Friday, February 29, 2008 8:44 AM
posted by Aric Thorpe, MHR The human desire for one to "keep options open" Recently, some MIT students, under the direction of professor Dan Ariely, took a test to examine the unproductive human desire for one to "keep options open." Holding on to relationships that you know won't work, keeping that outdated shirt that you haven’t worn in years, purchasing that extra protection plan on the camera you just bought, are all examples of most likely unproductive, encumbering decisions that we choose to make just to keep our options open. One of the role models in Professor Ariely's new book, "Predictably Irrational," is Chinese general Xiang Yu who, after crossing the Yanntze River into enemy territory with his troops, destroyed all of his troops pots for cooking and ships. The general told them that it was to keep them focused on moving forward. The following is an excerpt of an article by the New York Times that discusses this oddity of human behavior:
In the M.I.T. experiments, the students should have known better. They played a computer game that paid real cash to look for money behind three doors on the screen. (You can play it yourself, without pay, at tierneylab.blogs.nytimes.com.) After they opened a door by clicking on it, each subsequent click earned a little money, with the sum varying each time.
As each player went through the 100 allotted clicks, he could switch rooms to search for higher payoffs, but each switch used up a click to open the new door. The best strategy was to quickly check out the three rooms and settle in the one with the highest rewards.
Even after students got the hang of the game by practicing it, they were flummoxed when a new visual feature was introduced. If they stayed out of any room, its door would start shrinking and eventually disappear.
They should have ignored those disappearing doors, but the students couldn’t. They wasted so many clicks rushing back to reopen doors that their earnings dropped 15 percent. Even when the penalties for switching grew stiffer — besides losing a click, the players had to pay a cash fee — the students kept losing money by frantically keeping all their doors open.
Click here to read the rest of this article from the New York Times
link to this post  Wednesday, February 27, 2008 8:32 AM
posted by Aric Thorpe, MHR It is beneficial for rheumatologists to ask their patients about depression A recent study reveals that it may be beneficial for rheumatologists to ask their patients about depression. The study, a randomized trail of communication strategies between patient and doctor, is still underway. Its findings revealed that 80% of depressed patients failed to mention their state to their rheumatologists. According to Betsy Sleath, Ph.D., "Chronic diseases can greatly affect a patient's psychosocial well-being, and depression can also affect a patient's adherence to treatment regimens."
The key message here is that doctor patient communication is vital. It may benefit rheumatologists to obtain more resources and training in identifying depression in their patients. The following is an excerpt of an article from Medpage Today that reviews the study:
The study was part of a randomized trial of provider-patient communication strategies that is not yet completed. The new report is based on the baseline patient examinations by their rheumatologists, which were recorded and transcribed.
It included 200 patients and eight rheumatologists in four clinics. Most of the analysis focused on 21 patients with severe or moderately severe depression.
This level of depression was defined by scores of at least 15 on the Patient Health Questionnaire.
Patients had previously seen the rheumatologists, but the researchers did not determine for how long.
Dr. Sleath and colleagues found that only four of the encounters (19%) included discussion of patients' depressive symptoms. All four were initiated by the patients, not the physician.
Their report included quotes from the recorded conversations. In one case, the patient described feelings of depression and day-long crying jags. The physician was supportive and sympathetic, but did not explore the issues. According to Dr. Sleath and colleagues, the only medically substantive discussion was about the patient's drug regimen for arthritis and follow-up appointment.
Click here to read the entire article from Medpage Today
Click here for information on the treatment of depression
link to this post Monday, February 25, 2008 12:37 PM
posted by Aric Thorpe, MHR Childhood abuse increases the cost of healthcare later in life According to a recent study, childhood abuse increases the cost of healthcare later in life. According to Amy Bonomi, PhD, and colleagues, women who reported childhood abuse had an average of 35% higher costs of healthcare annually in their adult lives. Specifically, women who reported physical abuse had costs that were 22% and higher. Women who reported sexual abuse had costs that were 16% higher. "This study provides the strongest evidence to date about the impact of abuse well into adulthood," Dr. Bonomi said. This study is different from previous studies in that it reports actual cost increases relative to childhood abuse in females. The follow is an excerpt of an article from Medpage Today the reviews the study:
Dr. Bonomi and colleagues randomly selected women between 18 and 64 who had been members of the health plan for at least three years and conducted a telephone survey to discover the extent of abuse.
Of 6,321 women who were called, 3,333 completed the interview, gave consent for their health records to be used in the study, and met other inclusion criteria.
Their mean age was 47 and on average there was 7.4 years of data for each participant.
The telephone survey found that 34% of the women (1,128) reported at least one form of childhood abuse. Sexual abuse was reported by 671 women, physical abuse by 216, and both by 214.
Combining that information with recorded use of healthcare services, the researchers found that women who suffered both types of abuse were significantly more likely to use mental health services, emergency departments, hospital outpatient departments, pharmacy services, primary care services, and specialty care than were women with no history of abuse.
For instance, they were twice as likely to use mental health services and nearly twice as likely to visit an emergency department. The relative risks were 2.07 and 1.86, with 95% confidence intervals from 1.67 to 2.57 and from 1.47 to 2.35, respectively.
Click here to read the entire article from Medpage Today
Click here for information on the treatment of PTSD
link to this post Friday, February 22, 2008 8:30 AM
posted by Aric Thorpe, MHR Why some friends won't take advice Some friends simply won't take any advice. In some, this may be simply because they are hard headed. However, in others compulsions or other mental health issues may be at the center of their dilemma. According to Angela Wurtzel, a Santa Barbara psychotherapist, "These compulsions serve a purpose as a self-soothing or coping mechanism for deep psychological pain." The fact is that these kinds of coping mechanisms develop over lengthy periods of time and people cannot convince even the closest of their friends to change in these situations; in fact, you may alienate yourself from your friend in the process of overbearingly trying to do so. In situations like these, what a friend may see as a problem with a simple solution may be much more complex for the individual to overcome. "A friend can offer support, but finding the reasons behind the behavior, and breaking down resistance? That's a therapist's job," said Wurtzel. The following is an excerpt of an article from CNN.com that discusses the complexities of this issue:
"I told her I thought it was a mistake," says Theresa. "So she kicked me out of her wedding party. We didn't speak for six months."
And the happy couple?
"Within a year, her husband left her for another man," said Theresa, who asked that her full name not be used.
For Theresa, a medical receptionist in the Adirondacks, this was one more incident that followed a familiar pattern: Her friend picks the wrong man, and Theresa is left to pick up the pieces.
The final straw came when Theresa's friend gave a different boyfriend power of attorney even though Theresa begged her not to.
"I just felt powerless," says Theresa.
Such hard-to-control impulses cause behavior that is not only self-destructive but prompts frustration and anger among friends and family trying to lend a hand.
Roots of self-destructive behavior
"Nobody wants to watch someone they love hurt themselves," says Angela Wurtzel, a psychotherapist in Santa Barbara, California, specializing in "hunger diseases" like eating disorders, self-injury and compulsive shopping.
But in almost all cases, she warns, trying to help will backfire.
What a well-intentioned friend may see as a clear-cut problem with an obvious solution -- an anorexic should eat more, for example, or a compulsive shopper should cut up the credit card -- is something far more complex.
Click here to read the rest of this article from CNN.com
Click here for information on the treatment of compulsive behaviors
link to this post Thursday, February 21, 2008 12:16 PM
posted by Penny Rott, MS Suicide a Midlife Risk? The New York Times reports that suicide among men and women between the ages of 45 and 54 has increased by 20 percent from 1999 to 2004. For women between the ages of 45 to 54 the rate rose 31 percent, with a 28.8 percent rise in those between ages 50 and 54. Despite the suicide rate increase the overall number of women who died was 834 between the ages of 50 and 54. For men ages 45 to 54 the suicide rate increased 15.6 percent. Further studies show that overall, 1 out of 5 who commit suicide is a Vietnam Era Veteran, and 4 out of 5 people who commit suicide are men. While midlife suicide has increased a whopping 20 percent overall, the suicide rate among teens has increased by 2 percent, and for individuals over the age of 65 it has actually decreased. Dr. Caine attributes some of this to the lack of a national support system for those between the ages of 19 and 65. Experts say that the poignancy of a young death and higher suicide rates among the very old in the past have drawn the vast majority of news attention and prevention resources. For example, $82 million was devoted to youth suicide prevention programs in 2004, after the 21-year-old son of Senator Gordon H. Smith, Republican of Oregon, killed himself. Suicide in middle age, by comparison, is often seen as coming at the end of a long downhill slide, a problem of alcoholics and addicts, society’s losers. “There’s a social-bias issue here,” said Dr. Eric C. Caine, co-director at the Center for the Study of Prevention of Suicide at the University of Rochester Medical Center, explaining why suicide in the middle years of life had not been extensively studied before. The lack of concrete research has given rise to all kinds of theories, including a sudden drop in the use of hormone-replacement therapy by menopausal women after health warnings in 2002, higher rates of depression among baby boomers or a simple statistical fluke. Currently researchers are leaning towards a correlation between the use and abuse of prescription drugs and suicide; as there was a staggering increase in the total number of drug overdoses, both intentional and accidental, during the same five year period. Myrna M. Weissman, the chief of the department in Clinical-Genetic Epidemiology at New York State Psychiatric Institute, suggests that the growing pressures of modern life, the changes in the family unit, and the breakdown of family and friend support networks are the root of the problem.
More recently, reports of a study that spanned 80 countries found that around the world, middle-aged people were unhappier than those in any other age group, but that conclusion has been challenged by other research, which found that among Americans, middle age is the happiest time of life. Epidemiologists also emphasize that at least another five years of data on suicide are needed before any firm conclusions can be reached about a trend.
Click here to read the entire article in the New York Times
link to this post
8:24 AM
posted by Aric Thorpe, MHR Common antidepressants can help to treat obsessive-compulsive disorder According to a recent review of 17 studies published in the Cochrane Library, common antidepressants such as Zoloft or Prozac can help to treat obsessive-compulsive disorder (OCD). The review, which included 3,097 individuals, found that SSRI's (selective serotonin reuptake inhibitors), six to 13 weeks after initial use, were more effective than placebo. Patients that took SSRIs were twice as likely to have a level of relief from the symptoms of OCD. Current therapies for OCD encourage the individual to confront and tolerate the irrational fears that are created by the disorder. However, approximately 25 percent of people suffering from OCD refuse this type of therapy as a treatment option. SSRIs may offer some relief to this population. The following is an excerpt of an article from Medical News Today that summarizes the review:
Common antidepressant drugs such as Prozac and Zoloft can be effective treatment options for obsessive compulsive disorder (OCD), according to a new review of studies.
Patients who take selective serotonin reuptake inhibitors, or SSRIs, are twice as likely to get some relief from their OCD symptoms as those who take placebo pills are.
However, the drugs have a "modest" effect at best, said Dr. Ghulam Mustafa Soomro, lead review author and honorary research fellow at St. George's Hospital Medical School in London.
"Although SSRIs should be considered potentially effective treatments for OCD patients, treatment decisions need to take account of the potential adverse effects of these drugs," including nausea, insomnia and sexual dysfunction, he warned.
The review of studies appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
Many people with OCD seek out therapy that teaches them to confront, tolerate and gradually wean themselves from obsessive and compulsive behaviors.
"This is the primary kind of therapy used for OCD. It teaches patients to pay attention to their internal experiences and tolerate scary thoughts without having to act on them," said Sanjaya Saxena, M.D., director of the Obsessive-Compulsive Disorders Program at the University of California, San Diego School of Medicine. "They learn that nothing terrible happens if they refrain from their usual compulsive behaviors."
Click here to read the rest of this article from Medical News Today
Click here for more information on obsessive compulsive disorder
link to this post Wednesday, February 20, 2008 8:31 AM
posted by Aric Thorpe, MHR Obesity doubles the risk of developing several kinds of cancers A recent large study published in the February 16th issue of The Lancet confirms the long time association between body-fat and cancer. The study found that obesity doubled a person's chances of developing several kinds of cancers. Additionally, the researchers found that obesity may also play a role in some rare forms of cancer. The study has made a strong connection between obesity and colon, pancreas, breast, endometrium, and rectal cancer, as well as a particular kind of esophageal cancer. The main message that can be derived from this study, which the American Institute for Cancer Research has laid out in ten points, is exercise, eat your vegetables and leafy greens, and attempt to stay at a healthy weight. The following is an excerpt of an article from Medical New Today that reviews the findings of the study:
Experts at the American Institute for Cancer Research (AICR) welcomed new results from a British study that links excess body fat to several cancers.
"This new analysis falls closely in line with the conclusions of AICR's comprehensive expert report, Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective," said AICR Nutritionist Sarah Wally, RD. "The expert panel who wrote that report reviewed hundreds of studies and determined that staying lean may be the most important thing we can do to protect against cancer. Today's results bear that conclusion out."
The new study appears in the February 16 issue of the British medical journal The Lancet. Researchers found that obesity doubled the risk for several common cancers, and that excess body fat may play a role in some rare cancers as well.
Last November, the AICR expert panel concluded that carrying excess body fat is now convincingly linked to cancers of the colon, rectum, pancreas, kidney, endometrium, breast (post-menopausal) and a specific kind of esophageal cancer as well.
The metabolically active nature of body fat is thought to be a main reason for the cancer link. Fat cells constantly pump a variety of proteins and hormones into the bloodstream. Over time, these substances can raise risk for cancer.
Click here to read the entire article
Click here for information on compulsive overeating
link to this post Monday, February 18, 2008 1:14 PM
posted by Aric Thorpe, MHR Cannabis use connected with decreased cognitive function in MS patients A recent study has connected cannabis use with decreased cognitive function in MS patients. According to the study, published in the February 13th addition of Neurology, people with multiple sclerosis sometimes use marijuana in order to lessen the emotional difficulties of the disease; however, there is no scientific proof that the use of marijuana aids in reducing emotional difficulties in this population. Researchers relayed that the portion of MS patients that use marijuana is significant. According to Anthony Feinstein, MPhil, PhD, "this is the first study to show that smoking marijuana can have a harmful effect on the cognitive skills of people with MS.” The following is an excerpt of an article from Medical News Today that reviews the study:
"This is important information because a significant minority of people with MS smoke marijuana as a treatment for the disease, even though there are no scientific studies demonstrating that it is an effective treatment for emotional difficulties."
Feinstein noted that MS itself can cause cognitive problems. "In addition, cognitive problems can greatly affect the quality of life for both patients and their caregivers," he said.
For the study, researchers interviewed 140 Canadian people with MS. Of those, 10 people had smoked marijuana within the last month and were defined as current marijuana users. The marijuana users were then each matched by age, sex, the length of time they had MS, and other factors to four people with MS who did not smoke marijuana.
The researchers then evaluated the participants for emotional problems such as depression, anxiety and other psychiatric disorders. They also tested the participants' thinking skills, speed at processing information, and memory.
Click here to read the rest of this article from Medical News Today
link to this post Friday, February 15, 2008 8:27 AM
posted by Aric Thorpe, MHR Smoking cannabis is linked with periodotal disease in young adults According to a recent study conducted by Murray Thomson, PhD, of Sir John Walsh Research Institute, and associates, smoking cannabis is linked with periodotal disease in young adults. It has been long known that tobacco is a risk factor for periodontal disease, but research on cannabis in this regard has been limited. The study was composed of 1015 individuals born at Queen Mary Hospital in Dunedin, New Zealand who received dental exams at ages 26 and 32. Each of the participants were administered questioners about their cannabis use and as a result were divided into three categories, those who had no exposure (32.3%), some exposure (47.4%), and high exposure (20.2%). The study found that those who were categorized as having high exposure to cannabis experienced 23.6% incident attachment loss. The researchers reported that there was "no interaction between cannabis use and tobacco in predicting the condition's occurrence." The following is an excerpt of the study from The Journal of the American Medical Association:
The study's demonstration of a strong association between cannabis use and periodontitis experience by age 32 years indicates that long-term smoking of cannabis is detrimental to the periodontal tissues and that public health measures to reduce the prevalence of cannabis smoking may have periodontal benefits for the population. To our knowledge, no previous studies have examined this relationship, so there are no data with which to compare the findings. Determining whether the association exists in other populations should be a priority for periodontal epidemiological research. The nature of the biological mechanism for the observed association is currently unclear. The periodontal effects of tobacco smoke are thought to occur via the systemic effects of nicotine and other toxic constituents on immune function and the inflammatory response within the periodontal tissues. Cannabis contains more than 400 compounds, including more than 60 cannabinoids; the noncannabinoid constituents are similar to tobacco (except for nicotine), and those have been reported to carry systemic health risks and have histopathological effects that are similar to those of tobacco smoke.21-22
Although definitively establishing the periodontal effects of exposure to cannabis smoke should await confirmation in other populations and settings, health promoters and dental and medical practitioners should take steps to raise awareness of the strong probability that regular cannabis users may be doing damage to the tissues that support their teeth.
Click here to read the entire study from The Journal of the American Medical Association
link to this post Thursday, February 14, 2008 8:35 AM
posted by Aric Thorpe, MHR Link between PTSD and early death A recent study has found a link between PTSD and early death. The study, which was published in the February issue of the Journal of Nervous and Mental Disease, found that Vietnam era veterans were more than twice as likely to die by the year 2000. Joseph A. Boscarino, Ph.D., M.P.H., noted that the death rate probably stemmed from multiple risk factors associated with PTSD, factors which may interact negatively. For instance, vets with PSTD were also found to have systemic inflammation, were often drug abusers, and partook in other risky behaviors. The following is an excerpt of an article from Medpage Today that reviews the study:
Posttraumatic stress disorder is a risk factor for early death, a study of Vietnam-era veterans showed.
Veterans diagnosed with posttraumatic stress disorder in the mid-1980s were more than twice as likely to die by 2000 as those who did not have a PTSD diagnosis, reported Joseph A. Boscarino, Ph.D., M.P.H., of Geisinger Health System here, in the February issue of the Journal of Nervous and Mental Disease.
Dr. Boscarino found a hazard ratio for all-disease death in Vietnam-era veterans of 2.1 (95% CI 1.4 to 3.1, P<0.001) after adjusting for other risk factors, including markers of chronic inflammation and stress, as well as smoking, obesity, age, race, intelligence, Army intake status, alcohol abuse, depression, and antisocial personality disorder.
High erythrocyte sedimentation rate, white blood cell count, and cortisol:dehydroepiandrosterone sulfate ratio were also significant and independent predictors of early all-disease death, Dr. Boscarino reported.
"Although PTSD is a predictor of future disease mortality, there are other common biologic factors operative among trauma-exposed populations," he wrote.
Click here to read the rest of this article from Medpage Today
Click here for information on the treatment of PTSD
link to this post Wednesday, February 13, 2008 8:30 AM
posted by Aric Thorpe, MHR Smokers may be getting less sleep and experiencing more daytime fatigue A recent study suggests that smokers may be getting less sleep and experiencing more daytime fatigue than non-smokers. The basic theory for the restless sleep and fatigue is that smokers experience nicotine withdraws during the sleeping hours, which disrupts good sleep. Specifically, participants in the study reported restless sleep four times more than nonsmokers. Additionally, smokers were found to spend less time in deep sleep and more time in light sleep than nonsmokers.
The study, published in the February issue of Chest, was unique in that it analyzed data from a sleep EEG with a technique called power spectral analysis rather than conventional home polysomnography, a technique typical of many previous studies. The following is an excerpt of an article from Medpage Today that reviews the study’s finds:
Nightly nicotine withdrawal may contribute to a restless sleep and fatigue the next day, a small study showed.
Action Points
* Explain to interested patients that, in addition to all the other reasons not to smoke, it appears that nicotine withdrawal may interfere with getting a good night's sleep.
Four times more smokers reported lack of restful sleep than nonsmokers (P<0.02), Naresh M. Punjabi, M.D., Ph.D., of Johns Hopkins here, and colleagues, reported in the February issue of Chest.
Furthermore, smokers spent less time in deep sleep and more in light sleep than nonsmokers, with the greatest differences occurring in the early stages of sleep, according to an objective analysis of sleep EEGs, the researchers said.
Although the exact mechanism underlying the sleep disturbances in smokers is not known, withdrawal from nicotine is likely to be an important factor, Dr Punjabi said.
Previous studies comparing smokers and nonsmokers have primarily used subjective measures of sleep, the researchers said.
This study is unique, they said, because in addition to conventional home polysomnography using visual sleep-stage scoring, sleep architectures were studied with a technique known as power spectral analysis of sleep EEG activity.
The latter relies on a mathematical analysis (discrete fast Fourier transform) of the different frequencies within the sleep EEG.
Click here to read the rest of this excerpt from Medpage Today
link to this post Monday, February 11, 2008 9:01 AM
posted by Aric Thorpe, MHR Misery is not miserly A new study has revealed that people who are sad tend to spend more money and to generally be more extravagant. The study, preformed by four universities (Harvard, Stanford, Pittsburgh, and Carnegie Mellon) analyzed the spending responses of individuals after watching a movie clip. Thirty-three participants were asked to watch a sad video about a boy who lost his mentor, while others in a control group watched a video about the Great Barrier Reef. The participants were each given ten dollars to participate in the study and were offered a chance to exchange a portion of that money for a sports bottle. On average the group that watched the sad video spent $2.11 for a trendier bottle, while others that did not watch the sad video spent on average 56 cents. The researchers deducted that sad feelings caused the participant to focus on self and thus, presumably, spend more to feel better about themselves. The following is an excerpt of an article from CNN.com that reviews the study’s findings:
Study participants who watched a sadness-inducing video clip offered to pay nearly four times as much money to buy a water bottle than a group that watched an emotionally neutral clip.
The so-called "misery is not miserly" phenomenon is well-known to psychologists, advertisers and personal shoppers alike, and has been documented in a similar study in 2004.
The new study released Friday by researchers from four universities goes further, trying to answer whether temporary sadness alone can trigger spendthrift tendencies.
The study found a willingness to spend freely by sad people occurs mainly when their sadness triggers greater "self-focus." That response was measured by counting how frequently study participants used references to "I," "me," "my" and "myself" in writing an essay about how a sad situation such as the one portrayed in the video would affect them personally.
The brief video was about the death of a boy's mentor. Another group watched an emotionally neutral clip about the Great Barrier Reef, the vast coral reef system off Australia's coast.
On average, the group watching the sad video offered to pay nearly four times as much for a sporty-looking, insulated water bottle than the group watching the nature video, according to the study by researchers from Harvard, Carnegie Mellon, Stanford and Pittsburgh universities.
Thirty-three study subjects -- young adults who responded to an advertisement offering $10 for participation -- were offered the chance to trade some of the $10 to buy the bottle. The sad group offered to trade an average of $2.11, compared with 56 cents for the neutral group.
Click here to read the rest of this excerpt from CNN.com
Click here to read about depression treatment options
link to this post Friday, February 08, 2008 11:54 AM
posted by Rolf B. Gainer, Ph.D. A Long Ago Brain Injury May Account for Today's Problems Researchers at the Brain Injury Research Center at the Mt. Sinai School of Medicine are identifying previously unrecognized brain injury as the cause of many psychiatric problems. Wayne Gordon, the Center's Director and his team have identified high rates of "hidden brain injury"in individuals with other psychiatric and or addictions problems. The CDC acknowledges 5.3 million Americans living with brain injury. Dr. Gordon's research may find a link between mental health problems and addiction in many more cases than imaginable, making the CDC data look insignificant. The research may also lead us to a better understanding of why individuals fail in treatment. The neurocognitive problems from an untreated brain injury may prevent a person from benefiting from the traditional arsenal of medication and talk therapy.
Some years ago Dorothy Lewis, MD conducted a study of death row inmates and found an alarming rate of brain injury, neurological disease, child abuse and other factors which could account for the criminal conduct of these individuals. In another study involving incarcerated adolescent offenders, Dr. Lewis found a similar relationship between past neurological injuries and disease and dangerous criminal behavior. Were these adolescents waiting to join the death row adults?
In the 1970's when I was working for the Massachusetts Division of Legal Medicine we conducted an informal study of incarcerated males in the county system. Over 25% of the individuals we examined had untreated learning disabilities. The evidence is becoming increasingly clear. There is a relationship between many mental health and addiction problems and brain injury. We need to expand how we evaluate and assess individuals who enter into the mental health, substance abuse and criminal justice systems. Is there a history of brain injury that could be the cause of the problem? Does failure in earlier treatment relate to the person's diminished ability to benefit from an approach requiring specific cognitive skills, such as reading, memory, information process or decision making? Are the medications the ones we would use with a person who has a brain injury?
I think Dr. Gordon's study will tell us what we already know: there are more people with brain injuries than we can imagine.
link to this post 7:42 AM
posted by Aric Thorpe, MHR Is the door locked, the garage door shut, the stove off, the sink not dripping? An estimated five to seven million Americans are struggling with OCD (obsessive compulsive disorder) and anxiety disorders. These are people that you wouldn’t necessarily suspect, unless you saw them in action. Anyone from the common Joe to executive officers within organizations deals with the dynamic duo. Those that have learned how to cope with either of the two disorders can sometimes use them to their advantage, as a motivating force. For instance, individuals in roles surrounding tasks that require a great deal of detail may use their obsessive personality to be thorough, complete, accurate. Nevertheless, when OCD or anxiety, two conditions that are often found together in individuals, are out of the individual’s control, disrupting life and hindering productivity, it is always a good idea to seek the help of a professional.
There are many triggers surrounding OCD and anxiety disorder. Public places such as restaurants can cause a variety of issues for the person with OCD, from worry that others will notice their indulgent behaviors, to concern about the cleanliness of the food and those that prepared it. Individuals, for instance, at a buffet may need to go wash their hands after every item they retrieve for fear of germs. Perhaps upon arrival the individual with OCD feels the need to repeatedly check to make sure the car brake is on. Even worse, the individual with OCD may need to drive all the way home to ensure that the door is locked, the garage door shut, the stove and oven are off, and or the sink is not dripping.
Obviously, there are a variety of objects and situations that the person with OCD can become obsessed with. Some with OCD may focus on germs, another symmetry, and another may obsess about not hurting others. According to Dr. Micheal Jenike, medical director of the Obsessive Compulsive Disorders Institute, “The common thread, I think, has something to do with certainty… If you have O.C.D., whatever form, there seems to be some problem with being certain about things — whether they’re safe or whether they’ve been done right.” The following is an excerpt of an enjoyable article from the New York Times that paints a picture of the disorder(s) in a restaurant setting:
If Carole Johnson, a retired school administrator who lives near Sacramento, Calif., happens to have a distressing thought while passing through a doorway, she needs to “clear” the thought by passing through the door twice more, doing it precisely three times.
My own challenge is fighting the urge to return to my parked car and check yet again that the parking brake is secure. If I don’t, how can I be sure my car won’t roll into something — or worse, someone?
Ms. Johnson and I are but two of the estimated five to seven million Americans battling obsessive-compulsive disorder, an anxiety disorder characterized by intrusive distressing thoughts and repetitive rituals aimed at dislodging those thoughts. We are an eclectic bunch spanning every imaginable cross-section of society, and we battle an equally eclectic mix of obsessions and compulsions. Some of us obsess about contamination, others about hurting people, and still others about symmetry. Almost all of us can find something to obsess about at a restaurant.
Sometimes the trouble is the element of public theater in the dining room, meaning we have to indulge in our often-embarrassing rituals under the eyes of so many strangers while trying not to get caught. Or it might be worrying about the safety of the food and the people who serve it.
Click here to read the rest of this article from the New York Times
Click here for more information on Anxiety Disorders
link to this post Thursday, February 07, 2008 7:43 AM
posted by Aric Thorpe, MHR Have you ever felt like an imposter, a phony, a fraud? Have you ever felt like an imposter, a phony, a fraud? Perhaps that is a more normal and healthy response to the demands of life than you think. It is important, however, to under-gird this discussion with the idea that chronic and severe anxiety surrounding feelings of personal inadequacy are not normal and should be addressed by a professional. However, many people, many successful people such as doctors, graduate students, parents, perhaps even presidents, experience a phenomenon that, in the 1970's, was described as "impostor phenomenon."
The idea is that one feels as though their personal claims of competency fall short of what one is actually capable of. However, people experiencing the impostor phenomenon, later described as a reflection of an anxious personality, actually strive to perform better; they have an intense desire to show that they can perform better than others. Two psychologists from Purdue University, Shamala Kurmar and Carolyn M. Jagacinski, administered a questionnaire asking participants about their imposter feelings and levels of anxiety and found that female students that scored highly on the measures were in fact found to be more competitive.
The following is an excerpt of an article from the New York Times that reviews several studies surrounding this phenomenon:
Their findings have veered well away from the original conception of impostorism as a reflection of an anxious personality or a cultural stereotype. Feelings of phoniness appear to alter people’s goals in unexpected ways and may also protect them against subconscious self-delusions.
Questionnaires measuring impostor fears ask people how much they agree with statements like these: “At times, I feel my success has been due to some kind of luck.” “I can give the impression that I’m more competent than I really am.” “If I’m to receive a promotion of some kind, I hesitate to tell others until it’s an accomplished fact.”
Researchers have found, as expected, that people who score highly on such scales tend to be less confident, more moody and rattled by performance anxieties than those who score lower.
But the dread of being found out is hardly always paralyzing. Two Purdue psychologists, Shamala Kumar and Carolyn M. Jagacinski, gave 135 college students a series of questionnaires, measuring anxiety level, impostor feelings and approach to academic goals. They found that women who scored highly also reported a strong desire to show that they could do better than others. They competed harder.
By contrast, men who scored highly on the impostor scale showed more desire to avoid contests in areas where they felt vulnerable. “The motivation was to avoid doing poorly, looking weak,” Dr. Jagacinski said.
Click here to read the rest of this article from the New York Times
Click here for more information on anxiety disorders
link to this post Wednesday, February 06, 2008 8:11 AM
posted by Aric Thorpe, MHR Possible increase in suicides among army soldiers in 2007 The amount of army suicides has been growing. 2007 has experienced a “possible” increase in suicides of over 20 percent, with as many as 121 soldiers reported to have committed suicide. The exact numbers consist of 89 confirmed suicides and 32 deaths that are suspect and still under investigation. The number of suicides for 2007, if confirmed, would be more than double the amount reported in 2001, 52 suicides.
This occurred regardless of the various efforts over the past year to support the mental health of soldiers in Iraq and Afghanistan through various federally funded programs. Approximately a quarter of the estimated amount of suicide victims died during a tour in Iraq. Additionally, 2007 showed an increase in attempted suicides at 2,100, compared to 1,500 in 2006, and only 500 in 2002. The following is an excerpt of an article from CNN.com that reviews the numbers:
Officials said the rate of suicides per 100,000 active duty soldiers has not yet been calculated for 2007. But in a half million-person active duty Army, the 2006 toll of 102 translated to a rate of 17.5 per 100,000, the highest since the Army started counting in 1980, officials said. The rate has fluctuated over those years, with the low being 9.1 per 100,000 in 2001.
Col. Elspeth Ritchie, the psychiatry consultant to the Army surgeon general, has said that officials found failed personal relationships, legal and financial problems and the stress of their jobs have been main factors in soldiers' suicides.
Officials also have found that the number of days troops are deployed in Iraq, Afghanistan or nearby countries contributes to that stress.
With the Army stretched thin by years of fighting the two wars, the Pentagon last year extended normal tours of duty to 15 months from 12 and has sent some troops back to the wars several times.
The Army has been hoping to reduce tour lengths this summer. But the prospect could depend heavily on what Gen. David Petraeus, the top U.S. commander in Iraq, recommends when he gives his assessment of security in Iraq and troop needs to Congress in April.
Click here to read the rest of the AP’s story on CNN.com
Click here for information on suicide and depression
link to this post Tuesday, February 05, 2008 9:20 AM
posted by Rolf B. Gainer, Ph.D. Brain Function in Borderline Personality Disorder The cause of Borderline Personality Disorder has challenged researchers and clinicians for years. The hallmarks of Borderline Personality Disorder: a characteristic negative affective state; high reactivity and diminished ability to self-regulate emotion in previous neuropsychological studies have been attributed to orbitofrontal dysfunction. A study by Silbersweig et al published in the American Journal of Psychiatry 2007 December; 164: 1832 involving 16 individuals with Borderline Personality Disorder and 14 control subjects showed less activation of the subgenual anterior cingulate cortex and the posterior medial orbitofrontal cortex than the controls did and more activity in the left and right extended amygdala and ventral striatum. This study is important in helping individuals with Borderline Personality Disorder with more specific pharmacological interventions and in using more targeted approaches to help individuals learn to self-regulate their behavior.
link to this post 9:01 AM
posted by Rolf B. Gainer, Ph.D. Suicide Risk Consistent in World Survey The risk factors for suicide were found to be consistent according to a study released by the World Health Organization (WHO). The study involved face-to-face interviews with 84,850 participants in 17 countries. Approximately 9% reported they had "seriously thought about suicide" and 3% that they had made an attempt. The risk factors were consistent from, country to country. The risk factors were: having a mental illness, being female, being younger, less educated and unmarried. The rates varied from country to country; ranging from 3.1% in China to 15.9% in New Zealand. 60% of the individuals who transitioned from thinking about suicide to an attempt occurred in the first year. The average life rates of suicidal ideation, having a plan and making an attempt were 9.2%, 3.1% and 2.7% respectively.The mental health risk factors were highest among individuals with mood disorders and impulse control disorders followed by anxiety and substance abuse disorders. Economics entered into the study with high income countries showing a presence of a mood disorder as the strongest predictor of suicidal ideas and behavior and in low- and middle- income countries, the presence of an impulse control disorder was the stronger predictor.
This retrospective study, while not adjusted for traumatic life events and other stressors, offers us an understanding of the risk factors which are shared by all people and the progression from suicidal thought, to a plan and eventually to act.
link to this post 8:33 AM
posted by Aric Thorpe, MHR Suicide risk among users of Chantix? The FDA has confirmed 39 suicides (34 U.S.) among those that are using a new stop-smoking drug called varenicline (Chantix). In addition to the suicides, 420 reports of mood changes ranging from suicidal thoughts, anxiety, depression, and nervousness have been received. The drug, which has been used by approximately five million people since it was released in May of 2006, works by blocking the alpha4-beta2 nicotinic receptor in the brain.
The FDA has yet to confirm a causal link between the events and the drug itself. Additionally, the FDA still confirms their previous position that the smoking-cessation affects of the drug may outweigh the risks. Pfizer has issued new warnings on the drug's label and in their commercial advertising for the drug.
Action Point: Physicians should carefully monitor the behavior of patients using the drug. Additionally, any deviation from normal emotions or thoughts when using the drug should be reported to a physician.
The following is an excerpt of an article from Medpage Today that reviews the FDA's findings:
The FDA said today it has confirmed 39 suicides -- 34 of them in the U.S. -- among persons using the smoking-cessation drug varenicline (Chantix).
Overall the FDA said it has 420 confirmed reports of mood changes, including anxiety, nervousness, depressed mood, tension, and suicidal behavior or suicidal thoughts. Some of the reports have been from people taking the drug even though they have not yet quit smoking.
Moreover, the FDA said that although most of the symptoms were reported by patients using the drug, it has also confirmed cases where symptoms arose after the drug was stopped.
Nonetheless, the FDA reiterated its previous position that the drug was an effective smoking-cessation agent. At a press briefing, Bob Rappaport, M.D., director of the FDA's division of anesthesia, analgesia, and rheumatology products, said those benefits might outweigh the risks.
Click here to read the rest of the article
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link to this post Friday, February 01, 2008 7:56 AM
posted by Aric Thorpe, MHR Connection between cannabis and liver fibrosis among those that have chronic hepatitis C Researches have found a connection between cannabis and liver fibrosis among those that have chronic hepatitis C. The study was published in the January issue of Clinical Gastroenterology and Hepatology. Norah Terrault, M.D., and colleagues, studied 204 patients with chronic HCV from 2001 through 2004. Of the participants, the median age was 46.8, most were male (69.1%), and the major cause of infection with HCV was drug use with needles (70.1% of the cases). The practical message that the study conveys is that physicians should counsel those with HCV to abstain from use of marijuana. The following is an excerpt of an article from Medpage Today that reviews the study:
Participants were mostly male (69.1%) and their median age was 46.8. The source of the HCV infection was presumed to be injection drug use in 70.1% of cases.
The primary outcome of the study was fibrosis score, assessed by biopsy, and the main predictor that the researchers evaluated was use of cannabis.
They found that 13.7% of the participants used the drug daily during the 12 months before entering the study, 45.1% used it occasionally, and 41.2% never used it. For the risk analyses, cannabis use was broken into daily and non-daily use.
They also found that 27.5% of volunteers had a fibrosis stage of F0, 55.4% had mild fibrosis (stages F1 or F2), and 17.2% had moderate to severe fibrosis (stages F3 through F6).
Click here to read the entire article
Click here to learn more about treatment for drugs and alcohol
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Rolf B. Gainer, Ph.D., Diplomate ABDA, is the Chief Executive Office at Brookhaven Hospital and the Vice President of Rehabilitation Institutes of America. Dr. Gainer has been involved in the design and operation of treatment programs since 1977.
Stephen Harnish, MD is the Medical Director of Brookhaven Hospital. Dr. Harnish is a member of the American Psychiatric Association and is well known in Oklahoma for his informative radio and television appearances.
Aric Thorpe, MHR, is Brookhaven Hospital's Pastoral Liaison Representative. He conducts the quarterly Minister's Lifeline series and provides mental health information to pastors and clergy.
Sarah McGee serves as the Community Education Provider for Brookhaven Hospital. She provides information on mental health and drug and alcohol treatment to healthcare professionals in Oklahoma and surrounding states. |
