Category: Mental Health

Categories : Hospitals Mental HealthTags :

Social Support Boosts Patient Survival by 29%

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New research from Brigham Young University found that providing medical patients with social support increases odds of survival and prolongs life. It comes as healthcare is searching for new ways to improve medical treatment and outcomes.

“The premise of the research is that everyone is strongly influenced by their social context,” said BYU counseling psychology professor Timothy B. Smith, lead author of the study. “Relationships influence our behavior and our physical health. We now know that it is possible to prolong life by fostering coping and reducing distress.”

Co-author Julianne Holt-Lunstad, BYU psychology professor, said there is now ample evidence that social needs should be addressed within medical settings.

“From pediatrics to geriatrics, physicians may encounter patients who are struggling. These data suggest that social interventions integrated within clinical treatments that help patients cope and reduce distress also improve their survival,” she said.

Analysing data from 106 randomised controlled trials with over 40 000 patients, the researchers examined the effects of psychosocial support. Group meetings or family sessions that promoted healthy behaviours by encouraging exercise, the completion of medical treatments, or offering group support for diet adherence increased survival by 29%.

“Providing medical patients with social support can be just as helpful as providing cardiac rehabilitation for someone recovering from heart disease,” said Smith. “It can be just as helpful as a diet or lifestyle program for obese patients or treatment for alcoholism among patients with alcoholism.”

The findings  could be used to implement support programs in hospitals and clinics for patients, especially those at risk of not completing treatments. It could also inform programmes for family members or caregivers.

“We already had robust evidence that social connection and other social factors significantly influence health outcomes including risk for premature mortality, but it was unclear what can be done about it to reduce risk,” said Holt-Lunstad. “Is it the role of healthcare, or should this be addressed outside the healthcare system? This research combined with the other consensus reports suggests that it is a role of the healthcare system.”

“Ultimately, these data should be used to foster collaboration between medical professionals and mental health professionals,” said Smith. “About half of all patient medical visits are about conditions that entail psychological considerations. Large hospitals now routinely hire psychologists to consult with physicians and to evaluate or work with patients, but more integration is needed in smaller hospitals and clinics.”

The findings also hold important implications for medical patients. People respond differently to medical conditions. While some will immediately take action in rehabilitation or preventative measures, others might delay or even avoid engaging in prescribed healthy behaviors. On top of that, depression and anxiety rates can be high among patients, which can limit responsiveness to treatments, making social support efforts even more critical.

“We know that when hospitals implement a social support group, people simply live longer,” said Connor Workman, a BYU student who assisted with the research during his undergraduate years. “The data show that relationships have a tangible effect on a person’s mortality and health. This will give decision-makers at hospitals the information they need to start pushing out programs and implementing the right social connections for patients.”

Source:  Brigham Young University

Categories : Mental Health NeurologyTags :

Lithium Brain Variations Play Role in Depression

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New research into depression has uncovered a previously unknown role played by the trace element lithium appears to play a role, which has been shown to be different in healthy and depressive people. 

Image source: Pixabay

Lithium is widely known from rechargeable batteries but is also known in psychiatry as a first-line mood stabiliser for bipolar disorders. lithium is present in drinking water in trace amounts. Studies have shown that a higher natural lithium content in drinking water is associated with a lower suicide rate among the population. However, the exact role lithium that plays in the brain is still not known.

Forensic medical experts at Ludwig-Maximilians-Universitaet (LMU) in Munich teamed up with physicists and neuropathologists at the Technical University of Munich (TUM) and an expert team from the Research Neutron Source Heinz Maier-Leibnitz (FRM II) to develop a technique which can be used to precisely map the distribution of lithium in the brain.

Neutrons probe for lithium

The scientists investigated the brain of a patient who was a suicidal and compared it with two control persons. The investigation focused on the ratio of the lithium concentration in white brain matter to the concentration in the gray matter of the brain.

In order to determine where how much lithium is present in the brain, the researchers analysed 150 samples from various brain regions—for example those regions which are presumably responsible for processing feelings. At the FRM II Prompt Gamma-Ray Activation Analysis (PGAA) instrument the researchers irradiated thin brain sections with neutrons.

“One lithium isotope is especially good at capturing neutrons; it then decays into a helium atom and a tritium atom,” explains Dr. Roman Gernhäuser of the Central Technology Laboratory of the TUM Department of Physics. The two decay products are picked up by detectors which provide lithium’s location in the brain sections. 

Since the lithium concentration in the brain is usually very low, it is also very difficult to ascertain. “Until now it wasn’t possible to detect such small traces of lithium in the brain in a spatially resolved manner,” said Dr Jutta Schöpfer of the LMU Munich Institute for Forensic Medicine. “One special aspect of the investigation using neutrons is that our samples are not destroyed. That means we can repeatedly examine them several times over a longer period of time,” Gernhäuser points out.

Significant differences

“We saw that there was significantly more lithium present in the white matter of the healthy person than in the gray matter. By contrast, the suicidal patient had a balanced distribution, without a measurable systematic difference,” Dr Roman Gernhäuser summarised.

“Our results are fairly groundbreaking, because we were able for the first time to ascertain the distribution of lithium under physiological conditions,” Schöpfer said

“Since we were able to ascertain trace quantities of the element in the brain without first administering medication and because the distribution is so clearly different, we assume that lithium indeed has an important function in the body.”

Only the beginning

“Of course the fact that we were only able to investigate brain sections from three persons marks only a beginning,” Gernhäuser said. “However, in each case we were able to investigate many different brain regions which confirmed the systematic behaviour.”

“We would be able to find out much more with more patients, whose life stories would also be better known,” said Gernhäuser, adding that then the question of whether lithium distribution was a cause or a result of depression.

Source: Medical Xpress

Categories : Mental HealthTags :

Inflammation a Predictor of Future Depression in Widowed Spouses

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Researchers at Rice University have found that future depression in widowed spouses can be predicted by bodily inflammation after the death of their partners.

The study will be published in the June 2021 edition of the journal Psychoneuroendocrinology. The study was led by lead author Lydia Wu, a Rice psychology graduate student, and Christopher Fagundes, associate professor of psychology and principal investigator for the Biobehavioral Mechanisms Explaining Disparities (BMED) lab at Rice. The researchers recruited 99 participants who had lost their spouses within 2-3 months of the study, and evaluated them on a number of factors, including physical and mental health, over three months.

“Prior research has already linked bodily inflammation to a host of health issues, including cancer, memory issues, heart problems and depression,” Wu said. “We were interested in how systemic inflammation affects the mental health of spouses after losing a loved one. In particular, can inflammation help us identify who will experience clinical levels of depression at a future point in time?”

The researchers found that widowed spouses with higher levels of bodily inflammation immediately after the loss of their partners had more severe symptoms of depression three months later compared to those with lower inflammation levels. This was even more pronounced if they didn’t experience significant depression initially.

Prof Fagundes said that it is normal to experience depression following the death of a spouse, and research shows that undergoing psychotherapy right after the event can actually interfere with people’s natural coping ability.

“We know that most people are remarkably resilient,” he said.

In the case of persistent depression, or depression occurring six or more months after a spouse’s death, it may be a sign that clinical intervention is needed, Prof Fagundes said.

“Until this study, it was difficult to know who was at risk for these persistently high levels of depression and grief until the six-month mark,” he said. “This study identifies a potential biomarker that could help us predict who is at greatest risk for long-term repercussions of loss.”

“This information makes early intervention possible,” Wu said. “We can identify at-risk bereaved persons and introduce them to interventions early on to improve their mental health.”

The researchers said more research is needed to determine who might be at greatest risk.

Source: Rice University

Journal information: E. Lydia Wu et al, Inflammation and future depressive symptoms among recently bereaved spouses, Psychoneuroendocrinology (2021). DOI: 10.1016/j.psyneuen.2021.105206

Categories : General Interest Mental HealthTags :

SA Man’s Epic Coastal Run For Mental Health Charity

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One South African man, who, like many South Africans, suffered from COVID-related anxiety, is looking to set a running world record as he runs along the South African coastline in order raise funds for a mental health charity.

The lockdown was hard on millions of South African, including restauranteur Henry Cock. It forced the closure of his restaurants, leaving his employees without income. But even before the stresses of lockdown, he had been suffering from severe anxiety, and in 2019 had started seeing a therapist.

As with so many people faced with the unexpected hardships of lockdown, he came up with a way to help his employees. He aimed to raise R80 000 for them through a innovative campaign, which involved Cock ‘running the Comrades Marathon’ — consisting of some 6000 laps up and down his own passageway to make up the 90km.

Though no less a gruelling undertaking than doing it outdoors, this turned out to be more successful than anticipated.

“In the end, we managed to raise R120 000,” he related. “It took eleven hours. Eleven hours of running back and forth across a 15-metre passage with just a few short breaks to eat and rest my legs,” he said.

With only his walls to look at during his hours of running, the 34-year-old had time to think about helping out others in light of the mental health challenges he himself had experienced.

Cock has started the ‘Mentally Aweh’ campaign to raise funds for South African Depression and Anxiety Group (SADAG), an organisation that provides free counselling to thousands of South Africans on a daily basis. His inspiration was the Terry Fox Initative, started by Canadian Terry Fox, who attempted to run across that vast country to raise funds for cancer research, though he passed away before he could complete it.

“I will be running the length of the South African coastline, from Kosi Bay in KwaZulu-Natal to Vioolsdrift near the Namibia border, to raise awareness for mental health and raise R6 million for the South African Depression and Anxiety Group,” Cock told Health-e News.

And the unmet need is vast. As he explained on his fundraising page, only a shocking 0.89% of the uninsured South African population has access to free mental health care.

Call volumes doubled since lockdown

SADAG senior counsellor Fatima Seedat said that call volumes had doubled since the start of lockdown.

“We used to receive 600 calls a day. When we entered the pandemic, with lockdown, we were getting over 1200 calls a day. That’s excluding the emails we receive, the SMSes received, and the WhatsApp messages that we receive on a daily basis. We have had around 500,000 calls since lockdown until now.”

Because it is toll free, SADAG’s phone bill runs up to R120 000 each month, so Cock’s mission to raise R6 million will help greatly.

“It is an absolutely amazing initiative,” said Seedat. “Henry is an inspiration for standing up for mental health, because that alone breaks a lot of barriers and boundaries.”

Mental health in South Africa

A third of South Africans will experience a mental health issue during their lifetime, according to SADAG. Depression and anxiety are also considered as mental illnesses, and are much more common than believed.

Cock endured his own mental strain during the lockdown; financial uncertainty, the ending of a long-term relationship, and the illness of a family member all set off his battle with anxiety.

“I was in a very bad space last year, like a very bad space. I was struggling. You get to a point when you’re an anxiety sufferer that you just think this is normal. You just think that this state of being is normal, but it’s not normal,” he said.

This is a pattern that Alexa Scher, a clinical psychologist in private practice, often sees.

“I think there is a lot under the surface that blocks people from actually saying, you know what, I’m not okay. We are usually scared to acknowledge and admit that and notice that in ourselves, so it can creep in invisibly, and then all of a sudden, you’re crying all the time, and then you think, ‘Oh, yeah, maybe this isn’t actually normal.’”

She advised that one should seek help when their state of mind begins to impact their ability to function. 

Free help is available

While Cock was able to seek help, the majority of South Africans cannot access mental health treatment, which is why he is trying to help SADAG.

The organisation operates the only suicide crisis line in the country, and also has a 24-hour toll-free telephonic, SMS, and WhatsApp lines.

“We reach people not only in your urban areas, but deep rural areas. People are really in need of help in rural areas because there are not many resources available. So we try to help as many people as we can, by reaching out to everyone,” Seedat explained.

SADAG has about 200 volunteers working in shifts, and all go through a screening process.

While Cock will hit the road solo, and does feel a certain pressure to succeed within the 133 days, he said he is using his emotions to motivate himself.

“I channel all of that energy into days when I’m feeling down or feeling bad. I remind myself that I’m not doing it just for me — I’m doing it to raise awareness for these people that really struggle and don’t have access to the same resources that I do,” he said.

“No matter how dark it is, it’s important to remember that you’re not alone. Reach out. You’ll be surprised how much help you actually receive if you just ask.”

Henry Cock’s journey can be followed on Instagram at @cock.henry.

SADAG can be reached on 0800 567 567.

Source: Health-e News

Categories : Injury & Trauma Mental HealthTags :

Head Injuries Widespread Among Female Prisoners

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Photo by RODNAE Productions from Pexels

New research has found that 78% of women prisoners in Scotland have a history of significant head injury – most of which occurred in the context of years of domestic abuse.

The University of Glasgow-led study also found 66% of women prisoners had suffered repeat head injuries for many years. The majority of the study participants were from the most deprived 20% of the population. One US study of male prisoners found 63.7% of at least one traumatic brain injury, and 32.5% had experienced multiple such injuries.

Of those with a history of head injury, the most common cause (89%) of repeat head injury was domestic violence. Only five women had experienced a single incident of moderate-severe head injury. Of those with a history of significant head injury, a first head injury before the age of 15 was reported by 69% of women.

For the study, researchers interviewed around a quarter of women in Scottish prisons, 109 women in total, between 2018 and 2019. They were assessed for a history of head injury, including its causes, a history of abuse, as well as for disability and mental and physical health conditions.

Of the 78% with a history of significant head injury, 40% also had an associated disability. Previous research has reported that many women in prison have a history of head injury, but none looked at disability.

Those with a history of significant head injury were three times more likely to have violent criminal behaviour, and also spent three times longer in prison.

Nearly all participants (95%) reported a history of abuse, with over half reporting sexual abuse in childhood and 46% reporting sexual abuse in adulthood. Physical abuse in childhood was reported by 39%, while 81% of participants reported physical abuse in adulthood.

Alcohol or drug misuse history was common, with substantially higher rates in the group who reported significant head injuries. Almost all, 92%, complained of mental health difficulties, with anxiety and depression the most commonly reported. Although the participants had 12 years of education on average, schooling was often disrupted by exclusion or truanting and many required special schooling or support.

Professor Tom McMillan, Professor of Clinical Neuropsychology at the University of Glasgow and lead author of the study, said: “It is already recognised that women in prison are vulnerable because of histories of abuse and substance misuse. However, this research shows that a history of significant head injury is also a vulnerability and needs to be included when considering mental health needs and in developing criminal justice policy given the relationships with associated disabilities, abuse and violent crime’’.

“Our findings suggest that interventions to reduce mental health morbidity, and assessment and management of risk of violent offending should include history of significant head injury. There is a need to recognise these vulnerabilities at an early stage, including at the first contact with the criminal justice system, to assess these women and provide long term support.”

Common persistent effects of significant head injury include impairments in information processing and emotional changes associated with impulsivity, irritability and egocentricity. These effects can impair judgement and self-control, increase the risk of offending. Significant head injury can also impair the maturation of the developing brain if occurring before adulthood.

The characteristics of significant head injury in women in prison differ from women with significant head injury in the general population. Domestic violence was the most common cause of these injuries in women in prison, whereas  in the general population falls are most common. In addition head injury occurred repeatedly in around two-thirds of women in prison with significant head injury, whereas single incident head injury from an accident is more common in the general population.

Source: University of Glasgow

Journal information: Tom M McMillan et al. Associations between significant head injury and persisting disability and violent crime in women in prison in Scotland, UK: a cross-sectional study, The Lancet Psychiatry (2021). DOI: 10.1016/S2215-0366(21)00082-1

Categories : Diet and Nutrition General Interest Mental HealthTags :

Bulimia Experience as a Teen Shaped Man’s Healthy Recipe Project

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A UK man who started a project coming up with gut-healthy-recipes said that it was “shaped” by his having had bulimia in his teenage years.

Clinician and scientist Dr Sunni Patel, 35, said as a teen he thought he was “chubby” and experienced the eating disorder when he was aged 15 to 18.

Binge eating was his “solace” he said, and he used religious fasting “as a cover”.

Dr Patel started a website sharing recipes, and he urged people not to underestimate how gut health affects mental health.

“I’d find comfort and my escapism via food.”
Dr Sunni Patel

He said he would fast for four days a week, eating fruit at the end of the day.

Being from a traditional Asian background, the way “one looks and acts tends to be judged a lot more”, he said.

“Because I’d got bulimia as a get out, I’d binge eat. I might eat six or seven crisp packets at one sitting. I’d find comfort and my escapism via food.”

Suffering bullying at school, Dr Patel said that there was “pressure as a teenager to look cool”. He said that “the thinner I got, the more attractive I felt”. Bulimia became the “solution”, he added.

As he lost weight, he began receiving compliments which would “feed the beast”.

At least 1.5 million people in the UK have an eating disorder, experts estimate, with 25% being male. Bulimia nervosa is a condition that occurs most commonly in adolescent females, though it can appear in just about any patient. It is characterised by indulgence in binge-eating, and inappropriate compensatory behaviours to prevent weight gain.

Dr Patel said after he went to university he stopped, “I wasn’t able to find the safe space to have the… episodes, I didn’t want the truth to come out.”

From around the age of 24, he received cognitive behavioural therapy and in recent years has had psychotherapy.

“I was diagnosed with gut issues in 2014 and that’s when I started exploring the link between gut health and depression. As my diet became healthier so did my mind.”

A business director as well as a clinician, he now comes up with gut-healthy-recipes that are shared on his Dish Dash Deets website, set up during the COVID pandemic, where he also keeps a blog.

Included in his recipes are his top foods to combat depression and low mood, such as bananas, berries, beans and lentils.

He said to anyone that is in a similar position to his, “find a safe person to talk to”, who would not judge, adding: “Don’t feel any shame. You’re human.”

“The more that you rely on it, you use it as your way of escaping, the more it becomes your norm,” he said.

He also currently does live cook-alongs on Instagram with invited celebrities and chefs.

“Food is still my escapism. Now I enjoy being in the kitchen and making things that will serve my needs, not make things worse.”

Source: BBC News

Categories : Mental Health NeurologyTags :

Scientists Find How Enriched Environments Boost Brains

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Image by Colin Behrens from Pixabay

A recent study in Frontiers in Molecular Neuroscience has shown how environmental enrichment ‘opens up’ chromosomes through the action of ‘master switches’.

Environmental enrichment, that is, making stimulating and interesting surroundings, is often used in zoos, laboratories, and farms to stimulate animals and increase their wellbeing.

Stimulating environments are better for mental health and cognition because they boost the growth and function of neurons and their connections, the glia cells that support and feed neurons, and blood vessels within the brain. But what are the deeper molecular mechanisms that first set in motion these large changes in neurophysiology? 

The study investigators utilised a large molecular toolbox to map how environmental enrichment leads to changes in the 3D organisation of chromosomes in neurons and glia cells of the mouse brain, which change the activation of some genes within the genome. 

They show that genes which in humans are important for cognitive mental health are particularly affected, possibly leading to new treatments.

Chromosome ‘opens up’ with enrichment

“Here we show for the first time, with large-scale data from many state-of-the-art methods, that young adolescent mice that grew up in an extra stimulating environment have highly specific ‘epigenetic’ changes—that is, molecular changes other than in DNA sequence—to the chromosomes within the cells of the brain cortex,” said corresponding author Dr Sergio Espeso-Gil from the Centre for Genomic Regulation in Barcelona, Spain.

He continued, “These increase the local ‘openness’ and ‘loopiness’ of the chromosomes, especially around DNA stretches called enhancers and insulators, which then fine-tune more ‘downstream’ genes. This happens not only in neurons but also in the supportive glia cells, too often ignored in studies about learning.”

The team raised mice for the first month after birth in social groups inside housing with Lego blocks, ladders, balls, and tunnels that were frequently changed and moved around. As a control, other mice were raised in smaller groups inside standard housing. The researchers then used a variety of tools to pick up molecular changes in neurons and glia cells within the brain cortex. These included alterations in the 3D structure of chromosomes, particularly the local “chromatin accessibility” (openness) and “chromatin interactions” (where distant genes are brought together through loops, to coordinate activity). Chromatins are the proteins which make up chromosomes, carrying DNA and the proteins to package them.

Epigenetic ‘master’ switches

They show that two ‘master’ switches operational after environmental enrichment increase chromatin interactions and another increases chromatin availability, important for the pyramidal neurons involved in cognition. A third works on a key chromosomal protein histone H3, activating nearby genes as a result.

These switches mainly occur around genomic regions that contain enhancers, regulatory DNA that (when bound to proteins called transcription factors) can activate neighboring genes. Also affected were genomic regions with insulators, regulatory DNA that can override the gene-activating effect of neighboring enhancers.

The team concluded that growing up in an enriched environment causes highly local and specific epigenetic changes in neurons and glia cells. These then mostly increase the activity of a few genes within the genome.

Mental health in humans

“Our results show that many of the genes involved are known to play a role in the growth and differentiation of neurons, the development of blood vessels, the formation and patterning of new synaptic connections on neurons, and molecular pathways implicated in memory and learning in mice,” said Dr Espeso-Gil.

“And when we look for parallel regions in the human genome, we find many regions that are statistically associated with differences in complex traits such as insomnia, schizophrenia, and Alzheimer’s in humans, which means that our study could inform future research on these disorders. This points to the potential of environmental enrichment in therapies for mental health. Our research could also help to guide future research on chromatin interactions and the poorly known importance of glial cells for cognitive mental health.”

Source: Medical Xpress

Journal information: Sergio Espeso-Gil et al, Environmental Enrichment Induces Epigenomic and Genome Organization Changes Relevant for Cognition, Frontiers in Molecular Neuroscience (2021). DOI: 10.3389/fnmol.2021.664912

Categories : Medical Research & Technology Mental HealthTags :

Distraction a Big Problem in Teletherapy Sessions

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Photo by Tracy le Blanc from Pexels

A small survey has found that although therapists appear to prefer virtual sessions over in-person meetings, a significant proportion admit to being distracted while delivering care.

A third of respondents admitted to providing lower-quality care to clients during online sessions. Overall, 39% admitted to checking emails and social media while providing virtual care.

These were the results of a survey of 600 therapists conducted and published by OnlineTherapy.com, a virtual directory for teletherapists and counselors. It’s also an affiliate of the controversial app BetterHelp, stating on their website that the company “may receive compensation from BetterHelp if you purchase products or services through the links provided.”

Online care is generally well received by therapists: nearly half said they prefer virtual sessions over in-person meetings. They appreciated many advantages of virtual therapy, such as working from home which allows therapists to keep a flexible schedule and increases their availability. Video sessions also provide therapists with a uniquely intimate look into their clients’ daily lives, making assessing their mental health easier.

However, teletherapy has introduced its own challenges. Besides the struggle to remain for therapists to stay focused themselves, 56% of those surveyed said their clients are more easily distracted during virtual sessions, and 48% reported technological issues as a major impediment to their practice.

Peter Yellowlees, MD, of UC Davis Health in Sacramento, California, noted with concern and confusion that 16% of therapists reported substance use before or during their sessions.

“There are all sorts of people in this world who call themselves therapists, most of whom have very reasonable training, but quite a number don’t,” Dr Yellowlees told MedPage Today, expressing serious doubts about whether these rates of social media distraction and substance use during virtual sessions would ring true for mental health clinicians with PhDs and MDs.

According to a spokesperson from OnlineTherapy.com, the survey only asked if respondents were currently practicing mental health professionals and did not ask for their credentials or certifications.

The results of the survey did, however, echo Dr Yellowlees’s own concerns of mental health problems on the rise of among therapists in general. The vast majority (90%) said that during the last year they suffered mental health issues, including anxiety disorders (50%) and depressive disorder (48%). This would likely impact the level of care that a therapist able to provide to their clients.

A further concern is that 17% of respondents reported seriously considered suicide since the start of the pandemic.

But  Dr Yellowlees also sees teletherapy as a way for therapists to start getting the help that they need, rather than simply treating themselves in fear of stigma or possible repercussions for their licences.

“It’s undoubtedly helped significantly,” Dr Yellowlees said. “We know that certain teletherapies are actually good for the mental health of providers, as well as the patients.”

Source: MedPage Today

Categories : Expert Opinion Mental HealthTags :

Is PTSD Underdiagnosed or Overdiagnosed?

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Photo by Alex Green from Pexels

In an article published in the BMJ, experts debated as to whether diagnoses of post-traumatic stress disorder (PTSD) are surging in Western society due to real trauma, or whether it is simply being overdiagnosed. 

Some clinicians are concerned that diagnoses of PTSD have increased throughout Western society since the late 1980s.

PTSD is a serious and uncommon condition resulting from severe trauma, but is has come to mean an umbrella term encompassing other disorders and normal reactions to stress, argued John Tully at the University of Nottingham and Dinesh Bhugra at King’s College London’s Institute for Psychiatry, Psychology & Neuroscience (IoPPN).

Estimates of lifetime population prevalence are now around 7% in the US (26 million cases) and at 5% in other high income countries. In the UK, PTSD is estimated to be in 1 in 13 youths and in mothers after 4% of all births.

In military settings, there may be an underdiagnosis of PTSD, they acknowledged, as well as in the developing world due to limited psychiatric resources. 
But in other settings, they argue that PTSD is often conflated with normal responses to difficult situations, which has led to increased pressure on services to make this diagnosis. 

“The conflation of stress with trauma—and of trauma with PTSD—has become rife. This is the most convincing explanation for overdiagnosis,” they wrote.

This “concept creep” they argue, may also involve “compensation culture” and vested interests of the “trauma industry” as factors, they said. Am alternative explanation could be that psychiatry and society have become more accepting of trauma, and so give more leeway to diagnosis and treatment.

At a public health level however, they believe this approach is problematic as, “resources are finite, and a line must be drawn somewhere as to what level of symptoms meets criteria.”

PTSD misdiagnosis also risks other more common conditions, such as depression, anxiety disorder, and personality disorders, not being appropriately treated, while trivialising PTSD risks the medicalisation of everyday life, devaluing resilience and protective social factors, they warn.

“On this basis, we must reclaim the diagnosis of PTSD for what it is—a profound and severe response to catastrophic events—and not a spectrum of reactions to trauma or everyday life,” they conclude.

However Stephanie Lewis, Sarah Markham and Gerard Drennan at King’s IoPPN and the South London and Maudsley NHS Foundation Trust, contend that there is compelling evidence showing that PTSD is much more commonly underdiagnosed, which has concerning implications.

They say that PTSD has clear guidelines for diagnosis, and there is no evidence to suggest that it is being overdiagnosed – and rather the opposite.

“Large epidemiological studies representative of the population have found that less than half of adults and two fifths of young people who meet criteria for PTSD have sought help from any health professional,” they wrote.

“These findings fit with our professional experience that people with PTSD often find it difficult to seek help—for example, because of avoidance symptoms, concerns about stigma, or fear that there may be no effective treatment,” they write.

Additionally, only a fraction of people with PTSD who access health services receive a diagnosis, they added.

They warned that underdiagnosis is concerning because, compared to those without PTSD adults who meet the criteria are over six times more likely to attempt suicide, and 10 times for young people with PTSD. However, treatment can be effective.

They argued that underdiagnosis to PTSD should be reduced, and access increased to service for diagnosis and treatment.

“Prioritising these actions now may prove particularly timely because the COVID-19 pandemic may have exacerbated the underdiagnosis of PTSD,” they concluded.

Source: Medical Xpress

Journal information: Is PTSD overdiagnosed? BMJ (2021). www.bmj.com/content/373/bmj.n787

Categories : Ageing Cancer Mental HealthTags :

Loneliness in Middle-aged Men Tied to Cancer Risk

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Older man sitting alone on beach. Photo by Engin Akyurt from Pexels

A recent study by the University of Eastern Finland shows that loneliness among middle-aged men is associated with an increased risk of cancer.

Cancer is the second leading cause of death around the world, and in high-income countries it has become the main cause. Recent scientific evidence demonstrates that stress plays a positive role in cancer initiation, progression and cancer metastasis, as well as a negative role for anti-tumor immune function and therapy response.

“It has been estimated, on the basis of studies carried out in recent years, that loneliness could be as significant a health risk as smoking or overweight. Our findings support the idea that attention should be paid to this issue,” said project researcher Siiri-Liisi Kraav from the University of Eastern Finland.

The study was launched in the 1980s with middle-aged men from eastern Finland participating. To avoid reverse causality, individuals who already had a cancer diagnosis or received a cancer diagnosis within two years after the baseline data collection were excluded from the analysis. The  2570 eligible participants had their health and mortality monitored on the basis of register data through to the present. Follow-up lasted an average of 20.44 years, and the average age of cancer diagnosis was 69.96 years.
Factors accounted for included age, socio-economic status, lifestyle, sleep quality, depression symptoms, body mass index, heart disease and other risk factors.

During the follow-up, 649 men (25% of participants) developed cancer, and 283 men (11%) died of cancer. Loneliness was associated with a roughlt 10% increased cancer risk. In addition, cancer mortality was higher in cancer patients who were unmarried, widowed or divorced at baseline.
Based on these results, the researchers recommended that consideration of loneliness and social relationships should be an important part of comprehensive health care and disease prevention. The findings were published in Psychiatry Research.

“Awareness of the health effects of loneliness is constantly increasing. Therefore, it is important to examine, in more detail, the mechanisms by which loneliness causes adverse health effects. This information would enable us to better alleviate loneliness and the harm caused by it, as well as to find optimal ways to target preventive measures,” concluded Kraav.

Source: University of Eastern Finland

Journal information: Kraav, S., Lehto, S.M., Kauhanen, J., Hantunen, S., Tolmunen, T., 2021. Loneliness and social isolation increase cancer incidence in a cohort of Finnish middle-aged men. A longitudinal study. Psychiatry Research: https://doi.org/10.1016/j.psychres.2021.113868