This week we run the data analytics on Face Coverings and Country Stats using Seaborn and Pandas as well as cover the DANMASK-19 randomized trial, The Daily Mails fight with the British Government attempt to terrorize it, citizens, with bad COVID data. The Possible transmission of COVID-19 from pets to humans continues to gain traction, etc… #covid19 #masks #facecoverings Data API Sources: Our World in Data Covid Tracking Project Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers https://www.acpjournals.org/doi/10.7326/M20-6817 A cluster randomised trial of cloth masks compared with medical masks in healthcare workers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/ https://www.dailymail.co.uk/news/article-8973737/Fury-government-uses-Twitter-propaganda-tool-attack-Mails-covid-analysis.html https://www.washingtonpost.com/health/2020/11/20/mask-danish-study/ https://clinicalnews.org/2020/11/19/how-the-polio-vaccine-virus-occasionally-becomes-dangerous/ https://clinicalnews.org/2020/11/18/two-k-state-studies-focus-on-sars-cov-2-transmission-in-domestic-cats-pigs/ https://clinicalnews.org/2020/11/16/alarming-covid-19-study-shows-80-of-respondents-report-significant-symptoms-of-depression/
Raw Foods result in Greater Happiness then Processed Foods
“Our research has highlighted that the consumption of fruit and vegetables in their ‘unmodified’ state is more strongly associated with better mental health compared to cooked/canned/processed fruit and vegetables,”
Citation: Intake of Raw Fruits and Vegetables Is Associated With Better Mental Health Than Intake of Processed Fruits and Vegetables. Frontiers in Psychology, 2018; 9 DOI: 10.3389/fpsyg.2018.00487
Source: Thomson Reuters Foundation – Mon, 7 Oct 2013 01:28 PM
In Somalia there’s a belief that a mentally ill person can be cured by shutting them in a room with a hyena.
Mentally ill people in the war-ravaged country are often chained or locked up. Others are tied to trees and abandoned when their families are forced to flee fighting.
In one of the most moving radio interviews I’ve heard in a long time, psychiatric nurse Abdirahman Ali Awale, who is commonly known as Dr Habeeb, told how he was reduced to tears every day by what he sees.
“I have saved many, many patients who have been left to die. They have been tied to a tree and abandoned simply because they are mentally ill,” he told the BBC World Service.
Somalia has one of the world’s highest rates of mental illness with one in three people affected, according to the World Health Organisation (WHO).
But there has traditionally been almost no help. Somalia’s health sector was destroyed over two decades ago as the country descended into civil war.
The relentless shelling, fighting, killing and maiming, along with the repeated displacement of communities, has taken such a toll that Habeeb is on record as saying he doesn’t believe anyone in the whole of southern and central Somalia has good mental health.
The psychiatric nurse was spurred to set up the first of his six clinics in 2005 when he saw five mentally ill women being chased down the road by small boys.
He says his centres have since treated more than 15,000 patients. The most prevalent condition is post-traumatic stress disorder.
“This is usually what we see with many of our younger patients who come in,” says Habeeb. “We also see depression. A lot of our patients are very sad. They exclude themselves from society and they are very quiet and sad and stay in a corner.”
After the war, he believes the second biggest contributor to mental health issues is the widely used stimulant khat. The plant, which is chewed for its euphoric effects, has been linked to psychosis and depression.
But Habeeb doesn’t just treat people. He is on a mission to dispel the myths and stigma surrounding mental illness and end harmful practices.
This is done through radio broadcasts, lectures and classes.
“We tell them … that mental health illness is just like any other illness,” he told the World Service’s Outlook programme.
Many Somalis attribute behavioural problems to bad spirits and seek help from religious leaders or traditional healers. One of the most extreme treatments involves locking a person up with a hyena.
“In Somalia, there’s this belief that hyenas can see everything including the thing that causes mental illnesses,” says Habeeb.
“Two hyenas were brought from the bushes and brought to Mogadishu. Patients were locked in a room with the hyena with the belief that when the thing that caused the mental problem sees the hyena it would leave the body of the patient and the patient would be fine after that.”
This treatment is not cheap – the cost can be around $560, according to Habeeb. It’s also highly dangerous. Patients are left with long lasting trauma, physical injuries and even die, according to a WHO report on mental health in Somalia.
“I CRY EVERY DAY”
WHO says most mentally ill people in Somalia are chained up or imprisoned.
Habeeb told the BBC more than 170,000 people have been “locked and … left to die”. And no one in authority is talking about it.
You don’t have to look hard to find numerous images on the internet showing people chained to trees, rocks and beds. Many are chained for years on end, leading to long-lasting trauma and physical harm. Some commit suicide.
But the use of chains is often an act of desperation by families rather than cruelty, according to WHO. Families may believe they are preventing the person harming themselves or others, and that this is their only option.
Habeeb’s organisation, together with WHO, is pushing for an end to chaining.
But addressing mental illness is a very low priority in a country so devastated by fighting and hunger. It has also been ignored by international agencies.
Habeeb believes this is because treating mental health illness is expensive and does not bring quick results.
Not surprisingly, the work is exhausting.
“I’ve seen countless patients locked and left to die and that takes a toll mentally,” Habeeb says.
“I am alone. I am one person and I’m dealing with big, big, big problems that no one is ready to admit. Personally, I cry seven to eight times a day. I’m a big man, I’m a grown-up man, and in this society it is not common to see a grown man cry.
“I’ve cried on TV, I’ve cried in public places, I’ve even cried in front of presidents for them to speak about this problem, even for one day.”
August 21, 2013 in Featured
A chart from a Central Florida Intelligence Exchange (CFIX) study released in July shows cases of mass shootings believed to be attributable to mental illness.
Analysis conducted by the Central Florida Intelligence Exchange (CFIX) has found that 79% of mass shootings since 2011 have been perpetrated by individuals with “demonstrated signs of continuous behavioral health issues and mental illness.” In a July case study titled “Acts of Violence Attributed by Behavioral and Mental Health Issues“, CFIX analyzed 14 mass shooting incidents that occurred between 2011 and 2013 and found that only three of the shooters had no history of mental illness.
The study, which focuses primarily on “violence perpetrated against healthcare providers and emergency responders” particularly “by patients with behavioral and mental health issues”, also discusses the correlation between mental health issues and mass shootings. According to the CFIX analysts, across the country “the numbers of mass shootings involving perpetrators with behavioral health issues have noticeably increased” with 79% of mass shooting occurrences between January 2011 to May 2013 involving perpetrators that exhibited “continuous behavioral health issues” and “mental illness”. In the same period, the only mass shootings found to have been committed by individuals with no previous history of mental health issues were the Sikh temple shooting in Oak Creek, Wisconsin, which is described as a hate crime, and the “work-related” shooting spree perpetrated by Christopher Dorner in early 2013. Another incident in New York which involved a man named Kurt Myers killing several people at a car wash and barber shop in March 2013 has no known motive, though speculation centered on the shooter’s money problems.
The analysis provided by CFIX is useful for understanding the connection between mental health issues and senseless acts of large-scale violence, though the analysts’ conflation of mental disorders and mental illness leads to some conclusions that may not be warranted. For example, Adam Lanza, the perpetrator of the mass killing at Sandy Hook Elementary School in Newtown, Connecticut, had been reportedly diagnosed with mental disorders including Asperger syndrome that are fairly common and do not constitute mental illness. These issues are further complicated by the fact that many perpetrators of mass shootings suffer from mental illness throughout their lives, though are never formally diagnosed. Due to the fact that many perpetrators of mass shootings commit suicide or are killed by police during the incident, this diagnosis often never occurs leaving only vague statements from friends and family members about the perpetrator’s history of unusual behavior.
A list of the perpetrators of mass shootings that were found by CFIX to be linked to “mental illness” is included below with a brief synopsis of the shooters’ actions and history of mental health issues.
Mass Shootings Attributed to History of Mental Illness
- Jared Loughner; January 8, 2011; 6 killed, 13 injured – Loughner went to an event with U.S. Representative Gabrielle Giffords in a Safeway parking lot in Tucson, Arizona and killed six people, including a U.S. District Court Judge John Roll and a 9-year-old girl. Loughner was later diagnosed with paranoid schizophrenia and was initially ruled incompetent to stand trial.
- Eduardo Sencion; September 6, 2011; 4 killed, 7 injured – Sencion killed 4 and injured 7 in and around an IHOP restaurant in Carson City, Nevada using a Norinco Mak 90 semiautomatic rifle illegally converted to fully-automatic mode. Sencion was diagnosed with paranoid schizophrenia at age 18.
- Scott Evans Dekraai; October 12, 2011; 8 killed, 1 injured – Dekraai went into Salon Meritage hair salon where his ex-wife worked in Seal Beach, California and opened fire with several handguns killing 8 in the salon and injuring 1 in the parking lot. Dekraai had been diagnosed with posttraumatic stress disorder in September 2008.
- Jeong Soo Paek; February 21, 2012; 4 killed – Paek walked into a spa owned by his sisters’ families, killing his sisters and their husbands with a .45-caliber handgun before killing himself. Paek had a history of mental health issues according to court filings and had been described as suicidal in the years leading up to the attack.
- One L. Goh; April 2, 2012; 7 killed, 3 injured – Goh, a former student at Oikos University, a Korean Christian college in Oakland, California, stood up in a nursing classroom while class was in session, ordered classmates to line up against the wall, and opened fire with a .45-caliber semi-automatic handgun killing 7. Goh was later diagnosed with paranoid schizophrenia by court-appointed psychiatrists.
- Ian Lee Stawicki; May 30, 2012; 5 killed, 1 injured – Stawicki walked into Café Racer in the University District of Seattle, Washington and opened fire with two .45-caliber handguns, killing four patrons and wounding the café’s chef. Stawicki’s father later said his son suffered from mental health issues throughout his life and may have been manic depressive.
- James Eagan Holmes; July 20, 2012; 12 killed, 58 injured – Holmes used a Smith & Wesson M&P15 semi-automatic rifle, Remington tactical shotgun and two Glock 22 handguns to kill 12 and wound 58 during a midnight premiere screening of The Dark Night Rises at the Century 16 multiplex in Aurora, Colorado. Holmes was seeing a psychiatrist at the University of Colorado prior to the shooting who later reported that he had made “homicidal statements” and said he a was a threat to others. Holmes reportedly asked other students at the University of Colorado about dysphoric mania, a mental disorder characterized by simultaneous symptoms of mania and depression.
- Andrew Engeldinger; September 27, 2012; 5 killed, 3 injured – Engeldinger opened fire with a Glock 19 9mm pistol killing 6 and injuring 2 at his workplace Accent Signage Systems in Minneapolis, Minnesota after being fired. According to his parents, Engeldinger had a history of undiagnosed mental illness.
- Adam Lanza; December 14, 2012; 27 killed, 2 wounded – Lanza killed his mother, then took several firearms in his mother’s car to Sandy Hook Elementary School where he killed twenty children and six employees of the school with a semi-automatic Bushmaster XM15-E2S rifle. Lanza had behavioral problems throughout childhood and was said by family members to have a personality disorder. Lanza was reportedly diagnosed with sensory processing disorder as a child and family friends claimed that he had been diagnosed with Asperger syndrome.
- William Spengler; December 24, 2012; 3 killed, 2 wounded – Spengler killed his sister, then intentionally set their house on fire, firing an illegally-acquired Bushmaster semi-automatic rifle at firefighters responding to the scene, killing two and injuring two more. Spengler was convicted of manslaughter in 1980 after murdering his grandmother with a hammer and had spent years in a correctional mental health facility.
- John Zawahri; June 7, 2013; 5 killed, 4 wounded – Zawahri killed his father and brother after setting their house on fire, then hijacked a passing car, forcing the driver to drive him to Santa Monica College where he killed 3 more people and wounded 4. While attending high school, Zawahri had communicated to a classmate his desire to hurt other students and was later admitted to UCLA’s Neuropsychiatric Institute for a brief period of time.
Psychiatrists: 1-in-5 U.S.children have a mental disorder
Published: Aug. 27, 2013 at 12:21 AM
Dr. Adam Brenner and Dr. Preston Wiles at the University of Texas Southwestern Medical Center in Dallas says some early warning signs of mental illness include:
— Loss of interest in previously enjoyed activities such as spending less time with friends, quitting sports or other extracurricular activities.
— Decline in functioning such as failing at school or no longer keeping up with regular chores at home.
— Suspiciousness or strong nervous feelings such as spending excessive time alone in their room, or acting as though they are “being watched.”
— Changes in sleep, appetite or personal hygiene such as staying up all night, requiring frequent reminders to bathe or change clothing.
— Problems with concentration, memory or speech such as talking in a disorganized or unusual way, talking too fast, or jumping between unrelated topics.
“It is often difficult for young people who are suffering from mental illness to be aware of changes in their thinking, feelings or behavior,” Brenner said in a statement. “It may be a family member, friend or teacher who first notices the signs of the illness.”
What should someone do who notices these signs in my child or teen? Brenner says a gentle talk with the child or adolescent about your concerns may be a good first step.
“They may already have noticed something but have been too ashamed or frightened to discuss it,” Brenner says. “Consulting your primary care doctor or school counselor may also be beneficial when deciding how you can best help your child. Most importantly, if there is any concern that a person is a danger to themselves or others, either by voicing ideas of suicide or talking about shooting or harming others, call 911 or take the person to the nearest emergency room for assistance.”
© 2013 United Press International, Inc. All Rights Reserved.
Read more: http://www.upi.com/Health_News/2013/08/27/Psychiatrists-1-in-5-USchildren-have-a-mental-disorder/UPI-63761377577303/print#ixzz2dFKvlnJA
Germ fighters, antidepressants, opioids top list; women, elderly likelier to have prescriptions
Wednesday, June 19, 2013
CORRECTION: Corrects fourth most commonly prescribed drugs to drugs used to lower lipids rather than drugs to control blood pressure, and adds Olmsted Medical Center as study co-author.
ROCHESTER, Minn. — Nearly 70 percent of Americans are on at least one prescription drug, and more than half take two, Mayo Clinic and Olmsted Medical Center researchers say.. Antibiotics, antidepressants and painkilling opioids are most commonly prescribed, their study found. Twenty percent of patients are on five or more prescription medications, according to the findings, published online in the journal Mayo Clinic Proceedings.
MULTIMEDIA ALERT: For audio and video of Dr. Jennifer St. Sauver talking about the study, visit the Mayo Clinic News Network.
The findings offer insight into prescribing practices. The statistics from the Rochester Epidemiology Project in Olmsted County, Minn. are comparable to those elsewhere in the United States, says study author Jennifer St. Sauver, Ph.D., a member of the Mayo Clinic Population Health Program in the Mayo Clinic Center for the Science of Health Care Delivery.
“Often when people talk about health conditions they’re talking about chronic conditions such as heart disease or diabetes,” Dr. St. Sauver says. “However, the second most common prescription was for antidepressants — that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a bit concerning considering their addicting nature.”
Seventeen percent of those studied were prescribed antibiotics, 13 percent were taking antidepressants and 13 percent were on opioids. Drugs to lower lipids, such as cholesterol, came in fourth (11 percent) and vaccines were fifth (11 percent). Drugs were prescribed to both men and women across all age groups, except high blood pressure drugs, which were seldom used before age 30.
Overall, women and older adults receive more prescriptions. Vaccines, antibiotics and anti-asthma drugs are most commonly prescribed in people younger than 19. Antidepressants and opioids are most common among young and middle-aged adults. Cardiovascular drugs are most commonly prescribed in older adults. Women receive more prescriptions than men across several drug groups, especially antidepressants: Nearly 1 in 4 women ages 50-64 are on an antidepressant.
For several drug groups, use increases with advancing age.
“As you get older you tend to get more prescriptions, and women tend to get more prescriptions than men,” Dr. St. Sauver says.
Prescription drug use has increased steadily in the U.S. for the past decade. The percentage of people who took at least one prescription drug in the past month increased from 44 percent in 1999-2000 to 48 percent in 2007-08. Spending on prescription drugs reached $250 billion in 2009 the year studied, and accounted for 12 percent of total personal health care expenditures. Drug-related spending is expected to continue to grow in the coming years, the researchers say.
The study was funded by the National Institute on Aging and the Mayo Clinic Center for the Science of Health Care Delivery.
About Mayo Clinic
Journalists can become a member of the Mayo Clinic News Network for the latest health, science and research news and access to video, audio, text and graphic elements that can be downloaded or embedded.
Contact: Natalie Wood-Wright firstname.lastname@example.org 410-614-6029 Johns Hopkins University Bloomberg School of Public Health
Americans are over-diagnosed and over-treated for depression, according to a new study conducted at the Johns Hopkins Bloomberg School of Public Health. The study examines adults with clinician-identified depression and individuals who experienced major depressive episodes within a 12-month period. It found that when assessed for major depressive episodes using a structured interview, only 38.4 percent of adults with clinician-identified depression met the 12-month criteria for depression, despite the majority of participants being prescribed and using psychiatric medications. The results are featured in the April 2013 issue of Psychotherapy and Psychosomatics.
“Depression over-diagnosis and over-treatment is common in the U.S. and frankly the numbers are staggering,” said Ramin J. Mojtabai, PhD, author of the study and an associate professor with the Bloomberg School’s Department of Mental Health. “Among study participants who were 65 years old or older with clinician-identified depression, 6 out of every 7 did not meet the 12-month major-depressive-episodes criteria. While participants who did not meet the criteria used significantly fewer services and treatment contacts, the majority of both groups used prescription psychiatric medication.”
Using a sample of 5,639 participants from the 2009-2010 United States National Survey of Drug Use and Health, Mojtabai assessed clinician-identified depression based on questions about conditions that the participants were told they had by a doctor or other medical professional in the past 12 months. The study indicates that even among participants without a lifetime history of major or minor depression, a majority reported having taken prescription psychiatric medications.
“A number of factors likely contribute to the high false-positive rate of depression diagnosis in community settings, including the relatively low prevalence of depression in these settings, clinicians’ uncertainty about the diagnostic criteria and the ambiguity regarding sub-threshold syndromes,” said Mojtabai. “Previous evidence has highlighted the under-diagnosis and under-treatment of major depression in community settings. The new data suggest that the under-diagnosis and under-treatment of many who are in need of treatment occurs in conjunction with the over-diagnosis and over-treatment of others who do not need such treatment. There is a need for improved targeting of diagnosis and treatment of depression and other mental disorders in these settings.”
“Clinician-Identified Depression in Community Settings: Concordance with Structured-Interview Diagnoses,” was written by Ramin J. Mojtabai.
Wednesday, 24 April 2013
Women who take valproate (Depacon) during pregnancy may increase the risk of childhood autism and its spectrum disorders in their children, a population-based study showed.
In utero exposure to the drug was associated with a five-fold elevated risk of autism and three-fold elevated risk for autism spectrum disorder, Jakob Christensen, PhD, of Denmark’s Aarhus University Hospital, and colleagues found.
The absolute risks were 2.5% and 4.4%, respectively, and remained significantly elevated after adjustment for parents’ epilepsy and psychiatric disease, the group reported in the April 24 issue of the Journal of the American Medical Association.
“For women of childbearing potential who use anti-epileptic medications, these findings must be balanced against the treatment benefits for women who require valproate for epilepsy control,” they concluded.
But “because autism spectrum disorders are serious conditions with lifelong implications for affected children and their families, even a moderate increase in risk may have major health importance,” they added.
The American Academy of Neurology recommends avoiding valproate in pregnancy whenever possible due to cognitive and physical birth defect problems for children exposed in utero.
EEV: This is one incredibly disturbing article, geared more towards social engineering and not justice.
We can’t fight what has happened, so we should use it
MEDICAL experts are expecting a rapid increase in cases of depression and anxiety disorders as the extent of the economic crisis begins to register and impact on peoples’ lives.
The economic uncertainty, wage cuts and job losses of the last 18 months will now snowball as the effects of the tough conditions set by international lenders for a bailout are felt indiscriminately across society.
Psychologists all foresee an increase in depression, anxiety disorders, alcohol abuse and psychosomatic disorders – insomnia, fatigue and gastrointestinal illnesses – and even attempted suicides.
Severe, clinical depression is a biological illness and needs to be treated professionally, but those who might be suffering from milder forms are urged not to view what has happened as a tragedy, but rather as an opportunity to reform.
“The constant bombarding of talks about this crisis makes us focus on all this negativity, rendering us more vulnerable to any kind of illness,” said psychologist Dr Antonios Raftis. He likened the crisis and its burst of negativity with a river whose dividing channels have been blocked and the surge of the water downstream is such that it overflows and destroys its surroundings.
All psychologists agree that worrying constantly is unhelpful. “We cannot control life. What we can do is accept the facts and see how we can best deal with the situation,” said Dr Achilleas Koukkides, likening the crisis to a parent (the government and politicians) who has now betrayed us.
“This spreads fear and instability,” he said.
Cypriots are likely to feel particularly badly hit because social status has played such an important part in people’s lives for so long. According to Dr Jacqueline Widmer Kalochoritis, this will be even more apparent for the younger generation who have grown up believing wealth and luxury is their birth right.
“The older generations are more prepared for this crisis,” she said, “because they have experienced difficult situations in the past and know how to struggle. But the younger generation will potentially be the biggest victims of the crisis because they don’t know what it is like to fight.”
Men too will suffer, according to Widmer Kalochoritis, because in Western cultures men are still socialised to base their worth on their careers, income and wealth, and “losing that means losing their footing”.
But psychologists are eager to urge people to view the crisis as an opening to new possibilities for redefining who you are, without letting society and cultural values tell you what car to drive, what job to do, what house to live in.
Recent research indicates that the difference in the level of happiness between people who have suffered traumatic experiences and people who have, for example, won the lottery is actually statistically zero.
Widmer Kalochorits explained that people nowadays focus such a large part of their lives on their careers that everything else gains less significance. “Once that is pulled away,” she said, “as has happened with this crisis, people are forced to pay more attention to the other facets of their personality, of who they are.”
In this, focusing on relationships, marriage, family and friends are essential to maintaining some semblance of a positive attitude.
“These are the people who will support, boost and soothe you and this is the time more than ever to tend to these relationships,” said Widmer Kalochoritis. “Depression, feelings of helplessness and hopelessness, may provoke a greater tendency for isolation, but we must realise that the biggest protective factor for all this is our social support.”
Psychologists all recommend distractions – going for walks, picnics, social gatherings. But also exercise as this helps reduce stress hormones and increases feel-good levels, enabling you to feel more in control. The routine also gives a structure to your day.
Above all, it is about attitude. “We should see the glass as half-full and not half-empty,” said Raftis, “because the former is easier to refill and hence recover from this crisis.”
People suffering from depression need someone to validate their feelings of despair and fear, but simultaneously, they need someone to force them to change said Widmer Kalochoritis.
“Everybody has unexpected resources, that they have successfully used in past situations, and there is always something that can be done,” she said. “What blocks us is the pervasive hopelessness brought about by depression. We need to change our attitude to force ourselves to pull through and sometimes an absence of choice can be helpful for promoting change.”
The crisis has entered our lives as a shockwave, but that doesn’t necessarily mean it has to bring with it the misery, the doom and gloom many expect. It can also be a chance for people to redefine, rediscover and reinvent themselves.
Government psychological support
THE HEALTH ministry announced on Thursday the launch of a round-the-clock psychological support hotline to help those dealing with anxiety and depression because of the financial crisis.
The ministry is doing away with waiting lists, and has said that people will be referred to a specialist immediately.
From tomorrow, a hotline will be available round-the-clock. Officials will provide immediate psychological support, try to contain stress and depression and refer callers to support centres.
For the hotline call 22-603263 if you are in Nicosia, Larnaca or Famagusta. For Paphos and Limassol call 25-801107/106
Thu, 21 Mar 2013 00:05 GMT
* Boys four times more likely than girls to have diagnosis
* Milder cases made up much of the increase (Adds CDC and expert interview, byline, background)
By Julie Steenhuysen
March 20 (Reuters) – As many as one in 50 U.S. school age children have a diagnosis of autism, up 72 percent since 2007, but much of the increase involves milder cases, suggesting the rise is linked to better recognition of autism symptoms and not more cases, government researchers said on Wednesday.
Overall, the telephone survey of more than 100,000 parents found about 2 percent of children ages 6 to 17 have autism, up from 1.16 percent in 2007, the last time the study was conducted.
“That translates to 1 million school age children ages 6 to 17 who were reported by their parents to have autism spectrum disorder,” said Stephen Blumberg, a senior scientist at the National Center for Health Statistics, a part of the U.S. Centers for Disease Control and Prevention, who led the study.
As with prior estimates, boys were much more likely to be diagnosed with autism than girls, with 1 in 31 school-age boys, or 3.2 percent, having an autism diagnosis, compared with 1 in 143, or 0.7 percent of girls, having a diagnosis.
“Boys were more than 4 times as likely as girls to have autism spectrum disorder,” Blumberg said.
He said the increase among boys accounted for nearly all of the overall increase in autism diagnoses.
The new findings differ sharply from autism data released just a year ago by the CDC, which said 1 in 88 children in the United States had autism, a spectrum of disabilities that can range from highly functioning individuals to those with severe speech and intellectual disabilities.
In general, individuals with autism struggle with difficulties in communication, behavior and social interaction.
In the current study, the researchers surveyed parents of children age 6 to 17 as part of the 2011-2012 National Survey of Children’s Health or NSCH. They compared their findings to the same study done in 2007, which found 1 in 86 children had an autism diagnosis.
The estimate from last year involved a review of medical and educational records of 8 year olds in 14 sites around the country. Data in the records were last collected in 2008, so the finding of 1 in 88 is not far off from the 1 in 86 figure in 2007, the starting point of the current study.
Blumberg said much of the increase in the estimates from the current parent survey was the result of diagnoses of children with previously unrecognized autism.
Increased awareness of autism differences in children and better detection of autism symptoms by doctors, especially in children with milder cases, likely accounts for the increased diagnoses.
“We think the improved recognition is really a recognition of autism spectrum disorders in children with previously unrecognized autism as opposed to new cases,” Blumberg said
Symptoms of autism can be seen in children as young as 18 months of age, and doctors are urged to conduct a screening for developmental delays on all children by age 2. But doctors often fail to detect mild cases of autism until children enter school, when parents become aware of their child’s troubles making friends and teachers notice differences in the child’s ability to interact socially, the team said.
“This is not saying anything about an increased risk for autism but rather that the NSCH is capturing more of the cases that had been missed previously,” said Michael Rosanoff of the advocacy group Autism Speaks.
For families, the findings mean detection of autism, particularly milder forms, is improving but could still happen earlier.
“Even mildly affected children who are in general education settings can struggle without and benefit from appropriate autism spectrum disorder services,” he said in an e-mail.
While scientists believe genetics account for 80 to 90 percent of the risk for developing autism, a growing number of studies are beginning to suggest that a father’s age at the time of conception may play a role by increasing risks for genetic mistakes in the sperm that could be passed along to offspring.
And new research by a British team found that older fathers are more likely to have grandchildren with autism, suggesting that risk factors for autism may build up over generations.
(Reporting by Julie Steenhuysen; Editing by Doina Chiacu and Cynthia Osterman)
Tuesday, November 20, 2012
TAU researcher connects computer communications and psychosis
As Internet access becomes increasingly widespread, so do related psychopathologies such as Internet addiction and delusions related to the technology and to virtual relationships. Computer communications such as Facebook and chat groups are an important part of this story, says Dr. Uri Nitzan of Tel Aviv University‘s Sackler Faculty of Medicine and the Shalvata Mental Health Care Center in a new paper published in the Israel Journal of Psychiatry and Related Sciences.
In his study, the researcher presented three in-depth case studies linking psychotic episodes to Internet communications from his own practice. According to Dr. Nitzan, patients shared some crucial characteristics, including loneliness or vulnerability due to the loss of or separation from a loved one, relative inexperience with technology, and no prior history of psychosis or substance abuse. In each case, a connection was found between the gradual development and exacerbation of psychotic symptoms, including delusions, anxiety, confusion, and intensified use of computer communications.
The good news is that all of the patients, who willingly sought out treatment on their own, were able to make a full recovery with proper treatment and care, Dr. Nitzan says.
Behind the screen
The Internet is a free and liberal space that many individuals use on a daily basis and a growing part of a normal social life. But while technologies such as Facebook have numerous advantages, some patients are harmed by these social networking sites, which can attract those who are lonely or vulnerable in their day-to-day lives or act as a platform for cyber-bullying and other predatory behavior.
All three of Dr. Nitzan’s patients sought refuge from a lonely situation and found solace in intense virtual relationships. Although these relationships were positive at first, they eventually led to feelings of hurt, betrayal, and invasion of privacy, reports Dr. Nitzan. “All of the patients developed psychotic symptoms related to the situation, including delusions regarding the person behind the screen and their connection through the computer,” he says. Two patients began to feel vulnerable as a result of sharing private information, and one even experienced tactile hallucinations, believing that the person beyond the screen was physically touching her.
Some of the problematic features of the Internet relate to issues of geographical and spatial distortion, the absence of non-verbal cues, and the tendency to idealize the person with whom someone is communicating, becoming intimate without ever meeting face-to-face. All of these factors can contribute to a patient’s break with reality, and the development of a psychotic state.
A changing social landscape
Dr. Nitzan and his colleagues plan to do more in-depth research on Facebook, studying the features and applications that have the potential to harm patients emotionally or permit patients to cause emotional harm to others. Some psychotic patients use the Internet to disturb people, abusing their ability to interact anonymously, he says.
Because social media are now such an important part of our culture, mental health professionals should not overlook their influence when speaking to patients, Dr. Nitzan counsels. “When you ask somebody about their social life, it’s very sensible to ask about Facebook and social networking habits, as well as Internet use. How people conduct themselves on the Internet is quite important to psychiatrists, who shouldn’t ignore this dimension of their patients’ behavior patterns.”
For more technology news from Tel Aviv University, click here.
Keep up with the latest AFTAU news on Twitter: http://www.twitter.com/AFTAUnews.
Reality television’s obsession with the “emotional meltdown of losers” is damaging the British psyche – creating a society in which we revel in seeing people hacked to pieces, a leading mental health academic has warned.
Speaking ahead of an international conference on empathy and compassion, Professor Paul Gilbert, head of mental health research at Derby University, said that our ultra-competitive reality shows are akin to Roman gladiatorial contests. Shows such as Masterchef, The Apprentice and Big Brother are symptomatic of a society which is becoming more antagonistic, he said.
“Reality shows are designed to hold your interest in people when they lose, and see them despair. The focus is on the emotional meltdown of losers,” Professor Gilbert told The Independent.
“We need to be studying in detail the effect of this kind of competitive culture in the media on the young people who are growing up on it.”
“Supposing all the young people watching The Apprentice thought this was the way people did business, with all the back-stabbing and attacking each other. Would you really want to live in a world where everyone did that?”
He added: “So much is going on that is making people angry. I think people feel a bit hopeless.”
Professor Gilbert is among 30 speakers from around the world attending the Empathy and Compassion in Society Conference at Friends House in London, which starts on 23 November.
2009 study posted for filing
Young adults with higher blood lead levels appear more likely to have major depression and panic disorders, even if they have exposure to lead levels generally considered safe, according to a report in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
“Lead is a well-known neurotoxicant that is ubiquitous in the environment, found in air, soil, dust and water,” the authors write as background information in the article. Eliminating lead from gasoline has led to a dramatic decline in average blood levels, but remaining sources of exposure include paint, industrial processes, pottery and contaminated water. “Research on the neurotoxic effects of low-level lead exposure has focused on the in utero and early childhood periods. In adult populations, the neurotoxic effects of lead have been studied mainly in the context of occupational exposures, with levels of exposure orders of magnitude greater than that experienced by the general population.”
Maryse F. Bouchard, Ph.D., M.Sc., of the Universite de Montreal, Canada, and Harvard School of Public Health, Boston, and colleagues analyzed data from 1,987 adults age 20 to 39 years who participated in the National Health and Nutrition Examination Survey between 1999 and 2004. Participants underwent medical examinations that included collection of a blood sample, and also completed a diagnostic interview to identify major depressive disorder, panic disorder and generalized anxiety disorder.
The number of young adults who met diagnostic criteria for major depressive disorder was 134 (6.7 percent), 44 (2.2 percent) had panic disorder and 47 (2.4 percent) had generalized anxiety disorder. The average blood lead level was 1.61 micrograms per deciliter. The one-fifth of participants with the highest blood lead levels (2.11 micrograms per deciliter or more) had 2.3 times the odds of having major depressive disorder and nearly five times the odds of panic disorder as the one-fifth with the lowest lead levels (0.7 micrograms per deciliter or less).
Smoking is related to blood lead levels, so the researchers conducted additional analyses excluding the 628 smokers. Among non-smokers, the elevation in risk between the highest and lowest blood lead levels was increased to 2.5-fold for major depressive disorder and 8.2-fold for panic disorder.
Low-level lead exposure may disrupt brain processes, such as those involving the neurotransmitters catecholamine and serotonin, that are associated with depression and panic disorders, the authors note. Exposure to lead in individuals predisposed to these conditions could trigger their development, make them more severe or reduce response to treatment.
“These findings suggest that lead neurotoxicity may contribute to adverse mental health outcomes, even at levels generally considered to pose low or no risk,” they conclude. “These findings, combined with recent reports of adverse behavioral outcomes in children with similarly low blood lead levels, should underscore the need for considering ways to further reduce environmental lead exposures.”
(Arch Gen Psychiatry. 2009;66:1313-1319. Available pre-embargo to the media at www.jamamedia.org.)
Editor’s Note: This study was supported by a fellowship from the Canadian Institutes for Health Research and by a career development award from the National Institute of Environmental Health Sciences. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
2009 study posted for filing
Patients with the disorder, known as trichotillomania, reported feeling much improved after taking the supplement
MINNEAPOLIS/ ST. PAUL (July 6, 2009) – University of Minnesota Medical School researchers have discovered that a common anti-oxidant, widely available as a health food supplement, may help stop the urges of those with trichotillomania, a disorder characterized by compulsive hair-pulling.
Fifty people enrolled in a double-blind 12 week study; half were given N-Acetylcysteine, an amino acid commonly found in health food supplements. The average age of patients who enrolled was about 34, and most started pulling hair compulsively by the age of 12. Patients were given 1,200 mg of N-Acetylcysteine every day for six weeks. For the following six weeks, the dosage was increased to 2,400 mg per day. After nine weeks, those on supplement had significantly reduced hair-pulling. By the end of the 12 week study, 56 percent reported feeling much or very much improved, while only 16 percent on the placebo reported less pulling.
The study is published in the July, 2009 issue of the Archives of General Psychiatry.
“Trichotillomania is compulsive in the sense that people can’t control it. People feel unable to stop the behavior even though they know it is causing negative consequences,” said Jon Grant, M.D., J.D., a University of Minnesota associate professor of psychiatry and principal investigator of the study. “Some people don’t even know they are doing it.”
Those who have trichotillomania compulsively or habitually pull their hair to the point of noticeable loss. It is most commonly associated with women, but men can also be affected, and pulling can occur anywhere on the body. Grant believes 2 to 4 percent of the general population is impacted by trichotillomania on some level.
“These are people who have tried all kinds of things that have never worked,” Grant said. “The reality is that if you pull hair and it is on a noticeable part of the body, people are really disabled by this. It’s not easy to go out in public if people are noticing your bald spots. Self esteem is a huge problem. This supplement may offer hope.”
The study is significant on another level because it’s one of the first studies of compulsive behaviors to look at lowering levels of glutamate – a chemical that triggers excitement – in the brain to curb harmful behavior rather than serotonin, a naturally occurring chemical most commonly linked to compulsive behavior. This supplement affects levels of glutamate in a specific area of the brain, making it easier for patients to put the breaks on their harmful behavior.
For that reason, Grant believes glutamate modulators such as N-Acetylcysteine may be applicable to other disorders, addictions, and compulsive behaviors.
The study is funded by The University of Minnesota Medical School.
[PRESS RELEASE 16 October 2012]
People in creative professions are treated more often for mental illness than the general population, there being a particularly salient connection between writing and schizophrenia. This according to researchers at Karolinska Institutet, whose large-scale Swedish registry study is the most comprehensive ever in its field.
Last year, the team showed that artists and scientists were more common amongst families where bipolar disorder and schizophrenia is present, compared to the population at large. They subsequently expanded their study to many more psychiatric diagnoses – such as schizoaffective disorder, depression, anxiety syndrome, alcohol abuse, drug abuse, autism, ADHD, anorexia nervosa and suicide – and to include people in outpatient care rather than exclusively hospital patients.
The present study tracked almost 1.2 million patients and their relatives, identified down to second-cousin level. Since all were matched with healthy controls, the study incorporated much of the Swedish population from the most recent decades. All data was anonymized and cannot be linked to any individuals.
The results confirmed those of their previous study: certain mental illness – bipolar disorder – is more prevalent in the entire group of people with artistic or scientific professions, such as dancers, researchers, photographers and authors. Authors specifically also were more common among most of the other psychiatric diseases (including schizophrenia, depression, anxiety syndrome and substance abuse) and were almost 50 per cent more likely to commit suicide than the general population.
The researchers also observed that creative professions were more common in the relatives of patients with schizophrenia, bipolar disorder, anorexia nervosa and, to some extent, autism. According to Simon Kyaga, consultant in psychiatry and doctoral student at the Department of Medical Epidemiology and Biostatistics, the results give cause to reconsider approaches to mental illness.
“If one takes the view that certain phenomena associated with the patients illness are beneficial, it opens the way for a new approach to treatment,” he says. “In that case, the doctor and patient must come to an agreement on what is to be treated, and at what cost. In psychiatry and medicine generally there has been a tradition to see the disease in black-and-white terms and to endeavour to treat the patient by removing everything regarded as morbid.”
The study was financed with grants from the Swedish Research Council, the Swedish Psychiatry Foundation, the Bror Gadelius Foundation, the Stockholm Centre for Psychiatric Research and the Swedish Council for Working Life and Social Research
MPs have voted to end ‘discrimination’ which stops those suffering from mental illness serving in public life as a rare private members bill is backed by the House of Commons.
By Rosa Prince, Online Political Editor
3:36PM BST 14 Sep 2012
Nick Clegg, the Deputy Prime Minister, and Ed Miliband, the Labour leader, were among those who gave their backing to the Bill, which was introduced to the Commons by the Conservative backbencher Gavin Barwell.
It repeals the practice of barring those who have suffered from severe mental health issues from serving on juries or as company directors. MPs who have been institutionalised for psychiatric reasons for more than six months will no longer be forced to stand down from Parliament.
In a rare show of unity in the House of Commons, the Mental Health (Discrimination) Bill was passed without a vote. Private Members Bills such as Mr Barwell’s usually fail to win support, and are talked out of time when they reach the Commons.
But after the Government and Opposition sung behind the new law, the bill was passed with politicians on all sides of the health praising the reform.
Mr Clegg said: “It’s ludicrous in this day and age that a person can’t contribute to public life if they’ve had issues with their mental health.
“Discrimination like this has no place in modern society and it is right that these rules are repealed. These long overdue reforms will send out a positive message that the stigmatisation of people who have mental health problems should not be tolerated.”
Mr Miliband added: “These changes will help bring public understanding and attitudes towards mental health into the 21st Century.
“They will send a message that discrimination against people with mental ill health has no place in modern Britain.
“If people with experience of mental ill health play a full part in public life, our country will be a better place for it.”
Charles Walker, a Conservative MP who has previously spoken movingly about his battle with mental illness, was among those who supported the new law. “I am delighted to say that I have been a practising fruitcake for 31 years,” he told MPs.
“What we’re seeing is an absolute sea-change in the reporting of mental health problems. There’s still some distance to go but things are improving and they are improving quickly.”
The legislation repeals part of the 1983 Mental Health Act which forces MPs and members of the devolved assemblies to stand down if they have been sectioned for more than six moths.
It also relaxes the rules on jury selection and company directorships as they apply to mental illness.
Mr Barwell said: “It is high time we dragged the law of the land into the 21st century. My Bill’s purpose is very simple: to tackle the last legal form of discrimination in our society.
“To our shame the law of the land still discriminates against those with a mental health condition.
“An MP or a company director can be removed from their job because of mental ill health even if they go on to make a full recovery. Many people who are fully capable of performing jury service are ineligible to do so.
“The law as it stands sends out a clear message that if someone has a mental health condition, their contribution to public life is not welcome. That is an affront to a decent civilised society.”
Chloe Smith, a Cabinet Office minister, confirmed that the Government was giving its “full backing” to the Bill.
“It cannot be right that in the 21st century it is possible for somebody to be automatically expelled from this place, from the House of Commons, because they have had a mental illness,” she said.
“It sends out entirely the wrong message that if you have mental health problems, your contribution is not welcome in public life, not only for the House of Commons but of course also on a jury and in a directorship.”
The Bill, which will now go on to the next stage of the Parliamentary process, has the support of mental health charities and the Royal College of Phychiatrists.
April 30, 2007
There is growing interest in a suspected cause of some cases of depression: infection and inflammatory response. New research findings that add to our understanding of the interrelationship of immunology and depression, and the reasons that some currently used antidepressants work, may fundamentally change the way that mood disorders and drug therapies are conceptualized.
There are several unambiguous examples of psychiatric illness being the result of an inflammatory or immune reaction. Considerable evidence already exists about the Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), a disorder in which Streptoccal infection triggers an autoimmune response. The antibodies that form against the invading bacteria mistakenly recognize and “attack” certain parts of the brain, causing psychiatric symptoms.
Another notable example of immune-mediated depression is the response of some patients to treatment with Interferon α, who become profoundly depressed and suicidal. Interestingly, onset of depressive symptoms has been shown to be prevented by treatment with antidepressants that work on the serotonin system.
The involvement of immune activation and depressive-like “sickness behavior” symptoms has been suspected for many years. Evidence specifically suggests that patients with major depression exhibit changes in cytokine activity and inflammation. Immune-mediated psychological and neuroendocrine changes were observed following vaccination with live attenuated rubella virus. A subgroup of vulnerable subjects showed a significant virus-induced increase in depressed mood up to 10 weeks following their vaccination. In a related animal study, the investigators also showed that immune activation with a variety of immune challenges induced a “depressive-like syndrome in rodents: anhedonia, anorexia, body weight loess, and reduced exploratory, and social behavior.” Chronic treatment with TCAs or SSRIs attenuated many of the behavioral effects.
A team of English investigators have, for the first time, shown a possible link between administration of a vaccine, peripheral immune activation, psychological and behavioral changes, and the brain serotonin system. The researchers used antigens derived from the bacterium Mycobacterium vaccae, a generally benign and ubiquitous agent found in dirt. After vaccination, they found that the subsequent immune activation was temporally associated with increases in serotonin metabolism within the ventromedial prefrontal cortex. Treatment with the vaccine seemed to alter behavior in mice similarly as is typically seen with antidepressants. This research was initiated following observations that human cancer patients being treated with the bacteria Mycobacterium vaccae unexpectedly reported increases in their quality of life.
The identification of serotonin neurons in the dorsal raphe nucleus that are uniquely responsive to peripheral immune activation raises the possibility that one day there will be a vaccine designed to modulate the immune response which in turn will the prevent the onset or attenuate the symptoms of major depression and other psychiatric disorders
Repsoted at Request
CQC whistleblower ‘subjected to mental health assessment’
The organisation’s chief executive Cynthia Bower stood down in February after a Government review endorsed Mrs Sheldon’s concerns about poor governance, poor leadership and unclear accountability.
Mrs Sheldon, a non-executive director at the CQC, had spoken out at the public inquiry into the scandal at Mid Staffordshire hospital last November.
On the same day, Dame Jo wrote to Health Secretary Andrew Lansley recommending that she be “immediately” suspended and “urgently” replaced.
According to The Independent, Mrs Sheldon was also subject to “priority monitoring” and declared a “risk” to the regulator.
After a short telephone conversation and without meeting Mrs Sheldon, 49, who has a history of depression, the doctor had described her as possibly suffering from “paranoid schizophrenia”.
He had also “strongly recommended” that Mrs Sheldon’s medical history be obtained “in confidence” and that she should be “assessed or else removed from her position”.
Dame Jo had then told the board that she planned to share this opinion with Mr Lansley and expressed concerns to the Department of Health officials.
The revelations are likely to further damage Dame Jo’s position at the CQC following patient safety failures at a number of hospitals under the watch of the regulator – which is supposed to be a safe point of contact for NHS whistleblowers.
Mrs Sheldon said she had only learned about the investigation into her mental health after receiving information held by the CQC under the Data Protection Act and that it was “scary” to discover the degree to which she was being monitored.
She said that while she had been “stressed and frustrated” because the important patient safety issues she was trying to raise were being “brushed under the carpet”, her mental health was “fine”.
Mrs Sheldon said: “I was not ill; I was just trying to do my job. I am very open about my mental health problems, but it feels like they tried to use it against me.
“This is a public body meant to be protecting people. It was completely outrageous.”
A report earlier this year concluded that Mrs Sheldon should be removed but Mr Lansley agreed last month that she should remain on the board.
A CQC spokesman said: “The CQC has a duty to its staff. If there are concerns about an individual’s mental health, the CQC may refer staff to its occupational health services.”
Public release date: 12-Aug-2012 [
Yale team discovers how stress and depression can shrink the brain
Major depression or chronic stress can cause the loss of brain volume, a condition that contributes to both emotional and cognitive impairment. Now a team of researchers led by Yale scientists has discovered one reason why this occurs — a single genetic switch that triggers loss of brain connections in humans and depression in animal models.
The findings, reported in the Aug. 12 issue of the journal Nature Medicine, show that the genetic switch known as a transcription factor represses the expression of several genes that are necessary for the formation of synaptic connections between brain cells, which in turn could contribute to loss of brain mass in the prefrontal cortex.
“We wanted to test the idea that stress causes a loss of brain synapses in humans,” said senior author Ronald Duman, the Elizabeth Mears and House Jameson Professor of Psychiatry and professor of neurobiology and of pharmacology. “We show that circuits normally involved in emotion, as well as cognition, are disrupted when this single transcription factor is activated.”
The research team analyzed tissue of depressed and non-depressed patients donated from a brain bank and looked for different patterns of gene activation. The brains of patients who had been depressed exhibited lower levels of expression in genes that are required for the function and structure of brain synapses. Lead author and postdoctoral researcher H.J. Kang discovered that at least five of these genes could be regulated by a single transcription factor called GATA1. When the transcription factor was activated, rodents exhibited depressive-like symptoms, suggesting GATA1 plays a role not only in the loss of connections between neurons but also in symptoms of depression.
Duman theorizes that genetic variations in GATA1 may one day help identify people at high risk for major depression or sensitivity to stress.
“We hope that by enhancing synaptic connections, either with novel medications or behavioral therapy, we can develop more effective antidepressant therapies,” Duman said.
The study was funded by the National Institutes of Health and the Connecticut Department of Mental Health and Addiction Services.
Other Yale authors of the paper are Bhavya Voleti, Pawel Licznerski, Ashley Lepack, and Mounira Banasr
SPIEGEL Interview with Jerome Kagan 2 AUG 2012
Harvard psychologist Jerome Kagan is one of the world’s leading experts in child development. In a SPIEGEL interview, he offers a scathing critique of the mental-health establishment and pharmaceutical companies, accusing them of incorrectly classifying millions as mentally ill out of self-interest and greed.
Jerome Kagan can look back on a brilliant career as a researcher in psychology. Still, when he contemplates his field today, he is overcome with melancholy and unease. He compares it with a wonderful antique wooden chest: Once, as a student, he had taken it upon himself to restore the chest with his colleagues.
He took one of its drawers home himself and spent his entire professional life whittling, shaping and sanding it. Finally, he wanted to return the drawer to the chest, only to realize that the piece of furniture had rotted in the meantime.
If anyone has the professional expertise and moral authority to compare psychology to a rotten piece of furniture, it is Kagan. A ranking of the 100 most eminent psychologists of the 20th century published by a group of US academics in 2002 put Kagan in 22nd place, even above Carl Jung (23rd), the founder of analytical psychology, and Ivan Pavlov (24th), who discovered the reflex bearing his name.
Kagan has been studying developmental psychology at Harvard University for his entire professional career. He has spent decades observing how babies and small children grow, measuring them, testing their reactions and, later, once they’ve learned to speak, questioning them over and over again. For him, the major questions are: How does personality emerge? What traits are we born with, and which ones develop over time? What determines whether someone will be happy or mentally ill over the course of his or her life?
In his research, Kagan has determined that how we are shaped in our early childhood is not as irreversible as has long been assumed. He says that even children who suffer from massive privations in the first months of life can develop normally as long as they are later raised in a more favorable environment. Likewise, he has studied how people become human in a certain programmatic way in the second year of life: Their vocabulary suddenly grows in leaps and bounds, and they develop a sense of empathy, a moral sensibility and an awareness of the self.
But Kagan’s most significant contribution to developmental research has come through his examination of innate temperaments. As early as four months old, he has found, some 20 percent of all babies already have skittish reactions to new situations, objects and individuals. He calls these babies “high reactives” and says they tend to develop into anxious children and adults. Forty percent of babies, or what he calls the “low reactives,” behave in the opposite manner: They are relaxed, easy to care for and curious. In later life, they are also not so easily ruffled.
Kagan could have reacted to his finding in a “low-reactive” way by kicking back and letting subsequent generations of researchers marvel at his findings. Instead, he has attacked his own profession in his recently published book “Psychology’s Ghost: The Crisis in the Profession and the Way Back.” In it, he warns that this crisis has had disastrous consequences for millions of people who have been incorrectly diagnosed as suffering from mental illness.
SPIEGEL: Professor Kagan, you’ve been studying the development of children for more than 50 years. During this period, has their mental health gotten better or worse?
Kagan: Let’s say it has changed. Particularly in poorer families, among immigrants and minorities, mental health issues have increased. Objectively speaking, adolescents in these groups have more opportunities today than they did 50 years ago, but they are still anxious and frustrated because inequality in society has increased. The number of diagnosed cases of attention-deficit disorders and depression has increased among the poor…
SPIEGEL: … you could also say skyrocketed. In the 1960s, mental disorders were virtually unknown among children. Today, official sources claim that one child in eight in the United States is mentally ill.
Kagan: That’s true, but it is primarily due to fuzzy diagnostic practices. Let’s go back 50 years. We have a 7-year-old child who is bored in school and disrupts classes. Back then, he was called lazy. Today, he is said to suffer from ADHD (Attention Deficit Hyperactivity Disorder). That’s why the numbers have soared.
SPIEGEL: Experts speak of 5.4 million American children who display the symptoms typical of ADHD. Are you saying that this mental disorder is just an invention?
Kagan: That’s correct; it is an invention. Every child who’s not doing well in school is sent to see a pediatrician, and the pediatrician says: “It’s ADHD; here’s Ritalin.” In fact, 90 percent of these 5.4 million kids don’t have an abnormal dopamine metabolism. The problem is, if a drug is available to doctors, they’ll make the corresponding diagnosis.
SPIEGEL: So the alleged health crisis among children is actually nothing but a bugaboo?
Kagan: We could get philosophical and ask ourselves: “What does mental illness mean?” If you do interviews with children and adolescents aged 12 to 19, then 40 percent can be categorized as anxious or depressed. But if you take a closer look and ask how many of them are seriously impaired by this, the number shrinks to 8 percent. Describing every child who is depressed or anxious as being mentally ill is ridiculous. Adolescents are anxious, that’s normal. They don’t know what college to go to. Their boyfriend or girlfriend just stood them up. Being sad or anxious is just as much a part of life as anger or sexual frustration.
SPIEGEL: What does it mean if millions of American children are wrongly being declared mentally ill?
Kagan: Well, most of all, it means more money for the pharmaceutical industry and more money for psychiatrists and people doing research.
SPIEGEL: And what does it mean for the children concerned?
Kagan: For them, it is a sign that something is wrong with them — and that can be debilitating. I’m not the only psychologist to say this. But we’re up against an enormously powerful alliance: pharmaceutical companies that are making billions, and a profession that is self-interested.
SPIEGEL: You once wrote that you yourself often suffered from inner restlessness as a child. If you were born again in the present era, would you belong to the 13 percent of all children who are said to be mentally ill?
Kagan: Probably. When I was five, I started stuttering. But my mother said: “There’s nothing wrong with you. Your mind is working faster than your tongue.” And I thought: “Gee, that’s great, I’m only stuttering because I’m so smart.”
SPIEGEL: In addition to ADHD, a second epidemic is rampant among children: depression. In 1987, one in 400 American adolescents was treated with anti-depressants; by 2002, it was already one on 40. Starting at what age is it possible to speak of depression in children?
Kagan: That’s not an easy question to answer. In adults, depression either implies a serious loss, a sense of guilt or a feeling that you are unable to achieve a goal that you really wanted to reach. Infants are obviously not yet capable of these emotions. But, after the age of three or four, a child can develop something like a feeling of guilt, and if it loses its mother at that age, it will be sad for a while. So, from then on, mild depression can occur. But the feeling of not being able to achieve a vital goal in life and seeing no alternative only starts becoming important from puberty on. And that is also the age at which the incidence of depression increases dramatically.
SPIEGEL: The fact is that younger children are also increasingly being treated with antidepressants.
Kagan: Yes, simply because the pills are available.
SPIEGEL: So would you completely abolish the diagnosis of depression among children?
Kagan: No, I wouldn’t go as far as that. But if a mother sees a doctor with her young daughter and says the girl used to be much more cheerful, the doctor should first of all find out what the problem is. He should see the girl on her own, perhaps carry out a few tests before prescribing drugs (and) certainly order an EEG. From studies, we know that people with greater activity in the right frontal lobe respond poorly to antidepressants.
Part 2: ‘Psychiatrists Should Ask What the Causes Are’
SPIEGEL: Should one just wait to see whether depression will go away by itself?
Kagan: That depends on the circumstances. Take my own case: About 35 years ago, I was working on a book summarizing a major research project. I wanted to say something truly important, but I wasn’t being very successful. So I went into a textbook-type depression. I was unable to sleep, and I met all the other clinical criteria, too. But I knew what the cause was, so I didn’t see a psychiatrist. And what do you know? Six months later, the depression had gone.
SPIEGEL: In a case like that, does it even make sense to speak of mental illness?
Kagan: Psychiatrists would say I was mentally ill. But what had happened? I had set myself a standard that was too high and failed to meet that standard. So I did what most people would do in this situation: I went into a depression for a while. Most depressions like that blow over. But there are also people with a genetic vulnerability to depression in whom the symptoms do not pass by themselves. These people are chronically depressed; they are mentally ill. So it is important to look not just at the symptoms, but also at the causes. Psychiatry is the only medical profession in which the illnesses are only based on symptoms …
SPIEGEL: … and it seems to discover more and more new disorders in the process. Bipolar disorders, for example, virtually never used to occur among children. Today, almost a million Americans under the age of 19 are said to suffer from it.
Kagan: We seem to have passed the cusp of that wave. A group of doctors at Massachusetts General Hospital just started calling kids who had temper tantrums bipolar. They shouldn’t have done that. But the drug companies loved it because drugs against bipolar disorders are expensive. That’s how the trend was started. It’s a little like in the 15th century, when people started thinking someone could be possessed by the devil or hexed by a witch.
SPIEGEL: Are you comparing modern psychiatry to fighting witches’ hexes in the Middle Ages?
Kagan: Doctors are making mistakes all the time — despite their best intentions. They are not evil; they are fallible. Take Egas Moniz, who cut the frontal lobes of schizophrenics because he thought that would cure them …
SPIEGEL: … and received a Nobel Prize for it in 1949.
Kagan: Yes, indeed. Within a few years, thousands of schizophrenics had their frontal lobes cut — until it turned out that it was a terrible mistake. If you think of all the people who had their frontal lobes cut, being called bipolar is comparatively harmless.
SPIEGEL: It’s not entirely harmless either, though. After all, children with this diagnosis are being subjected to a systematic change in their brain chemistry through psychoactive substances.
Kagan: I share your unhappiness. But that is the history of humanity: Those in authority believe they’re doing the right thing, and they harm those who have no power.
SPIEGEL: That sounds very cynical. Are there any alternatives to giving psychoactive drugs to children with behavioral abnormalities?
Kagan: Certainly. Tutoring, for example. Who’s being diagnosed with ADHD? Children who aren’t doing well in school. It never happens to children who are doing well in school. So what about tutoring instead of pills?
SPIEGEL: Listening to you, one might get the impression that mental illnesses are simply an invention of the pharmaceutical industry.
Kagan: No, that would be a crazy assertion. Of course there are people who suffer from schizophrenia, who hear their great-grandfather’s voice, for example, or who believe the Russians are shooting laser beams into their eyes. These are mentally ill people who need help. A person who buys two cars in a single day and the next day is unable to get out of bed has a bipolar disorder. And someone who cannot eat a bite in a restaurant because strangers could be watching them has a social phobia. There are people who, either for prenatal or inherited reasons, have serious vulnerabilities in their central nervous system that predispose them to schizophrenia, bipolar disease, social anxiety or obsessive-compulsive disorders. We should distinguish these people from all the others who are anxious or depressed because of poverty, rejection, loss or failure. The symptoms may look similar, but the causes are completely different.
SPIEGEL: But how are you going to distinguish between them in a concrete case?
Kagan: Psychiatrists should begin to make diagnoses the way other doctors do: They should ask what the causes are.
SPIEGEL: The problems you describe are not new. Why do you believe psychiatry is in a crisis at this specific time?
Kagan: It’s a matter of the degree. Epidemiological studies are saying that one person in four is mentally ill. The Centers for Disease Control and Prevention in Atlanta recently announced that one in 88 American children has autism. That’s absurd. It means that psychiatrists are calling any child who is socially awkward autistic. If you claim that anyone who can’t walk a mile in 10 minutes has a serious locomotor disability, then you will trigger an epidemic of serious locomotor disabilities among older people. It may sound funny, but that’s exactly what’s going on in psychiatry today.
SPIEGEL: Do you sometimes feel ashamed of belonging to a profession that you think wrongly declares large parts of society to be mentally ill?
Kagan: I feel sad, not ashamed … but maybe a little ashamed, too.
SPIEGEL: Over 60 years ago, when you decided to become a psychologist, you wanted “to improve social conditions so that fewer people might experience the shame of school failure … and the psychic pain of depression,” as you once put it. How far did you get?
Kagan: Not very far, unfortunately, because I had the wrong idea. I thought family circumstances were crucial to being successful in life. I thought that, if we could help parents do a better job, we could solve all these problems. That’s why I chose to be a child psychologist. I didn’t recognize the bigger forces: culture, social standing, but also neurobiology. I really thought that everything was decided in the family, and that biology was irrelevant.
SPIEGEL: Over time, you’ve come to realize that the bond between a mother and her child is not so important after all.
Kagan: That’s right, though one must remember that the mother’s role was not emphasized until quite recently. Sixteenth-century commentators even wrote that mothers were not suited to looking after children: too emotional, overprotective. But when the bourgeoisie increased in the 19th century, women didn’t have to go out and work anymore. They had a lot of time on their hands. So society gave them an assignment and said: “You are now the sculptress of this child.” At the same time, middle-class children didn’t have to contribute to their family the way peasants’ children did. They were not needed and therefore ran the risk of feeling worthless. But when a child doesn’t feel needed, it needs another sign. So love suddenly became important. And who gives love? Women. Eventually, John Bowlby came along and romanticized maternal attachment.
SPIEGEL: Bowlby, the British psychiatrist, was one of the fathers of attachment theory. Do you consider his hypotheses to be wrong?
Kagan: People wanted simple answers, and they longed for a gentler conception of humanity, especially after the horrors of World War II. This fit the idea that only children who are able to trust their mothers from birth are able to lead a happy life.
SPIEGEL: Anxieties over whether raising children in day care centers could harm them persist to this day.
Kagan: Unfortunately, even though we already disproved this in the 1970s. Nixon was president at the time, and Congress was toying with the idea of national day care centers. Along with two colleagues, I got a big grant to study the effect of day care on a group of infants. The children in the control group were looked after at home by their mothers. At the end of 30 months, we found that there was no difference between the two groups. Nonetheless, to this day, 40 years later, people are still claiming that day care centers are bad for children. In 2012.
SPIEGEL: Professor Kagan, we thank you for this conversation.
Interview conducted by Johann Grolle and Samiha Shafy
Depression alert over progesterone-only Pill as doctors are warned to prescribe with caution
PUBLISHED:16:46 EST, 4 August 2012 | UPDATED:08:50 EST, 5 August 2012
Women who take the most widely prescribed type of contraceptive pill may be less likely to suffer depression.
New research shows that those taking the combined Pill – which contains the hormones oestrogen and progestogen (of which progesterone is the most commonly known form) – were two-thirds less likely to develop a mood disorder, but those using progestogen-only contraceptive pills were three times more likely to have a mental illness than women who were not on any medication.
The researchers who carried out the study say that doctors should use caution in prescribing progestogen-only pills because of these potential side effects.
In the new study, in the Journal of Affective Disorders, psychiatrists from universities in Australia and Norway, including Melbourne and Bergen, looked at Pill use and the prevalence of mood disorder in women aged 20 to 50.
Progestogen is known to act on the brain chemical glutamate, and research has shown that higher than usual levels of the chemical are found in the brains of patients with bipolar disorder and major depression