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Recent research: six papers with broad social implications – inequality, health insurance, spanking, bullying, and religion

Here are half a dozen recent research papers with broad social implications (all details & abstracts to these studies are given further down this blog posting).  Kay and colleagues publish on "Inequality, discrimination, and the power of the status quo: Direct evidence for a motivation to see the way things are as the way they should be."  They report four studies showing how widely this motivation acts - with political power, public funding, gender demographics, and in attacks on those who are trying to work for change.  There's relevance here to the second paper by Wilper et al on "Health Insurance and Mortality in US Adults" estimating that, even after adjusting for income, education, health status, weight, exercise, smoking and alcohol use, lack of insurance was associated with about 45,000 excess deaths annually in the United States among people aged 18 to 64.  Still in the area of inequality and discrimination, Wexler et al publish on

The health professions: selfless vocation or well-paid career?

The overlap between money and the health professions seems to involve a complex, multi-faceted set of issues.  I was triggered into thinking about this by the coincidence of three events.  One was a conversation at the recent annual BABCP psychotherapy conference, a second was reading Lewis Hyde's book "The gift", and the third was struggling to pay my most recent tax bill.

Recent research: six articles on wellbeing – meaning in life, reappraisal, positive emotions, and neighbourliness

Here are six research articles (see below for abstracts and links) loosely falling into the overall area of wellbeing.  Boyle, Barnes et al report on the association between purpose in life and mortality in older people.  They found that greater purpose in life was associated with considerably reduced mortality even when allowing for a series of possible confounders like depressive symptoms, disability, neuroticism, the number of chronic medical conditions, and income.  Also showing benefits for purpose and meaning, Maselko, Gilman, et al looked at religious involvement in the USA and and its associations with psychological health - specifically links between high, medium and low tertiles (dividing the study population into thirds) of spiritual well-being and religious service attendance and lifetime risk of depression. They found that "Religious service attendance was associated with 30% lower odds of depression. In addition, individuals in the top tertile of existential well-being had a 70% lower odds of depression compared to individuals in the bottom tertile. Contrary to our original hypotheses, however, higher levels of religious well-being were associated with 1.5 times higher odds of depression".

Recent research: five papers on depression, stigma, biology, & extending the reach of psychotherapy

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.     

“Antidepressants are not all created equal”

Cipriani and colleagues published a major multiple-treatments meta-analysis of new generation antidepressants last week - see abstract below.  As Parikh wrote in his linked editorial (see below) "Andrea Cipriani and colleagues provide the field with a major answer.  Free of any potential funding bias (and including an analysis of studies based on pharmaceutical-company sponsorship), these researchers used a newer methodology, multiple treatments meta-analysis, to examine 117 head-to-head randomised trials in almost 26 000 patients ... Of 12 newer antidepressants, four emerged as superior in efficacy: escitalopram, mirtazapine, sertraline, and venlafaxine ... In terms of acceptability, four agents were better tolerated: bupropion, citalopram, escitalopram, and sertraline.  Balancing efficacy and acceptability and lower drug costs, the researchers concluded that sertraline might be particularly appropriate as a first-choice treatment ... "  This is superbly useful information.  Parikh's editorial goes on to raise helpful queries about next step questions, however Cipriani et al have done antidepressant prescribers and users a major service with this very important paper.

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.

Some interesting articles from February ‘08

Here are details and links for a couple of dozen mainly February articles that I found interesting. Most of these articles (and many others) are also listed on my searchable Connotea online database.

Barbui, C. M. D., T. A. M. D. Furukawa, et al. (2008). "Effectiveness of paroxetine in the treatment of acute major depression in adults: a systematic re-examination of published and unpublished data from randomized trials." CMAJ 178(3): 296-305. [Abstract/Full Text]
Blakely, T., M. Tobias, et al. (2008). "Inequalities in mortality during and after restructuring of the New Zealand economy: repeated cohort studies." BMJ 336(7640): 371-375. [Abstract/Full Text]
Bradley, R. G., E. B. Binder, et al. (2008). "Influence of Child Abuse on Adult Depression: Moderation by the Corticotropin-Releasing Hormone Receptor Gene." Arch Gen Psychiatry 65(2): 190-200. [Abstract/Full Text]

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