A recent article in the British Medical Journal (Kmietowicz 2009) reports that "The chief medical officer for England has called for a minimum price of 50 pence (0.54; $0.70) to be charged for a unit of alcohol to reduce excessive drinking and its associated harms.  Liam Donaldson said that antisocial drinking should be targeted in the same way as smoking in public places so that being drunk is no longer an aim or socially acceptable.  ‘England has a drink problem and the whole of society bears the burden,' said Professor Donaldson at the launch of his 2008 annual report. ‘The passive effects of heavy drinking on innocent parties are easily underestimated and frequently ignored. The concept of passive drinking and the devastating collateral effect that alcohol can have on others must be addressed on a national scale.'  He said that evidence shows that price and access are the two key factors that can help to change drinking habits, as they were for tobacco."  

This set of five papers documents, in part, our mixed viewpoints on depression.  Worryingly, Mehta & colleagues show deteriorating public attitudes towards mental illness in England (and to a lesser extent Scotland) between 1994 and 2003.  Meanwhile Blumner et al demonstrate a shift towards a more biological view on causes and treatment of depression in the US between 1996 and 2006.

In contrast, Miranda et al's editorial (and Grote et al's research) highlight the growing evidence showing psychotherapies for depression can be "very effective for low-income and minority populations in the United States and abroad" - extending their validity well beyond more privileged groups in developed countries.  Andersson too discusses a further way to make psychotherapies more widely available and helpful - in this case, the increasing literature documenting the widespread value of delivering cognitive behavioural therapy via the internet.     

On 26^th 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.

The SIGN draft guideline day on "Non-pharmacological management of mild to moderate depression" last Wednesday continued with two further presentations in this first section on "Lifestyle and Alternative/Complementary Therapies 1".  After the "grade A" recommendations on exercise and St John's Wort given during the first two presentations (covered in the two previous blog posts), the rest of this section felt a bit of an anticlimax.

This is the third in a series of blog posts on last Wednesday's SIGN draft guideline seminar on "Non-pharmacological management of mild to moderate depression."  The first session of the day was on "Lifestyle and Alternative/Complementary Therapies 1".  Yesterday's blog discussed the first presenter, Ian Ross's talk on the value of exercise in depression.  The second presentation was by Cliff Sharp, a psychiatrist from NHS borders.  He reviewed St John's Wort & Dietary Supplements.  He talked about the possible value of folate in treating depression when used to supplement conventional antidepressants.  He concluded that current evidence was insufficient to determine whether folate boosts response for those on antidepressants only if their initial folate levels are low, or whether it boosts response for anyone taking antidepressants.  See an

There are a series of interesting recent research studies here highlighting the drastic reduction in physical exercise taken by young people as they move into their teenage years, the fascinating pro

Modest alcohol intake seems pretty harmless and maybe even does a bit of good healthwise. However last month's editorial (Gilmore and Sheron 2007) in the Christmas edition of the British Medical Journal drummed in points it's important to remember.