Incidence of psychiatric diagnoses in offspring prenatally exposed to SSRIs

A recent article in the Journal of the American Academy of Child and Adolescent Psychiatry presents a study looking at prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) and associated increased rates of depression diagnoses in early adolescence. The report stresses that these findings are preliminary and should not be construed to change clinical practice.

The study is the first to investigate the incidence of psychiatric diagnoses in offspring prenatally exposed to SSRIs as far out as adolescence, noting however the vital importance of treating maternal depression, which can have significant adverse effects on offspring. Untreated maternal depression has been shown to increase risks of several perinatal outcomes including preterm birth, delivery by C-section, and bleeding during delivery.

Researchers used Finnish national birth registry data to determine the cumulative incidence of depression, anxiety disorders, autism spectrum disorder, and attention-deficit/hyperactivity disorder in the offspring of four groups of mother-offspring dyads: mothers exposed to SSRIs during pregnancy, mothers exposed to psychiatric disorder but not to antidepressants, mothers who used SSRIs only before pregnancy), and children of mothers unexposed to either antidepressants or psychiatric disorders.

They found the cumulative incidence of depression among offspring exposed prenatally to SSRIs was 8.2% by age 14.9 years, compared with 1.9% in the psychiatric disorder/no medication group and 2.8% in the SSRI-discontinued group. In contrast, SSRI prenatal exposure was not associated with an increased risk of autism spectrum disorder, ADHD, or anxiety.

Can depressive disorder be the outcome of an infectious disease

One in five Australians aged 16-85 experience a mental illness in any year. The most common mental illnesses are depressive, anxiety and substance use disorder. These three types of mental illnesses often occur in combination. For example, a person with an anxiety disorder could also develop depression, or a person with depression might misuse alcohol or other drugs, in an effort to self-medicate. Of the 20% of Australians with a mental illness in any one year, 11.5% have one disorder and 8.5% have two or more disorders. Almost half (45%) Australians will experience a mental illness in their lifetime.

Recently Psychiatric News ran a story with at least one researcher asking if major depressive disorder is the outcome of an infectious disease? This question arises from the belief that a variety of infectious pathogens affect the central nervous.

Patients with depression exhibit sickness behavior. Also, depression is significantly associated with infectious agents, including viruses like Borna disease virus, herpes simplex virus-1, varicella zoster, and Epstein-Barr virus. Parasites like Toxoplasma gondii may play a role. And even if every case of depression isn’t caused by an infectious agent; given its prevalence, even a subset of patients would still add up to a large number of cases. We know, for example, infectious agents have been known to affect the brain and cause psychiatric disorders. Syphilis helped fill America’s mental asylums in the late 19th century.

It’s said that among patients with diagnosed major depression or bipolar disorder, those with a history of suicide attempt had higher Toxoplasma gondii antibody titers.

Another possibility is the “leaky gut” hypothesis, suggesting that cytokines increase intestinal-tract permeability to lipopolysaccherides from gram negative bacteria and that antibodies to the LPS are found at higher levels in depressed patients.

The key may not be a disease, however, rather an inflammatory reaction caused by disease given that higher levels of pro-inflammatory cytokines are found in people with depression. A recent report, drawing on data from the Avon Longitudinal Study of Parents and Children in Great Britain, found that children with the highest levels of the systemic inflammatory marker IL-6 at age 9 were more likely to be depressed at age 18.

Depression history among different professions

Gallup recently decided to rank the occupations in which workers are most likely to suffer from depression. The takeaway: Your boss is probably in a pretty decent psychological place. Managers, executives, and officials were the least likely to have ever been diagnosed with depression. The clerical and office staff who toil beneath them, on the other hand, were diagnosed at somewhat higher rates. Meanwhile, workers in manufacturing or service industries were the most likely to have ever been depressed. The drudgery of clocking in on an assembly line or at a cash register apparently takes a toll, just in case you were wondering.

See below

The impact of mobile phones on psychology and depression

Much has been written recently about the impact mobile phone usage has on our psychology and mental health.

According to researchers at the University of Gothenburg, Sweden, young people who heavily use mobile phones and computers also complain more about sleep disturbances, stress and other mental health problems. The research team conducted four separate studies aimed at investigating the correlation between computers and mobile phones, and their impact on the mental health of young adults.

The findings reveal that extreme use of mobile phones and computers may be linked to stress, sleep disorders and depressive symptoms. The researchers could not determine causation, so it may be that people with depression or sleep problems are simply more likely to reach out to others using mobile technology. Their conclusion is that intensive use of information and communication technology can have an impact on mental health among young adults.

The research reveals, for example, that heavy cell phone use is correlated with an increase in sleeping difficulties in men and an increase in depressive symptoms in both men and women. Those who find the constant accessibility via mobile phones to be stressful are most likely to report mental symptoms.

The call for an academic discipline

Florie Brizel, who is currently working on her third book, which examines what she calls Mobilology, the study of the effects of mobile phone use on behavior, community, culture, entertainment, and economics says; Mobile phones allow people to talk to the world, but they can do so much more. We must teach people how to really maximize the global linkage available to them through their mobile devices, especially if we expect them to be used for any kind of social good.

Of course, technology and humanity are not necessarily compatible. One is about an anonymous push forward into the unknown... to explore it, to develop and exploit it, which is important. The other is about paying undivided attention to the individual and the world in front of you, developing relationships, and increasing consciousness. Both are necessary. The challenge is figuring out how to use technology to enhance humanity, not degrade it.

Mobilology addresses how mobile phone use affects life in the modern world. Not only does it address the five main sectors of behavior, community, culture, entertainment, and economics and whatever else comes along. 
It's the first academic discipline that is inherently collaborative as well as being interdependent with other academic disciplines.

Depressive realism - better time keeping

We’ve known for quite a while that depressed people appear to have a more realistic perception of their importance, reputation, locus of control, and abilities than those who are not depressed. In fact this depressive realism was something the French philosopher Voltaire dealt with as early as 1759 in his novel Candide: Or, Optimism.

New research led by the University of Hertfordshire shows that depressed people are more accurate when it comes to time estimation than their happier peers.

In the study, volunteers gave verbal estimates of the length of different time intervals of between two and sixty-five seconds and they also produced their own time intervals. For non-depressed people, their verbal time interval estimations were too high; while their own production of times in the same range were too low. In contrast, the mildly-depressed people were accurate in both their verbal time estimates and also their own production times.

It’s said that the findings may help to shed light on how people with depression can be treated. People with depression are often encouraged to check themselves against reality, but maybe this timing skill can help in the treatment of mildly-depressed people. These findings may also link to successful mindfulness based treatments for depression which focus on encouraging present moment awareness.

When Happiness and Depression Meet

About a year ago I wrote about happiness and what it is that makes us happy. It turns out that what makes us happy, what motivates us, follows the philosophy of Autonomy, Mastery and Purpose. We do things for ourselves that help grow us and are important to us, we do things that we have to struggle with to improve ourselves, and we do things that make us part of a bigger world, and all of these three things have the capacity to make us happy or happier. Follow link below.

http://appliedpsychologyresearch.blogspot.com.au/2012/03/happiness-is-synthetic-so-why-not.html

I wanted today to check, basically, how users of Google search for information associated with happiness and depression. This is essentially search volume index over time. As you can see above there is a fascinating convergence between these two search volumes. As the search volume for Depression decreases over time, the search volume for Happiness has increased to almost the same volume matching Depression. Even when you ask Google to extrapolate these trends (in dotted lines) the trend continues.

Can you keep a secret

Recently much has been written about the physical and psychological consequences of secrecy. We know for example, that some of us can be trusted with other’s private matters, while some of us are less capable of keeping our mouths shut.

A diagnostic tool called the Self-Concealment Score gauges how secretive we are on a scale of ten (very open) to 50 (bank vault). Most of it turns out fall somewhere near the middle, which is the healthy range.

Generally, people with high-self concealment scores are those who tend to keep their thoughts and feelings bottled up and can be correlated with a host of emotional and physical issues, including stress, depression and have low self esteem.

Secrecy, it turns out, is taxing. Studies suggest that exercising the kind of self control required to deliberately conceal information is psychologically and even physically tiring, which sheds light on why secrecy can sabotage our health and well-being. It may also help explain why, for instance, it’s harder to diet during times of stress—because restraint depletes the same physical and emotional reserves as do stress and exhaustion.

We're Out of Miltown

Back in 2006 ABC’s All in the Mind program presented what they called “in the spirit of Sigmund Freud and his One hundred fiftieth birthday” an interview with Jonathan Metzl. In a sense, the presenter offered “we are psychoanalysing psychiatry itself.” The timing for this was of course also related to Metzl just having published Prozac on the Couch: Prescribing Gender in the Era of Wonder.

The premise of the book is that the biochemical revolution in psychiatry, which displaced Freudianism from its central role in treating mental illness in the United States. The ABC program opens with the vey fitting jingle, Mother's Little Helper, and introduction along the lines “You may remember this 1967 Rolling Stones hit "Mother's Little Helper", a tongue in cheek tribute to a housewife coping with whinging kids and a demanding husband with a little help from the minor tranquiliser Valium.”

Jonathan Metzl sees himself as someone who on one hand is a practitioner of psychiatry and on the other hand someone who studies the kind of cultural history of the ways that depression came to be seen and thought of in present day American society but also internationally. His book examines, for example, how pharmaceutical advertisements, representations of depression in film and media and medical writings are framed.

The book gives a historic account of psychiatric medications in medicine and popular culture starting in the 1950s, a time when Miltown (Meprobamate) became really the first of the modern psychiatric wonder drugs. Prior to the 1950s these kind of drugs weren't an established phenomenon. Metzl tells the story of initial scepticism among psychiatrists and drug companies because, interestingly, they would ask who would use medication when there is talk therapy. However, within two months the demand for Miltown in the United States was so great that there were like these famous signs in the windows of pharmacies saying 'We're out of Miltown.

So whilst the biological basis for depression was perhaps beginning to be addressed through medication Metzl suggests that the rhetoric by which these drugs came into being, again in popular representation, took a lot from Freud even if there was an implication that Freudianism was being overthrown. In the first chapter aptly called The Freud of Prozac, Metzl argues that the ways that these drugs were understood in the popular realm, biology owes a lot to Freud with regard to gender.

Metzl looks at these medications through the lens of what are the implications for gender He says even though we think of Valium as being the 'mother's little helper' for the popularity of the Rolling Stones’ song and in part because of the fact that according to some studies up to 70% of prescriptions for Valium in the United States were written to white middle class women. He goes on, Miltown set the stage for Valium by creating a set of connections between the anxieties of motherhood, or more aptly the anxieties that people who were creating a certain kind of public rhetoric had about the role of mothers in society, and treatment with psychiatric drugs.

Metzl discusses the cultural history of the ways that depression came to be seen and thought of. We saw that for women, overwhelmingly, depression came to be described in popular articles in relation to the women's roles as mothers, or being married, or menstruation.. For men, there was almost nothing about men getting depressed and it impacting their roles as fathers, or as boyfriends, or as anything that might imply emotions or inner-lives. Depression related to aggression, athletics, sports and, to a little bit lesser extent, work. And so we would see articles about famous athletes who got depressed and couldn't win races, or hit the ball, or something and then they would take Prozac and they would start winning again.

However, Metzl never gives an alternative to the Freudian father/superego, mother/unconscious, and his interpretations of women are filtered through this distorting lens. Hence, his sometimes absorbing and adroit presentation of examples is hamstrung by an interpretive paradigm that is no broader than that which he seeks to question.