For everyone who goes on psychiatric drugs, the reason comes back to power imbalances in their personal life. Women who’s husbands “make all of the money” and have an unequal share of the power, kids who’s parents have power over them—frequently people who have less money and security, therefore less platform for authority than those around them. Mental illness is not in fact an illness but an unequal division of power and sense of security in a social group. Full Article →
Since I left the psychiatric prescribing trenches and came south for the winter, I’ve been staying in a beach town within driving distance of a technology metropolis. I take breaks from my writing and walk to the beach. There, I meet and talk with the winners of the American dream. They are intelligent, highly educated and financially successful. They take their beach vacations here. Full Article →
In a study of 6,767 reports of antidepressant trials in juveniles treated for depressive and anxiety disorders, the risk of psychopathological behavioral or mood elevation was 3.5x greater with antidepressants than with placebo. The authors (which include Giovanni Fava of the University of Bologna and Ross Baldessarini of Harvard Medical School) urge “particular caution and monitoring for potential risk of future bipolar disorder.”
A report from the Healthcare Cost and Utilization Project finds that hospital stays for a diagnosis of bipolar disorder in children aged 5-9 increased 696% from 1997 to 2010, 475% in children aged 10-14, and 345% in those aged 15-17. By 2010, mood disorders had become the most frequent principal diagnosis in children aged 1-17.
A North Carolina study of 1,420 participants finds higher rates of agoraphobia (4.6x), generalized anxiety disorder (2.7x), and panic disorder (3.1x) among victims of bullying. Among those who had been both bullies and victims, the study found higher rates of depression (4.8x), panic disorder (14.5x), agoraphobia (26.7x) and suicidality (18.5x) in both childhood and young adulthood. Results appeared in JAMA Psychiatry.
The humor newspaper The Onion satirizes the conversion of transient human emotions into lifelong illnesses, reporting that “Shortly after losing grip of a helium-filled balloon and watching it float into the air above the San Diego Zoo Tuesday, local child Caleb Tremont, 3, reportedly began a battle with chronic depression that will last for the rest of his life.”
Japanese engineers have devised a robotic rat that bullies laboratory rats into a state of depression, creating a model of human depression they deem suitable for testing antidepressants. The research, published this month in Advanced Robotics, reports that continuous attacks in young and intermittent attacks (in response to movement) in older rats is most effective.
“It’s happening,” said researchers at Northeastern University, “Kids are becoming irritated, aggressive, impulsive, agitated, hostile. So you ask the question: Why?” They found (through study of the effect of fluoxetine on hamsters) that SSRIs may “take the brake off” of aggression by allowing another neurotransmitter – vasopressin – to kick the brain’s aggression system into overdrive. “There’s the likelihood,” said a lead researcher, “that by virtue of the fact that our clinical diagnosis is not based in neurobiology, but rather in symptomology, that we may be giving kids a serotonin drug inappropriately.”
Noting that more people die from suicide than car accidents in the U.S., and the majority of those suffer from depression, The Atlantic explores a theory put forth in a recent paper linking depression to immune system activation and associated behavioral responses. “The basic idea is that depression and the genes that promote it were very adaptive for helping people – especially young children – not die of infection in the ancestral environment,” the paper’s authors comment, by activating a set of protective behaviors – such as social withdrawal – in response to stressful events in the wild that may expose us to risk of infection.
1 Boring Old Man bores ever more deeply into the newly available raw data from GlaxoSmithKline’s study of Paxil in children, finding that “if this information had been available eleven years ago, all of this wouldn’t have happened. GSK, Sally Laden, and the guest authors couldn’t have published a study that said, “Paroxetine is generally well tolerated and effective for major depression in adolescents.” The only reason they could say that is because this raw data wasn’t available to the curious or the critics. The authors could twist it and turn it into something it wasn’t, because it couldn’t be checked.”
The U.K.’s Guardian writes today that “the proposal by the American Psychiatric Association to create a new illness – prolonged grief disorder – and to redefine children’s mental health is the stuff of dreams for Big Pharma.”
Eminent developmental psychologist Jerome Kagan, in an interview with Spiegel, accuses the mental-health establishment and pharmaceutical companies of incorrectly classifying millions as mentally ill out of self-interest and greed. “That is the history of humanity: Those in authority believe they’re doing the right thing, and they harm those who have no power,” Kagan says.
Findings from a survey of 6,082 individuals, designed to explore racial and ethnic differences in mental disorders, reinforce the relationship between social support and depression. The authors suggest a re-examination of “the individualistic models of treatment that are most evaluated in the United States. The lack of evidence-based data on support groups, peer counseling, family therapy, or other social support interventions may reflect a majority-culture bias toward individualism, which belies the extensive body of research on social support deficits as a major risk factor for depression.” The study appears in Ethnicity & Disease.
A study of 566 families with 1416 bipolar-disordered members, and 675 families with 1726 depressed members by researchers from Johns Hopkins and the University of Iowa, published in Psychological Medicine‘s July issue finds that the comorbidity of these disorders with OCD, panic disorder and specific phobia is “at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity.”
In a study to be published in a forthcoming IEEE Technology and Society researchers at Missouri University recruited 216 undergraduates, finding that the 30% who met criteria for depression engaged in more file sharing (as for movies and music), gaming, chatting, and very high rate of e-mail usage. Frequent e-mail checking, the authors note, may relate to high levels of anxiety, which also correlates with depression. The study also found indications that depressive people switch between applications frequently in a manner consistent with a lack of concentration – also associated with depressive symptoms.
Data drawn from the Bucharest Early Intervention Project show that children raised in institutions in Romania exhibit elevated symptoms of ADHD, anxiety, depression, and disruptive behavior compared with controls. Researchers from Harvard, the University of Maryland and Tulane also found disrupted brainwave patterns consistent with with risk for psychopathology. Exposure to early life deprivation, the authors write, may contribute to abnormal patterns of neurodevelopment generated by adverse rearing environments. The study is available online from the Archives of General Psychiatry.
Robert Whitaker, author of Anatomy of an Epidemic, discusses the disturbing effects of psychotropic drugs prescribed for children. Such medications, used for ADHD, depression, and anxiety, for example, have become commonplace over the past 30 years. This practice profoundly alters the lives of the children, and so now we, as a society, urgently need to address this question: do the medications help the children thrive and grow up into healthy adults? Or does this practice do more harm than good over the long term. Robert Whitaker emphasizes two things: first, the need for an objective, evidence-based approach to evaluating these drugs; and second, the need for better public understanding of how these medications work.
The Marine Corps Times writes of a dramatic increase in prescriptions of psychiatric medication for children of active-duty military personnell during their parents’ deployment and re-integration; a trend seen as contributing to a rise of suicides among military children. “The psychiatrist never once told me Celexa was a risk” said one parent, “I didn’t find out the seriousness until after he died.”
In response to pressure over the 40-fold increase of bipolar diagnoses in children, many of which are being reviewed and dropped in retrospect, the APA has proposed a new, potentially more transient “disruptive mood dysregulation disorder” that would apply to children with chronic irritability and recurrent temper outbursts, and would ostensibly be treated with antidepressants instead of antipsychotics. The proposal, according to the Boston Globe, has brought new scrutiny to Joseph Biederman,who argued that chronic irritability can be interpreted as juvenile mania.
“Mixed anxiety-depressive disorder,” “attenuated psychosis syndrome,” “obsessive-compulsive personality disorder,” “antisocial personality disorder,” and “nonsuicidal self-injury” were among diagnoses that met with disappointing results in field trials for the new DSM-5. Either low interrater reliability (a lack of sufficient agreement between clinicians), or a lack of sufficient examples of people with a proposed diagnosis in the real world meant that these diagnoses could not be included in this round of the APA’s official list of disorders. One architect of the trials said that a goal of the DSM-5 was to test diagnoses “with real clinicians and real patients,” a goal that may explain why even “major depressive disorder” was found to be surprisingly unreliable, possibly because the previous version of the DSM excluded patients with complicated “psychiatric comorbidities.”
The APA DSM-5 Development website announced today that “Psychosis Risk” and “Mixed Anxiety Depression” will not be included in the DSM-5 (apart from recommendations for further study), and added criteria to “clarify” the distinction between bereavement and major depressive disorder. Criteria for ADHD have also been tightened. The statement invites “Final Public Comment” through June 15th.
SPARX, an interactive video game in which significantly depressed adolescents shoot down “GNATs” (Gloomy Negative Automatic Thoughts) in a quest to restore the balance in a fantasy world is as effective at reducing anxiety and depression than standard therapy. 187 adolescents at 24 primary healthcare sites in New Zealand either played SPARX or received treatment-as-usual over a period of four to seven weeks. At three-month follow-up remission rates were significantly higher in the SPARX arm (43.7%) than in treatment-as-usual (26.4%). “Around 80 percent of young people with depression never get treatment,” said lead author Sally N. Merry. “When you do the calculations of how many therapists you need to meet that need, it’s enormous.” Results are in the British Medical Journal.
Researchers testing the blood of 14 teenage subjects with major depressive disorder and 14 with no disorder for a set of candidate biomarkers from animal models of depression found that 11 of the 26 candidate markers differentiated depressed participants from controls. Results will appear in Translational Psychiatry.