Clinical depression and smoking

Jack Dikian

October 2011

Not long ago I was using the Google trends tool to look at various search volume correlations for clinical depression and other factors including smoking. I noticed Australians are in the top three countries using Google to search “depression”. The first was Ireland followed by South Africa. Another interesting thing, albeit, without a real hard look seems like there is about half the volume of searches for depression now compared to 5 or 6 years ago.

As I mentioned, my real objective was to see if there was anything to glean from data reflecting people’s propensity to use a search engine for perceived tag combinations such as “depression” and “smoking”.

Indeed, a study by the Toronto-based Centre for Addiction and Mental Health reports that the same enzyme, Monoamine oxidase (MAO), is found in elevated levels in both people suffering from clinical depression as well as heavy smokers in the early stages of abstaining from smoking. This could be why people struggle to quit the habit.

Smokers in the study also reported increased feelings of sadness in questionnaires done as part of the study. The researchers said such findings could explain why smokers are at a higher risk of suffering from depression — almost twice that of the general population, according to Jeffrey Meyer, a senior scientist with the Centre for Addiction who led the study.

Cross-cultural Psychopathology

Jack Dikian

October 2011

A few years I attended a conference where Anthony Marsella from the University of Hawaii at Manoa gave a fascinating talk. He was interweaving topics such as Global Challenges, Peace, Social Justice with Cultural psychology and psychopathology.

I remember being engrossed by the idea of Cultural Psychopathology. From a cross-cultural standpoint psychopathology is understood not only in terms of cognitive or physiological mechanisms, but also in terms of its social context and norms.

In addition, syndromes and folk illness can be considered within Culture-bound syndrome, culture-specific syndrome or folk illness. There are numerous combinations of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture.

The fourth edition of Diagnostic and Statistical Manual (DSM) classifies syndromes as culture-bound syndromes. Here is an extract.

Name	Geographical localization/populations
Running amok	Malaysia, Indonesia, Philippines, Brunei, Singapore
ataque de nervios	Latinos
bilis, cólera	Latinos
bouffée délirante	West Africa and Haiti
brain fag	West African students
dhat syndrome	India
falling-out, blacking out	Southern United States and Caribbean
ghost sickness	American Indian
Hwabyeong	Korean
koro	Chinese and Malaysian populations in southeast Asia; Assam; occasionally in West
latah	Malaysia and Indonesia
locura	Latinos in the United States and Latin America
evil eye	Mediterranean; Hispanic populations
nervios	Latinos in the United States and Latin America
Piblokto	Arctic and subarctic Eskimo populations
Qigong psychotic reaction	Chinese
rootwork	African American and White populations in southern United States; Caribbean
sangue dormido	Portuguese populations in Cape Verde
shenjing shuairuo	Chinese
shenkui	Chinese
shinbyeong	Korean
spell	African American and White populations in the southern United States
susto	Latinos in the United States; Mexico, Central America and South America
taijin kyofusho	Japanese
zār	Ethiopia, Somalia, Egypt, Sudan, Iran, and other North African and Middle Eastern societies

Senses - much more than the traditional five

Jack Dikian

October 2011

In clinical practice we consider assessing sensory processing deficits or sensory integration dysfunction as an important part of global assessment and treatment, particularly when working with people with autism. I for one was a late entrant in making sensory assessments, almost a routine part of the battery of assessments that can help inform pathology.

Sensory integration dysfunction is a neurological disorder characterized by a neurological sensory integration deficit. The idea of treating sensory integration dysfunction as a discrete disorder was popularized by Anna Jean Ayres, an occupational therapist and developmental psychologist in the 60s.

Even though this and associated theories have been in existence for almost four decades we are seeing, increasingly, a greater number of clinicians and therapists actively consider the impact of sensory deficits, seek the assistance of occupational therapists to undertake sensory assessments, devise sensory diets and interventions.

This is just as well given we know Sensory integration dysfunction impairs the functional skills of 1 in 20 children and much higher in kids with intellectual disability and/or autism. These people may misinterpret everyday sensory information, such as touch, sound and movement. They may feel overwhelmed by sensory information, may seek out sensory experiences or may avoid certain experiences.

Often experiences are either over-reactive (sensory avoidance) or under-reactive (sensory seeker). They may also present with motor skill problems and may react with strong emotional behaviors and experience what may be described as ‘melt downs’.

Oxytocin and Social Behaviours

Jack Dikian

October 2011

Yesterday I attended the Developmental Disabilities, Challenging Behaviour and Mental Health conference hosted by The Faculty of Health Sciences and Brain and Mind Research Institute, University of Sydney in association with the NSW Council for Intellectual Disability.

It was a packed program including local and international speakers who have shaped and informed the fields of Developmental Disabilities, Psychology, Psychiatry and Psychological Medicine – with names including Professor Stewart Einfeld, Professor Eric Emerson, Professor Gwynnyth Llewellyn, Professor Bruce Tonge, and Professor Emeritus Trevor Parmenter.

The presentation by Associate Professor Adam Guastella was a particular interest to me in my work with autism and challenging behaviour. Guastella’s work demonstrates the critical role of Oxytocin and Arginine Vasopressin in enhancing social processes (some of which are known to be important in the overall Autism Spectrum Disorder symptomatology) in humans and has laid the foundation for potential new treatments for social dysfunction.

Looking at studies involving the use of Oxytocin and social behaviours, there appears to a number of reports linking Oxytocin with:

• Reduction of trust of strangers and increasing cultural and racial bias 1
• Positive correlation between Oxytocin plasma levels and an anxiety scale measuring the adult romantic attachment 2
• Enhancing eye gaze 3

Also, some studies report links between Oxytocin and improvement in peer and social recognition and bonding, reducing threat sensitivity where threat biases are likely to exist and improvement in retention of social memory.

1. Ed Yong (11 Jan 2011). "No love for outsiders – oxytocin boosts favouritism towards our own ethnic or cultural group". Discover Magazine. Kalmbach Publishing Co.. Retrieved 21 Feb 2011.

2. Marazziti D, Dell'Osso B, Baroni S et al. (2006). "A relationship between oxytocin and anxiety of romantic attachment". Clinical Practice and Epidemiology in Mental Health 2: 28. doi:10.1186/1745-0179-2-28.

3. Guastella AJ, Mitchell PB, Dadds MR (Jan 2008). "Oxytocin increases gaze to the eye region of human faces". Biological Psychiatry 63 (1): 3–5. doi:10.1016/j.biopsych.2007.06.026. PMID 17888410.