Mental Health Information Center: Disorders

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Primary Suicide Risk Factor For Veterans Is Post-Traumatic Stress Disorder

Wednesday, September 2, 2009

Researchers working with Iraq and Afghanistan war veterans have found that post-traumatic stress disorder, the current most common mental disorder among veterans returning from service in the Middle East, is associated with an increased risk for thoughts of suicide.

Results of the study indicated that veterans who screened positive for PTSD were four times more likely to report suicide-related thoughts relative to veterans without the disorder. The research, published in the Journal of Traumatic Stress, establishes PTSD as a risk factor for thoughts of suicide in Iraq and Afghanistan war veterans. This holds true, even after accounting for other psychiatric disorder diagnoses, such as substance abuse and depression. Veterans who screened positive for PTSD and two or more comorbid mental disorders were significantly more likely to experience thoughts of suicide relative to veterans with PTSD alone.

As many as forty-six percent of veterans in the study experienced suicidal thoughts or behaviors in the month prior to seeking care, and of those veterans, three percent reported an actual attempt within four months prior to seeking the care. Suicide-related thoughts and behaviors discovered in a returning veteran who has been diagnosed with PTSD, especially in the presence of other mental disorders, may suggest an increased risk for suicide. This study is published in the August 2009 issue of the Journal of Traumatic Stress.

Lead author Matthew Jakupcak, Ph.D. is a researcher at the Mental Illness Research, Education, and Clinical Center (MIRECC) as part of the VA Puget Sound Health Care System. He is also a Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine in Seattle, WA.

Source:
Bethany H. Carland-Adams
Wiley-Blackwell
www.medicalnewstoday.com

Death of patients in a psychiatric hospital in New York presents mental health crisis

Friday, July 4, 2008

Death of woman in Kings County Hospital in Brooklyn, New York, demonstrates the need

for more public services for people with mental disorders, according to the American Psychiatric Association.

According to newspaper reports, the woman suffered from psychosis and agitation, is still waiting in the emergency room for nearly 24 hours because the hospital was clearly not a place for psychiatric patients. He fell to the floor and put it about an hour before emergency personnel tried to revive them. Unfortunately, women died from causes that have not yet been determined.

"The question is how and why the hospital staff can ignore that person, fell to the ground in an emergency or war, and went around them when they died," said APA President Nada Stotland, MD "However, the lack of emergency The patient psychiatric services only part of a global health crisis, and that includes mental health. "

Stotland pointed to the lack of state and municipal center of mental health services, which are used for intervention to avoid a crisis that would lead to the person who will help in an emergency, poorly equipped to prevent such crises. It is a fact that most hospitals financial losses for mental health services, and may also play a role, thin as a high priority to hospital, where mental health.

"Incidents of this kind reflect a complete breakdown of mental health," said Stotland. "There is little continuity of care, but there are only a few are not adequately funded outpatient services so that repeated mental breakdowns, visits to the emergency room, and the need for hospitalization in the sickest people. Personala and emergency treatment for patients with heart attacks and broken Boneless, faces hundreds, sometimes thousands of critically ill patients with mental problems, often compounded by general medical illness, homelessness, ill-treatment and lack of insurance. "

Lack of resources leads to a permanent reduction in the number of beds for these people. At the same time, many times hospitals have no emergency room physician in the use of the ability to handle psychological problems. Limited access to necessary services can only intensify the feeling of stigma, many patients believe, to seek mental health care problem in the first place.

"The time for action long before the person is in a state of emergency to require hospitals ill-equipped to combat it," said Stotland. "The tragedy is that we know how to help these people recover and remain useful members of society, unnecessary suffering and ends costs society as much or more than enough attention to cost. Our society is not the largest network of basic security for our most vulnerable citizens. "

adapted from http://www.psych.org

Scientists Create Genetically Accurate Mouse Model for Autism

Thursday, May 29, 2008

Marlene Busko

May 28, 2008 (London, United Kingdom) — Mice containing a mutation in a gene encoding neuroligin-3, which is implicated in human autism, may represent the first genetically accurate model of autism that is not confounded by other neurological diseases, researchers report.

The study, by Craig M. Powell, MD, and colleagues, from the University of Texas Southwestern Medical Center, in Dallas, Texas, showed that mice with a neuroligin-3

R451C substitution exhibited impaired social interaction but also showed superior spacial learning skills.

Dr. Powell presented these findings in an oral presentation at the 7th Annual International Meeting for Autism Research. Part of this work was recently published (Tabuchi K et al. Science. 2007;318:71-76).

"We've created the first animal model that’s a genetically accurate model of autism that’s not associated with other neuropsychiatric syndromes like fragile X syndrome, Rett's syndrome, or tuberous sclerosis," Dr. Powell told Medscape Psychiatry.

Their data suggest that this mouse model may be useful to better understand the molecular mechanism of autism and ultimately to design and test new therapeutic approaches, he added.

What Is Happening in the Autistic Brain?

During the past several years, scientists have been attempting to develop an appropriate animal model for autism, the group writes.

A small percentage of patients with autism spectrum disorder (ASD) carry mutations in genes encoding neuroligin-3 and -4, which are postsynaptic cell-adhesion molecules, they note. In addition, mutations in neuroligin binding partners, neurexin-1 and shank-3, have also been found in patients with ASD.

The team aimed to create and characterize a genetically accurate mouse model of autism by introducing a mutation linked with autism — the R451C substitution in neuroligin-3 — into mice.

The researchers examined the performance of 19 "knock-in" mice with this mutation vs 19 wild-type littermate controls in a variety of behavioral tests relevant to autism. They also performed various tests to measure synaptic protein activity.

Compared with the control mice, the R451C-mutant knock-in mice showed impaired social interaction, but they had normal anxiety, coordination, and sensitivity to pain. Interestingly, the mice with the mutated gene performed better in the Morris water maze, which showed that they had enhanced spatial learning ability.

Unexpectedly, these behavioral changes in the mutant mice were accompanied by an increase in inhibitory synaptic transmission in the cortex.

Encouraging Early Results

"These are very encouraging preliminary data," said Dr. Powell.

"What we are trying to do now is target the changes in synaptic function in these mice — the increase in inhibitory synaptic function in the cortex," he said. "We're using drugs that might reduce the level of inhibition that's abnormally elevated in the knock-in mice," he added, noting that it is hoped that this will treat the behavioral symptoms in the mice.

By looking at more mouse models and gaining a better understanding of what is wrong with the brain in autism, researchers hope to find common pathways that would some day be potential drug targets for patients, he said.

7th Annual International Meeting for Autism Research: Oral Presentation 132.1. May 15-17, 2008

taken from medscape.com

Female Sex Offenders Often Have Mental Problems

Women who commit sexual offences are just as likely to have mental problems or drug addictions as other violent female criminals. This according to the largest study ever conducted of women convicted of sexual offences in Sweden.

Between 1988 and 2000, 93 women and 8,500 men were convicted of sexual offences in Sweden. Given that previous research has focused on male perpetrators, knowledge of the factors specific to female sex offenders has been scant.

A group of researchers at the Swedish medical university Karolinska Institutet have now looked into incidences of mental illness and drug abuse in these 93 convicted women, and compared them with over 20,000 randomly selected women in the normal population and with the 13,000-plus women who were convicted of non-sexual crimes over the same period.

Thirty-seven per cent of the women convicted of sex offences had undergone treatment at a psychiatric clinic during the period, and eight per cent had been diagnosed as having a psychosis. There was no difference in incidences of mental illness and drug abuse between these women and women who had committed other kinds of violent crime.

"This is interesting as men who commit sexual offences usually have fewer psychiatric problems than men who commit other violent crimes," says Niklas Långström, Associate Professor at Karolinska Institutet's Centre for Violence Prevention and one of the authors of the study. "So it seems as if female sex offenders, more so than male, suffer from mental illness or have drug problems."

However, the figures differ widely from the control group. Incidences of psychosis were 16 times higher amongst the sex offenders than the control group, drug abuse 23 times higher. According to the research team, the results indicate that women suspected or convicted of sexual offences should undergo routine psychiatric examination, something which, at present, is not done.

By sexual offence in this study is meant rape, non-consensual sex, sexual abuse and sexual molestation. The group has earlier published a similar study on male sexual offenders.

Publication:

'Sexual Offending in Women and Psychiatric Disorder: A National Case-Control Study'
Seena Fazel, Gabrielle Sjöstedt, Martin Grann & Niklas Långström
Archives of Sexual Behavior, online Maj 2008, DOI 10.1007/s10508-008-9375-4.

Karolinska Institutet is one of the leading medical universities in Europe. Through research, education and information, Karolinska Institutet contributes to improving human health. Each year, the Nobel Assembly at Karolinska Institutet awards the Nobel Prize in Physiology or Medicine

taken from medicalnewstoday

Not Just the Absence of Mental Disorders

Friday, February 29, 2008

Most people think that mental health only applies to those people who have diagnosable mental disorders. The truth is ALL of us should be concerned about our mental health. It is our basis of being healthy. It is the holistic approach to health. In fact, many people adhere to the belief that mental health is the core of healthiness. Health starts and ends with mental health. It encompasses everything and it is everybody's business.

For virtually all people, mental health is often neglected until something apparently becomes wrong. Until then, we will have to wait for signs that it is vital to our existence, to our well being, to our relationships with other people, to our perceptions, to our fulfillment and even to our own happiness.

Even though we have achieved great medical advancements, there still seems to be lacks in our general knowledge on mental health. We have developed quick fixes to our physical ailments but we are left far behind with our solutions to mental illnesses. If we have anything, there still remain some loopholes and what we know is inconclusive. We haven�t developed universal treatments for psychological disorders and even assessments and diagnosis of such ailments are flawed.

In the past, the general concept for being healthy is the "absence of disease". If so, then someone who doesn�t have diagnosable heart attack but experience irrational fear on something like chicken or heights is a healthy person. In fact, no.

While blood pressure, cholesterol level, and body temperature are easy to asses these are still seen as singular components of our health. Disruptions in these mechanisms mean that a person could be physically ill. However, the health of a person is not only associated to how well his body functions but also to how well are his psychological, emotional and social dispositions. Manifestations of mental illness are much harder to asses since most symptoms occur discreetly during the developmental stages of the disorders and internal states are dependent on the subjective nature of the disorder. For example, someone who usually feels "blue" may or may not be diagnosed with depression.

We also have to take into account the social aspect of mental health. People who have sickness have more obvious manifestations that they are ill, therefore the society and immediate environment could easily identify whether or not a person is sick. For mental health, however, ignorance could lead to wrong perceptions. For example, a teenager who became drug-dependent and later committed suicide is viewed as irresponsible and desperate when in fact he may be suffering from a psychological disorder.

A simplistic definition to mental health could be "successful mental functioning". But what are the parameters of this definition? What could possibly tell us that someone is struggling through mental illness?

a) Someone who is distressed for a prolonged period without apparent, logical reason.

b) Someone who has disruptions in thinking

c) Someone who has altered behaviors and moods

d) Someone who relies on substances such as drugs, alcohol and cigarettes may have issues on their mental health

e) Someone who has impaired social functions

These are just representations of how a person with mental health may behave. However, these are not conclusive bases.

As we may yet to understand, mental health is directly correlated with physical ailment or health. Both may be one and the same but are very different in nature.

How Common Mental Disorders Are (Mental Health Statistics)

At any time of the year, there is one person in every group of five people who has a diagnosable mental disorder. This means that 1/5 of all families in the United States have family members who are experiencing developing or aggravated symptoms of mental impairment. This translates to approximately 20% of the American society.

Mental health or the lack of it is experienced by all types of people in America- from children to elderly, from Native Americans to Hispanics, from physically healthy individuals to those who have chronic diseases.

General statistics

a. Nearly 9% of the American general population suffers from all forms of phobias.

b. 5% have major depression

c. Nearly 4 million individuals suffer from Obsessive Compulsive Disorder

d. 2 million Americans have Schizophrenia

e. MAnother 2 million have Bipolar Disorders

f. MNearly 2.5 million have Panic Disorders

Statistics on the Prevalence of Mental Disorders in Children

It is estimated that around 7 to 12 million children have symptoms of psychological disorders.

a. ADHD or Attention Deficit Hyperactivity Disorder � 5% to 10% of the children population is diagnosable with ADHD. It is the most prevalent clinical disorder among children. Half of all children with this psychiatric disorder do not receive diagnosis.

b. Manic Depression � 30% of all children aged 6 to 12 ld who have manic depression are likely to develop Bipolar Disorder, a type of disorder that has symptoms of mania or a sense of "high" on activity plus periods of depression.

c. Conduct Disorder � 10% of all American children have conduct disorder.

d. Depression � In every group of 33 children there is one who has symptoms of clinical depression

e. Learning Disorders � Almost 20% of all American children have learning disability. Half of them have diagnosable ADHD.

f. Suicide � Suicide is the fifth leading cause of death among children.

Statistics on the Prevalence of Mental Disorders in Young People

a. General Data - Nearly 75% of all young people who suffer from mental disorders do not get the help they need. Like in the general population, 1 in every 5 adolescent have a diagnosable psychological disorder which include minor depression, drug-dependence, Attention Deficit Disorder, Anorexia Bulimia, Hypochondriasis, Gender Identity Disorders and Eating Disorders, and more aggravated disorders.

b. Anorexia Nervosa � This disorder is more common among females than males affecting an average of 150 individuals in any given time. Thus, 1% of all female young people population is affected by anorexia nervosa and 10% of all affected individuals die due to suicide, cardiac arrest and starvation.

c. Bulimia Nervosa � One to three out of 100 people show signs and symptoms of bulimia nervosa.

d. Anxiety Disorder � 10% of the young adult population have anxiety disorders.

e. Depression � One in every eighth individuals have clinical depression. One in every five young people have emotional problems and 30% of all adolescents who were diagnosed for emotional problems are depressed.

f. Juvenile Delinquency � More than 150, 000 American teenagers are under the criminal justice system. The majority of them have more than two mental disorders. 57% of all juvenile delinquents have reported of prior hospitalization associated with their mental problems.

g. Schizophrenia - In every 1000 adolescents, there are three people who are suffering from Schizophrenia.

h. Serious Emotional Disturbances � 10% of all young adults have severe disturbances in their emotional states.

i. Suicide � For ages 15 to 24, this is the leading cause of death. There are at least 500, 000 individuals who take their own lives yearly.

Statistics on the Prevalence of Mental Disorders in Adults

a. Depression � Depression is the leading psychiatric disorder among elderly affecting 5% of the entire elderly population.

b. 6.5 million Adult people have severe mental disorders.

c. In every group of 100,000 people, there are at least 240 of them suffering from a type of mental illness

d. 6000 adult Americans commit suicide each year

e. Approximately 1 million old Americans suffer from organic mental disorders

f. An estimated 15% of the adult population experience dementia

g. 1 million adult Americans have severe Alzheimer's disease

The Budding Disorders: Mental Health of Children

Thursday, February 28, 2008

We would like to think that we have built our environments in such a way that they minimize the factors that could result to psychological and behavioral disturbances among individuals. Thus, optimizing our mental health. But statistics tell us that the majority of our population's mental health is largely subjected to negative environments.

Complications brought about by negative environment

For many children, symptoms of psychological disorders are linked to the negative stressors in the environment. In the United States alone, one in every five children suffers severe physical abuse and one in every group of five lives below the poverty line. Additionally, psychosocial structures in cities where there is poor housing expose children to violence that could detriment their mental health. (You can imagine how many children in other countries which have far lower economic status and far fewer programs for child protection are subjected to negative stressors.)

Both of the above stressors are considered as traumatic experiences to children that could resurface as psychological disorders during adulthood.

A negative or a positive environment during childhood explains why there are adults who are more likely than not to develop psychological disorders and there are those who are not affected by these at all.

For example, children who repeatedly experienced sexual trauma or sexual abuse are most likely to develop dissociative disorders such as multiple personality disorder. The rate of victimization within intimate relationships only reinforces the dissociative response. Also, repetitive exposure to violence or to the activities of a dysfunctional environment could also contribute to the development of severe dissociative disorders. These mental illnesses root from the child's effort to deny the violence, abuse, or trauma they experience as coping mechanism so as to protect his mental wellness. However, failure to completely get over these experiences would result to the impairment of his psychological wellness and even his social and emotional well-being.

Parental deprivations

Some researchers assumed that the large difference in number of psychological disorders being treated these days as compared to prevalence in the past century is largely contributed by dysfunctional family structures and parental deprivations. Indifference and neglect by familial figures, maternal-social deprivations, isolation and separation from parents are viewed as the root causes of psychological disorders such as depressions, mental retardation, psychomotor impairments and the manifestations of autistic-like behaviors among children.

Pathogenic Parent-Child Relationship

The traumatic interpersonal relationship between a parent or a parent-figure and a child is viewed as a negative environment for the child's growth and development. This relationship only means that their relationship is structured in the manner that it damages a child's psychological well-being. These give stress to certain beliefs that are psychologically unfavorable to the child such as irrational beliefs on self-blame, irrational explanations on traumatic experiences, maladaptive behaviors, unconscious guilt, shame and doubt about oneself. These beliefs are very powerful and could lead the child to over generalize negative incidents.

Children experience all sorts of negative environments including war and violence, daily stress, economic problems and accelerating negative effects of technological changes. But among these, the most aggravated is the disabling relationship he has with his immediate environment- his parents, his family and his direct interaction to his society. Above everything else, there is a need to modify these negative environments in order to develop children with better mental health and in the future, adults who can readily adapt to the stressors from their environments.

Causes of Mental Health Disorders

Wednesday, February 27, 2008

It is amazing how a lump of gray matter could manipulate all the systems in our body in the most systematic way possible with all the intricacies and complex functioning. But what's queer about this stuff (the organ we call brain) is that it could malfunction in a way that it could result to single or multiple representations of mental health problems all in an individual.

Clinical research and laboratory observations consistently arrive at a conclusion that mental health disorders are products of the accumulation and interaction of several contributing factors. It would have been easier to identify each disorder if there is only one cause to all meal health disorders but that simply isn't the truth. In reality, all mental disorders could root from several causes such as an environment that is conducive to the development of a mental disorder or individual genetic make-up that programs the brain (or the faulty components of the brain) to develop into something non-normal.

Saying that it's all about the pathological make-up of the brain that causes the mental health disorders is simplistic, to say the least. Looking at the strange development of these disorders would reveal that there are actually at least 3 contributing factors that may be seen as potential causes, all of which have varying degrees. This means that a particular culprit could be more dominant than the other.

First with the physical causes. This bracket of causes is biological in nature. Each individual has a distinct and unique biological make-up that dictates the direction of his health, may it be physical or mental. Some people are born with inherent tendency to develop a specific mental disorder in comparison with other people while others are less prone to risks. This cause also covers the genetic make-up of an individual, the biological make-up and the events in life that affects the physical body (such as a trauma on the head or substance abuse).

Second are the environmental or social causes. Nature VS Nurture has been a great debate in the scientific community but research confirms that a person experience a spilt-half of both. Nature of course are the physical attributes of an individual while Nurture reflects more on the social structures and physical, emotional and mental environments to which an individual was exposed to. This factor tells us more on how an individual grew up, the interaction of influences that affected all facets of his growth and the mechanisms he used to cope with a specific environment.

It is observable that some mental disorders are caused primarily by the consequences of experience brought about by the environment. For example, people (especially children) living in a stressful, chaotic and unstable environment are more likely to develop mental illnesses than those individuals living in peaceful environment. This consequence is due to the fact that there are certain social and environmental components that may become risk factors to the development of mental health problems.

Third is the psychological factor. This particular factor tells us more on the psychological state of a person, his coping mechanisms to certain life events that could otherwise end up with psychological disorders, his perception on his own self and his environment and thought patterns that affect his mental health. For example, someone who has gone beyond the limit of his stress coping capacity is likely to break down mentally as a result of the psyche's automatic "lock down" to protect itself.

For the majority of people lacking mental health, it is often the case of triggering the mental health to break down through series factors that have eventually contributed to the cause of mental health disorder.

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