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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]  

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.

Recent research: half a dozen studies on cognitive therapy

Here are half a dozen recent studies involving cognitive therapy (CBT).  The first by Craigie et al explores the use of mindfulness-based cognitive therapy (MBCT) to treat generalized anxiety disorder (GAD).  Although, as one would expect, MBCT helped GAD sufferers, it was noteworthy that results "fall well short of outcomes achieved by past research".  This adds to my concern that mindfulness training may at times be being over-hyped - see a blog I wrote in September for for more on this.  The next study by Cuijpers et al also suggests limitations to the march of CBT with interpersonal psychotherapy looking a somewhat better candidate for prevention of depression onset.  I guess one could argue that CBT can - and probably more often should - include  behavioural interventions to promote improved relationships.  Click here for tools that can help this approach.   The third piece of research by Grey et al is exciting.  It challenges the Alice in Wonderland dodo bird suggestion that "everyone has won, and all must have prizes"

Recent research: egosystem & ecosystem

In the end the love you take is equal to the love you make.   Beatles

This is essentially the Beatles closing statement. It is the last lyric on the last album they recorded.
(Let It Be was the last album they released, but it was recorded earlier).

Recent research: fish and n-3 fatty acids

Fish, fish oils, and n-3 fatty acids are often in the health news.  Here are seven recent papers illustrating the breadth of fish oil relevance.  The papers look at treatment of rheumatoid arthritis, the potential of flax as a dietary source of n-3 fatty acids, effects on indicators of cardiovascular disease, potential protection against dementia, reduction in mortality, and importance in pregnancy.  The papers also illustrate the patchwork, three steps forward/one step back, meandering, spreading, accretion of scientific knowledge.  As the proverb goes "One swallow doesn't make a summer".  Similarly, a single research study is usually simply one brick in the gradual building of our knowledge.  For more on fish and n-3 fatty acids, see other relevant blog posts I've written, articles in the linked Connotea database, and some recommended websites.     

Recent research: mothers, children & depression

Here are five recent papers on mothers, families, children and depression.  The first is a freely viewable editorial by Markowitz which begins with a quote from the Aeneid "I cannot bear a mother's tears".  Markowitz looks at evidence demonstrating the importance of both nature (genetic risk) and nurture (effects of the mother-child relationship and other environmental factors) on psychological outcomes.  The second paper is a good overview of postnatal depression by Musters et al.  Unfortunately the full text is only viewable if you are a BMJ subscriber or if you pay for the article (or contact the authors).  The third study looks at the benefits for children of effective treatment for maternal depression.  The fourth paper - a freely viewable editorial by Reiss - looks both at the effects of maternal depression on children and the effects of children's psychological symptoms on mothers.  The fifth study is unusual and interesting as it compares the effects of parental depression on both nonadopted and on adopted children.

Markowitz, J. C. (2008). "Depressed Mothers, Depressed Children." Am J Psychiatry 165(9): 1086-1088. [Free Full Text]

Handouts & questionnaires for “outcomes toolkit” (IAPT)

The "Improving Access to Psychological Therapies" (IAPT) initiative is very ambitious and exciting.  It states its principal aim is to support English Primary Care Trusts in implementing "National Institute for Health and Clinical Excellence" (NICE) guidelines for people suffering from depression and anxiety disorders.  IAPT go on to say that "At present, only a quarter of the 6 million people in the UK with these conditions are in treatment, with debilitating effects on society."

One aspect of this carefully planned initiative is strong encouragement to assess and monitor the progress of those who are getting help.  Visiting the IAPT "Outcomes Toolkit and FAQ" web page provides access to several freely downloadable documents.  The emphasis is on good assessment measures that are free to use.  See below:

IAPT Outcomes Toolkit 2008/9 PDF - this 81 page 1.1Mb Adobe PDF is the September 08 version with amended IAPT Paper Based Data Set Questionnaires.

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