A couple of interesting, helpful websites

Here are a couple of very interesting, helpful websites that I've been reminded of recently.  They illustrate in a fun way the diversity and possibilities of the internet.

Time to change: let’s challenge mental health discrimination

On 26th January the BMJ reported on the new £18 million Time to Change campaign  " ... to tackle the discrimination and stigma that surrounds mental health ... The Time to Change initiative is funded by Comic Relief and the National Lottery. Its aim is to tell the public that it is no longer acceptable to discriminate against people with a mental illness ... The campaign's website gives details of what can be done to help people with a mental illness and how to run a local campaign to support national initiatives ... The campaign says that mental illness is one of the last taboos and that shame and stigma can stop people seeking help. It highlights the fact that mental illness is far more common than people realise with one in four people experiencing a mental health problem at some time in their life. And it promotes the message that it is possible to help people with a mental heath problem by being there for them and not cutting them out of your life ... The campaign is based on similar national initiatives in New Zealand and Scotland.

Recent research: half a dozen papers relevant to psychotherapy

Here are half a dozen papers relevant to psychotherapy.   The first two throw some light on the question of whether it matters which form of established psychotherapy one uses to treat a particular depression sufferer - bearing in mind Cuijpers et al's recent meta-analysis suggesting that " ...

Recent research: six studies on prevalence of depression & anxiety, and risk factors for depression, bipolar disorder & suicide

Here are a couple of studies on the prevalence of depression and anxiety, and four on risk factors for depression, bipolar disorder and suicide.  Strine et al report on a major survey of depression and anxiety in the United States.  They found "The overall prevalence of current depressive symptoms was 8.7% (range by state and territory, 5.3%-13.7%); of a lifetime diagnosis of depression, 15.7% (range, 6.8%-21.3%); and of a lifetime diagnosis of anxiety, 11.3% (range, 5.4%-17.2%)."  Smoking, lack of exercise, and excessive drinking were all associated with increased likelihood of mental disorders, as too was physical ill health.  Young et al, in a separate study, looked at the likelihood of depression and anxiety becoming persistent.  They estimated - at nearly 3 year follow-up - that the US prevalence of persistent depressive or anxiety disorder was 4.7%.  Only about a quarter of these sufferers were using appropriate medication and only about a fifth appropriate counselling.

Recent research: two papers on mindfulness & four on sleep

Here are two papers on mindfulness and four on sleep.  The Kuyken et al paper is important.  It compares mindfulness-based cognitive therapy (MBCT) with continuation antidepressants in the prevention of relapse in recurrent depression.  The results are great - "Relapse/recurrence rates over 15-month follow-ups in MBCT were 47%, compared with 60% in the m-ADM (maintenance antidepressant) group (hazard ratio = 0.63; 95% confidence interval: 0.39 to 1.04).  MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains."  I have been cautious in my enthusiasm for MBCT (see previous post) but this is exactly the kind of research that we need to help clarify MBCT's potential further.  The second paper on mindfulness is lower key.  It is a mention of its potential in enhancing sexuality.  It makes sense - see last month's posts on the effects of meditation training on experiencing positive emotions - but the relevant research is still in its early stages. 

Recent research: mind-body & body-mind effects for cancer, allergy, dementia, & mental health

Here are five studies on the loose theme of how the mind affects the body, and the body affects the mind ... and that the distinction between mind and body is pretty arbitrary anyway.  Using meta-analysis, Chida & colleagues highlight considerable evidence suggesting that stress-related psychosocial factors have an adverse effect on cancer incidence and survival.  Andersen & colleagues report a randomized controlled trial to respond to this in women diagnosed with breast cancer.  Women in the stress management arm of the study received an initial one-year, 26 session intervention in groups of 8 to 12 people.  The aim was to reduce distress and improve quality of life, improve health behaviors (diet, exercise, smoking cessation), and facilitate cancer treatment compliance and medical follow-up.

Recent research: six studies on depression – bereavement, pregnancy, bipolar disorder, suicide, & stress in hospital staff

Five of these six studies are from last month's American Journal of Psychiatry.  Kendler et al discuss the many similarities and only occasional differences between bereavement-related and other life event-related depression - an issue explored further in Maj's editorial.  Li et al show that depression in pregnancy (exacerbated further by stressful life events and obesity) increases the risk of preterm delivery.  Miklowitz reviews research on the value of adjunctive psychotherapy for bipolar disorder sufferers (already taking medication) and discusses the various ways it can be helpful.  Oquendo et al (in a freely viewable editorial) argue that suicidal behaviour should be placed on a "separate axis" in the next version of the DSM diagnostic system.  Finally Vertanen et al, in an interesting study, demonstrate that increased hospital overcrowding - measured by bed occupancy rates - is associated with increased use of antidepressants by hospital staff.

Kendler, K. S., J. Myers, et al. (2008). "Does Bereavement-Related Major Depression Differ From Major Depression Associated With Other Stressful Life Events?" Am J Psychiatry 165(11): 1449-1455.  [Abstract/Full Text]  

Barbara Fredrickson’s recent research study on loving-kindness meditation (first post)

I've just been reading the recent paper by Barbara Fredrickson and colleagues "Open hearts build lives: Positive emotions, induced through loving kindness meditation, build consequential personal resources" (Fredrickson, Cohn et al.

Recent research: seven studies on diet, supplements & smoking

Here are a couple of studies on smoking, a couple on B vitamins, a couple on vitamin D, and an intriguing study on iron.  The smoking papers underline the varieties of damage this habit produces.  So the Pasco et al study shows that, for women, being a smoker is associated with double the risk of developing subsequent major depression.  The Strandberg research challenges any notion of "Eat, drink and be merry for tomorrow we die".  This study of 1658 men reports that "During the 26-year follow-up of this socioeconomically homogeneous male cohort, HRQoL (quality of life) deteriorated with an increase in daily cigarettes smoked in a dose-dependent manner.

Handouts & questionnaires for problem solving & behavioural activation

Here are a series of forms, questionnaires and handouts that I use regularly in my work.  The problem solving diagram is a recurring theme - both at the start of therapy and as a sheet to return to when reviewing and considering additional therapeutic options.  Other sheets are classic variants on the tools used by many cognitive behavioural therapists - with occasional alternatives and additions, that I've come up with over the years, thrown in as well.

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