The National Comorbidity Survey showed that among adult patients surveyed ADHD existed comorbidly in 32 percent of those with a depressive disorder, 21.2 percent of those with BPD and 9.5 percent of those with an anxiety disorder.

An analysis of medical claims derived from a large managed care database in the United States, over a 12 month period, found approximately 2.5 percent of adults initially diagnosed with a depressive disorder or an anxiety disorder were later also diagnosed with ADHD.

The findings suggest that many adult patients with psychiatric disorders such as a depressive disorder, BPD or an anxiety disorder may also have undiagnosed ADHD.

The research team found a higher rate of PTSD and substance use in adolescents with bipolar disorder. They also found also found significantly more substance use disorder in subjects meeting full criteria for PTSD than in cases of sub-threshold PTSD.

The team performed psychiatric assessments of study subjects using the Kiddie Schedule for Affective Disorders-Epidemiologic Version (KSADS-E). They also assessed substance use with the KSADS Substance Use module in subjects younger than 18 years and the Structured Clinical Interview for the Diagnostic and Statistical Manual IV (SCID) module for Substance Use Disorders in subjects who were 18 years or older.

In the bipolar subjects, 8% met the full criteria for PTSD and another 8% met criteria for sub-threshold PTSD. In contrast, 1 control subject met the full criteria for full PTSD and 2 met criteria for sub-threshold PTSD.

Among the 18 subjects with bipolar disorder who met the criteria for full or sub-threshold PTSD, 7 (39%) met the criteria for substance use disorder. Within the bipolar group, the investigators documented significantly more substance use in full PTSD than in sub-threshold PTSD.

Among the subjects with all 3 conditions, 3 developed bipolar disorder first, then PTSD, and then substance use disorder. Two developed PTSD first, and then bipolar disorder followed by substance abuse. The remaining 2 cases experienced the onset of bipolar disorder and substance abuse at approximately the same time. They then experienced trauma and subsequent PTSD, with worsening substance use.

In their new study involving four hospitals, the team found that encouraging patients to express themselves through music seemed to improve their symptoms.

This type of treatment has only been attempted before with patients who are already fairly stable.

“This study shows that music therapy provides a way of working with people when they are acutely unwell,” Dr. Crawford said.

Music therapy is a type of psychotherapy in which the patient is encouraged to utilize music to improve interpersonal and communication skills in ways that regular dialogue is limited. Forms of music therapy generally are based around cognitive/behavioral, humanistic or psychoanalytic frameworks or a mixture of approaches. There are usually both active and receptive parts of the therapy, meaning that at times music is listened to and at other times there is the use of musical improvisation or creation.

A recent study conducted by a team at Wake Forest University Baptist Medical Center reports upon the influence of reading ability on suicide risk. Suicide is an issue of growing concern in children and adolescents groups and researchers are trying to learn more about the risk factors.

The research tem screened a group of over 1,000 participating students and, and compared a group of poor readers and average readers. Those with poor reading skills proved to be more likely to experience suicidal thoughts and attempts as well as school dropout. Further research showed that reading problems were a risk factor for suicidal behavior, regardless of whether there was a history of psychiatric problems, such as depression.

Long term studies conducted over 25 years, by the same research team, revealed that students with reading problems tended to have a higher rate of suicide.

BPD is results in a long term pattern of impulsive behaviour, changeable moods and instability- some of the traits that are commonly seen in bipolar disorder.

John Gunderson, MD, medical director of the Borderline Personality Disorder Treatment Center at McLean Hospital, conducted test to see whether BPD is a variant of bipolar disorder. He did so by assessing 196 people with BPD and 433 people with other personality disorders.

His findings revealed only a modest connection to bipolar disorder among the people with BPD, with the rate of co-occurring bipolar among these people at nineteen percent. Among other people with other personality disorders, the rate of co-occurring bipolar was eight percent.

The results have important implications for treatment since many people with BPD only receive a diagnosis of bipolar disorder and the two disorders are treated differently.

The study is published in The American Journal of Psychiatry and is entitled “Descriptive and Longitudinal Observations on the Relationship of Borderline Personality Disorder and Bipolar Disorder.

Researchers in Taiwan studied 94 people with acute bipolar mania, one third of them were medicated and two thirds were unmedicated, along with 44 people in remission and 48 people without the disorder. The team examined blood samples taken from all the participants.

They found that levels of anti-heat shock protein 90 to be significantly higher in people with bipolar disorder in acute manic phases that in other participants.

The study, entitled, “Anti-Heat Shock Protein 90 is Increased in Acute Mania,” was published in The Australian and New Zealand Journal of Psychiatry.

The study, known as STAR*D, included nearly 3,700 patients treated at 41 primary-care and psychiatric clinics across the United States. All the patients initially received the same antidepressant medication. Those who didn’t respond to or couldn’t tolerate the medication were encouraged to move on to the next treatment steps, where they were divided into various groups that received treatments including cognitive therapy alone or in combination with medication, as well as several different antidepressants used alone or in combination.

Of the patients in the study who worked with their doctors and tried various therapies, 67 percent achieved full remission of depression symptoms by the end of one to four treatment steps. Researchers found that thirteen percent of the 123 adults who took part in the study who did not get better on the first three drugs they tried were helped by a fourth. However, the study also showed that the more tries people made, the more likely it was that they later would relapse and slide back into depression.

About 15 million Americans each year suffer depression, the nation’s top mental health problem.

Elevated levels of cortisol - a stress hormone linked to depression, obesity and other chronic health problems – signal to the body that it is time to deal with negative emotions such as loneliness, according to Northwestern University’s Emma K. Adam, the lead investigator of the study.

Cortisol is often characterized as a negative hormone because of evidence, mostly in animal models, that long-term elevations could be potentially harmful to physical health. But in the short term the stress hormone can be adaptive and helpful.

It is believed that he morning cortisol boost could help adults who went to bed with troubled or overwhelming feelings go out in the world the next day and have the types of positive social experiences that help regulate hormone levels.

The study, “Day-to-day experience-cortisol dynamics,” was published online this week by the Proceedings of the National Academy of Sciences (PNAS).

The scientists, at Jerusalem’s Hebrew University, said mice that were given drugs to induce behavior similar to human depression suffered from a loss of mass in their bones, mainly their hips and vertebrae. After being given anti-depressants, the bone density of the mice increased, along with their level of activity and social interaction.

Dr. Philip Gold, chief of the Clinical Neuroendocrinology branch at the National Institute of Mental Health, is conducting pioneering research on the effects of depression on bone density. According to Dr. Gold women under 45 who have a bout of major depression has up to a 30 percent chance of having decreased bone density. There is also preliminary evidence that it can have similar effects on men. Depression that lasts only a few months can trigger significant bone loss.

Bone loss during depression is caused by the brain’s manipulation of hormones. Depression is like a severe and prolonged state of stress, which causes blood pressure and heart rate to increase. It also causes the release of a chemical compound called noradrenaline that harms bone-building cells.

Jon W. Johnson, University of Pittsburgh associate professor of neuroscience, Anqi Qian, of Carnegie Mellon University in Qatar, have discovered how different types of NMDA receptors perform varied functions.

Communication between cells in the brain depends on specialized molecular receptors that conduct charged particles, or ions, between the outside and inside of cells. Ions also modify how receptors work. In their study, Johnson and Qian found the effects of ions vary between different types of receptor molecules. They used computer modeling to show that variation in how ions interact with receptors combined with variation in the structure of receptors is responsible for specialization of receptor function.

NR1/2D receptors are believed to play important roles in the brain, including the process of long-term depression and disease. A better understanding of how NMDA receptors work could lead to better treatments for schizophrenia, depression and Alzheimer’s disease.

The brain is like an electrical circuit board but it is very complicated to figure out how it all functions together. Memories are formed by strengthening the connections between brain cells, known as synapses. Specifically, memory requires the coordinated activation of many types of receptors at synapses.

Prozac (Fluoxetine) is currently the only anti-depression medication approved to treat juveniles. However, controversy is mounting over claims that the drug actually increases suicidal behaviors in children and adolescents.

Prozac is a serotonin reuptake inhibitor (SSRI), which is already known to inhibit aggression in adult hamsters, both in low and high doses. But the new study revealed that when juvenile hamsters were given low doses of Prozac, they become more aggressive whether the dose was low or high.

The study clearly shows that adult and adolescent brains are different. Previous studies on adolescents have shown that the brain continues to mature throughout adolescence and into the early adult years.

The researchers believe that it may be possible that because adolescents have lower levels of serotonin than adults, there may not be enough serotonin in their systems for fluoxetine, or other SSRIs to work effectively.

It may also be possible that some teens who are taking Prozac and become aggressive or suicidal are having an unusual reaction to the drug.

Researchers studied a group of patients who were referred to two web sites: The MoodGYM and education site BluePages. The MoodGYM is a cognitive behavior therapy site dedicated to preventing depression by helping users to identify and overcome difficult emotions, and showing them how to develop good coping skills, in order to improve their mental health. BluePages is a depression education site, providing information about the symptoms of and treatments for depression.

After 12 months, users of both web sites reported improvement. The educational site BluePages was more effective than the behavior-therapy site. BluePages users were “less likely to use actions that did not have an evidence basis,” researcher Helen Christensen said.
It is possible that the web sites are effective because the willingness to use the web sites shows the kind of initiative needed to successfully treat depression. Someone who is visiting an educational site like BluePages is taking the necessary steps with their own self-care, which is a crucial step in successful treatment.

Benefits of online therapy:

Dr. David Silbersweig and his colleagues at Weill Cornell Medical Center brought 22 people into the research laboratory to undergo brain scans while watching words come up on a monitor. Some words were positive, some negative and others neutral. The aim was to see if the depressed brain looked different in the region that governs reward when reading these words.

The results show that indeed it does. The scientists tested 10 depressed people who had not yet received treatment and 12 volunteers with no history of mental illness. One key characteristic of depression is that patients have a very hard time motivating themselves and enjoying things that once made them feel good. The brain scan measured blood oxygen changes in active brain regions. The color-coded statistical images allowed the researchers to determine which areas were most active in response to emotion-laden words.

The scientists found that the brains of non-depressed volunteers responded differently to positive and negative words, particularly in an area called the ventral striatum, a key reward center of the brain. Positive words like ‘rejoice’ and ’success’ triggered more activity in this region than negative words like ‘damaged’ and ‘useless’ or the neutral words. By comparison, those with depression had decreased activity in this brain region when reading the positive words. Silbersweig said that this finding, published in the latest issue of the American Journal of Psychiatry, suggests that the reward area is not reacting to positive stimuli in depressed people. The team also identified another region that differed in those diagnosed with depression: an area in the front of the brain that regulates self-awareness of emotion.

Drs. Miles Cunningham and Kim Kwang-soo at Harvard Medical School and Professor Kim Dong-wook at Yonsei University differentiated embryonic stem cells into nerve cells generating dopamine and serotonin and devised a model of psychiatric disease for applying the technology. The eighty animals involved in the experiment behaved as if they had taken anti-depressant medication.

Dopamine and serotonin are well-known neurotransmitters, or the chemicals playing a key role in relaying, amplifying and modulating electrical signals between brain cells - and which are known to also play a role in schizophrenia.

More experiments are progress, but it will take a long time to apply them to human beings.

The three year initiative, called ‘Action on Stigma’, urges employers to sign up to a set of anti-stigma principles - for example, demonstrating that they have made changes in their work environment and employment practices to ensure that people with mental health problems are treated fairly and equally with others.

Many employers who have taken part in projects to make their workplace culture more ‘mental health friendly’ have reported reduced staff turnover and sickness absences. Despite this:

Only about 20% of people with severe mental health problems are employed, compared to 65% of people with physical health problems and 75% for the whole adult population

Even for people with more common types of mental illness, such as depression, only about half are competitively employed

However, people with mental health problems have the highest ‘want to work rate’ with up to 90% wanting to work, compared to 52% for disabled people generally.

Although some of the principles are voluntary, adopting them will help public sector organisations, including local councils, government departments and hospitals, to meet the requirements of a new duty under the Disability Discrimination Act which comes into force in December 2006. This will require them to set out precisely how they intend to eliminate unlawful discrimination and promote equality of opportunity.