Psych Central News

DSM-5 Published, ‘Critical Guidebook for Clinicians’

2013-05-18T22:33:56Z

The much-anticipated 5th edition of the reference manual mental health professionals use to classify and diagnose mental disorders — called the Diagnostic and Statistical Manual of Mental Disorders — was officially released today. The DSM-5, as it’s called, was published today after a 14 year revision process.

The manual is published by the American Psychiatric Association (APA).

The process included the analysis of hundreds of research studies published in the past two decades by multi-disciplinary, disorder-based workgroups. Then drafts of the proposed manual were published three times, resulting in over 13,000 comments, emails and letters from other researchers, clinicians and the public.

James Scully, Jr., MD, CEO of the APA, suggested that the DSM-5 will be a “critical guidebook for clinicians.”

“The manual is first and foremost a guidebook for clinicians,” reiterated David Kupfer, M.D., DSM-5 task force chair, who noted that the overall number of disorders remains largely the same as what appeared in the DSM-IV, the prior edition of the book. The number has stayed largely the same because new disorders have been offset by the combining or removing old, outdated disorders.

Details of the biggest changes made in the DSM-5 were first reported by us earlier today in a blog entry.

New disorders added since the publication of the DSM-IV nearly 19 years ago include Disruptive Mood Dysregulation Disorder (formerly known by clinicians as childhood bipolar disorder), mild neurocognitive disorder, binge eating disorder and premenstrual dysphoric disorder. The latter two were first suggested in the DSM-IV, and were formally recognized as disorders by the DSM-5.

Childhood bipolar disorder has been recognized by some pediatric clinicians and researchers for over a decade. The DSM workgroup, however, decided that using a new term to describe this cluster of symptoms was more appropriate. Disruptive mood dysregulation is characterized by a child or teen under age 18 who exhibits persistent irritability and frequent episodes of extreme, out-of-control behaviors that cause significant distress in the child or teen.

Mild neurocognitive disorder was added to recognize the neurodegenerative decline witnessed by many clinicians who wanted to help their patients, but had no diagnosis to give people who were beginning to experience out-of-the-ordinary memory problems associated with aging. Since normal aging is not associated with memory or cognition problems, the new diagnosis appears to fill the gap between such problems and full-blown dementia (now called Major Neurocognitive Disorder).

Other changes include a difference in how attention deficit hyperactivity disorder (ADHD) is diagnosed in adults, and the merging of four disorders into the single label, Autism Spectrum Disorder. This last change was a significant re-labeling of well-known disorders such as Asperger’s syndrome, and lesser-known disorders: childhood disintegrative disorder and pervasive developmental disorder not otherwise specified.

While some critics contend the new edition of the DSM will result in significant changes in how mental disorders are diagnosed in the U.S., they have failed to produce much research data to support their contentions.

With little research producing reliable biomarkers or laboratory tests for mental disorders, the DSM-5 remains the most reliable diagnostic system that is empirically-based.

Review all the major changes made in the DSM-5 here.

Source: American Psychiatric Association

Kids Who First Drink During Puberty at Greater Risk of Alcohol Problems

2013-05-18T11:24:59Z

New research shows that youths who first drink during puberty are at greater risk for developing later alcohol problems.

“Most teenagers have their first alcoholic drink during puberty. However, most research on the risks of early-onset alcohol use up to now has not focused on the pubertal stage during which the first alcoholic drink is consumed,” said Miriam Schneider, Ph.D., a researcher at the Central Institute of Mental Health, University of Heidelberg, and one of the authors of the new study.

She noted that a common notion in alcohol research is that the earlier adolescents began to drink, the bigger problems they faced later in life.

“However, a closer look at the statistics revealed a peak risk of alcohol use disorders for those beginning at 12 to 14 years of age, while even earlier beginners seemed to have a slightly lower risk,” she said.

On average, girls begin puberty between the ages of 10 and 11, while boys typically start between the ages 11 of 12. Puberty lasts approximately 5 to 6 years for most teens.

For the study, Schneider and her colleagues determined the age at first drink in 283 young adults — 152 females, 131 males — who were part of a larger epidemiological study.

In addition, the participants’ drinking behavior — such as number of drinking days, amount of alcohol consumed, and hazardous drinking — was assessed at ages 19, 22, and 23 years via interviews and questionnaires.

The researchers also concurrently conducted a rodent study to examine the effects of mid-puberty or adult alcohol exposure on voluntary alcohol consumption in later life by 20 male Wistar rats.

“Both studies revealed that those individuals that initiated alcohol consumption during puberty tended to drink more and also more frequently than those starting after puberty,” said Schneider.

That means that puberty is a “risk window” for having that first drink, said Rainer Spanagel, Ph.D., head of the Institute of Psychopharmacology at the University of Heidelberg.

The study’s results also show a higher Alcohol Use Disorders Identification Test (AUDIT) score later in life in those individuals who had their first drink in puberty, he said.

“A higher AUDIT score is indicative of a high likelihood of hazardous or harmful alcohol consumption,” he explained. “This information is of great relevance for intervention programs. Even more interesting, neither pre-pubertal nor post-pubertal periods seem to serve as risk-time windows. Therefore, intervention programs should be directed selectively towards young people in puberty.”

Both Schneider and Spanagel noted the influence of a high degree of brain development that occurs during puberty.

“Numerous neurodevelopmental alterations are taking place during puberty, such as maturational processes in cortical and limbic regions, which are characterized by both progressive and regressive changes, such as myelination and synaptic pruning,” said Schneider.

“Typically, an overproduction of axons and synapses can be found during early puberty, followed by rapid pruning during later puberty, indicating that connections and communication between subcortical and cortical regions are in a highly transitional state during this period.”

“Puberty is a phase in which the brain reward system undergoes major functional changes,” added Spanagel. “For example, the endocannabinoid and dopamine systems are at their peak and these major neurobiological changes are reflected on the behavioral level; reward sensitivity is highest during puberty.

“Therefore, during puberty the brain is in a highly vulnerable state for any kind of reward, and drug rewards in particular. This high vulnerability might also affect reward seeking, or in this particular case, alcohol seeking and drinking behavior later in life.”

Said Schneider, “It is exactly during puberty that substances like drugs of abuse — alcohol, cannabis, etc. — may induce the most destructive and also persistent effects on the still developing brain, which may in some cases even result in neuropsychiatric disorders, such as schizophrenia or addictive disorders.

“Prevention work therefore needs to increase awareness of specific risks and vulnerability related to puberty.”

Source: Alcoholism: Clinical & Experimental Research

Adolescent drinking alcohol photo by shutterstock.

Rat Study Shows How Brain Rewires Itself After Injury

2013-05-18T11:17:56Z

When the brain’s primary learning center is damaged, new neural circuits arise to compensate for the lost function, a new study has found.

Researchers from the University of California-Los Angeles and Garvan Institute of Medical Research in Australia found that parts of the prefrontal cortex take over when the hippocampus — the brain’s key center of learning and memory formation — is disabled.

For the study, researchers Michael Fanselow, Ph.D. and Moriel Zelikowsky conducted laboratory experiments showing that rats were able to learn new tasks even after damage to the hippocampus. While the rats needed more training than they would have normally, they nonetheless learned from their experiences, said the researchers.

“I expect that the brain probably has to be trained through experience,” said Fanselow, who was the study’s senior author. “In this case, we gave animals a problem to solve.”

After discovering the rats could learn to solve problems, Zelikowsky, traveled to Australia to work with Dr. Bryce Vissel at the Garvan Institute. There, they analyzed the anatomy of the changes that had taken place in the rats’ brains.

Their analysis identified significant functional changes in two specific regions of the prefrontal cortex.

“Interestingly, previous studies had shown that these prefrontal cortex regions also light up in the brains of Alzheimer’s patients, suggesting that similar compensatory circuits develop in people,” Vissel said.

“While it’s probable that the brains of Alzheimer’s sufferers are already compensating for damage, this discovery has significant potential for extending that compensation and improving the lives of many.”

The hippocampus plays critical roles in processing, storing and recalling information, the researchers said. It is highly susceptible to damage through stroke or lack of oxygen and is “critically involved” in Alzheimer’s disease, according to Fanselow.

“Until now, we’ve been trying to figure out how to stimulate repair within the hippocampus,” he said. “Now we can see other structures stepping in and whole new brain circuits coming into being.”

Sub-regions in the prefrontal cortex compensated in different ways, with one sub-region — the infralimbic cortex — silencing its activity and another sub-region — the prelimbic cortex — increasing its activity, Zelikowsky said.

Complex behavior always involves multiple parts of the brain communicating with one another, with one region’s message affecting how another region will respond, Fanselow noted. These molecular changes produce our memories, feelings and actions.

“The brain is heavily interconnected — you can get from any neuron in the brain to any other neuron via about six synaptic connections,” he said. “So there are many alternate pathways the brain can use, but it normally doesn’t use them unless it’s forced to.

“Once we understand how the brain makes these decisions, then we’re in a position to encourage pathways to take over when they need to, especially in the case of brain damage.”

Behavior creates molecular changes in the brain, Fanselow said. “If we know the molecular changes we want to bring about, then we can try to facilitate those changes to occur through behavior and drug therapy. I think that’s the best alternative we have. Future treatments are not going to be all behavioral or all pharmacological, but a combination of both.”

The study was published in the journal Proceedings of the National Academy of Sciences.

Source: University of California-Los Angeles

Schizophrenia Risk Linked to Declining IQ

2013-05-18T10:54:12Z

A long-term study provides evidence that the genetic risk for schizophrenia is associated with lower IQ among people who do not develop this disorder.

Schizophrenia is a rare but serious psychiatric disorder, usually beginning in late adolescence, and is characterized by hallucinations, delusions, paranoia, cognitive impairment, social withdrawal, self-neglect and loss of motivation and initiative.

The study, published in Biological Psychiatry, involved data from 937 individuals in Scotland who first completed IQ testing in 1947, at age 11.

At age 70, their IQ was tested again, and their DNA was analyzed to estimate their genetic risk for schizophrenia.

The findings show that those with a higher genetic risk for schizophrenia had a lower IQ at age 70 but not at age 11.

Having more schizophrenia risk-related gene variants was also linked to a greater decline in lifelong cognitive ability.

“If nature has loaded a person’s genes towards schizophrenia, then there is a slight but detectable worsening in cognitive function between childhood and old age.

“With further research into how these genes affect the brain, it could become possible to understand how genes linked to schizophrenia affect people’s cognitive function,” said Andrew McIntosh, M.D., from the University of Edinburgh.

These findings suggest that common genetic variants may underlie both cognitive aging and the risk of schizophrenia.

“While this study does not show that these common gene variants produce schizophrenia per se, it elegantly suggests that these variants may contribute to declines in intelligence, a clinical feature associated with schizophrenia,” commented Dr. John Krystal, editor of Biological Psychiatry.

“However, we have yet to understand the development of cognitive impairments that produce disability in young adulthood, the period when schizophrenia develops for many affected people.”

More research is needed, but these new findings add to the growing and extensive effort to figure out how the gene variants that contribute to the development of schizophrenia give rise to the cognitive problems often associated with it.

Source: Biological Psychiatry

Abstract of human mind photo by shutterstock.

Depression Nearly Doubles Stroke Risk in Middle-Aged Women

2013-05-18T10:49:27Z

Middle-aged women who suffer from depression face almost double the risk of having a stroke, according to a 12-year Australian study.

The research, published in Stroke: Journal of the American Heart Association, involved 10,547 women ages 47 to 52. Depressed women were found to be 1.9 times more likely to have a stroke after factors such as age, lifestyle and socio-demographics were taken into account.

“When treating women, doctors need to recognize the serious nature of poor mental health and what effects it can have in the long term,” said study author Caroline Jackson, Ph.D., an epidemiologist in the School of Population Health at the University of Queensland in Australia. “Current guidelines for stroke prevention tend to overlook the potential role of depression.”

This is the first large-scale study that investigated the association between depression and stroke in younger middle-aged women.

The closest prior comparison was the U.S.-based Nurses’ Health Study — which showed a 30 percent higher risk of stroke among depressed women. However, the average participant’s age in that study was 14 years older.

For the new study, researchers analyzed survey results from the nationally representative Australian Longitudinal Study on Women’s Health. Participants reported on their mental and physical health and other personal details every three years during 1998-2010.

About 24 percent of participants were depressed, based on their responses to a standardized depression scale (Epidemiological Studies Depression Scale, short version) and their use of antidepressants in the past month.

Self-reported responses and death records revealed 177 first-time strokes occurred during the study.

The researchers then used statistical software and repeated measures at each survey point to analyze the relationship between depression and stroke.

To distinguish the effects of depression alone, they factored out several characteristics that can affect stroke risk, including: age; socioeconomic status; lifestyle habits such as smoking, alcohol and physical activity; and physiological conditions including high blood pressure, heart disease, being overweight and diabetes.

Jackson noted that although the increased stroke risk associated with depression was large, the absolute risk of stroke is still fairly low for this age group.

Only about 2 percent of American women in their 40s and 50s suffer from stroke. In the study, only about 1.5 percent of all women had a stroke.

Similar results could be expected among American and European women, Jackson said.

“We may need more targeted approaches to prevent and treat depression among younger women, because it could have a much stronger impact on stroke for them now rather than later in life,” she said.

It’s still undetermined why depression is strongly linked to stroke in this age group. Inflammatory and immunological processes and their effects on our blood vessels may be part of the reasons, she said.

Source: Stroke: Journal of the American Heart Association

Depression is Deadly among Cancer Survivors

2013-05-17T12:02:31Z

New research suggests that surviving cancer may only be a first step – survivors must also work to avoid depression.

Dutch researchers have found depressed cancer survivors are twice as likely to die prematurely as those who do not suffer from depression.

The researchers say the findings, published online in the Journal of Cancer Survivorship, are applicable to all forms, and sites of cancer. It is an important discovery as the prevalence of cancer is rising, as are the number of individuals who are cured of their cancer or are living with it as a chronic disease.

Experts say this is partly due to the aging of the population and more effective treatments.

Thus, our success in eliminating the cancer, or transforming the condition into a chronic disease, has resulted in many cancer survivors facing continuing problems including a high prevalence of depression.

Floortje Mols, Ph.D., from Tilburg University in The Netherlands, and her colleagues examined whether depressive symptoms observed between one and 10 years after cancer diagnosis were linked to an increased risk of premature death two to three years later.

Their work focused on survivors of endometrial cancer, colorectal cancer, lymphoma or multiple myeloma, where little work looking at this potential link has been done to date.

They analyzed data collected from several large population-based surveys in 2008 and 2009. A total of 3,080 cancer survivors completed questionnaires to identify symptoms of depression.

Researchers found that depressive symptoms increased the risk of death: clinically high levels of depressive symptoms were more common in those who died than in those who survived.

Overall, after controlling for treatment, type of cancer, co-morbidity, and metastasis, one-to-ten-year cancer survivors with depression were twice as likely to have died early.

Investigators believe that paying attention to the recognition and treatment of depressive symptoms in this patient group is paramount. Moreover, future research is needed to explain the association between depressive symptoms and death from cancer, say the researchers.

“We also need to better understand whether treatments for depressive symptoms in cancer patients have life-prolonging effects,” Mols said.

Source: Springer

Depressed cancer survivor photo by shutterstock.

Brain Links Common Emotions to Colors

2013-05-17T12:18:17Z

Emerging research discovers an association between how music makes us feel and colors.

That is, our brains are wired to make music-color connections depending on how the melodies charge our emotional state.

For instance, Mozart’s jaunty “Flute Concerto No. 1 in G major” is most often associated with bright yellow and orange, whereas his dour “Requiem in D minor” is more likely to be linked to dark, bluish gray.

University of California – Berkeley researchers also discovered that people in both the United States and Mexico linked the same pieces of classical orchestral music with the same colors.

This suggests that humans share a common emotional palette — when it comes to music and color — that appears to be intuitive and can cross cultural barriers.

“The results were remarkably strong and consistent across individuals and cultures and clearly pointed to the powerful role that emotions play in how the human brain maps from hearing music to seeing colors,” said vision scientist Stephen Palmer, Ph.D.

Palmer is the lead author of a paper published in the journal Proceedings of the National Academy of Sciences.

Using a 37-color palette, the UC Berkeley study found that people tend to pair faster-paced music in a major key with lighter, more vivid, yellow colors, whereas slower-paced music in a minor key is more likely to be teamed up with darker, grayer, bluer colors.

“Surprisingly, we can predict with 95 percent accuracy how happy or sad the colors people pick will be based on how happy or sad the music is that they are listening to,” said Palmer.

Researchers say the findings may have implications for creative therapies, advertising and even music player gadgetry.

For example, they could be used to create more emotionally engaging electronic music visualizers — computer software that generates animated imagery synchronized to the music being played.

Currently, the colors and patterns appear to be randomly generated and do not take emotion into account, researchers said.

Investigators also believe the findings may provide insight into synesthesia, a neurological condition in which the stimulation of one perceptual pathway, such as hearing music, leads to automatic, involuntary experiences in a different perceptual pathway, such as seeing colors.

An example of sound-to-color synesthesia was portrayed in the 2009 movie The Soloist when cellist Nathaniel Ayers experiences a mesmerizing interplay of swirling colors while listening to the Los Angeles symphony.

For the music-color study, nearly 100 men and women participated with half of the participants residing in the San Francisco Bay Area and the other half in Guadalajara, Mexico.

In three experiments, they listened to 18 classical music pieces by composers Johann Sebastian Bach, Wolfgang Amadeus Mozart and Johannes Brahms that varied in tempo (slow, medium, fast) and in major versus minor keys.

In the first experiment, participants were asked to pick five of the 37 colors that best matched the music to which they were listening. The palette consisted of vivid, light, medium, and dark shades of red, orange, yellow, green, yellow-green, green, blue-green, blue, and purple.

Researchers found that participants consistently picked bright, vivid, warm colors to go with upbeat music and dark, dull, cool colors to match the more tearful or somber pieces. Separately, they rated each piece of music on a scale of happy to sad, strong to weak, lively to dreary and angry to calm.

Two subsequent experiments studying music-to-face and face-to-color associations supported the researchers’ hypothesis that “common emotions are responsible for music-to-color associations,” said Karen Schloss, Ph.D., co-author of the paper.

For example, the same pattern occurred when participants chose the facial expressions that “went best” with the music selections, Schloss said.

Upbeat music in major keys was consistently paired with happy-looking faces while subdued music in minor keys was paired with sad-looking faces. Similarly, happy faces were paired with yellow and other bright colors and angry faces with dark red hues.

A future research study will assess participants in Turkey where traditional music uses a wider range of scales than just major and minor.

“We know that in Mexico and the U.S. the responses are very similar,” Palmer said. “But we don’t yet know about China or Turkey.”

Source: University of California – Berkeley

Abstract of music and color photo by shutterstock.

Color Red Linked to High Testosterone

2013-05-17T11:24:45Z

A new study suggests that the choice of red clothing in athletic completion may be linked to high levels of testosterone.

Psychological scientist Daniel Farrelly of the University of Sunderland and colleagues recruited 73 men to participate in the study. Participants were unaware of the study’s aims.

The men were told that they would be performing a competitive task and that their performances would be placed on a leaderboard.

The participants then chose either a red or blue symbol to represent them in the table and completed the competitive tasks. They also answered questionnaires aimed at gauging whether various personal reasons may have affected their color choice.

Researchers found that males who chose red as their color in a competitive task had higher testosterone levels than other males who chose blue.

“The research shows that there is something special about the color red in competition, and that it is associated with our underlying biological systems,” Farrelly said.

The researchers believe that the link may explain why many sports stars wear red clothing — Tiger Woods, for example, famously chooses to wear a red shirt on the last day of a major competition.

Choosing to wear red “may, unconsciously, signal something about their competitive nature, and it may well be something that affects how their opponents respond,” Farrelly explains.

The study will be published in Psychological Science.

To determine participants’ testosterone levels, the researchers took saliva samples at the start of the study, before the participants knew about the competitive task, and again at the end.

The data revealed that men who chose red had higher baseline testosterone levels, and they rated their color as having higher levels of characteristics such as dominance and aggression, than men who chose blue.

Color choice did not, however, seem to be related to actual performance in the competitive task.

The researchers believe that direct competition, in which opponents can be seen wearing red or appearing red, may be necessary for the red advantage to occur.

Along these lines, previous research has shown that wearing red can be advantageous through its influence on opponents’ perceptions, leading them to view red competitors as being “high quality” competitors.

Source: Association of Psychological Science

Staying In Touch with College Kids Can Improve Their Health

2013-05-17T11:19:54Z

Most moms and dads don’t want to be known as “helicopter parents” when their kids go away to college.

Still, a new study suggests college kids eat healthier and exercise more on the days when they talk with a parent.

“Only a third of college students consumes a diet that is consistent with national recommendations,” said Penn State’s Meg Small, Ph.D., a research associate in the Prevention Research Center for the Promotion of Human Development.

“In addition, college students’ physical activity levels decline from the first semester to their seventh semester. Our research suggests that parents may play an important role in influencing their adolescents to establish behavioral patterns that improve their long-term health and chronic-disease risk.”

For the study, researchers recruited 746 first-year students at a large university in the U. S. to complete a baseline survey plus 14 daily surveys.

The surveys included questions about how much time students spent talking to, e-mailing or text messaging their parents. In addition, the surveys included questions about how often and for how long students worked out or played sports and how many times they ate fruits or vegetables.

Investigators found that on days when students communicated with their parents for 30 minutes or more, they were 14 percent more likely to consume fruits and vegetables and 50 percent more likely to engage in 30 minutes or more of physical activity.

The results appear in the Journal of Adolescent Health.

According to Small, the researchers did not document the content of the conversations between students and their parents; therefore, they do not know why the conversations had such positive effects on students’ behaviors.

“It is likely that communication with parents has both direct and indirect effects on college students’ eating and physical activity behaviors,” said Small.

“Parents may directly remind students to eat a variety of healthy foods and engage in physical activity. Indirectly, communication with parents may remind students someone cares about their health and well-being, and that may motivate them to take better care of themselves.”

Source: Penn State

College student with her mother photo by shutterstock.

Long-Term Use of Pain Meds Linked to Erectile Dysfunction

2013-05-16T11:13:38Z

Eighty percent, if not more, of the public has experienced back pain. Despite the best technology, the latest in surgical practices and the most advanced rehabilitative techniques, pain may persist, compromising sleep and in some cases, helping bring on depression.

To combat the pain, some individuals resort to taking prescription painkillers on a regular basis. The medications are often opioids, and, in a new research study, these are found to be associated with a higher risk of erectile dysfunction (ED) in men.

In a study published online in the journal Spine, researchers reviewed the health records of more than 11,000 men with back pain to find out if men taking prescription painkillers were more likely to also receive prescriptions for testosterone replacement or ED medications.

More than 19 percent of men who took high-dose opioids for at least four months also received ED prescriptions, while fewer than 7 percent of men who did not take opioids received ED prescriptions.

In the study, men over 60 were much more likely to receive ED prescriptions, but even after researchers adjusted for age and other factors, men taking high-dose opioids were still 50 percent more likely to receive ED prescriptions than men who did not take prescription painkillers.

“Men who take opioid pain medications for an extended period of time have the highest risk of ED,” said lead author Richard A. Deyo, M.D., M.P.H., investigator with the Kaiser Permanente Center for Health Research.

“This doesn’t mean that these medications cause ED, but the association is something patients and clinicians should be aware of when deciding if opioids should be used to treat back pain.” Deyo added.

Opioid use is growing in the United States as the Centers for Disease Control reports prescription opioid sales quadrupled between 1999 and 2010.

Another recent survey, published in the journal Pain, estimates 4.3 million adults in the U.S. use these opioid medications on a regular basis. The most commonly used prescription opioids are hydrocodone, oxycodone, and morphine.

“There is no question that for some patients opioid use is appropriate, but there is also increasing evidence that long-term use can lead to addiction, fatal overdoses, sleep apnea, falls in the elderly, reduced hormone production, and now erectile dysfunction,” said Deyo, who has spent more than 30 years studying treatments for back pain.

For this study, Deyo and colleagues identified 11,327 men in Oregon and Washington enrolled in the Kaiser Permanente health plan who visited their doctors for back pain during 2004. The researchers examined the men’s pharmacy records for six months before and after the back pain visit to find out if they had filled prescriptions for opioids and for ED or testosterone replacement.

Opioid use was categorized as “none” for men who did not receive a prescription for opioids; “acute” for men who took opioids for three months or less; “episodic” for men who took opioids for more than three months, but less than four months and with fewer than 10 refills; and “long-term” for men who took opioids (a) for at least four months or (b) for more than three months with 10 or more refills. Anything more than 120 mg of morphine equivalent was categorized as high-dose use.

More than 19 percent of the men who took high-dose opioids for at least four months also received ED medications or testosterone replacement. More than 12 percent of men who took low-dose opioids (under 120 mg) for at least four months also received ED medications or testosterone replacement. Fewer than 7 percent of men who didn’t take opioids received ED medications or testosterone replacement.

Researchers found that age was the factor most significantly associated with receiving ED prescriptions. Men 60 to 69 were 14 times more likely to receive prescriptions for ED medication than men 18 to 29.

Depression, other health conditions (besides back pain), and use of sedative hypnotics like benzodiazepines also increased the likelihood that men would receive ED prescriptions.

But even after researchers adjusted for these factors, long-term opioid use increased the likelihood of also receiving prescriptions for ED medication by 50 percent.

Source: Kaiser Permanente

Cure worse than the problem pill bottle photo by shutterstock.

More Sleep Lowers Suicide Risk For Insomniacs

2013-05-16T11:12:57Z

A lack of sleep can literally be a killer as people with insomnia are more apt to initiate suicidal actions.

A new study suggests helping people with insomnia get more sleep significantly reduces the thoughts of suicide.

Specifically, researchers discovered that every one-hour increase in sleep duration was associated with a 72 percent decrease in the likelihood of moderate or high suicide risk.

The federal Centers for Disease Control and Prevention report suicide is the 10th leading cause of death in the U.S., accounting for more than 38,000 deaths each year. More people now die of suicide than in car accidents.

Moreover, difficulty with sleep is common in American society as about 10 to 15 percent of adults have an insomnia disorder with distress or daytime impairment.

“We were surprised by the strength of the association between sleep duration and suicide risk,” said primary author Linden Oliver, M.A., clinical research coordinator for the University of Pennsylvania Behavioral Sleep Medicine Research Program.

“A 72 percent decrease in the likelihood of moderate or high suicide risk with a one-hour increase in sleep is interesting given the small sample size.”

The research abstract has been published in an online supplement of the journal SLEEP.

For the study, researchers merged data from two studies of insomnia capturing 471 individuals. Seventy-three indicated suicide risk with 55 classified as low suicide risk and 18 were classified as moderate or high risk.

Experts say that sleep loss is associated with depression, executive dysfunction and poor decision-making. However, few studies have investigated the role of short sleep duration in suicidal ideation.

“These results further highlight the importance of obtaining adequate amounts of sleep,” said Oliver.

Source: American Academy of Sleep Medicine

Prayer Can Facilitate Forgiveness

2013-05-16T11:41:05Z

New research suggests prayer can be a powerful agent to aid relationship reconciliation.

Florida State University researchers found that praying for a romantic partner or close friend can lead to more cooperative and forgiving behavior toward the partner.

Experts say the findings are the first in which the partners who are the subject of the prayers reported a positive change in the behavior of the person who prayed, said Frank D. Fincham, Ph.D., director of the Florida State University Family Institute.

“My previous research had shown that those who prayed for their partner reported more prosocial behavior toward their partner, but self-reports are subject to potential biased reporting,” Fincham said.

“This set of studies is the very first to use objective indicators to show that prayer changed actual behavior, and that this behavior was apparent to the other partner, the subject of the prayer.”

Moreover, objective observers found those who engaged in partner-focused prayer exhibited more positive behavior toward their partners compared to those who did not pray for their partner.

The paper is published in the journal Personal Relationships.

Authors report on the results of five separate studies in the paper. Each study was designed to find out whether partner-focused prayer shifted individuals toward cooperative behaviors and tendencies both over time and in the immediate aftermath of hurtful behavior.

Among the findings:

Participants who prayed more frequently for their partner were rated as less vengeful in discussing something the partner had done to upset or annoy them;
The partners of participants who prayed for them noticed more forgiving behavior than the partners of participants who were assigned to set aside time each day to think positive thoughts about them;
Participants assigned to pray following a partner’s hurtful behavior were more cooperative with their partners compared to participants assigned to engage in thinking about God;
Participants who prayed for a close relationship partner on days in which conflict occurred reported higher levels of cooperative tendencies and forgiveness than on days when conflict occurred and they did not pray.

“These findings highlight the potential benefit of using partner-focused prayer, where culturally appropriate, in clinical settings or in relationship education programs,” the researchers wrote.

Although the study was designed to evaluate relationship education and couples therapy for religious clients, researchers say the findings may also help clarify the types of interventions that might be developed for nonreligious couples.

That is, interventional techniques could increase cooperation in order to facilitate forgiveness across the board, regardless of religiosity.

For the studies, participants were undergraduate college students who indicated they were comfortable with prayer and praying for others.

Additional research is needed on older, more mature or more ethnically diverse couples to ensure that the effects of partner-focused prayer is not limited to young adult relationships, researchers said.

Until recently, social scientists have stayed away from studying religion, spirituality and especially prayer, Fincham said, despite the fact that some 5 billion people, or about 75 percent of the world’s population, profess some religious faith.

“In the United States, some 90 percent of people say that they pray at least occasionally, and prayer is a form of spiritual activity common to all the Abrahamic traditions, including Judaism, Christianity and Islam, with strong parallels in other religious traditions, such as Buddhism, Hinduism, and Shinto,” said Fincham.

“Yet we know very little about its role in romantic relationships. This is the first time that objective indicators have documented the impact of prayer in such relationships.”

Source: Florida State University

Woman praying photo by shutterstock.

Upbeat Music Helps Improve Mood

2013-05-16T11:35:36Z

Although the notion of listening to music to improve mood may not come as a surprise, researchers at the University of Missouri found that an individual can indeed successfully try to be happier, especially when cheery music aids the process.

Experts say the study highlights that people can actively improve their mood if the process is gone about in the correct manner.

“Our work provides support for what many people already do – listen to music to improve their moods,” said lead author Yuna Ferguson, Ph.D.

“Although pursuing personal happiness may be thought of as a self-centered venture, research suggests that happiness relates to a higher probability of socially beneficial behavior, better physical health, higher income and greater relationship satisfaction.”

In two studies by Ferguson, participants successfully improved their moods in the short term and boosted their overall happiness over a two-week period.

During the first study, participants improved their mood after being instructed to attempt to do so, but only if they listened to the upbeat classical music of Copland, as opposed to the more somber Stravinsky.

Other participants, who simply listened to the music without attempting to change their mood, also didn’t report a change in happiness.

In the second study, participants reported higher levels of happiness after two weeks of lab sessions in which they listened to positive music while trying to feel happier, compared to control participants who only listened to music.

However, Ferguson noted that for people to put her research into practice, they must be wary of too much introspection into their mood or constantly asking, “Am I happy yet?”

“Rather than focusing on how much happiness they’ve gained and engaging in that kind of mental calculation, people could focus more on enjoying their experience of the journey towards happiness and not get hung up on the destination,” said Ferguson.

Ferguson’s work corroborated earlier findings by co-author of the current study, Kennon Sheldon, Ph.D., professor of psychological science.

“The Hedonic Adaptation Prevention model, developed in my earlier research, says that we can stay in the upper half of our ‘set range’ of potential happiness as long as we keep having positive experiences, and avoid wanting too much more than we have,” said Sheldon.

“Yuna’s research suggests that we can intentionally seek to make mental changes leading to new positive experiences of life. The fact that we’re aware we’re doing this has no detrimental effect.”

The study is published in The Journal of Positive Psychology.

Source: University of Missouri

Happy woman listening to music photo by shutterstock.

Personality Changes Associated with Weight Gain

2013-05-16T11:06:38Z

A new study looks at the relationship between fluctuations in body weight and personality traits.

Florida State University researchers discovered people who gain weight are more likely to give in to temptations but also are more thoughtful about their actions.

The study is published in Psychological Science.

To understand how fluctuations in body weight might relate to personality changes, Angelina Sutin, Ph.D., and colleagues at the National Institutes of Health (NIH) examined data from two large-scale longitudinal studies of Baltimore residents.

“We know a great deal about how personality traits contribute to weight gain,” said Sutin.

“What we don’t know is whether significant changes in weight are associated with changes in our core personality traits. Weight can be such an emotional issue — we thought that weight gain may lead to long-term changes in psychological functioning.”

Researchers used the Baltimore Longitudinal Study of Aging (BLSA), and the Baltimore Epidemiologic Catchment Area (ECA) study, to review more than 1,900 people of all ages and socioeconomic levels.

Data about participants’ personality traits and their body weight were collected at two time points separated by nearly a decade.

In one study, a clinician measured participants’ weight at the two time points; in the other study, the participants reported their weight at baseline and had it measured by a clinician at follow-up.

Sutin and colleagues found that participants who had at least a 10 percent increase in body weight showed an increase in impulsiveness — with a greater tendency to give in to temptations — compared to those whose weight was stable.

While the study is not an experimental design to evaluate cause and effect, or whether increased impulsiveness is a cause, or an effect, of gaining weight – researchers say the findings suggest an intimate relationship between a person’s physiology and his or her psychology.

Researchers were surprised to find that people who gained weight also reported an increase in deliberation, with a greater tendency to think through their decisions.

Deliberation tends to increase for everyone in adulthood, but the increase was almost double for participants who gained weight compared to those whose weight stayed the same.

“If mind and body are intertwined, then if one changes the other should change too,” she said. “That’s what our findings suggest.”

Sutin and colleagues speculate that this increase in deliberation could be the result of negative feedback from family or friends — people are likely to think twice about grabbing a second slice of cake if they feel that everyone is watching them take it.

These findings suggest that even though people who gain weight are more conscious of their decision-making, they may still have difficulty resisting temptations.

“The inability to control cravings may reinforce a vicious cycle that weakens the self-control muscle,” the researchers note.

“Yielding to temptation today may reduce the ability to resist cravings tomorrow. Thus, individuals who gain weight may have increased risk for additional weight gain through changes in their personality.”

Source: Florida State University

Woman on weight scales photo by shutterstock.

Flu While Pregnant May Quadruple a Child’s Risk of Bipolar

2013-05-15T12:08:45Z

A new study funded by the National Institutes of Health discovers a pregnant mothers’ exposure to the flu may have extreme mental health consequences for the child.

If the mother contracts the flu, the child has a nearly four-fold increased chance of developing bipolar disorder in adulthood, say researchers.

The findings add to mounting evidence of possible shared underlying causes and illness processes with schizophrenia, which some studies have also linked to prenatal exposure to influenza.

“Prospective mothers should take common sense preventive measures, such as getting flu shots prior to and in the early stages of pregnancy and avoiding contact with people who are symptomatic,” said Alan Brown, M.D., M.P.H, of Columbia University.

“In spite of public health recommendations, only a relatively small fraction of such women get immunized. The weight of evidence now suggests that benefits of the vaccine likely outweigh any possible risk to the mother or newborn.”

Brown and colleagues reported their findings online in the journal JAMA Psychiatry.

Although researchers have suspected a linkage between maternal influenza and bipolar disorder, the new study is the first to prospectively follow families using physician-based diagnoses and structured standardized psychiatric measures.

The research was made possible by use of comprehensive electronic medical records by Kaiser-Permanente, in association with county and Child Health and Development Study databases.

This shared health care data repository allowed the evaluation of more cases with detailed maternal flu exposure information than in previous studies.

Among nearly a third of all children born in a northern California county during 1959-1966, researchers followed, 92 who developed bipolar disorder, comparing rates of maternal flu diagnoses during pregnancy with 722 matched controls.

The nearly fourfold increased risk implicated influenza infection at any time during pregnancy, but there was evidence suggesting slightly higher risk if the flu occurred during the second or third trimesters.

Moreover, the researchers linked flu exposure to a nearly six-fold increase in a subtype of bipolar disorder with psychotic features.

Prior research suggested a threefold increased risk for schizophrenia associated with maternal influenza during the first half of pregnancy.

Autism has similarly been linked to first trimester maternal viral infections and to possibly related increases in inflammatory molecules.

“Future research might investigate whether this same environmental risk factor might give rise to different disorders, depending on how the timing of the prenatal insult affects the developing fetal brain,” suggested Brown.

Bipolar disorder shares with schizophrenia a number of other suspected causes and illness features, the researchers note.

For example, both share onset of symptoms in early adulthood, susceptibility genes, run in the same families, affect nearly one percent of the population, show psychotic behaviors and respond to antipsychotic medications.

Source: NIH/National Institute of Mental Health