Theories abound about the cause of Irritable Bowel Disease (IBD): Diet? Stress? Perhaps an infection?
On the other hand, is it possible depression could be triggering the disease in some of the 20 per cent of Canadians suffering from this digestive system disorder?
New research conducted by scientists in McMaster University's Intestinal Disease Research Program suggests it's highly likely that in some patients depression is wreaking havoc on the gut. Their research appears in today's online edition of The Journal of Clinical Investigation.
"The gut is intimately connected to the brain, more than any other organ in the body. In fact, the gut contains more nerves than the spinal cord," said Jean-Eric Ghia, lead researcher and a post-doctoral fellow in McMaster's program.
Ghia and his colleagues evaluated mice which had been induced with depressive-like behaviours, then continued to follow them after the animals had been given anti-depressants. The experiment illustrated how the nervous system influences inflammation in the gut.
"Our study shows that depression increases susceptibility to inflammation, and anti-depressant therapies improve not only the depression but also the inflammation in the gut," he said.
The researchers also demonstrated that the vagus nerve - which starts in the brain stem and extends to the gastrointestinal tract - protects against inflammation by releasing nicotine. "In the absence of this nerve, the anti-depressant therapy does not improve inflammation in the gut, suggesting that this nerve is a major link between the brain and the gut," Ghia said.
For patients, he said the findings are significant: They illustrate the close relationship between depression and IBD and indicate selected depressed patients with IBD might benefit from novel treatment strategies, such as anti-depressants, the use of highly selective nicotinic stimulant (nicotinic receptors are found in the autonomic nervous system) or nerve stimulation.
McMaster University, a world-renowned, research-intensive university, fosters a culture of innovation, and a commitment to discovery and learning in teaching, research and scholarship. Based in Hamilton, the University, one of only four Canadian universities to be listed on the Top 100 universities in the world, has a student population of more than 23,000, and an alumni population of more than 131,000 in 128 countries.
McMaster University
среда, 29 июня 2011 г.
воскресенье, 26 июня 2011 г.
Paranoid Thoughts Almost As Common As Depression/Anxiety Reveal King's College Scientists
Ground-breaking research from clinical psychologists at the Institute of Psychiatry, King's College London, shows that one in three people in the UK regularly suffers paranoid or suspicious fears. In fact this level of paranoia is much higher than previously suspected and means that paranoid thoughts may well be almost as common as depression or anxiety.
Paranoid thinking is the suspicion that other people intend to do us harm.
The study found that:
-- over 40% of people regularly worry that negative comments are being made about them
-- 27% think that people deliberately try to irritate them
-- 20% worry about being observed or followed
-- 10% think that someone has it in for them
-- 5% worry that there's a conspiracy to harm them
The research conducted amongst 1200 people highlights the surprising extent of paranoia amongst the UK population, and the distress they can cause. Worries about other people are so common that they seem to be an essential - if unwelcome - part of what it means to be human.
Dr Daniel Freeman, who conducted the study with Professor Philippa Garety at the Institute of Psychiatry, said: "We were astonished at how common paranoia and suspicion are amongst the population and that these thoughts may be almost as common as anxious or depressed thinking. Understandably there are certain instances when it is important to practice caution, such as taking money from a cash machine without alerting too much attention and walking down a poorly-lit street at night. Following last year's London bombings, it is natural that underground train travellers are more vigilant than before. However our research demonstrates that there can be a tendency to exaggerate our fears. Our study shows just how many of us are worrying - probably unnecessarily - about something that might not happen instead of getting on with the more enjoyable and productive parts of our lives."
"What we also found in our study was that these suspicious thoughts can cause real distress. Our research has highlighted this trend - until recently we had little idea of the extent of the problem, and little sense of how to help people overcome their fears. But the good news is that there are now very effective ways of reducing unfounded suspiciousness."
Overcoming Paranoid and Suspicious Thoughts
A new website is being launched: paranoidthoughts which provides information on paranoid thoughts, advice on seeking help, and opportunities for people to share their experiences. Also the results of the research are detailed in the world's first self-help book on dealing with paranoid thoughts published on the 3 July 2006, Overcoming Paranoid and Suspicious Thoughts, published by Constable and Robinson. The book explains how these fears arise and presents practical steps to deal with them, alongside personal accounts by those affected by paranoid thoughts and includes questionnaires and exercises to help readers learn about and combat their fears.
The frequency of paranoid and suspicious thoughts in the general population
% having thought at least weekly
-- I need to be on my guard against others - 52%
-- Strangers and friends look at me critically - 48%
-- There might be negative comments being circulated about me - 42%
-- People are laughing at me - 34%
-- Bad things are being said about me behind my back - 30%
-- People might be hostile towards me - 29%
-- People deliberately try to irritate me - 27%
-- I might be being observed or followed - 19%
-- People are trying to make me upset - 12%
-- Someone I know has bad intentions towards me - 12%
-- I am under threat from others - 10%
-- I have a suspicion that someone has it in for me - 8%
-- Someone I don't know has bad intentions towards me - 8%
-- People would harm me given the opportunity - 8%
-- There is a possibility of a conspiracy against me - 5%
Examples of paranoid thoughts
Doreen is a fifty-eight year-old shop worker from London: At work, if I am restocking the shelves and other staff members are nearby, I sometimes think they are joking and talking about me, but I know they aren't really.
Chris, a twenty-six year-old teacher: Standing at a bus stop at night when I was back in Liverpool, a group of drunken youths were walking towards me, and I was worried they may be intent on causing trouble, or they may try to hurt me.
Liz, a twenty-four year-old musician from Bristol: I once thought a housemate was trying to steal my possessions as I often caught her standing in the corridor near my room and nowhere near her own room. I got really wound up about this and ended up locking some of my valuables in the garden shed. After this, I began to have other thoughts - like she was trying to poison me because she was always asking me to eat food that she had made and giving me new foreign alcohol to try.
Alex, a forty-two year-old lorry driver and former soldier from Scotland: For a while I used to believe that M15, Mossad, and the police were trying to kidnap and torture me.
Melissa, a thirty-nine year old mother of three, felt that a neighbour was intent upon entering her house and stealing her property.
Greg, a nineteen year-old student: If I'm with a friend and someone rings them on their mobile and they tell the caller they're with me, well if the caller then says something I can't hear and the friend I'm with laughs, I always think that the person on the other end of the phone said something horrible about me.
Richard is a thirty-four year-old journalist. He became fearful that his family was trying to physically harm him.
Institute of Psychiatry
King's College London
De Crespigny Park, London
United Kingdom SE5 8AF
iop.kcl.ac.uk
Paranoid thinking is the suspicion that other people intend to do us harm.
The study found that:
-- over 40% of people regularly worry that negative comments are being made about them
-- 27% think that people deliberately try to irritate them
-- 20% worry about being observed or followed
-- 10% think that someone has it in for them
-- 5% worry that there's a conspiracy to harm them
The research conducted amongst 1200 people highlights the surprising extent of paranoia amongst the UK population, and the distress they can cause. Worries about other people are so common that they seem to be an essential - if unwelcome - part of what it means to be human.
Dr Daniel Freeman, who conducted the study with Professor Philippa Garety at the Institute of Psychiatry, said: "We were astonished at how common paranoia and suspicion are amongst the population and that these thoughts may be almost as common as anxious or depressed thinking. Understandably there are certain instances when it is important to practice caution, such as taking money from a cash machine without alerting too much attention and walking down a poorly-lit street at night. Following last year's London bombings, it is natural that underground train travellers are more vigilant than before. However our research demonstrates that there can be a tendency to exaggerate our fears. Our study shows just how many of us are worrying - probably unnecessarily - about something that might not happen instead of getting on with the more enjoyable and productive parts of our lives."
"What we also found in our study was that these suspicious thoughts can cause real distress. Our research has highlighted this trend - until recently we had little idea of the extent of the problem, and little sense of how to help people overcome their fears. But the good news is that there are now very effective ways of reducing unfounded suspiciousness."
Overcoming Paranoid and Suspicious Thoughts
A new website is being launched: paranoidthoughts which provides information on paranoid thoughts, advice on seeking help, and opportunities for people to share their experiences. Also the results of the research are detailed in the world's first self-help book on dealing with paranoid thoughts published on the 3 July 2006, Overcoming Paranoid and Suspicious Thoughts, published by Constable and Robinson. The book explains how these fears arise and presents practical steps to deal with them, alongside personal accounts by those affected by paranoid thoughts and includes questionnaires and exercises to help readers learn about and combat their fears.
The frequency of paranoid and suspicious thoughts in the general population
% having thought at least weekly
-- I need to be on my guard against others - 52%
-- Strangers and friends look at me critically - 48%
-- There might be negative comments being circulated about me - 42%
-- People are laughing at me - 34%
-- Bad things are being said about me behind my back - 30%
-- People might be hostile towards me - 29%
-- People deliberately try to irritate me - 27%
-- I might be being observed or followed - 19%
-- People are trying to make me upset - 12%
-- Someone I know has bad intentions towards me - 12%
-- I am under threat from others - 10%
-- I have a suspicion that someone has it in for me - 8%
-- Someone I don't know has bad intentions towards me - 8%
-- People would harm me given the opportunity - 8%
-- There is a possibility of a conspiracy against me - 5%
Examples of paranoid thoughts
Doreen is a fifty-eight year-old shop worker from London: At work, if I am restocking the shelves and other staff members are nearby, I sometimes think they are joking and talking about me, but I know they aren't really.
Chris, a twenty-six year-old teacher: Standing at a bus stop at night when I was back in Liverpool, a group of drunken youths were walking towards me, and I was worried they may be intent on causing trouble, or they may try to hurt me.
Liz, a twenty-four year-old musician from Bristol: I once thought a housemate was trying to steal my possessions as I often caught her standing in the corridor near my room and nowhere near her own room. I got really wound up about this and ended up locking some of my valuables in the garden shed. After this, I began to have other thoughts - like she was trying to poison me because she was always asking me to eat food that she had made and giving me new foreign alcohol to try.
Alex, a forty-two year-old lorry driver and former soldier from Scotland: For a while I used to believe that M15, Mossad, and the police were trying to kidnap and torture me.
Melissa, a thirty-nine year old mother of three, felt that a neighbour was intent upon entering her house and stealing her property.
Greg, a nineteen year-old student: If I'm with a friend and someone rings them on their mobile and they tell the caller they're with me, well if the caller then says something I can't hear and the friend I'm with laughs, I always think that the person on the other end of the phone said something horrible about me.
Richard is a thirty-four year-old journalist. He became fearful that his family was trying to physically harm him.
Institute of Psychiatry
King's College London
De Crespigny Park, London
United Kingdom SE5 8AF
iop.kcl.ac.uk
четверг, 23 июня 2011 г.
Depression In Females Linked To Sense Of Smell
Can't smell the roses? Maybe you're depressed. Smell too much like a rose yourself? Maybe you've got the same problem. Scientists from Tel Aviv University recently linked depression to a biological mechanism that affects the olfactory glands. It might explain why some women, without realizing it, wear too much perfume.
Scientific research that supports this theory was published this year in the journal Arthritis and Rheumatism. "Our scientific findings suggest that women who are depressed are also losing their sense of smell, and may overcompensate by using more perfume," explains researcher Prof. Yehuda Shoenfeld, a member of the Sackler Faculty of Medicine at Tel Aviv University. "We also believe that depression has biological roots and may be an immune system response to certain physiological cues."
Women who are depressed are also more likely to lose weight. With a reduced sense of smell, they are less likely to have a healthy appetite, he says.
Prof. Shoenfeld draws his conclusions from lifetime research on autoimmune diseases, focusing on conditions such as lupus, arthritis and rheumatism.
More Than a Feeling
Affecting about 1.5 million Americans, depression accompanying lupus, Prof. Shoenfeld has found, is much more than an emotional reaction to being ill. It appears to have a biological cause.
In lupus patients and those with other autoimmune diseases, a particle known as an "autoantibody" attacks the person's own immune system, appearing in the human body as an aberrant reaction to autoimmune diseases. This particle "is a real novelty," says Prof. Shoenfeld. "We have found that, when generated, it weakens a person's sense of smell and can induce the feeling of depression."
Scientists today widely accept the fact that people with Alzheimer's disease lose their sense of smell. Prof. Shoenfeld's research is the first that links depression to smell in lupus patients, however.
The implications are wide and can be applied to the general population, says Prof. Shoenfeld. "People who are depressed seem to respond well to aromatherapy. Certain smells seem to help them overcome the effects of the biological factors, suggesting that depression may have a biological cause."
This research also raises questions about the cause of psychotic disorders such as schizophrenia. "There may be an organic cause to these disorders, and if this is the case, clinicians might have to change their attitude about current therapies they use," Prof. Shoenfeld says. "I think that science is able to show that aromatherapy might not be just for quacks. After all, some of these remedies have been used since the time of the Egyptians to treat organic diseases."
Prof. Shoenfeld also suggests that a standardized "smell test" could be used by doctors to help diagnose depression as well as autoimmune diseases.
Retail Therapy and Aromatherapy
He adds that the association between one's sense of smell and depression has interesting implications for "smell marketing," used by retailers to encourage shoppers to buy, especially around holiday time. "These tactics are already being used by retailers and banks all over the world," says Prof. Shoenfeld.
"The retail industry has learned that if it splashes good smells around, it can convince clients to buy more and invest more money. It certainly has an effect on one's mood."
Prof. Shoenfeld is an internationally recognized expert in autoimmune diseases and a medical doctor. He is the head of the Department of Medicine "B" at the Sheba Medical Center in Israel and edits four medical journals, including Harefua (in Hebrew), The Journal of Autoimmunity, Autoimmunity Reviews and the Israel Medical Association Journal. Work on this recent study was done in close collaboration with Prof. Joab Chapman, the head of the Neurology Department at Sheba Medical Center, and a professor at Tel Aviv University.
American Friends of Tel Aviv University supports Israel's largest and most comprehensive center of higher learning. It is ranked among the world's top 100 universities in science, biomedical studies, and social science, and rated one of the world's top 200 universities overall. Internationally recognized for the scope and groundbreaking nature of its research programs, Tel Aviv University consistently produces work with profound implications for the future.
Scientific research that supports this theory was published this year in the journal Arthritis and Rheumatism. "Our scientific findings suggest that women who are depressed are also losing their sense of smell, and may overcompensate by using more perfume," explains researcher Prof. Yehuda Shoenfeld, a member of the Sackler Faculty of Medicine at Tel Aviv University. "We also believe that depression has biological roots and may be an immune system response to certain physiological cues."
Women who are depressed are also more likely to lose weight. With a reduced sense of smell, they are less likely to have a healthy appetite, he says.
Prof. Shoenfeld draws his conclusions from lifetime research on autoimmune diseases, focusing on conditions such as lupus, arthritis and rheumatism.
More Than a Feeling
Affecting about 1.5 million Americans, depression accompanying lupus, Prof. Shoenfeld has found, is much more than an emotional reaction to being ill. It appears to have a biological cause.
In lupus patients and those with other autoimmune diseases, a particle known as an "autoantibody" attacks the person's own immune system, appearing in the human body as an aberrant reaction to autoimmune diseases. This particle "is a real novelty," says Prof. Shoenfeld. "We have found that, when generated, it weakens a person's sense of smell and can induce the feeling of depression."
Scientists today widely accept the fact that people with Alzheimer's disease lose their sense of smell. Prof. Shoenfeld's research is the first that links depression to smell in lupus patients, however.
The implications are wide and can be applied to the general population, says Prof. Shoenfeld. "People who are depressed seem to respond well to aromatherapy. Certain smells seem to help them overcome the effects of the biological factors, suggesting that depression may have a biological cause."
This research also raises questions about the cause of psychotic disorders such as schizophrenia. "There may be an organic cause to these disorders, and if this is the case, clinicians might have to change their attitude about current therapies they use," Prof. Shoenfeld says. "I think that science is able to show that aromatherapy might not be just for quacks. After all, some of these remedies have been used since the time of the Egyptians to treat organic diseases."
Prof. Shoenfeld also suggests that a standardized "smell test" could be used by doctors to help diagnose depression as well as autoimmune diseases.
Retail Therapy and Aromatherapy
He adds that the association between one's sense of smell and depression has interesting implications for "smell marketing," used by retailers to encourage shoppers to buy, especially around holiday time. "These tactics are already being used by retailers and banks all over the world," says Prof. Shoenfeld.
"The retail industry has learned that if it splashes good smells around, it can convince clients to buy more and invest more money. It certainly has an effect on one's mood."
Prof. Shoenfeld is an internationally recognized expert in autoimmune diseases and a medical doctor. He is the head of the Department of Medicine "B" at the Sheba Medical Center in Israel and edits four medical journals, including Harefua (in Hebrew), The Journal of Autoimmunity, Autoimmunity Reviews and the Israel Medical Association Journal. Work on this recent study was done in close collaboration with Prof. Joab Chapman, the head of the Neurology Department at Sheba Medical Center, and a professor at Tel Aviv University.
American Friends of Tel Aviv University supports Israel's largest and most comprehensive center of higher learning. It is ranked among the world's top 100 universities in science, biomedical studies, and social science, and rated one of the world's top 200 universities overall. Internationally recognized for the scope and groundbreaking nature of its research programs, Tel Aviv University consistently produces work with profound implications for the future.
понедельник, 20 июня 2011 г.
The Blues Aren't Black And White For Teens, Australia
Teenagers think mental illness carries much more stigma than it actually does, according to new research from The Australian National University.
A study of over 1,300 12 to 17 year-olds by the Centre for Mental Health Research (CMHR) at ANU found that mental illness does carry a stigma amongst adolescents, but that teenagers overestimate its extent.
The study differentiated between 'personal depression stigma', an individual's beliefs about depression, and 'perceived depression stigma', or an individual's perception of what other people think and feel about depression.
Lead researcher, Dr Alison Calear, said that identifying the levels of personal and perceived depression stigma in Australian adolescents is extremely important.
"Young people do not seek help for depression because of fear of negative attitudes in the wider community, especially from their peers," said Dr Calear.
"Stigmatising attitudes and beliefs towards depression are not uncommon and can lead to feelings of fear, avoidance, bias, anger or distrust towards individuals with the disorder.
"Greater understanding of the development of stigmatising attitudes and beliefs can help inform new strategies and techniques to reduce stigma in the community and ultimately increase help-seeking behaviour," she said.
Another key finding in the study was that teenagers considered other people's depression stigma as significantly higher than their own.
"Most young people do not believe that mental health problems arise from a 'weakness of character'," said Dr Calear. "However teenagers are inclined to think that others their age would believe this to be the case.
"Because teenagers overestimate the extent of negative views surrounding depression publicising the actual levels of personal depression stigma will help reduce perceived stigma.
"Anti-stigma campaigns and interventions aimed at challenging stereotypes and increasing education about the nature of mental illness would help young people," she added.
Other key findings in the study were that males were more likely to be stigmatising than girls, younger adolescents had more stigmatising views than older ones, and young people were more likely to think others would have stigmatising beliefs if they themselves had a parent who experienced depression.
A study of over 1,300 12 to 17 year-olds by the Centre for Mental Health Research (CMHR) at ANU found that mental illness does carry a stigma amongst adolescents, but that teenagers overestimate its extent.
The study differentiated between 'personal depression stigma', an individual's beliefs about depression, and 'perceived depression stigma', or an individual's perception of what other people think and feel about depression.
Lead researcher, Dr Alison Calear, said that identifying the levels of personal and perceived depression stigma in Australian adolescents is extremely important.
"Young people do not seek help for depression because of fear of negative attitudes in the wider community, especially from their peers," said Dr Calear.
"Stigmatising attitudes and beliefs towards depression are not uncommon and can lead to feelings of fear, avoidance, bias, anger or distrust towards individuals with the disorder.
"Greater understanding of the development of stigmatising attitudes and beliefs can help inform new strategies and techniques to reduce stigma in the community and ultimately increase help-seeking behaviour," she said.
Another key finding in the study was that teenagers considered other people's depression stigma as significantly higher than their own.
"Most young people do not believe that mental health problems arise from a 'weakness of character'," said Dr Calear. "However teenagers are inclined to think that others their age would believe this to be the case.
"Because teenagers overestimate the extent of negative views surrounding depression publicising the actual levels of personal depression stigma will help reduce perceived stigma.
"Anti-stigma campaigns and interventions aimed at challenging stereotypes and increasing education about the nature of mental illness would help young people," she added.
Other key findings in the study were that males were more likely to be stigmatising than girls, younger adolescents had more stigmatising views than older ones, and young people were more likely to think others would have stigmatising beliefs if they themselves had a parent who experienced depression.
пятница, 17 июня 2011 г.
First-Tme Mothers At Increased Risk For Postpartum Mental Disorders
New mothers are at an increased risk for mental disorders such as schizophrenia, depression and bipolar disorder in the 3 months following the birth of their first child, according to a study in the December 6 issue of JAMA. The study also found that first-time fathers do not have an increased risk for mental disorders.
Postpartum depression is a serious mental health problem for women and their families, with an estimated prevalence of about 10 percent to 15 percent among mothers. Postpartum disorders can also include more severe mental disorders, with a prevalence of about 1 per 1,000 births, according to background information in the article. There is some indication that a small percentage of men experience postpartum depression, but the possible relationship between becoming a father and first onset of mental disorders has not been established.
Trine Munk-Olsen, M.Sc., of the University of Aarhus, Denmark and colleagues conducted a study to estimate the risk of postpartum mental disorders requiring hospital admission or outpatient contact for first-time mothers and fathers up to 12 months after becoming a parent. The researchers analyzed data from Danish health and civil service registers, which for this study included a total of 2,357,942 Danish-born persons who were followed up from their 15th birthday or January 1973, whichever came later, until date of onset of the disorder in question, date of death, date of emigration from Denmark, or July 2005, whichever came first.
From 1973 to 2005, a total of 630,373 women and 547,431 men became parents for the first time. A total of 1,171 women and 658 men were admitted with a mental disorder to a psychiatric hospital during the first 12 months after parenthood, and the corresponding prevalence of severe mental disorders through the first 3 months after childbirth was 1.03 per 1,000 births for mothers and 0.37 per 1,000 births for fathers. For first-time mothers, the first weeks and months after the delivery were associated with an increased risk of first admission with any mental disorder, and the period from 10 to 19 days following the birth was associated with the highest risk (7.3 times increased risk) compared with women who had given birth 11 to 12 months previously. The increased risk of admission among mothers remained statistically significant through the first 3 months after childbirth regardless of age of the mother. Risk for mothers was also increased for psychiatric outpatient contacts through the first 3 months after childbirth, also with the highest risk occurring 10 to 19 days following the birth.
Unlike motherhood, fatherhood was not associated with any increased risk of hospital admission or outpatient contact. "This may indicate that the causes of postpartum mental disorders are more strongly linked to an altered physiological process related to pregnancy and childbirth than psychosocial aspects of motherhood."
"Accurate estimates of the rates of and risk factors for postpartum depression are highly important for the scientific and clinical understanding of mental and behavioral disorders during the postpartum period as well as for planning mental health services for childbearing women and their families," the authors write.
(JAMA. 2006;296:2582-2589.)
This study was supported by the Stanley Medical Research Institute, Chevy Chase, Md. Psychiatric epidemiological research at the National Centre for Register-Based Research is in part funded through a collaborative agreement with the Centre for Basic Psychiatric Research, Psychiatric Hospital, Aarhus, Denmark. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Postpartum Depression - A Major Public Health Problem
In an accompanying editorial, Katherine L. Wisner, M.D., M.S., of the University of Pittsburgh Medical Center, and colleagues comment on the findings concerning postpartum depression.
"These collective data [Munk-Olsen et al and other studies] emphasize the importance of recognizing childbearing as a potent health factor in the life course of women. Childbearing influences the course of any disease state and acts as a biopsychosocial factor that may precipitate new episodes of illness. The data also provide evidence to inform and support universal screening for postpartum mood episodes. The studies converge on the time frame of elevated risk for both hospitalization and outpatient contacts as the first 3 months postpartum, particularly in primiparae [first birth], independent of considerations of diagnosis," they write. "Therefore, screening should be implemented as early as 2 weeks after delivery and no later than 12 weeks postpartum to identify episodes of major mood disorder and other mental illnesses."
"Effective treatments for these episodes exist. Rapid implementation of treatment is prudent because mood episodes can be lengthy and psychosocial sequelae increase with duration. Maternal depression exacts a heavy toll on women's functioning and the health and well-being of their children. … Mental health is crucial to a mother's capacity to function optimally, enjoy relationships, prepare for the infant's birth, and cope with the stresses and appreciate the joys of parenthood."
(JAMA. 2006;296:2616-2618.)
Please see the editorial for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Trine Munk-Olsen
JAMA and Archives Journals
Postpartum depression is a serious mental health problem for women and their families, with an estimated prevalence of about 10 percent to 15 percent among mothers. Postpartum disorders can also include more severe mental disorders, with a prevalence of about 1 per 1,000 births, according to background information in the article. There is some indication that a small percentage of men experience postpartum depression, but the possible relationship between becoming a father and first onset of mental disorders has not been established.
Trine Munk-Olsen, M.Sc., of the University of Aarhus, Denmark and colleagues conducted a study to estimate the risk of postpartum mental disorders requiring hospital admission or outpatient contact for first-time mothers and fathers up to 12 months after becoming a parent. The researchers analyzed data from Danish health and civil service registers, which for this study included a total of 2,357,942 Danish-born persons who were followed up from their 15th birthday or January 1973, whichever came later, until date of onset of the disorder in question, date of death, date of emigration from Denmark, or July 2005, whichever came first.
From 1973 to 2005, a total of 630,373 women and 547,431 men became parents for the first time. A total of 1,171 women and 658 men were admitted with a mental disorder to a psychiatric hospital during the first 12 months after parenthood, and the corresponding prevalence of severe mental disorders through the first 3 months after childbirth was 1.03 per 1,000 births for mothers and 0.37 per 1,000 births for fathers. For first-time mothers, the first weeks and months after the delivery were associated with an increased risk of first admission with any mental disorder, and the period from 10 to 19 days following the birth was associated with the highest risk (7.3 times increased risk) compared with women who had given birth 11 to 12 months previously. The increased risk of admission among mothers remained statistically significant through the first 3 months after childbirth regardless of age of the mother. Risk for mothers was also increased for psychiatric outpatient contacts through the first 3 months after childbirth, also with the highest risk occurring 10 to 19 days following the birth.
Unlike motherhood, fatherhood was not associated with any increased risk of hospital admission or outpatient contact. "This may indicate that the causes of postpartum mental disorders are more strongly linked to an altered physiological process related to pregnancy and childbirth than psychosocial aspects of motherhood."
"Accurate estimates of the rates of and risk factors for postpartum depression are highly important for the scientific and clinical understanding of mental and behavioral disorders during the postpartum period as well as for planning mental health services for childbearing women and their families," the authors write.
(JAMA. 2006;296:2582-2589.)
This study was supported by the Stanley Medical Research Institute, Chevy Chase, Md. Psychiatric epidemiological research at the National Centre for Register-Based Research is in part funded through a collaborative agreement with the Centre for Basic Psychiatric Research, Psychiatric Hospital, Aarhus, Denmark. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Postpartum Depression - A Major Public Health Problem
In an accompanying editorial, Katherine L. Wisner, M.D., M.S., of the University of Pittsburgh Medical Center, and colleagues comment on the findings concerning postpartum depression.
"These collective data [Munk-Olsen et al and other studies] emphasize the importance of recognizing childbearing as a potent health factor in the life course of women. Childbearing influences the course of any disease state and acts as a biopsychosocial factor that may precipitate new episodes of illness. The data also provide evidence to inform and support universal screening for postpartum mood episodes. The studies converge on the time frame of elevated risk for both hospitalization and outpatient contacts as the first 3 months postpartum, particularly in primiparae [first birth], independent of considerations of diagnosis," they write. "Therefore, screening should be implemented as early as 2 weeks after delivery and no later than 12 weeks postpartum to identify episodes of major mood disorder and other mental illnesses."
"Effective treatments for these episodes exist. Rapid implementation of treatment is prudent because mood episodes can be lengthy and psychosocial sequelae increase with duration. Maternal depression exacts a heavy toll on women's functioning and the health and well-being of their children. … Mental health is crucial to a mother's capacity to function optimally, enjoy relationships, prepare for the infant's birth, and cope with the stresses and appreciate the joys of parenthood."
(JAMA. 2006;296:2616-2618.)
Please see the editorial for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Trine Munk-Olsen
JAMA and Archives Journals
вторник, 14 июня 2011 г.
American Association Of Kidnay Patients Develops Understanding Depression Brochures
The American Association of Kidney Patients (AAKP) announced the development of two new depression brochures. Understanding Depression in Kidney Disease is the latest addition to the AAKP Understanding series. It is accompanied by When Your Loved One is Depressed, Tips on How You Can Help.
Nearly 30 million Americans suffer from some form of depression. Many people with depression do not seek help, even though most of those with severe cases can be helped. Kidney disease patients are at an increased risk of suffering from depression. Understanding Depression in Kidney Disease and When Your Loved One is Depressed, gives readers an understanding of what depression is, what may cause it and how it is treated.
"People just don't understand depression," says AAKP President Bobbi Wager, MSN, RN. "But knowing the signs and symptoms may prompt a patient to seek the help he or she needs."
"This is a terrible disease that affects millions of people," says AAKP Executive Director/CEO Kris Robinson. "Not only does it affect the patient, but their loved ones also. These brochures are part of AAKP's mission to help kidney patients and their loved ones deal with the emotional impact of kidney disease."
AAKP would like to thank Amgen for sponsoring the brochures. If you would like a copy of Understanding Depression in Kidney Disease or When Your Loved One is Depressed, call AAKP at 800-749-AAKP. You can also download a copy from the AAKP Web site, aakp.
AAKP is the voluntary, patient organization, which for more than 35 years, has been dedicated to improving the lives of fellow kidney patients and their families by helping them deal with the physical, emotional and social impact of kidney disease. The programs offered by AAKP inform and inspire patients and their families to better understand their condition, adjust more readily to their circumstances, and assume more normal, productive lives in their communities.
Nearly 30 million Americans suffer from some form of depression. Many people with depression do not seek help, even though most of those with severe cases can be helped. Kidney disease patients are at an increased risk of suffering from depression. Understanding Depression in Kidney Disease and When Your Loved One is Depressed, gives readers an understanding of what depression is, what may cause it and how it is treated.
"People just don't understand depression," says AAKP President Bobbi Wager, MSN, RN. "But knowing the signs and symptoms may prompt a patient to seek the help he or she needs."
"This is a terrible disease that affects millions of people," says AAKP Executive Director/CEO Kris Robinson. "Not only does it affect the patient, but their loved ones also. These brochures are part of AAKP's mission to help kidney patients and their loved ones deal with the emotional impact of kidney disease."
AAKP would like to thank Amgen for sponsoring the brochures. If you would like a copy of Understanding Depression in Kidney Disease or When Your Loved One is Depressed, call AAKP at 800-749-AAKP. You can also download a copy from the AAKP Web site, aakp.
AAKP is the voluntary, patient organization, which for more than 35 years, has been dedicated to improving the lives of fellow kidney patients and their families by helping them deal with the physical, emotional and social impact of kidney disease. The programs offered by AAKP inform and inspire patients and their families to better understand their condition, adjust more readily to their circumstances, and assume more normal, productive lives in their communities.
суббота, 11 июня 2011 г.
Conference - A Whole School Approach To Crisis Intervention And Suicide Prevention - Irish Association Of Suicidology
Youth suicide remains a major problem in Ireland. According to the WHO Ireland has the seventh highest rate of suicide in people aged 15- 24 in the EU. A very high proportion of adolescents have thoughts of suicide and research has revealed that children as young as 6 years of age have presented at casualty departments following attempted suicide. Research has also shown that for every person who presents at casualty there are probably as many as ten who do not.
The Irish Association of Suicidology, dedicated to suicide prevention, is holding its Seventh National Conference on suicide prevention in schools in the Brandon Hotel, Tralee, Co Kerry from Tuesday 13th to Thursday 16th of November. Suicide prevention begins in the home and in the school. The school has a very important part to play in suicide prevention in identifying pupils at risk and dealing with them appropriately and in insuring that pupils leave school with adequate life skills and problem solving skills including help seeking behaviour to cope with life in the real world.
The conference addresses A Whole School Approach to Suicide Prevention and Crisis Intervention and the role of school principals, teachers and school guidance counsellors in the process. Suicide risk factors, warning signs of suicide and how to cope with the aftermath of suicide will be covered in detail. The importance of developing a comprehensive suicide prevention policy in every school is examined in detail. Leading experts in the field from home and abroad will share their expertise and experience.
The conference is tailored to the needs of all school staff, members of parents and youth organisations and any body with an interest in suicide prevention. Your attendance may save a life.
Irish Association of Suicidology
The Irish Association of Suicidology, dedicated to suicide prevention, is holding its Seventh National Conference on suicide prevention in schools in the Brandon Hotel, Tralee, Co Kerry from Tuesday 13th to Thursday 16th of November. Suicide prevention begins in the home and in the school. The school has a very important part to play in suicide prevention in identifying pupils at risk and dealing with them appropriately and in insuring that pupils leave school with adequate life skills and problem solving skills including help seeking behaviour to cope with life in the real world.
The conference addresses A Whole School Approach to Suicide Prevention and Crisis Intervention and the role of school principals, teachers and school guidance counsellors in the process. Suicide risk factors, warning signs of suicide and how to cope with the aftermath of suicide will be covered in detail. The importance of developing a comprehensive suicide prevention policy in every school is examined in detail. Leading experts in the field from home and abroad will share their expertise and experience.
The conference is tailored to the needs of all school staff, members of parents and youth organisations and any body with an interest in suicide prevention. Your attendance may save a life.
Irish Association of Suicidology
среда, 8 июня 2011 г.
Vitamin D Lifts Mood During Cold Weather Months
A daily dose of vitamin D may just be what Chicagoans need to get through the long winter, according to researchers at Loyola University Chicago Marcella Niehoff School of Nursing (MNSON). This nutrient lifts mood during cold weather months when days are short and more time is spent indoors.
"Vitamin D deficiency continues to be a problem despite the nutrient's widely reported health benefits," said Sue Penckofer, PhD, RN, professor, MNSON. "Chicago winters compound this issue when more people spend time away from sunlight, which is a natural source of vitamin D."
Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements can decrease the risk of certain health concerns. The preferred range in the body is 30 - 60 ng/mL of 25(OH) vitamin D.
Loyola faculty members plan to take vitamin D research a step further by evaluating whether weekly vitamin D supplements improve blood sugar control and mood in women with diabetes. Depression is associated with increased insulin resistance, so people with diabetes have a greater risk for the disease than those without depression. Women also tend to have greater rates of depression and poorer blood sugar control than men with diabetes.
"There is evidence to suggest that vitamin D supplementation may decrease insulin resistance," said Dr. Penckofer. "If we can stabilize insulin levels, we may be able to simply and cost effectively improve blood sugar control and reduce symptoms of depression for these women."
Loyola is currently enrolling women in this clinical trial. In order to enter the study, they must be 18 to 70 years of age, have stable type 2 diabetes, signs of depression and no other major medical illness. Eighty women with type 2 diabetes and signs of depression will be given a weekly dose of vitamin D (50,000 IU) for a period of six months. Study participants will be evaluated at three points during this time.
"Vitamin D has widespread benefits for our health and certain chronic diseases in particular," Dr. Penckofer said. "Our research may shed greater light on the role this nutrient plays in managing two conditions that impact millions of Americans. If proven to be successful, vitamin D may an important addition to care for diabetes and depression."
The Marcella Niehoff School of Nursing was founded in 1935 as the first baccalaureate nursing program in Illinois. Today, the School is accredited by the Commission on Collegiate Nursing Education. Top-rated nursing programs are offered at all levels along with programs for dietetics and health systems management. In addition to academic programs, the School is home to the Center for Ethics in Nursing, the Center for Spiritual Leadership in Health Care, and the Center for Nursing Research. The School is part of Loyola University Chicago, ranked one of the country's top national universities by U.S. News & World Report. In concert with the Loyola's Jesuit heritage, the School of Nursing stresses excellence in teaching, research, service and practice.
"Vitamin D deficiency continues to be a problem despite the nutrient's widely reported health benefits," said Sue Penckofer, PhD, RN, professor, MNSON. "Chicago winters compound this issue when more people spend time away from sunlight, which is a natural source of vitamin D."
Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements can decrease the risk of certain health concerns. The preferred range in the body is 30 - 60 ng/mL of 25(OH) vitamin D.
Loyola faculty members plan to take vitamin D research a step further by evaluating whether weekly vitamin D supplements improve blood sugar control and mood in women with diabetes. Depression is associated with increased insulin resistance, so people with diabetes have a greater risk for the disease than those without depression. Women also tend to have greater rates of depression and poorer blood sugar control than men with diabetes.
"There is evidence to suggest that vitamin D supplementation may decrease insulin resistance," said Dr. Penckofer. "If we can stabilize insulin levels, we may be able to simply and cost effectively improve blood sugar control and reduce symptoms of depression for these women."
Loyola is currently enrolling women in this clinical trial. In order to enter the study, they must be 18 to 70 years of age, have stable type 2 diabetes, signs of depression and no other major medical illness. Eighty women with type 2 diabetes and signs of depression will be given a weekly dose of vitamin D (50,000 IU) for a period of six months. Study participants will be evaluated at three points during this time.
"Vitamin D has widespread benefits for our health and certain chronic diseases in particular," Dr. Penckofer said. "Our research may shed greater light on the role this nutrient plays in managing two conditions that impact millions of Americans. If proven to be successful, vitamin D may an important addition to care for diabetes and depression."
The Marcella Niehoff School of Nursing was founded in 1935 as the first baccalaureate nursing program in Illinois. Today, the School is accredited by the Commission on Collegiate Nursing Education. Top-rated nursing programs are offered at all levels along with programs for dietetics and health systems management. In addition to academic programs, the School is home to the Center for Ethics in Nursing, the Center for Spiritual Leadership in Health Care, and the Center for Nursing Research. The School is part of Loyola University Chicago, ranked one of the country's top national universities by U.S. News & World Report. In concert with the Loyola's Jesuit heritage, the School of Nursing stresses excellence in teaching, research, service and practice.
воскресенье, 5 июня 2011 г.
Depression As Deadly As Smoking, But Anxiety May Be Good For You
A study by researchers at the University of Bergen, Norway, and the Institute of Psychiatry (IoP) at King's College London has found that depression is as much of a risk factor for mortality as smoking.
Utilising a unique link between a survey of over 60,000 people and a comprehensive mortality database, the researchers found that over the four years following the survey, the mortality risk was increased to a similar extent in people who were depressed as in people who were smokers.
Dr Robert Stewart, who led the research team at the IoP, explains the possible reasons that may underlie these surprising findings: 'Unlike smoking, we don't know how causal the association with depression is but it does suggest that more attention should be paid to this link because the association persisted after adjusting for many other factors.'
The study also shows that patients with depression face an overall increased risk of mortality, while a combination of depression and anxiety in patients lowers mortality compared with depression alone. Dr Stewart explains: 'One of the main messages from this research is that 'a little anxiety may be good for you'.
'It appears that we're talking about two risk groups here. People with very high levels of anxiety symptoms may be naturally more vulnerable due to stress, for example through the effects stress has on cardiovascular outcomes. On the other hand, people who score very low on anxiety measures, i.e. those who deny any symptoms at all, may be people who also tend not to seek help for physical conditions, or they may be people who tend to take risks. This would explain the higher mortality.'
In terms of the relationship between mortality and anxiety with depression as a risk factor, the research suggests that help-seeking behaviour may explain the pattern of outcomes. People with depression may not seek help or may fail to receive help when they do seek it, whereas the opposite may be true for people with anxiety.
Dr Stewart comments: 'It would certainly not surprise me at all to find that doctors are less likely to investigate physical symptoms in people with depression because they think that depression is the explanation, but may be more likely to investigate if someone is anxious because they think it will reassure them. These are conjectures but they would fit with the data.'
The researchers point out that the results should be considered in conjunction with other evidence suggesting a variety of adverse physical health outcomes and poor health associated with mental disorders such as depression and psychotic disorders.
In light of the findings, Dr Stewart makes suggestions on the focus of future developments in the treatment of depression and anxiety: 'The physical health of people with current or previous mental disorder needs a lot more attention than it gets at the moment.
'This applies to primary care, secondary mental health care and general hospital care in the sense that there should be more active screening for physical disorders and risk factors, such as blood pressure, cholesterol, adverse diet, smoking, lack of exercise, in people with mental disorders. This should be done in addition to more active treatment of disorders when present, and more effective general health promotion.'
Arnstein Mykletun, Ottar Bjerkeset, Simon ??verland, Martin Prince, Michael Dewey and Robert Stewart: Levels of anxiety and depression as predictors of mortality: the HUNT study. The British Journal of Psychiatry (2009) 195: 118-125. The full paper can be accessed on bjp.rcpsych/cgi/content/abstract/195/2/118.
Utilising a unique link between a survey of over 60,000 people and a comprehensive mortality database, the researchers found that over the four years following the survey, the mortality risk was increased to a similar extent in people who were depressed as in people who were smokers.
Dr Robert Stewart, who led the research team at the IoP, explains the possible reasons that may underlie these surprising findings: 'Unlike smoking, we don't know how causal the association with depression is but it does suggest that more attention should be paid to this link because the association persisted after adjusting for many other factors.'
The study also shows that patients with depression face an overall increased risk of mortality, while a combination of depression and anxiety in patients lowers mortality compared with depression alone. Dr Stewart explains: 'One of the main messages from this research is that 'a little anxiety may be good for you'.
'It appears that we're talking about two risk groups here. People with very high levels of anxiety symptoms may be naturally more vulnerable due to stress, for example through the effects stress has on cardiovascular outcomes. On the other hand, people who score very low on anxiety measures, i.e. those who deny any symptoms at all, may be people who also tend not to seek help for physical conditions, or they may be people who tend to take risks. This would explain the higher mortality.'
In terms of the relationship between mortality and anxiety with depression as a risk factor, the research suggests that help-seeking behaviour may explain the pattern of outcomes. People with depression may not seek help or may fail to receive help when they do seek it, whereas the opposite may be true for people with anxiety.
Dr Stewart comments: 'It would certainly not surprise me at all to find that doctors are less likely to investigate physical symptoms in people with depression because they think that depression is the explanation, but may be more likely to investigate if someone is anxious because they think it will reassure them. These are conjectures but they would fit with the data.'
The researchers point out that the results should be considered in conjunction with other evidence suggesting a variety of adverse physical health outcomes and poor health associated with mental disorders such as depression and psychotic disorders.
In light of the findings, Dr Stewart makes suggestions on the focus of future developments in the treatment of depression and anxiety: 'The physical health of people with current or previous mental disorder needs a lot more attention than it gets at the moment.
'This applies to primary care, secondary mental health care and general hospital care in the sense that there should be more active screening for physical disorders and risk factors, such as blood pressure, cholesterol, adverse diet, smoking, lack of exercise, in people with mental disorders. This should be done in addition to more active treatment of disorders when present, and more effective general health promotion.'
Arnstein Mykletun, Ottar Bjerkeset, Simon ??verland, Martin Prince, Michael Dewey and Robert Stewart: Levels of anxiety and depression as predictors of mortality: the HUNT study. The British Journal of Psychiatry (2009) 195: 118-125. The full paper can be accessed on bjp.rcpsych/cgi/content/abstract/195/2/118.
четверг, 2 июня 2011 г.
Black Teen Mothers With Depression More Likely Than Non-Depressed Teen Moms To Have Subsequent Pregnancy, Study Finds
Black teen mothers who have depression after giving birth are at higher risk of a subsequent pregnancy than teen mothers who are not depressed, according to a study in the Archives of Pediatric and Adolescent Medicine, Reuters reports.
For the study, Beth Barnet and colleagues at the University of Maryland School of Medicine looked at 245 mostly black females ages 12 to 18 who received prenatal care at five community centers. According to Reuters, the teenagers were mostly from low-income families.
Teenage mothers are more than twice as likely as adult mothers to become depressed, Reuters reports. Further, previous research has shown that black teenage mothers have depression at twice the rate of white teen moms. According to Barnet, the racial disparity is likely associated with poverty. Barnet also said that exposure to violence and a drug culture are additional factors for disparities within the study group.
The study found that 46% of the teenagers had symptoms of depression at the beginning of the study. Those who showed such symptoms of depression had a 40% higher risk of a subsequent pregnancy than teenagers who showed no signs of depression.
According to Barnet, depression among teen mothers could cause feelings of fatigue and helplessness that then lead to less use of birth control. In addition, teen mothers with depression might "seek out intimacy with additional sexual relationships," Barnet said.
Of all the teenagers in the study, 120 had another pregnancy within two years of giving birth. The average time span between the pregnancies was slightly more than 11 months, according to the study.
Barnet said, "Teens having a subsequent pregnancy were more likely to be school dropouts; not use condoms consistently at follow-up; and report a relationship with their baby's father, who tended to be older."
She added, "This study provides evidence that depression may be an important independent risk factor for rapid subsequent pregnancy in African-American adolescent mothers" (Conlon, Reuters, 3/3).
An abstract of the study is available online.
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
For the study, Beth Barnet and colleagues at the University of Maryland School of Medicine looked at 245 mostly black females ages 12 to 18 who received prenatal care at five community centers. According to Reuters, the teenagers were mostly from low-income families.
Teenage mothers are more than twice as likely as adult mothers to become depressed, Reuters reports. Further, previous research has shown that black teenage mothers have depression at twice the rate of white teen moms. According to Barnet, the racial disparity is likely associated with poverty. Barnet also said that exposure to violence and a drug culture are additional factors for disparities within the study group.
The study found that 46% of the teenagers had symptoms of depression at the beginning of the study. Those who showed such symptoms of depression had a 40% higher risk of a subsequent pregnancy than teenagers who showed no signs of depression.
According to Barnet, depression among teen mothers could cause feelings of fatigue and helplessness that then lead to less use of birth control. In addition, teen mothers with depression might "seek out intimacy with additional sexual relationships," Barnet said.
Of all the teenagers in the study, 120 had another pregnancy within two years of giving birth. The average time span between the pregnancies was slightly more than 11 months, according to the study.
Barnet said, "Teens having a subsequent pregnancy were more likely to be school dropouts; not use condoms consistently at follow-up; and report a relationship with their baby's father, who tended to be older."
She added, "This study provides evidence that depression may be an important independent risk factor for rapid subsequent pregnancy in African-American adolescent mothers" (Conlon, Reuters, 3/3).
An abstract of the study is available online.
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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