Moving toward suicide test

According to a small study by researchers at Johns Hopkins University in Baltimore, Maryland and published in The American Journal of Psychiatry, they have identified a chemical change in a single gene that is common in people who attempt or commit suicide. The research has identified a gene mutation that could lead to a blood test to predict risk.

Such a test is years away from being widely available to the public. For now, researchers say they have found a chemical change in a single gene, called SKA2, which is linked to how the brain responds to stress hormones.

This gene "plays a significant role in turning what might otherwise be an unremarkable reaction to the strain of everyday life into suicidal thoughts and behaviours.” Researchers found it by examining brain samples from people who had killed themselves, and found that levels of SKA2 were significantly reduced compared to healthy people. 

They also tested blood samples from 325 people in a prevention study at JHU and found that changes in the gene could predict with 80 per cent certainty those who were experiencing suicidal thoughts or who had attempted suicide. Among certain groups, the accuracy of the test was even higher. "Those with more severe risk of suicide were predicted with 90 per cent accuracy," said the study. "In the youngest data set, they were able to identify with 96 per cent accuracy whether or not a participant had attempted suicide, based on blood test results."

The SKA2 gene works to inhibit negative thoughts and control impulsive actions. When there isn't enough of it, or it is altered, the brain releases abnormal levels of the stress hormone, cortisol. Previous studies have shown that people who try to kill themselves, or who commit suicide, have an abnormal cortisol release. More research is needed to determine if a blood test could predict suicide in a larger group of people.

Mental health is an increasingly important topic in the workplace

Mental health is an increasingly important topic in the workplace. According to a report by the National Mental Health Commission and the Mentally Healthy Workplace Alliance It is estimated that, at any point in time, one in six working age people will be suffering from mental illness, which is associated with very high personal and economic costs. 

Mental illness is one of the leading causes of sickness absence and long-term work incapacity in Australia and is one of the main health related reasons for reduced work performance. Individuals with mental health problems, and their caregivers, are some of the most stigmatised and marginalised groups in the workplace and often miss out on the many benefits good work can offer.  There is increasing evidence that workplaces can play an important and active role in maintaining the mental health and well-being of their workers.

Now, The Workplace Bipolar Inventory, a 39-item questionnaire used to screen for bipolar disorder in the workplace, has showed promise in a small study at the department of mental health at the University of Tokyo.

The investigator asked workers who were on sick leave because of mental health problems to complete the Workplace Bipolar Inventory (WBI), the Mood Disorder Questionnaire, and the Bipolar Spectrum Diagnostic Scale. A subscale of the WBI called the WBI-AB4 proved to have the screening performance that was most informative.

According to the optimal cut-off point, WBI-AB4 would be useful for occupational mental health staffs to screen out bipolarity among workers who have depressive symptoms at the workplace; however, more information of the suspected subjects about the manic/hypomanic episode from their supervisor, colleagues, or family was needed.

This study aimed to develop a new instrument for bipolar disorder screening, the Workplace Bipolar Inventory (WBI), and examine its efficiency as compared with Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) among workers on leave of the absence due to their mental health problems.

Participants were recruited at a psychiatric outpatient clinic for return-to-work in Tokyo, Japan, during September to November 2009. 81 outpatients were recruited, 55 of whom (68%) agreed to participate in this study. Participants answered questionnaires including WBI, MDQ, BSDS, and demographic factors. Their diagnostic information according to the international statistical classification of diseases and related health problems 10th revision (ICD-10) was obtained from their attending psychiatrists. The WBI is a new self-rating 39-item questionnaire which developed with input from occupational mental health specialists and an analysis of WHO Composite International Diagnostic Interview (CIDI) items. 

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.

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.

Hansels and Gretels

On my supervisors’ retirement about a year ago I was left with a large box of books, some of which long out of print and still others, with almost faded pencil lines marking sections that must have had some relevance to his work all those years ago. One of these was the 1971 Hansels and Gretels, Studies of Children in Institutions for the Mentally Retarded, by Dorothea & Benjamin Braginsky (New York: Holt, Rinehart and Winston). I finally got around to reading this book in the last week, more so out of interest for its historical context.

The book, as expected, is peppered with language that many of my younger colleagues would hardly believe is possible – I’m of course referring to clinical labels and accepted terminology of the time. Consider; for example “…as a psychologist in a large state school and colony,…”, “classified as high-grade mental defectives…”, “…I prepared myself through library research and clinical conferences to look for moronic behaviour…”.

Chapter 5, titled “Retardates and Their Keepers: Conflict of Interests” particularly caught my curiosity. Here the authors begin the chapter with an acknowledgment of an assumed covert ideological conflict between the retardates and the institutional staff. I think they were correct in seeing this to be crucial in interpretations concerning retardate behaviour. The authors’ show insight when are expounding questions such as “what is the nature of their affliction, who are they, how should they be treated, what are their needs, and why are they incarcerated,..” etc.

In order to ascertain the attitudes that the training school staff maintain about mental retardation, its treatment and prognosis, and the institution, the Braginskys provide the results of a 100-item adaptation of the Retardation Attitude Test (RAT). What's really fascinating here isn't so much the variance between "Upper Staff" and "Lower staff" attitudes, which by the way is in itself interesting, but the kind items in the RAT. For example, item 15 "Although Retardates may seem all right when they have left here, they shout not be allowed to marry." Something incidentally about 30% of both upper and lower staff agreed with.

As well as my interest in this book’s historical throwback – I had also read the more current paper by Dianne E. Green (et al) New Zealand Attitudes to Mental Health (New Zealand Journal Of Psychology, 1987, 16, 37-41) that also dealt with stereotyped attitudes towards the mentally ill. I’d wondered if attitudes have indeed changed and if so by how much.

The researchers examined propositions about stereotyped attitudes towards the mentally ill based on responses of a group of New Zealand university students and the results compared with those if similar New Zealand studies carried out by the authors some three and six years previously, and with a U.S.A study carried out nine years previously.

In a historical sense, the authors talk of a contemporary shift in the care and treatment for the mentally ill and that has been away from institutional care and towards greater involvement of the community. Also, an acknowledgment of proposals introduced by various countries for the community to be more deeply involved in the care and treatment of the mentally ill, for a diversity of fresh therapeutic treatment and management styles with different types of institution to be initiated, and for the adoption of safeguards to prevent the oppressive control of patients.

In order to throw some light on the validity of these assumptions the present authors examined attitudes of one section of New Zealand community (in this case university students) with a rationale that, subject to social and situational pressures, attitudes are generally a precursor to behaviour, and that attitudes to the mentally ill might indicate the readiness with which people could be expected to respond personally to the specific demands for community mental health care.

Three propositions were examined; two of which are described below.

Proposition one:

That people attach a stigma to the mentally ill, was confirmed. Ratings of the three relevant concepts (a) “mental patient”, “insane people”, and (c) “ex-mental patient” were examined.  When it came to the concept of “mental patient” the stereotype had a highly negative rating without bothering you with the statistical reliability. Interestingly, this did not differ significantly from the 1981 negative stereotype. 

Proposition one:

That the public holds moderately favourable attitudes toward mental health professional was tested via 2 concepts (a) “psychiatrist” and (b) “doctor”. The rating for this mental health professional was moderately positive as it was in 1981. However, the rating for the concept “doctor” was much more positive than for the psychiatrist, as it was in 1981, 1978, and 1971.

The authors conclude that social attitudes towards the mentally ill need to be changed before community-oriented mental health carte policies can have much hope of long-term success.

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.

Crazy and Social Networks

Over the years I’ve been on and off Facebook for quite a large periods of time depending on my perceived need to socialize, catch-up with people I had lost touch with, and perhaps unwittingly, and as one “friend” put it “stalk away” with an all knowing smile J to say it was okay.

We all know Facebook, Twitter, Google+, and some other sites have become the gold standard for socialization and the connectivity that such sites offer have made them compelling and for some people essential to daily life.

Some psychologists now believe that having a social network account is a sign of good mental health and, as evidenced by people like James Holmes and Anders Behring Breivik who didn’t have such accounts. So it’s a good thing I was tempted to reactivate my Facebook account – not a minute to lose.

Avoiding social networks won’t in itself make a person a psychopath, however, people who are prone to serious mental illness like these people are perhaps more likely to avoid such sites in the first place.

According to one psychologist, “Crazy people tend to not have a lot of friends and the ones they do have tend to not be very close. It’s not the lack of friends that make them crazy it’s the crazy that makes them not have any friends.

However, a person not having friends is not a rock solid indicator that the person will eventually go on a shooting rampage. Those types of things are traditionally very tough to predict,”