonusers in terms of gender, education, or MS disease course or duration.
However, MS patients who used marijuana were found to perform 50 percent slower on tests tracking information-processing speed and were more likely than nonusers to have a mental disability of some kind.
Marijuana use was also associated with a greater risk for being depressed or experiencing anxiety. However, the authors were not able to determine whether the drug had triggered such conditions, or if patients had sought out marijuana to help deal with a preexisting emotional issue.
They nonetheless cautioned that smoking marijuana might further raise the risk for experiencing the kind of neuro-psychological impairment that typically occurs among 40 percent to 65 percent of all MS patients.
Feinstein said that he next hopes to gather a much larger pool of patients, while exploring possible differences in the health impact of street-purchased marijuana versus prescribed cannabis.
Meanwhile, Dr. Marshall Keilson, director of neurology at Maimonides Medical Center in Brooklyn, N.Y., said he thinks it best to proceed on a case-by-case basis.
"There are some MS patients who are emotionally disabled from their disease, and if we can use cannabis to help them feel better about the world or life, we should," he said. "We need to always err on the side of doing what's best for our patients. And I don't necessarily believe there is a permanent damage to the brain, based on occasional marijuana use. If they're smoking 10 times a day, yes, there will be damage done. But this goes for excessive alcohol use, too. So, I think we're going to end up somewhere in the middle with this."
More information
For more on multiple sclerosis, visit the National Multiple Sclerosis Society.
A slowing down in the ability to process and remember information is one significant side effect, as is a rise in the rate of depression and anxiety.
"This is a small study, so our findings are preliminary, but the bottom line is that multiple sclerosis patients who smoke cannabis appear to be at an increased risk for cognitive issues, particularly with respect to the speed of their thinking," said study author Dr. Anthony Feinstein, a professor of psychiatry with the Sunnybrook Health Sciences Centre's department of psychiatry at the University of Toronto.
Feinstein's observations are published in the Feb. 13 online edition of Neurology and are focused exclusively on the impact of smoking marijuana illegally obtained by patients themselves. Medically prescribed marijuana was not studied.
The authors noted that a "significant minority" of multiple sclerosis patients smoke marijuana to combat the tingling, numbness, blindness and paralysis that can accompany the progressive and often disabling nervous system disease.
However, Feinstein's team stressed that scientists have yet to definitively prove that the psychoactive substance -- long linked to psychosis, anxiety and delirium among healthy users -- provides a measurable benefit to the more than 400,000 Americans and 2.5 million people worldwide who suffer from the disease.
The researchers therefore assessed the experience of 140 Toronto-based MS outpatients, 10 of whom had smoked the drug at least once in the previous month and were considered regular marijuana users.
All the patients -- three-quarters of them women -- underwent cognitive and mental health exams by a neurologist and a neuro-psychiatrist. Interviews were also conducted to assess disease severity and course, medications being used, and current disability.
Feinstein and his team observed that while pot smokers were younger, there were no differences between marijuana users and nonusers in terms of gender, education, or MS disease course or duration.
However, MS patients who used marijuana were found to perform 50 percent slower on tests tracking information-processing speed and were more likely than nonusers to have a mental disability of some kind.
Marijuana use was also associated with a greater risk for being depressed or experiencing anxiety. However, the authors were not able to determine whether the drug had triggered such conditions, or if patients had sought out marijuana to help deal with a preexisting emotional issue.
They nonetheless cautioned that smoking marijuana might further raise the risk for experiencing the kind of neuro-psychological impairment that typically occurs among 40 percent to 65 percent of all MS patients.
Feinstein said that he next hopes to gather a much larger pool of patients, while exploring possible differences in the health impact of street-purchased marijuana versus prescribed cannabis.
Meanwhile, Dr. Marshall Keilson, director of neurology at Maimonides Medical Center in Brooklyn, N.Y., said he thinks it best to proceed on a case-by-case basis.
"There are some MS patients who are emotionally disabled from their disease, and if we can use cannabis to help them feel better about the world or life, we should," he said. "We need to always err on the side of doing what's best for our patients. And I don't necessarily believe there is a permanent damage to the brain, based on occasional marijuana use. If they're smoking 10 times a day, yes, there will be damage done. But this goes for excessive alcohol use, too. So, I think we're going to end up somewhere in the middle with this."
More information
For more on multiple sclerosis, visit the National Multiple Sclerosis Society.
Saturday, February 02, 2008
Quit-Smoking Drug May Raise Suicide Risk
(HealthDay News) -- There's increasing evidence that the smoking-cessation drug Chantix is linked to serious "neuropsychiatric" side effects, including agitation, depressed mood and even suicide, U.S. health officials said Friday.
The U.S. Food and Drug Administration has asked Chantix's manufacturer, Pfizer Inc., to make the warning about these potential problems more prominent on prescribing information and on the drug's label. The agency is also working with Pfizer to produce a Medication Guide for patients, officials said.
"We have become increasingly concerned as we have seen a number of compelling cases that truly look as if they are the result of exposure to the drug and not to other causes," Dr. Bob Rappaport, director of the FDA's Division of Anesthesia, Analgesia and Rheumatology Products, said during an afternoon teleconference.
"These cases involve abnormal behaviors, changes in mood, and suicidal ideation and suicide," Rappaport said.
The FDA knows of 491 cases of suicidal behavior associated with Chantix, said Dr. Celia Winchell, a team leader in the FDA's Division of Anesthesia, Analgesia and Rheumatology Products.
"Of these, 420 are from the United States," Winchell said. "There are 39 that involve completed suicides, 34 in the United States."
According to Pfizer, 5 million patients have taken Chantix, whose generic name is varenicline.
Friday's warning follows a Nov. 20 FDA statement that the agency was "evaluating post-marketing adverse event reports on Chantix related to changes in behavior, agitation, depressed mood, suicidal ideation, and actual suicidal behavior."
At that time, Pfizer said there had never been a cause-and-effect relationship shown between Chantix and these symptoms. The company also said that part of the problem may be due to nicotine withdrawal.
Last month, Pfizer agreed, after consulting with the FDA, to update packages of Chantix sold in the United States to more prominently display a warning that users should be monitored for suicidal behavior, depressed mood, and other mental health symptoms.
The FDA approved Chantix in May 2006 as a smoking-cessation drug. It acts in areas of the brain affected by nicotine and may ease withdrawal symptoms and block the effects of nicotine if users resume smoking.
On Friday, FDA officials advised patients to tell their doctor about any history of psychiatric illness before starting Chantix. The drug can cause current psychiatric illness to get worse even if it is under control. Chantix may also cause the recurrence of an old psychiatric illness, the officials warned.
Patients should also report changes in mood and behavior to their doctor. Symptoms to look out for include anxiety, nervousness, tension, depressed mood, unusual behaviors and thinking about or attempting suicide, the FDA officials said.
In most cases, these symptoms developed while taking Chantix, but they can also appear after stopping the drug, the officials noted.
"We are continuing with the review process over the next several months as we try to pin down to what extent these problems are being seen with Chantix," Rappaport said.
Vivid, unusual, or strange dreams may occur while taking the drug. Patients may also experience impaired ability to drive or operate heavy machinery, the officials said.
More information
For more on quitting smoking, visit Smokefree.gov.
The U.S. Food and Drug Administration has asked Chantix's manufacturer, Pfizer Inc., to make the warning about these potential problems more prominent on prescribing information and on the drug's label. The agency is also working with Pfizer to produce a Medication Guide for patients, officials said.
"We have become increasingly concerned as we have seen a number of compelling cases that truly look as if they are the result of exposure to the drug and not to other causes," Dr. Bob Rappaport, director of the FDA's Division of Anesthesia, Analgesia and Rheumatology Products, said during an afternoon teleconference.
"These cases involve abnormal behaviors, changes in mood, and suicidal ideation and suicide," Rappaport said.
The FDA knows of 491 cases of suicidal behavior associated with Chantix, said Dr. Celia Winchell, a team leader in the FDA's Division of Anesthesia, Analgesia and Rheumatology Products.
"Of these, 420 are from the United States," Winchell said. "There are 39 that involve completed suicides, 34 in the United States."
According to Pfizer, 5 million patients have taken Chantix, whose generic name is varenicline.
Friday's warning follows a Nov. 20 FDA statement that the agency was "evaluating post-marketing adverse event reports on Chantix related to changes in behavior, agitation, depressed mood, suicidal ideation, and actual suicidal behavior."
At that time, Pfizer said there had never been a cause-and-effect relationship shown between Chantix and these symptoms. The company also said that part of the problem may be due to nicotine withdrawal.
Last month, Pfizer agreed, after consulting with the FDA, to update packages of Chantix sold in the United States to more prominently display a warning that users should be monitored for suicidal behavior, depressed mood, and other mental health symptoms.
The FDA approved Chantix in May 2006 as a smoking-cessation drug. It acts in areas of the brain affected by nicotine and may ease withdrawal symptoms and block the effects of nicotine if users resume smoking.
On Friday, FDA officials advised patients to tell their doctor about any history of psychiatric illness before starting Chantix. The drug can cause current psychiatric illness to get worse even if it is under control. Chantix may also cause the recurrence of an old psychiatric illness, the officials warned.
Patients should also report changes in mood and behavior to their doctor. Symptoms to look out for include anxiety, nervousness, tension, depressed mood, unusual behaviors and thinking about or attempting suicide, the FDA officials said.
In most cases, these symptoms developed while taking Chantix, but they can also appear after stopping the drug, the officials noted.
"We are continuing with the review process over the next several months as we try to pin down to what extent these problems are being seen with Chantix," Rappaport said.
Vivid, unusual, or strange dreams may occur while taking the drug. Patients may also experience impaired ability to drive or operate heavy machinery, the officials said.
More information
For more on quitting smoking, visit Smokefree.gov.
Tuesday, November 27, 2007
Depression Linked to Bone Loss in Younger Women
(HealthDay News) -- Premenopausal women struggling with depression have lower bone mass than do non-depressed women in the same age range, a new study found.The bone loss was most pronounced in certain regions of the hip, which is troubling given that hip fractures are one of the most serious -- and potentially fatal -- consequences of osteoporosis.
The level of bone loss seen in the depressed women was the same or higher than that associated with other, established risk factors for osteoporosis, including smoking, low calcium intake and lack of physical exercise, the researchers said.
The findings, published in the Nov. 26 issue of the Archives of Internal Medicine, could have implications for the prevention of osteoporosis.
"Premenopausal women with depression should be screened for low bone mass," said Dr. Giovanni Cizza, senior author of the study who conducted the research while at the U.S. National Institute of Mental Health. "They should do a bone mineral density measurement, because osteoporosis is a silent condition. Until someone fractures, you don't know you have osteoporosis."
Cizza is now a staff clinician at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
A woman's bone mass peaks during youth then thins after menopause. Previous, preliminary studies had suggested that depression might be a risk factor for low bone mass in older women.
For this study, Cizza and his colleagues looked at 89 women with depression and 44 women without depression. The women ranged in age from 21 to 45. The depressed women were taking antidepressant medications.
Seventeen percent of the depressed women had thinner bone density in the femoral neck, a vulnerable part of the hip. Only 2 percent of non-depressed women, by contrast, had thinner bone in this area.
Twenty percent of depressed women also had low bone density in the lumbar spine, compared with 9 percent of the non-depressed women.
Blood and urine samples also revealed that the depressed women had lower levels of "good" proteins called cytokines. "The bad cytokines that may cause bone loss are higher," Cizza said.
It's not clear what role antidepressants might play, but by relieving the depression, the drugs may also help bone mineral density, the researchers said.
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Wednesday, November 14, 2007
Follow-Up Exams Uncover More Iraq Vets With Emotional Woes
(HealthDay News) -- The number of Iraq war veterans needing mental-health care has risen sharply since the U.S. Defense Department began screening them a second time for emotional problems, U.S. military researchers reported Tuesday.
Initial screenings of veterans uncovered 4.4 percent who needed treatment for problems such as depression or post-traumatic stress disorder (PTSD). But six months later, a second screening found 11.7 percent were in need of mental health care, indicating that it might take several months for emotional disorders to emerge, the study suggested.
"We know mental health problems are a problem for soldiers who have been to war," said lead researcher Dr. Charles S. Milliken, of the Walter Reed Army Institute of Research at the U.S. Army Medical Research and Materiel Command. "We are doing a good thing by having erected these screening programs. Between the two screenings, we are finding a large group of soldiers that are having problems."
The findings are published in the Nov. 14 issue of the Journal of the American Medical Association.
For the study, Milliken and his colleagues collected data on the mental health of 88,235 Iraq war veterans who completed an initial screening and a second screening about six months later. Both screenings included a questionnaire and a short interview with a clinician.
"In the second screening, you do find a larger group of soldiers the first screening completely missed," Milliken said. "It's about twice as big."
The researchers found that more soldiers had mental health problems -- such as PTSD, major depression or alcohol abuse -- during the later screening. In the first screening, 4.4 percent of the soldiers were referred for mental health care, but, after the second screening, 11.7 percent were referred.
Milliken thinks the two-step screening process helps remove the stigma attached to seeking help for emotional problems. "Soldiers are like other young males, they have a stigma about seeking mental health care," he said.
Among all the soldiers screened, 20.3 percent of active duty personnel were referred for mental health care, as were 42.4 percent of reserve soldiers, the study found.
Milliken said he didn't know why the difference exists between the active duty soldiers and the reservists. He speculated, however, that it might have to do with the VA's insurance structure that allows reservists access to free care for service-related health problems.
One expert thinks the new, two-tier system for identifying soldiers with emotional problems is working, but the shear numbers of affected veterans could overburden the VA's health-care system.
"I am not surprised by the rates of PTSD among Iraqi vets," said Dr. Randall Marshall, director of Trauma Studies at the New York State Psychiatric Institute and an associate professor of clinical psychiatry at Columbia University College of Physicians and Surgeons.
Marshall said the difference in PTSD rates among active duty and reserve personnel is expected. "Part of what training is meant to do is desensitize soldiers to all the potential experiences on the battlefield, and the reservists have less training and are therefore more vulnerable to war experiences," he said.
Marshall also said that many reservists have had several tours of duty, "which is something they had not signed up for."
Also, many of these part-time soldiers were split from their units, which means they didn't have as much of a support system as active duty personnel, he said.
Marshall sees another major problem developing for returning veterans. Most psychotherapists aren't trained in the best ways to treat PTSD, he said. "You can't assume because it's a VA hospital everyone there has had this kind of training," he said.
In addition, the number of soldiers needing mental health care is straining an already overburdened system.
"If 20 percent of the veterans realize they need help and start to seek treatment, the system will be overwhelmed. Signs are, it already is," Marshall said.
More information
To learn more, visit the U.S. Department of Veterans Affairs.
Initial screenings of veterans uncovered 4.4 percent who needed treatment for problems such as depression or post-traumatic stress disorder (PTSD). But six months later, a second screening found 11.7 percent were in need of mental health care, indicating that it might take several months for emotional disorders to emerge, the study suggested.
"We know mental health problems are a problem for soldiers who have been to war," said lead researcher Dr. Charles S. Milliken, of the Walter Reed Army Institute of Research at the U.S. Army Medical Research and Materiel Command. "We are doing a good thing by having erected these screening programs. Between the two screenings, we are finding a large group of soldiers that are having problems."
The findings are published in the Nov. 14 issue of the Journal of the American Medical Association.
For the study, Milliken and his colleagues collected data on the mental health of 88,235 Iraq war veterans who completed an initial screening and a second screening about six months later. Both screenings included a questionnaire and a short interview with a clinician.
"In the second screening, you do find a larger group of soldiers the first screening completely missed," Milliken said. "It's about twice as big."
The researchers found that more soldiers had mental health problems -- such as PTSD, major depression or alcohol abuse -- during the later screening. In the first screening, 4.4 percent of the soldiers were referred for mental health care, but, after the second screening, 11.7 percent were referred.
Milliken thinks the two-step screening process helps remove the stigma attached to seeking help for emotional problems. "Soldiers are like other young males, they have a stigma about seeking mental health care," he said.
Among all the soldiers screened, 20.3 percent of active duty personnel were referred for mental health care, as were 42.4 percent of reserve soldiers, the study found.
Milliken said he didn't know why the difference exists between the active duty soldiers and the reservists. He speculated, however, that it might have to do with the VA's insurance structure that allows reservists access to free care for service-related health problems.
One expert thinks the new, two-tier system for identifying soldiers with emotional problems is working, but the shear numbers of affected veterans could overburden the VA's health-care system.
"I am not surprised by the rates of PTSD among Iraqi vets," said Dr. Randall Marshall, director of Trauma Studies at the New York State Psychiatric Institute and an associate professor of clinical psychiatry at Columbia University College of Physicians and Surgeons.
Marshall said the difference in PTSD rates among active duty and reserve personnel is expected. "Part of what training is meant to do is desensitize soldiers to all the potential experiences on the battlefield, and the reservists have less training and are therefore more vulnerable to war experiences," he said.
Marshall also said that many reservists have had several tours of duty, "which is something they had not signed up for."
Also, many of these part-time soldiers were split from their units, which means they didn't have as much of a support system as active duty personnel, he said.
Marshall sees another major problem developing for returning veterans. Most psychotherapists aren't trained in the best ways to treat PTSD, he said. "You can't assume because it's a VA hospital everyone there has had this kind of training," he said.
In addition, the number of soldiers needing mental health care is straining an already overburdened system.
"If 20 percent of the veterans realize they need help and start to seek treatment, the system will be overwhelmed. Signs are, it already is," Marshall said.
More information
To learn more, visit the U.S. Department of Veterans Affairs.
Monday, August 20, 2007
Does Pathological Shyness Make for School Shooters?
(HealthDay News) -- What motivates some teens to gun down fellow students in the hallways or grounds of their schools?
Perhaps a characteristic called "cynical shyness." This is an extreme form of shyness affecting mostly males that can lead to violent behavior such as that seen at Columbine, Colo., or, most recently, Virginia Tech, according to researchers who were to present their findings Saturday evening at the American Psychological Association's annual meeting, in San Francisco.
"Cynically shy people are shy people who are motivated toward moving to others, and then they are rejected," said Bernardo Carducci, lead author of the study and director of the Shyness Research Institute at Indiana University Southeast in New Albany.
"In addition to feelings of anxiety about social situations, cynically shy people, who are a small subclass of shy people, also have feelings of anger and hostility toward others and that comes from this sense of disconnect," Carducci explained. "Shyness has more in common with extroversion than with introversion. Shy people truly want to be with others, so they make the effort, but when they are rejected or ostracized, they disconnect. Once you disconnect, it's very easy to start being angry and hate other people. It's you against them, and they become what I call a cult of one. Once you start thinking 'it's me versus them,' then it becomes easy to start hurting these people."
Eventually, the new research may help identify the likely perpetrators of such crimes before they happen, the study authors said.
"It would be great if we could better characterize people who might be likely to do something violent," said Dr. Jane Ripperger-Suhler, assistant professor of psychiatry and behavioral science at the Texas A&M Health Science Center College of Medicine and a psychiatrist with Scott & White Mental Health Center in Temple. "Right now, our ability to predict violence is not very good at all, so people overreact to a lot of things because of a fear of something happening.
For years, we were under-reacting. It would be nice if psychologists could help us characterize who would be more likely to be a school shooter."
But it's important not to stigmatize shy kids, other experts emphasized.
"Shyness is not inherently a good or bad thing," said Heather Henderson, assistant professor of psychology at the University of Miami. "But one thing we know about shyness in boys, particularly in North America, they seem to be particularly at risk for maladaptive outcomes.
We expect boys to be more outgoing and assertive. Boys are particularly sensitive and are exposed to cues from other people that shyness is not a good thing."
According to the study authors, there are a number of subtypes of shyness, cynical shyness being just one.
For the study, Carducci and a co-author examined news accounts and background information on seven high school shooting cases involving eight teen shooters between 1995 and 2004.
Those individuals were:
Jeffrey Weise -- 16, killed seven people at Red Lake High School in Minnesota as well as his grandfather and grandfather's girlfriend in 2005;
Jamie Rouse -- 17, killed one student and one teacher at Richland High School in Tennessee in 1995;
Luke Woodham -- 17, killed two people at Pearl High School in Mississippi in 1997;
Barry Loukaitis -- 14, killed three at Frontier Junior High in Washington state in 1996;
Eric Harris and Dylan Klebold -- 18 and 17 years old, they killed 12 students and a teacher at Columbine High School in Colorado in 1999;
Michael Carneal -- 14, killed three girls at Heath High School in Kentucky in 1997;
Kip Kinkel -- 15, killed his parents and two classmates at Thurston High School in Oregon in 1998.
Weise, the two Columbine killers and Kinkel had a "cynically shy score" of 10 (on a scale of 10). Rouse, Woodham and Loukaitis had scores of 8, and Carneal had a score of 6, the researchers said.
Cynically shy people tend to be male and want to relate to other people but just don't know how. As a result, they get rejected, and feelings of hurt gradually turn into intense rage, the study authors said.
This seems to be an extreme version of the frustrations other shy people often face.
"We often misinterpret why people are shy," Henderson said. "If you walk by somebody and avoid eye contact, you interpret that as they don't want to interact, but I think often it's completely the opposite. They really do want to interact and don't know how.
"It's important for parents and teachers to start at a young age, before the person is walking down the high school corridor ready to shoot, not to interpret their behavior as not wanting to interact," Henderson continued. "If we flip our interpretations, people may respond differently.
As a field, we need to understand prospectively what's happening, so we can start identifying kids at a very young age, what would drive a shy kid into this pattern. We don't want the message to be 'shyness will lead to shooting.' "
More information
To learn more, visit the Center for the Prevention of School Violence.
Perhaps a characteristic called "cynical shyness." This is an extreme form of shyness affecting mostly males that can lead to violent behavior such as that seen at Columbine, Colo., or, most recently, Virginia Tech, according to researchers who were to present their findings Saturday evening at the American Psychological Association's annual meeting, in San Francisco.
"Cynically shy people are shy people who are motivated toward moving to others, and then they are rejected," said Bernardo Carducci, lead author of the study and director of the Shyness Research Institute at Indiana University Southeast in New Albany.
"In addition to feelings of anxiety about social situations, cynically shy people, who are a small subclass of shy people, also have feelings of anger and hostility toward others and that comes from this sense of disconnect," Carducci explained. "Shyness has more in common with extroversion than with introversion. Shy people truly want to be with others, so they make the effort, but when they are rejected or ostracized, they disconnect. Once you disconnect, it's very easy to start being angry and hate other people. It's you against them, and they become what I call a cult of one. Once you start thinking 'it's me versus them,' then it becomes easy to start hurting these people."
Eventually, the new research may help identify the likely perpetrators of such crimes before they happen, the study authors said.
"It would be great if we could better characterize people who might be likely to do something violent," said Dr. Jane Ripperger-Suhler, assistant professor of psychiatry and behavioral science at the Texas A&M Health Science Center College of Medicine and a psychiatrist with Scott & White Mental Health Center in Temple. "Right now, our ability to predict violence is not very good at all, so people overreact to a lot of things because of a fear of something happening.
For years, we were under-reacting. It would be nice if psychologists could help us characterize who would be more likely to be a school shooter."
But it's important not to stigmatize shy kids, other experts emphasized.
"Shyness is not inherently a good or bad thing," said Heather Henderson, assistant professor of psychology at the University of Miami. "But one thing we know about shyness in boys, particularly in North America, they seem to be particularly at risk for maladaptive outcomes.
We expect boys to be more outgoing and assertive. Boys are particularly sensitive and are exposed to cues from other people that shyness is not a good thing."
According to the study authors, there are a number of subtypes of shyness, cynical shyness being just one.
For the study, Carducci and a co-author examined news accounts and background information on seven high school shooting cases involving eight teen shooters between 1995 and 2004.
Those individuals were:
Jeffrey Weise -- 16, killed seven people at Red Lake High School in Minnesota as well as his grandfather and grandfather's girlfriend in 2005;
Jamie Rouse -- 17, killed one student and one teacher at Richland High School in Tennessee in 1995;
Luke Woodham -- 17, killed two people at Pearl High School in Mississippi in 1997;
Barry Loukaitis -- 14, killed three at Frontier Junior High in Washington state in 1996;
Eric Harris and Dylan Klebold -- 18 and 17 years old, they killed 12 students and a teacher at Columbine High School in Colorado in 1999;
Michael Carneal -- 14, killed three girls at Heath High School in Kentucky in 1997;
Kip Kinkel -- 15, killed his parents and two classmates at Thurston High School in Oregon in 1998.
Weise, the two Columbine killers and Kinkel had a "cynically shy score" of 10 (on a scale of 10). Rouse, Woodham and Loukaitis had scores of 8, and Carneal had a score of 6, the researchers said.
Cynically shy people tend to be male and want to relate to other people but just don't know how. As a result, they get rejected, and feelings of hurt gradually turn into intense rage, the study authors said.
This seems to be an extreme version of the frustrations other shy people often face.
"We often misinterpret why people are shy," Henderson said. "If you walk by somebody and avoid eye contact, you interpret that as they don't want to interact, but I think often it's completely the opposite. They really do want to interact and don't know how.
"It's important for parents and teachers to start at a young age, before the person is walking down the high school corridor ready to shoot, not to interpret their behavior as not wanting to interact," Henderson continued. "If we flip our interpretations, people may respond differently.
As a field, we need to understand prospectively what's happening, so we can start identifying kids at a very young age, what would drive a shy kid into this pattern. We don't want the message to be 'shyness will lead to shooting.' "
More information
To learn more, visit the Center for the Prevention of School Violence.
Wednesday, April 18, 2007
Antidepressants Help More Kids Than They Harm
(HealthDay News) -- Whether depressed or troubled kids should take antidepressants has been the question at the center of an intense public debate in recent years, and the latest evidence suggests the answer is "yes."A study in the April 18 issue of the Journal of the American Medical Association found that the benefits of antidepressants outweighed the risks for children and adolescents under the age of 19.
Anecdotal reports released over the past few years suggest that antidepressants raise suicide risk in children and teens. But the drugs may also prevent deaths by curbing depression, experts say.
"Our study shows that, at least in the short-term, treatment benefits appear to outweigh the risks," confirmed study author Jeffrey A. Bridge, an investigator with Columbus Children's Research Institute, in Ohio.
The findings seem to tip the scale more in favor of antidepressants, which include widely used selective serotonin reuptake inhibitors (SSRIs) such as Celexa, Paxil, Prozac and Zoloft.
"They're saying that, yes, there is a slightly increased risk but it's not as big as we thought and the risk-benefit ratio is favorable. But that's a decision that every family has to make. It's not a generalized decision," said Dr. Jane Ripperger-Suhler, an assistant professor of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine and a psychiatrist with Scott & White Mental Health Center in Temple.
"This leans us more toward the middle -- that we don't have to say these are terrible medicines, that this looks like a fairly good option. and let's not take them off the table," she said.
Antidepressants, particularly SSRIs, have been the subject of intense controversy in recent years.
In October 2003, the U.S. Food and Drug Administration issued a public health advisory, warning of an increased risk of suicide attempts or suicide-related behavior among children and teens taking SSRIs.
One year later, the FDA directed manufacturers of those drugs to revise their labeling to include a black-box warning. The warning alerts health-care providers to an increased risk of suicide and suicidal thoughts in children and teens.
On the other side of the argument, a major new study found that SSRIs have actually saved thousands of lives by preventing suicides since they were introduced in 1988.
The negative press SSRIs received may have had a chilling effect on their use in the pediatric population, however. One recent study found that the number of U.S. children being prescribed the antidepressants has dropped since warnings about suicidal behavior associated with the drugs emerged. This trend could be worrisome if it means that young patients who might benefit from SSRIs aren't getting them, experts have said.
The only SSRI approved by the FDA for use in pediatric patients is Prozac, but others are prescribed on an off-label basis.
In 2004, an FDA review of 24 placebo-controlled trials involving antidepressant medication in more than 4,400 children and adolescents found that the medications spurred a twofold (4 percent vs. 2 percent) increased risk for suicidal behavior or ideation (thoughts of suicide), although no completed suicides were reported.
The current paper was a large review of all of the published and unpublished randomized clinical trials involving the use of antidepressants by children and adolescents younger than 19. The youngsters were being treated for major depressive disorder (MDD), obsessive-compulsive disorder (OCD) and anxiety disorders other than OCD. In all, 27 trials were reviewed and 5,310 patients were followed.
For every 100 children and adolescents treated with antidepressants, about one child would have thoughts of suicide or would attempt suicide beyond the risk associated with the underlying condition, the researchers found.
This was a number that was lower than the FDA's review, which found two instances of suicidal ideation or attempted suicide per 100 patients.
The study also found that the only antidepressant effective in treating depression in children under 12 was Prozac. Several medications were effective in older children.
The effects of the drugs were most pronounced for non-OCD anxiety disorders, followed by OCD and then MDD.
But the new findings are unlikely to be the last word on the subject.
"There are a few studies that are ongoing right now and that will certainly inform our findings," Bridge said.
"It doesn't seem like they have resolved the issue completely," added Ripperger-Suhler. "I'm hoping that someone will do a prospective study."
More information about Depression
Monday, March 19, 2007
Eating Disorders: A Midlife Crisis for Some Women
(HealthDay News) -- You starve yourself, shedding pounds, and it feels too good to ever stop.
Or you eat lots -- as much as you want, more than you want -- and then sneak away from your loved ones to purge it all.
But you're not 16, not 19, not 21. Not a young woman at all. You're in your 30s, 40s, or 50s. And you can't stop.
Anorexia and bulimia used to be considered health problems that afflicted teenage girls. But doctors are finding that a growing number of older women are now being diagnosed with some sort of eating disorder.
"It can happen to anybody at any stage of their life," said Dr. Alexander Sackeyfio, a psychiatrist and eating-disorder specialist at the Beaumont Hospital in Royal Oak, Mich. "I think we're becoming more aware of it and are better at diagnosing it."
People tend to make another mistake in their perception of eating disorders -- they assume they are relatively benign psychological problems that are easily treated and without lasting physical effects, said Doug Bunnell, clinical director of the Renfrew Center in Wilton, Conn.
"People are surprised when they learn these have the highest mortality rate of any psychiatric diagnosis, somewhere between 10 and 15 percent," said Bunnell, who's also a member of the National Eating Disorders Association board of directors.
Anorexia produces dramatic weight loss caused by excessive or compulsive dieting. An estimated 0.5 percent to 3.7 percent of women suffer from anorexia nervosa at some point in their lifetime, according to the National Institute of Mental Health.
Anorexics see themselves as overweight even though they're dangerously thin. The process of eating becomes an obsessive minefield and unusual eating habits develop, such as picking out just a few foods and eating them in tiny, carefully measured quantities.
Bulimia is characterized by excessive binge eating followed by purging the food through vomiting, laxatives or over-exercising. An estimated 1.1 percent to 4.2 percent of American females will struggle with bulimia nervosa in their lifetime.
Because of the purging, people with bulimia usually weigh within the normal range for their age and height. But they still suffer the same fears about weight gain as anorexics. So, they often perform bulimic behaviors in secret, feeling disgusted and ashamed when they binge, yet relieved once they purge.
Bunnell said he's seeing more middle-age or even older women coming in for treatment of an eating disorder. But, he's not sure that all of these are new cases developing later in life.
"My experience is that virtually all the women we've seen with eating-disorder symptoms in their 30s or 40s had some prior activity in the more typical age range," Bunnell said. "It may not have been diagnosed, or just short of being serious, but there was a period when they were really struggling with it. We've not seen a lot of brand new, out-of-the-blue eating disorder cases in older women."
Other doctors believe that hormonal fluctuations that occur near menopause could set off an eating disorder, as could mid-life changes like divorce or the departure of grown children. As the family changes, some women find themselves grasping for some semblance of control -- one of the needs that an eating disorder can fulfill.
Complicating matters for the older patient is the fact that women coming in for treatment later in life may find it harder to get the help they need. For decades, the focus has been young women, and only recently has the therapeutic field begun to expand into treatment for older women -- and men, Sackeyfio said.
"No one is catering to their needs," he said. "That's the same problem that gentlemen had for a while."
Bunnell said anorexics tend to be preoccupied with their body shape or weight, and often suffer from anxiety, perfectionism and obsessive-compulsive disorder. By contrast, bulimics tend to be depressed and impulsive, often struggling with substance-abuse issues.
"The anorexic style is more overly controlled, tense and rigid, while the bulemic style is less controlled, impulsive or disregulated," Bunnell said.
Treatment for eating disorders has evolved as well, with doctors now emphasizing a team-based approach, Sackeyfio said.
"Originally, what people would look at was that it is a psychological problem, but it quickly becomes a physical problem," he said. "You need somebody who's aware of those physical changes to work with you if you're a therapist."
Ideally, someone with an eating disorder should be working with a team that includes a psychiatrist, a nutritionist and a physician, Sackeyfio said.
Most important, the people surrounding someone with an eating disorder need to understand that the patient truly is out of control and needs help, Sackeyfio said.
"They aren't spoiled brats who are trying to make people's lives harder," he said. "They really have very little control over the physical changes that they cause in their own bodies."
More information
To learn more, visit the National Mental Health Information Center.
Or you eat lots -- as much as you want, more than you want -- and then sneak away from your loved ones to purge it all.
But you're not 16, not 19, not 21. Not a young woman at all. You're in your 30s, 40s, or 50s. And you can't stop.
Anorexia and bulimia used to be considered health problems that afflicted teenage girls. But doctors are finding that a growing number of older women are now being diagnosed with some sort of eating disorder.
"It can happen to anybody at any stage of their life," said Dr. Alexander Sackeyfio, a psychiatrist and eating-disorder specialist at the Beaumont Hospital in Royal Oak, Mich. "I think we're becoming more aware of it and are better at diagnosing it."
People tend to make another mistake in their perception of eating disorders -- they assume they are relatively benign psychological problems that are easily treated and without lasting physical effects, said Doug Bunnell, clinical director of the Renfrew Center in Wilton, Conn.
"People are surprised when they learn these have the highest mortality rate of any psychiatric diagnosis, somewhere between 10 and 15 percent," said Bunnell, who's also a member of the National Eating Disorders Association board of directors.
Anorexia produces dramatic weight loss caused by excessive or compulsive dieting. An estimated 0.5 percent to 3.7 percent of women suffer from anorexia nervosa at some point in their lifetime, according to the National Institute of Mental Health.
Anorexics see themselves as overweight even though they're dangerously thin. The process of eating becomes an obsessive minefield and unusual eating habits develop, such as picking out just a few foods and eating them in tiny, carefully measured quantities.
Bulimia is characterized by excessive binge eating followed by purging the food through vomiting, laxatives or over-exercising. An estimated 1.1 percent to 4.2 percent of American females will struggle with bulimia nervosa in their lifetime.
Because of the purging, people with bulimia usually weigh within the normal range for their age and height. But they still suffer the same fears about weight gain as anorexics. So, they often perform bulimic behaviors in secret, feeling disgusted and ashamed when they binge, yet relieved once they purge.
Bunnell said he's seeing more middle-age or even older women coming in for treatment of an eating disorder. But, he's not sure that all of these are new cases developing later in life.
"My experience is that virtually all the women we've seen with eating-disorder symptoms in their 30s or 40s had some prior activity in the more typical age range," Bunnell said. "It may not have been diagnosed, or just short of being serious, but there was a period when they were really struggling with it. We've not seen a lot of brand new, out-of-the-blue eating disorder cases in older women."
Other doctors believe that hormonal fluctuations that occur near menopause could set off an eating disorder, as could mid-life changes like divorce or the departure of grown children. As the family changes, some women find themselves grasping for some semblance of control -- one of the needs that an eating disorder can fulfill.
Complicating matters for the older patient is the fact that women coming in for treatment later in life may find it harder to get the help they need. For decades, the focus has been young women, and only recently has the therapeutic field begun to expand into treatment for older women -- and men, Sackeyfio said.
"No one is catering to their needs," he said. "That's the same problem that gentlemen had for a while."
Bunnell said anorexics tend to be preoccupied with their body shape or weight, and often suffer from anxiety, perfectionism and obsessive-compulsive disorder. By contrast, bulimics tend to be depressed and impulsive, often struggling with substance-abuse issues.
"The anorexic style is more overly controlled, tense and rigid, while the bulemic style is less controlled, impulsive or disregulated," Bunnell said.
Treatment for eating disorders has evolved as well, with doctors now emphasizing a team-based approach, Sackeyfio said.
"Originally, what people would look at was that it is a psychological problem, but it quickly becomes a physical problem," he said. "You need somebody who's aware of those physical changes to work with you if you're a therapist."
Ideally, someone with an eating disorder should be working with a team that includes a psychiatrist, a nutritionist and a physician, Sackeyfio said.
Most important, the people surrounding someone with an eating disorder need to understand that the patient truly is out of control and needs help, Sackeyfio said.
"They aren't spoiled brats who are trying to make people's lives harder," he said. "They really have very little control over the physical changes that they cause in their own bodies."
More information
To learn more, visit the National Mental Health Information Center.
Tuesday, January 02, 2007
New Year, New Goal to Get Healthy
(HealthDay News) -- Have trouble sticking to that annual "get healthy" resolution every New Year? Experts at the International Council on Active Aging (ICAA) offer advice to help older Americans stay with the program in 2007.
To begin, schedule 15 minutes a day for the next four days to plan how you're going to get started. You can boost your motivation by getting a friend involved or by starting a club at your community center or place of worship.
Here are 10 tips for active, healthy aging:
To begin, schedule 15 minutes a day for the next four days to plan how you're going to get started. You can boost your motivation by getting a friend involved or by starting a club at your community center or place of worship.
Here are 10 tips for active, healthy aging:
- Buy a good pair of shoes. Comfortable, well-fitting shoes are essential. Foot pain is not a normal part of aging, says the American Podiatric Medical Association.
- Play games to keep your brain sharp. There are many different kinds of games -- such as trivia, memory and math -- and skill levels to suit all kinds of people. Games can also be a fun way to spend time with others.
- Go for walks, which will help improve lower body strength, maintain mobility and help prevent cognitive decline. Start easy and gradually increase your speed and distance. If you rely on a cane, walker or wheelchair, you can ask a friend to join you for outings.
- Do balance exercises to help you with everyday activities, such as reaching into cupboards. Good balance also helps prevent falls. Many exercise classes for older adults include balance training.
- Get your eyes checked. A study published this year in the Journal of the American Medical Association found that nearly all vision impairment in a large group of people older than 60 years could be improved with corrective lenses.
- Increase your physical activity. This can include yard and house work, walking to the store, or playing ball with the neighbor children. Make a weekly walking date with a friend, join a wellness center, community center, or a health club with programs geared to your interests and needs.
- Nurture relationships with family, friends and neighbors. These kinds of social connections are good for your emotional well-being.
- Eat plenty of fruits and vegetables.
- Laugh a lot. Laughing increases circulation, immune system defenses and mental function.
Get seven to eight hours of sleep per night. If you have trouble falling or staying asleep, make a few changes such as: skipping daytime naps; adopting a nighttime routine; starting a regular exercise program. Changing habits does more to improve sleep than taking medications. - You don't have to do all these things at once, the ICAA said. Start trying them over the next few months.
More information
The U.S. National Center for Chronic Disease Prevention and Health Promotion has more about healthy aging.
Resolve to Exercise Your Brain
(HealthDay News) -- Getting in shape tops many New Year's resolution lists, but the Alliance for Aging Research is encouraging Americans to boost their brain health, too.
"There is a lot we can do to keep our brains healthy and potentially prevent or lessen the cognitive decline that often comes with aging," Daniel Perry, executive director of the nonprofit Alliance for Aging Research, said in a prepared statement. "We are encouraging people to take steps to improve brain health as part of their overall fitness regimen for the New Year."
The Alliance for Aging Research recommends these 10 steps for improving your brain health.
Eat a Brain-Healthy Diet. A diet rich in omega-3 fatty acids (commonly found in fish), protein, antioxidants, fruits and vegetables and vitamin B; low in trans fats; and with an appropriate level of carbohydrates will help keep your brain healthy.
Stay Mentally Active. Activities such as learning a new skill or language, working on crossword puzzles, taking classes, and learning how to dance can help challenge and maintain your mental functioning.
Exercise Regularly. Exercising often can increase circulation, improve coordination, and help prevent conditions that increase the risk of dementia such as heart disease, stroke and diabetes.
Stay Social. Spending time with friends, volunteering, and traveling can keep your mind active and healthy.
Get Plenty of Sleep. Not getting enough sleep can have a negative impact on brain health.
Manage Stress. Participating in yoga, spending time with friends, or doing other stress-relieving activities can help preserve your ability to remember and learn.
Prevent Brain Injury. Wearing protective head gear and seat belts can help you avoid head injury, which has been associated with an increased risk of dementia.
Control Other Health Conditions. Maintaining a healthy weight, exercising, eating a well-balanced and nutritious diet, and controlling stress can help reduce your risk of diseases that affect your brain, including diabetes, heart disease, high blood pressure and hypertension.
Avoid Unhealthy Habits. Smoking, heavy drinking and use of recreational drugs can increase the risk of dementia and cognitive decline.
Consider Your Genes. If your family history puts you at risk for developing dementia, work with your doctor to find ways to maintain your brain health to help avoid or slow the progression of cognitive decline.
More information
The National Institute on Aging has more about forgetfulness.
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"There is a lot we can do to keep our brains healthy and potentially prevent or lessen the cognitive decline that often comes with aging," Daniel Perry, executive director of the nonprofit Alliance for Aging Research, said in a prepared statement. "We are encouraging people to take steps to improve brain health as part of their overall fitness regimen for the New Year."
The Alliance for Aging Research recommends these 10 steps for improving your brain health.
Eat a Brain-Healthy Diet. A diet rich in omega-3 fatty acids (commonly found in fish), protein, antioxidants, fruits and vegetables and vitamin B; low in trans fats; and with an appropriate level of carbohydrates will help keep your brain healthy.
Stay Mentally Active. Activities such as learning a new skill or language, working on crossword puzzles, taking classes, and learning how to dance can help challenge and maintain your mental functioning.
Exercise Regularly. Exercising often can increase circulation, improve coordination, and help prevent conditions that increase the risk of dementia such as heart disease, stroke and diabetes.
Stay Social. Spending time with friends, volunteering, and traveling can keep your mind active and healthy.
Get Plenty of Sleep. Not getting enough sleep can have a negative impact on brain health.
Manage Stress. Participating in yoga, spending time with friends, or doing other stress-relieving activities can help preserve your ability to remember and learn.
Prevent Brain Injury. Wearing protective head gear and seat belts can help you avoid head injury, which has been associated with an increased risk of dementia.
Control Other Health Conditions. Maintaining a healthy weight, exercising, eating a well-balanced and nutritious diet, and controlling stress can help reduce your risk of diseases that affect your brain, including diabetes, heart disease, high blood pressure and hypertension.
Avoid Unhealthy Habits. Smoking, heavy drinking and use of recreational drugs can increase the risk of dementia and cognitive decline.
Consider Your Genes. If your family history puts you at risk for developing dementia, work with your doctor to find ways to maintain your brain health to help avoid or slow the progression of cognitive decline.
More information
The National Institute on Aging has more about forgetfulness.
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Sunday, November 19, 2006
ADHD Drug to Get Stronger Warning
(HealthDay News) -- U.S. officials have asked a pharmaceutical company to add a label warning of a risk for heart problems for patients taking the prescription drug Dexedrine, a stimulant used to treat attention-deficit hyperactivity disorder (ADHD).The warning describes some instances of sudden death in children and teens with structural cardiac abnormalities or other heart problems. It also mentions various potential psychological side effects, including hallucinations or delusional thinking.
The U.S. Food and Drug Administration could not be reached for comment, and it was unclear what other ADHD drugs might be affected by this new warning.
Back in May, the FDA had asked makers of similar stimulant ADHD drugs to add the warnings.
"This had already been done with other stimulants," said Dr. Melvin Oatis, an assistant professor of clinical psychiatry at New York University School of Medicine's Child Study Center. "Dexedrine is in an older class of stimulant,s and not much new had been done with that."
A letter sent from Dexedrine's maker, GlaxoSmithKline, to health-care providers was posted Tuesday on the FDA's Web site. The letter detailed the planned changes to prescription recommendations.
In March, an FDA pediatric advisory committee had recommended that ADHD drugs not carry the more severe "black-box" warnings and instead use simpler language and include more information on the labels about the heart risks posed by the drugs. But the month before, a different FDA advisory committee had reached the opposite conclusion, and called for a black-box warning on ADHD drugs because of possible cardiac risks.
The FDA has apparently settled for the less-severe advisory.
"This is not a black-box warning," Oatis said. "There's some association [between Dexedrine and heart problems]. They're not making this a causality."
An estimated 2.5 million American children under the age of 19 take ADHD drugs, as do 1.5 million adults.
This represents a huge surge in use, experts said.
"ADHD is being recognized more often than it was before," said Dr. Eugenio Rothe, an associate professor of psychiatry at the University of Miami Miller School of Medicine, and director of the child and adolescent psychiatry clinic at Jackson Memorial Hospital. "When the disorder is being recognized more often, obviously there's more use of medication," he said.
In addition to "serious" cardiovascular side effects, the warnings issued since last spring cite possible suppression of children's growth, as well as heightened risks for psychosis, Bipolar disorder and aggression.
The revisions may have an effect on prescribing patterns, Rothe said.
"On the one hand, it may actually help pediatricians and even some psychiatrists be more careful," Rothe said. "But, on the other hand, it scares people away from getting treatment and also increases the amount of time that one has to spend with parents trying to convince them this is the right thing to do. Doctors are already stretched thin."
Oatis added that the new warning "should remind clinicians to review the side-effect profiles of medications. It reminds you to take more of a history of family issues regarding stimulant use and medical cardiac risk."
According to the U.S. National Institutes of Health, ADHD is a disorder characterized by inattention, hyperactivity and impulsivity. These symptoms typically appear early in a child's life. However, many healthy children may have these symptoms, but only at a low level, or the symptoms may be caused by another disorder. For that reason, many experts believe it is important the child receive a thorough examination and appropriate diagnosis by a qualified professional.
More information
The National Institute of Mental Health has more on ADHD.
Wednesday, October 25, 2006
Behavioral Problems Common in Mentally Retarded Children
(HealthDay News) -- Behavioral and emotional problems are common among young people who are mentally retarded, and the incidence of such problems declines very slowly over the years, an Australian study finds.
Not much attention has been paid to these problems, ranging from cursing and head-banging to failure to communicate with other people, said researchers from the University of Sydney. But the study found that 41 percent of the young people they followed had such problems, and the incidence dropped by only about 1 percent a year over a 14-year period.
"Although it declined, the level remained relatively high," said Andrea M. Piccinin, who took part in the study and now is a research associate professor of human development and family sciences at Oregon State University. "We make the case that intervention and more understanding of the factors that would lessen psychopathology would be important."
The findings are published in the Oct. 25 issue of the Journal of the American Medical Association.
The study included 578 children and teens who were ages 5 to 19 at the start of the research in 1991. They were judged by the Developmental Behavior Checklist, a standard measure for children with what are formally called developmental disabilities.
"We looked at a global score and five subscales," Piccinin said. "The social relations subscale showed an increase. As these children come into adolescence and get older, there are more issues with their social relations, because they are in a situation where more is expected of them."
The decrease occurred in the scales that measured anxiety, communication ability, destructive behavior and general disturbance, she said. Overall, the incidence of problems was 30 percent at the end of the study.
The decrease in problems was greater in boys than girls over time, and the decrease was greater in those with mild retardation than in those with severe mental disability.
"The observation that severe psychopathology was already present in a high proportion of the cohort at commencement of the study, and the persistence of these symptoms, suggest the need for effective mental interventions," the researchers said. "This should include support, education and skills training for their parents, who are likely to be stressed by the burden of care."
Only 10 percent of the young people with behavioral and emotional problems received mental health interventions during the study, the researchers found.
"This points to the importance of intervention," Piccinin said.
More information
More on mental retardation is offered by the National Dissemination Center for Children With Disabilities.
Not much attention has been paid to these problems, ranging from cursing and head-banging to failure to communicate with other people, said researchers from the University of Sydney. But the study found that 41 percent of the young people they followed had such problems, and the incidence dropped by only about 1 percent a year over a 14-year period.
"Although it declined, the level remained relatively high," said Andrea M. Piccinin, who took part in the study and now is a research associate professor of human development and family sciences at Oregon State University. "We make the case that intervention and more understanding of the factors that would lessen psychopathology would be important."
The findings are published in the Oct. 25 issue of the Journal of the American Medical Association.
The study included 578 children and teens who were ages 5 to 19 at the start of the research in 1991. They were judged by the Developmental Behavior Checklist, a standard measure for children with what are formally called developmental disabilities.
"We looked at a global score and five subscales," Piccinin said. "The social relations subscale showed an increase. As these children come into adolescence and get older, there are more issues with their social relations, because they are in a situation where more is expected of them."
The decrease occurred in the scales that measured anxiety, communication ability, destructive behavior and general disturbance, she said. Overall, the incidence of problems was 30 percent at the end of the study.
The decrease in problems was greater in boys than girls over time, and the decrease was greater in those with mild retardation than in those with severe mental disability.
"The observation that severe psychopathology was already present in a high proportion of the cohort at commencement of the study, and the persistence of these symptoms, suggest the need for effective mental interventions," the researchers said. "This should include support, education and skills training for their parents, who are likely to be stressed by the burden of care."
Only 10 percent of the young people with behavioral and emotional problems received mental health interventions during the study, the researchers found.
"This points to the importance of intervention," Piccinin said.
More information
More on mental retardation is offered by the National Dissemination Center for Children With Disabilities.
Sunday, October 08, 2006
PTSD Can Take Months to Strike Wounded Iraq and Afghanistan Vets
(HealthDay News) -- Soldiers wounded during combat in Iraq and Afghanistan often develop post-traumatic stress disorder and depression months after getting out of a hospital, instead of soon after suffering their injuries, a new study found.
And the severity of the injuries also helps predict the risk of developing post-traumatic stress disorder (PTSD) or depression.
It's not clear why it's taking more than half a year, in some cases, for symptoms of PTSD and depression to emerge. However, the study authors speculated that the concentrated treatments and therapies offered in a hospital may temporarily ward off psychological problems, leaving them to surface once a soldier has been released and comes to realize the extent of the injuries.
The report was published in the October issue of The American Journal of Psychiatry.
"The rates of PTSD and depression are much lower immediately following the injury than what we were expecting," said lead researcher Dr. Thomas A. Grieger, of the Uniformed Services University of the Health Sciences and Walter Reed Army Medical Center, in Washington, D.C. "We were expecting rates of around 20 percent."
Instead, Grieger and his colleagues found the initial rate of PTSD and depression was 4 percent. The researchers expected the rates of PTSD and depression to be controlled early, as is often the case with victims of automobile accidents. "In contrast, in this [military] population, the rates went up instead of down with time," he said.
For the study, the researchers screened 613 soldiers, who were severely wounded between March 2003 and September 2004. Of those, 243 completed health assessments at one, four, and seven months after their injuries. The rates of PTSD were 4 percent at one month, 12 percent at four months, and 12 percent at seven months. Rates of depression were 4.4 percent at one month, 9 percent at four months, and 9 percent at seven months.
Grieger noted that 78 percent of those soldiers with PTSD or depression at seven months showed no signs of either condition at one month. "There is a need for ongoing evaluation of the individuals that have had these sorts of exposures," he said.
The reasons for these findings aren't clear, Grieger said. He noted, however, that soldiers in a hospital are getting psychiatric care and medication, which may not be continued after the soldiers leave. "It may be that these symptoms come on after they leave the hospital because they are not continuing with their medications," he said. "It may also be that individuals don't report symptoms in the immediate aftermath of the injury."
Grieger further speculated that it's only when the soldiers return home and realize the full impact of their injuries on their lives that PTSD and depression strike.
One expert thinks this study could be helpful in designing programs to prevent and treat PTSD and depression in military personnel.
"Being wounded is a risk factor for PSTD," said Dr. Matthew J. Friedman, executive director of the Department of Veterans Affairs National Center for Post-Traumatic Stress Disorder.
Friedman believes it's important to understand why some soldiers recover from PTSD and depression when they struggle with it early, and why others develop these problems later. "This would enable us to do a better job of developing preventive approaches and trying to improve the situation for people following hospital discharge," he said.
Another researcher noted the rates of PTSD and depression seen among wounded soldiers returning from Iraq and Afghanistan are about the same as those seen among non-wounded soldiers.
"One of the important findings is that wounded soldiers did not have higher rates of PTSD than healthy soldiers surveyed using the same instruments and criteria," said Dr. Charles Hoge, who's with the department of psychiatry and behavioral sciences at Walter Reed Army Institute of Research. "This suggests that the preventive psychiatry services that wounded service members receive at Walter Reed has been effective in mitigating PTSD symptoms."
"The increase from 4 to 12 percent from one to four months is exactly what we've been seeing among non-wounded soldiers," Hoge added, who co-authored the new study. "We know that soldiers may not report mental-health symptoms until several months after they return home, and this study shows that this is true also among the wounded."
More information
The U.S. National Institute of Mental Health can tell you more about PTSD.
And the severity of the injuries also helps predict the risk of developing post-traumatic stress disorder (PTSD) or depression.
It's not clear why it's taking more than half a year, in some cases, for symptoms of PTSD and depression to emerge. However, the study authors speculated that the concentrated treatments and therapies offered in a hospital may temporarily ward off psychological problems, leaving them to surface once a soldier has been released and comes to realize the extent of the injuries.
The report was published in the October issue of The American Journal of Psychiatry.
"The rates of PTSD and depression are much lower immediately following the injury than what we were expecting," said lead researcher Dr. Thomas A. Grieger, of the Uniformed Services University of the Health Sciences and Walter Reed Army Medical Center, in Washington, D.C. "We were expecting rates of around 20 percent."
Instead, Grieger and his colleagues found the initial rate of PTSD and depression was 4 percent. The researchers expected the rates of PTSD and depression to be controlled early, as is often the case with victims of automobile accidents. "In contrast, in this [military] population, the rates went up instead of down with time," he said.
For the study, the researchers screened 613 soldiers, who were severely wounded between March 2003 and September 2004. Of those, 243 completed health assessments at one, four, and seven months after their injuries. The rates of PTSD were 4 percent at one month, 12 percent at four months, and 12 percent at seven months. Rates of depression were 4.4 percent at one month, 9 percent at four months, and 9 percent at seven months.
Grieger noted that 78 percent of those soldiers with PTSD or depression at seven months showed no signs of either condition at one month. "There is a need for ongoing evaluation of the individuals that have had these sorts of exposures," he said.
The reasons for these findings aren't clear, Grieger said. He noted, however, that soldiers in a hospital are getting psychiatric care and medication, which may not be continued after the soldiers leave. "It may be that these symptoms come on after they leave the hospital because they are not continuing with their medications," he said. "It may also be that individuals don't report symptoms in the immediate aftermath of the injury."
Grieger further speculated that it's only when the soldiers return home and realize the full impact of their injuries on their lives that PTSD and depression strike.
One expert thinks this study could be helpful in designing programs to prevent and treat PTSD and depression in military personnel.
"Being wounded is a risk factor for PSTD," said Dr. Matthew J. Friedman, executive director of the Department of Veterans Affairs National Center for Post-Traumatic Stress Disorder.
Friedman believes it's important to understand why some soldiers recover from PTSD and depression when they struggle with it early, and why others develop these problems later. "This would enable us to do a better job of developing preventive approaches and trying to improve the situation for people following hospital discharge," he said.
Another researcher noted the rates of PTSD and depression seen among wounded soldiers returning from Iraq and Afghanistan are about the same as those seen among non-wounded soldiers.
"One of the important findings is that wounded soldiers did not have higher rates of PTSD than healthy soldiers surveyed using the same instruments and criteria," said Dr. Charles Hoge, who's with the department of psychiatry and behavioral sciences at Walter Reed Army Institute of Research. "This suggests that the preventive psychiatry services that wounded service members receive at Walter Reed has been effective in mitigating PTSD symptoms."
"The increase from 4 to 12 percent from one to four months is exactly what we've been seeing among non-wounded soldiers," Hoge added, who co-authored the new study. "We know that soldiers may not report mental-health symptoms until several months after they return home, and this study shows that this is true also among the wounded."
More information
The U.S. National Institute of Mental Health can tell you more about PTSD.
Wednesday, September 20, 2006
Poor Sleep Contributes to Health Problems
(HealthDay News) -- New studies are discovering just how vital sleep is to overall health.So, sleep habits should become a standard part of a complete check-up, researchers say.
"There is increasing evidence that there is a very strong relationship between sleep quality and physical and mental health," said Dr. Phyllis C. Zee, a professor of neurology at Northwestern University's Feinberg School of Medicine.
"If you have poor health, that is associated with poor sleep. Also, if you have poor sleep, there is an association between that and poor health," Zee said. "What we don't have yet is the research to categorically say that if you improve sleep, you will improve conditions, such as diabetes or hypertension, or other medical conditions."
Still, physicians should be asking their patients about the quality and quantity of their sleep, Zee said. "Sleep should be another vital sign," she said.
Zee wrote an editorial in the Sept. 18 issue of the Archives of Internal Medicine, a special, themed issue on sleep and its relationship to overall health.
In one study, led by Richard L. Nahin, a senior advisor for scientific coordination and outreach at the U.S. National Center for Complementary and Alternative Medicine, looked at why people had trouble sleeping and how many were using alternative drugs to help them sleep.
Insomnia and trouble sleeping are most often associated with high blood pressure, heart failure, anxiety and depression, according to a national survey of 31,044 adults. "That's unusual. It had been most often thought that insomnia was quite prevalent on its own, but only 4 percent of the people who said they had insomnia said they had it without any of those conditions," Nahin said.
The researchers also found that 1.6 million Americans are using alternative therapies, such as melatonin to treat their insomnia. "That's quite high when you consider that there is very little reliable data on the efficacy and safety of using the products people are using," Nahin said.
These findings have implications for treating sleep problems, Nahin said.
"Instead of treating the insomnia itself, a health-care provider might be better off treating one of these comorbidities," he said. "In addition, a physician seeing a patient for insomnia should ask if the patient is using any alternative and complementary treatments, because they might upset the treatments the health-care provider wants to apply."
Another study found that people who have sleep-related breathing disorder -- marked by frequent pauses in breathing, labored breathing, or reduced breathing during the night -- were two to 2.6 times more likely to develop depression. Moreover, the odds of depression increased as breathing disorders became more severe, according to researcher Paul E. Peppard and colleagues from the University of Wisconsin.
And a study by French researchers found that people with allergic rhinitis, caused by hay fever and other allergies, have more difficulty sleeping and more sleep disorders than people without allergies. "The results show a significant impact of allergic rhinitis on all dimensions of sleep quality and, consequently, a lower quality of life as reflected by more somnolence [sleepiness]; daytime fatigue and sleepiness; and impaired memory, mood and sexuality, with a significantly increased consumption of alcohol and sedatives in cases compared with the control group," the study authors wrote.
One expert agrees that sleep problems shouldn't be ignored.
"If you think insomnia is an annoyance and merely something you should tough out, that may be a mistake," said Michael L. Perlis, director of the Sleep Research Laboratory at the University of Rochester, in New York. "It may lead you down the path to other morbidities. It would also be a mistake because it's treatable."
Other studies in the same journal issue found that:
· Fewer hours of sleep may contribute to poor health in young adults.
· Those in rural areas who sleep fewer hours appear to weigh more.
· The immune system may play a role in narcolepsy, a disorder characterized by an uncontrollable urge to sleep.
· The immune system may be affected by a lack of sleep that contributes to inflammation and a variety of diseases.
More information
The National Sleep Foundation can tell you more about getting a good night's sleep.
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