The study also showed MBCT to be as cost-effective as prescription drugs in helping people with a history of depression stay well  long-term.

The randomized control trial involved 123 people from urban and rural locations who had suffered repeat depressions and were referred to the trial by their GPs.

The participants were split randomly into two groups. Half continued their ongoing antidepressant drug treatment and the rest participated in an MBCT course and were given the option of coming off antidepressants.

Over the 15 months after the trial, 47 percent of the group following the MBCT course experienced a relapse compared with 60 percent of those continuing their normal treatment, including antidepressant drugs.

In addition, the group on the MBCT program reported a higher quality of life, in terms of their overall enjoyment of daily living and physical well-being.

Members of the study team from the Institute of Psychiatry, King’s College London also compared the cost of providing MBCT programs with the cost of maintenance antidepressant treatment.

The findings suggest that MBCT provides a cost-effective alternative to antidepressant drugs.

Unlike most other psychological therapies, MBCT can be taught in groups by a single therapist, and patients then continue to practice the skills they have learned at home by themselves.

Therefore, MBCT is less costly than individual treatments and is not dependent on having the large number of trained therapists needed for one-to-one psychological treatment.  It could help the National Health Service shorten its waiting lists for psychological therapies.

During the eight-week trial, groups of between eight and fifteen people met with one therapist. They learned a range of meditation exercises that they could continue to practice on their own once the course ended.

Many of the exercises were based on Buddhist meditation techniques and helped the individual take time to focus on the present, rather than dwelling on past events, or planning for future tasks.

The exercises worked in a different way for each person, but many reported greater acceptance of, and more control over, negative thoughts and feelings.

Professor Willem Kuyken of the University of Exeter said: “Anti-depressants are widely used by people who suffer from depression and that’s because they tend to work.

“But, while they’re very effective in helping reduce the symptoms of depression, when people come off them they are particularly vulnerable to relapse. MBCT takes a different approach – it teaches people skills for life. What we have shown is that when people work at it, these skills for life help keep people well.”

Professor Kuyken continues: “Our results suggest MBCT may be a viable alternative for some of the 3.5 million people in the UK known to be suffering from this debilitating condition.

“People who suffer depression have long asked for psychological approaches to help them recover in the long-term and MBCT is a very promising approach. I think we have the basis for offering patients and GPs an alternative to long-term anti-depressant medication. We are planning to conduct a larger trial to put these results to the test and to examine how MBCT works.”

MBCT was developed by a team of psychologists from Toronto (Zindel Segal), Oxford (Mark Williams) and Cambridge (John Teasdale) in 2002 to help people who suffer repeated bouts of depression.

It focuses on targeting negative thinking and aims to help people who are very vulnerable to recurring depression stop depressed moods from spiraling out of control into a full episode of depression. MBCT is becoming more widely available as part of psychological treatment services in the NHS.

Source: University of Exeter

The retrospective study examined the medical records of 407 patients with strabismus (misaligned eyes) and compared them with records of children matched for age and sex but with normal eye alignment.

Children with eyes that diverged (exotropia) were three times more likely to develop a psychiatric disorder than were the control subjects, while those with inward deviating eyes (esotropia) showed no increase in the incidence of mental illnesses.

Brian Mohney, M.D., the Mayo Clinic pediatric ophthalmologist who led the study, says the results can help alert physicians to potential problems in their pediatric patients.

“Pediatricians and family practice physicians who see children with strabismus should be aware of the increased risk of mental illness,” says Dr. Mohney.

“They can hopefully be alert to the earliest signs of psychiatric problems in patients with exotropia, so they can consider having them seen by a psychologist or psychiatrist.”

Strabismus is a misalignment of the eyes that affects three to five percent of children, and about 125,000 new cases are diagnosed each year in the United States.

Further information about the study, including a video interview with Dr. Mohney describing the findings and how the study was prompted by a medical student’s observation, is available on the Mayo Clinic News Blog at: http://newsblog.mayoclinic.org/2008/11/25/eye-divergence-triples-mental-illness-risk/

Source: Mayo Clinic

The report cites excessive workloads, cost cutting, a hostile work environment and competing role demands as causing the stress.

The study was based on a survey of over 1,000 registered nurses and personal care workers in Victoria last year.

University of Melbourne researchers Associate Professor Leisa Sargent, Professor Bill Harley and Ms Belinda Allen say the study also reveals that long-term or aged care facilities need to drastically improve their training and human resource management.

“Facilities that provide more training, have rigorous recruitment, selection and performance management practices and developed grievance procedures benefit from staff who have a more positive attitude toward their work and better physical and mental health outcomes.

“Workers at these facilities also reported that the quality of care provided for residents was better than workers at facilities where there were poor human resource management practices and high levels of cost cutting in relation to staffing levels. In particular having fewer residents for each nurse to care for was associated with less frequent medication errors.”

Associate Professor Sargent says current Commonwealth funding arrangements for nursing homes, introduced in 1997, have placed pressure on operators to cut costs.

“The rapidly-ageing population in Australia is placing an unprecedented strain on aged-care provision and it seems likely this pressure will continue in coming years,” she says.

“This pressure is likely to further damage the quality of working life for staff and undermine resident care.”

Source: University of Melbourne

“We discovered that people who are able to find meaning and purpose in their work, and can see how they make a difference through that work, are healthier, happier and more productive employees,” said Val Kinjerski, a University of Alberta Ph.D graduate who co-authored the study and now works with organizations to cultivate productive workplaces.

The study focused on two groups of long-term health-care workers from two different care facilities in Canada. One group of 24 employees attended a Spirit at Work one-day workshop, followed by eight weekly booster sessions offered at shift changes.

The workers were led through a variety of exercises designed to help staff create personal action plans to enhance spirit at work. They were asked to consider concepts like the deeper purpose of their work, being of service, appreciation of themselves and others, sense of community and self-care.

The second group of 34 workers was offered no support program.

The result for the intervention group was a 23 percent increase in teamwork, a 10 percent hike in job satisfaction and a 17 percent jump in workplace morale.

In addition, employer costs related to absenteeism were almost $12,000 less for the five months following the workshop than for the same period in the previous year. The employees also showed an increased interest in and focus on their patients, Kinjerski said.

“They really had a sense of what they were there to do, to be of service to their clients. This notion of being of service is important in all work, but in the field of long-term health care, it is of utmost importance.”

Ultimately, the findings will aid employers in retaining and fostering a happier, more motivated workforce, said Berna Skrypnek, a human ecology professor at the U of A and co-author of the study.

“This has become a leading concern in the long-term health-care field and for that matter, in any field, as labor markets become tighter and employees are demanding meaning and fulfillment from their work.”

The results were published recently in the Journal of Gerontological Nursing.

Source: University of Alberta

Saint Louis University psychiatrist George Grossberg, M.D., has seen an increase in economy-related anxiety.

“The anxiety and worry are immense. It is affecting millions and millions of people, especially those who were looking forward to a comfortable retirement,” said Grossberg.

Grossberg, who directs Saint Louis University’s geriatric psychiatry program, notes that in many cases, older adults respond well in a crisis, drawing on a lifetime of experience.

For example, after September 11, seniors often had a less impulsive, more measured response than did younger people. In today’s economic crisis, however, older adults have the most to lose financially and a sense of what a true economic depression can look like.

Retirees who have planned to rely on investments are hit hardest by financial downturns, but they may also have less obvious reasons for their fears. For some, the worry extends beyond retirement funds to a general and sometimes intangible sense of unease.

“I’ve had patients who are themselves financially secure talk about their anxiety for society as a whole or their worry that there may be unprecedented problems, like civil unrest,” said Grossberg.

The constant drumbeat of bad economic news and promises of worse to come can be stressful for everyone. For those who are suffering because of economy-related stress, Grossberg offers the following pieces of advice:

• Do a reality check: Take a breath and look at the facts. Don’t let speculation about the future run wild. Most over-the-top grim predictions won’t come to pass.
• Don’t act impulsively: Be careful that you don’t make poor decisions in a moment of panic. Grossberg gives the example of one patient who sold off the bulk of his investments while the market was low, fearful that he was losing his retirement savings. Discuss what you plan to do with someone else before you make a rash decision.
• Count your blessings: Take time to think about the things for which you’re grateful. Whether it’s your health, your family, or $1.49/gallon gas, being thankful is a healthy reminder of what’s good in your life.
• Take care of your health: Exercise, eat right, get enough sleep, and don’t put off preventive doctor visits. Staying healthy will help you to deal with financial issues and other stressful problems, and exercise has benefits for mood.
• Get help: If you feel overwhelmed, anxious, or depressed, seek help from a doctor.

Source: Saint Louis University Medical Center

Despite the substantial body of evidence demonstrating a strong link between depression and cardiovascular disease, the explanation for this association remains unclear, according to background information in the article.

“Understanding how depression leads to cardiovascular events is necessary for developing interventions to decrease the excess cardiovascular morbidity [illness] and mortality [death] associated with depression,” the authors write.

Mary A. Whooley, M.D., of the VA Medical Center, San Francisco, and colleagues conducted a study to determine why depressive symptoms are associated with an increased risk of cardiovascular events.

The study included 1,017 outpatients with stable coronary heart disease who were followed for an average of 4.8 years.

Symptoms of depression were measured with a questionnaire, and various models were used to evaluate the extent to which the association of depressive symptoms with subsequent cardiovascular events (heart failure, heart attack, stroke, transient ischemic attack [a temporary cessation or reduction of blood supply to part of the brain], or death) were explained by disease severity at the beginning of the study and potential biological or behavioral factors.

The researchers found that participants with depressive symptoms had a 50 percent greater risk of cardiovascular events: the age-adjusted annual rate of cardiovascular events was 10.0 percent among the 199 participants with depressive symptoms and 6.7 percent among the 818 participants without depressive symptoms.

Adjustment for physical activity was associated with a reduction in the strength of association between depressive symptoms and cardiovascular events.

When adjusted for other existing conditions and cardiac disease severity, depressive symptoms remained associated with a 31 percent higher rate of cardiovascular events. After further adjustment for certain health behaviors, including physical inactivity, there was no longer a significant association between depressive symptoms and cardiovascular events.

Physical inactivity was associated with a 44 percent greater rate of cardiovascular events, after adjusting for various factors.

The researchers note that patients with depressive symptoms are less likely to adhere to dietary, exercise, and medication recommendations, and poor health behaviors can lead to cardiovascular events.

“These findings raise the hypothesis that the increased risk of cardiovascular events associated with depression could potentially be preventable with behavior modification, especially exercise.

“Given the relatively modest effects of traditional therapies on depressive symptoms in patients with heart disease, there is increasing urgency to identify interventions that not only reduce depressive symptoms but also directly target the mechanisms by which depression leads to cardiovascular events.”

The new study is published in the November 26 issue of JAMA.

Source: JAMA and Archives Journals

Kent State University’s Dr. Steven Toepfer, an assistant professor of family and consumer studies says that expressive writing is something that has been available to mankind since ink first appeared in Egypt more than 4,000 years ago.

“Everyone is pursuing the American dream. We are wealthier than previous generations, consuming more and experiencing more, but yet so many of us are so unhappy,” Toepfer says.

“The question of ‘is there something simple we can do to be happier?’ is one that I have been thinking about for many years and one that has interested people for much longer.”

With that question in mind, Toepfer enlisted students from six courses to explore the effects of writing letters of gratitude to people who had positively impacted the students’ lives.

Over the course of a six-week period, students wrote one letter every two weeks with the simple ground rules that it had to be positively expressive, required some insight and reflection, were nontrivial and contained a high level of appreciation or gratitude.

After each letter, students completed a survey to gauge their moods, satisfaction with life and feelings of gratitude and happiness.

“I saw their happiness increase after each letter, meaning the more they wrote, the better they felt,” says Toepfer, who also witnessed improvement in participants’ life satisfaction and gratitude throughout the study.

“The most powerful thing in our lives is our social network. It doesn’t have to be large, and you don’t always need to be the life of the party, but just having one or two significant connections in your life has shown to have terrific psychological and physical benefits.”

In all, 75 percent of the students said they planned to continue to write letters of gratitude even when the course was over.

Studies demonstrate, according to Toepfer, that practicing expressive writing is often associated with fewer health problems, decreased depression, an improved immune system and improved grades.

“We are all walking around with an amazing resource: gratitude,” says Toepfer.

“It helps us express and enjoy, appreciate, be thankful and satisfied with a little effort. We all have it, and we need to use it to improve our quality of life.”

Source: Kent State University

But a researcher at Kansas State University has found that simply providing programs might not be enough to maintain a supreme equilibrium.

Satoris Culbertson, assistant professor of psychology at K-State, and colleagues have been studying how soldiers’ perceptions of a family-friendly environment relates to their physical fitness, confidence in task performance and intentions to remain in the military.

“Given the especially difficult circumstances surrounding military obligations for U.S. soldiers — for example, an increased threat of deployment due to the current wartime context — a better understanding of how family-friendly perceptions can benefit soldiers is increasingly important,” Culbertson said.

Culbertson and colleagues examined survey data and performance measures of 230 U.S. Army personnel who were stationed in Europe in units with high deployment loads in 2001.

Work environments are considered family-friendly when they help employees manage family time and responsibilities, Culbertson said, adding that the U.S. military has policies in place like on-site educational classes and support groups for family members to create this ideal environment.

“The issue we were concerned about was not merely the availability of such programs, but the perceptions of the workplace as being family-friendly,” Culbertson said.

“Perceptions of a family-friendly organization can differ among employees because much of the perceptions are formed through policies, culture of the organization, and the attitudes and behaviors of the most direct supervisor or work group.”

Some military personnel might not perceive the environment to be family-friendly if they have a superior or peer who is unsupportive or disparages them for taking advantage of a particular policy, Culbertson said.

The study’s results indicated that a perceived family-friendly environment benefited both the individual and the organization. It increased the individuals’ intent to remain in the military once they completed their obligation, and it increased the soldiers’ feelings of their unit’s capability of successful performance.

To better create a family-friendly culture, Culbertson concludes that the military’s local leadership needs to foster and support the policies.

Culbertson collaborated on the project with Ann Huffman, assistant professor of psychology at Northern Arizona University, and Col. Carl Castro, chief of military psychiatry at the Walter Reed Army Institute of Research.

“Family-Friendly Environments and U.S. Army Soldier Performance and Work Outcomes” was published in the October 2008 issue of Military Psychology and details the researchers’ findings.

Culbertson has performed numerous studies focusing on individuals’ work-life conflicts. She said studies show that individuals who report higher levels of work-life conflict also report lower levels of general well-being, lower levels of job satisfaction, higher levels of burnout, more alcohol use and lower levels of performance.

They also are more likely to leave an organization.

“Ideally, we can balance these responsibilities so that we are effective in each of these roles,” Culbertson said. “Or, even better, we can somehow make the participation in one role benefit another role.”

Source: Kansas State University

In this study, University of Michigan researchers found older people who spent at least 14 hours a week taking care of a disabled spouse lived longer than others.

“These findings suggest that caregivers may actually benefit from providing care under some circumstances,” said U-M researcher Stephanie Brown, lead author of the study report.

“Previous studies have documented negative health effects of caregiving. But the current results show that it is time to disentangle the presumed stress of providing help from the stress of witnessing a loved one suffer.”

Brown is an assistant professor of internal medicine at the U-M Medical School and a faculty associate at the U-M Institute for Social Research (ISR). She is also affiliated with the Ann Arbor Veterans Affairs Hospital.

For the study, Brown and colleagues reviewed seven years of data from the U-M Health and Retirement Study, a nationally representative sample of Americans age 70 and older. The analysis focused on 1,688 couples, all of whom lived on their own.

At the start of the study in 1993, both members of each couple reported how much help they received from their spouse with a long list of everyday activities. These included eating, dressing and bathing, preparing meals, managing money and taking medications.

The vast majority—approximately 81 percent—said they received no help at all from their spouse. Another nine percent reported getting less than 14 hours of help a week, and the remaining ten percent reported getting 14 hours of help or more each week.

Over the course of the study, 909 people died—about 27 percent of the study population. After controlling for health, age, race, gender, education, employment status and net worth, Brown and colleagues found that the individuals who provided at least 14 hours of care a week to their spouses were significantly less likely to have died during the study period than those who provided no spousal care.

The results of this study add to a growing literature on the positive, beneficial health effects of caregiving, helping and altruism, according to Brown. Her own earlier work has shown that providing social support to friends, relatives and neighbors has a beneficial impact on mortality and on coping with spousal loss.

Brown has a theory about why this is the case. Rather than assuming that humans are selfish and necessarily act only on the basis of rational self-interest, she believes that strong evolutionary forces favor altruistic motivation when individuals are interdependent.

“There is growing recognition that economic decisions may be influenced by complex motivations, not limited to self-interest,” she said.

“We don’t know yet exactly how caregiving motivation and behavior might influence health, but it could be that helping another person—especially someone you love—relieves some of the harmful stress effects of seeing that person suffer.”

With support from the National Science Foundation, Brown will examine how altruistic, helpful behavior, including caregiving, enhances well-being. Starting in 2009, this research will focus on the neuro-affective mechanisms of helping behavior.

The report will be published in Psychological Science, a journal of the Association for Psychological Science.

Source: University of Michigan

Psychological control did not affect the psychological well-being of boys.

Jelani Mandara and Crysta L. Pikes examined a sample of 152 African-American students in the ninth through twelfth grades at a high school in a large Midwestern city.

The sample consisted of 102 females and 50 males. Researchers assessed the degree to which maternal psychological control had an effect on depressive symptoms.

Mandara and Pikes suggested that, “The key for practitioners will be to impress upon parents the need to find a balance between psychological autonomy and behavioral regulation at each stage of their children’s development.”

Source: Blackwell Publishing

In the first published study on the topic, scientists looked at 208 typically sedentary 7- to 11-year-olds who participated in a 10-15 week after-school aerobic exercise program or maintained their usual inactive routine.

“Exercise had a significant impact on anger expression in children,” said Dr. Catherine Davis, clinical health psychologist in the Medical College of Georgia School of Medicine.

“This finding indicates that aerobic exercise may be an effective strategy to help overweight kids reduce anger expression and aggressive behavior.”

The finding fits with evidence that exercise reduces depression and anxiety in children and with what’s considered common knowledge that exercise helps adults manage anger, she said.

It also gives parents and other caregivers another reason to get and keep children moving.

“I think it’s reasonable to encourage children to exercise for a lot of good reasons,” said Dr. Davis whose research on overweight children has shown regular physical activity not only reduces fatness but improves cognition and reduces insulin resistance – which can lead to diabetes.

“I think if teachers could see that exercise helps kids control their behavior and get along, they would be the top proponents of physical activity for kids,” said Dr. Davis, noting that other studies suggests overweight children are more likely to be bullies and to be bullied.

High levels of anger and hostility have been associated with delinquency in children, cardiovascular disease in adults and metabolic syndrome - which can lead to heart attack, stroke and diabetes - in adolescents.

The new finding, published in the November issue of Pediatric Exercise Science, appears to apply to overweight children generally, regardless of factors such as race, gender, socioeconomic status or even fitness or fatness levels, the researchers wrote.

In fact, even though all participants in the exercise portion lost a significant amount of weight, they remained overweight at the study’s conclusion.

With help from a five-year $3.6 million grant from the National Heart, Lung and Blood Institute, Dr. Davis already is looking to see if the finding holds in a similar group of children, who are part of a study on the impact of exercise on cognition. The goal is to determine if it was the exercise or participation in an after-school program that made the difference.

Extra attention from adults and time away from usual routines that could include disagreements with siblings and watching violence on television definitely could have a psychological impact.

“With a psychological outcome like cognition or anger control, positive interaction with adults can make a big difference,” Dr. Davis said.

In the published study, only the exercising children came to MCG’s Georgia Prevention Institute after school. In the new study, both groups are coming to the institute, with non-exercisers enjoying arts, crafts and games.

“We are trying to make it so the only difference is exercise,” said Dr. Davis.

Source: Medical College of Georgia

Watching plenty of television combined with low self-esteem, poor relationships with parents, and low academic achievement are some of the factors that may add up to young people having sex before the age of 15.

Alternatively, a parent’s positive influence may go a long way to reduce risky sexual behavior during adolescence.

Myeshia Price and Dr. Janet Hyde from the University of Wisconsin in the USA publish their findings online in the Journal of Youth and Adolescence.

Adolescents who engage in sexual acts before the age of 15 are likely to do so without adequate protection, putting them at higher risk of sexually transmitted infections and, for girls, unwanted pregnancies.

In 2006, the Centers for Disease Control and Prevention found that 750,000 pregnancies and almost half of new cases of sexually transmitted infections were among adolescents.

To help identify ways to reduce the number of adolescents who have sex before the age of 15, Price and Hyde examined a combination of individual, family, and sociocultural factors thought to predict early sexual activity.

A total of 273 adolescents (146 girls and 127 boys) took part in the Wisconsin Study of Families and Work and were studied between the ages of 13 and 15.

They were asked about their sexual behavior, puberty, academic achievement, self-esteem, depression, sports participation, symptoms of attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), family structure and quality of relationships with parents, and exposure to sexuality through the media.

Of the 273 adolescents studied, 15 percent had experienced early sex – intercourse and/or oral sex. Girls who had been sexually active before the age of 15 spent more time watching television, had lower self-esteem, had poor relationships with their parents, had lived with either a single mother or step-parent, showed signs of ADHD, and underachieved at school.

Those boys who had engaged in early sexual activity were further into their puberty, spent more time watching television, had lower self-esteem, showed signs of ADHD and ODD, and had poor relationships with their parents.

One factor had a particularly large effect: the amount of time spent watching television. Across all risk factors, the more factors pushing young people to have sex early, the more likely they were to do so.

For example, compared to an adolescent with zero risks, someone with three of the above influences (the average for the studied sample) was five times more likely to have had sex by the age of 15. These findings strongly suggest that intervention programs aimed at reducing the number of adolescents who have sex at a younger age are more likely to be effective if they target a combination of factors.

This study also shows that parents influence adolescents’ decision to engage, or not, in early sexual activity. The authors recommend that “preventive measures should not be left up to teachers and counselors alone, but might include parents.”

They add that “positive influence from parents, coupled with comprehensive education programs, have the potential to have an unsurpassed effect on early adolescent sexual activity.”

Source: Springer

Women who took the antidepressant fluoxetine gave birth to four times as many babies with heart problems as women who did not, while women who took paroxetine experienced a three fold increase in heart conditions among their newborns.

Although some of the conditions were serious, others were not severe and resolved themselves without the need for medical intervention, finds a three-country study in the November issue of the British Journal of Clinical Pharmacology .

Researchers have advised women taking the drugs to continue unless they are advised to stop by their doctor or consultant. But they are being urged to give up smoking, as the study also found that more than ten cigarettes a day was associated with a five-fold increase in babies with major heart problems.

The team has also suggested that women on fluoxetine should be given a fetal echocardiogram in their second trimester to diagnose possible heart anomalies.

International researchers from Israel, Italy and Germany followed the pregnancies of 2,191 women - 410 who had taken paroxetine during pregnancy, 314 who had taken fluoxetine and 1,467 controls who hadn’t taken either of the drugs.

“After we excluded genetic and cytogenic anomalies, we found a higher rate of major heart anomalies in the women who had been taking the antidepressants” says lead author Professor Asher Ornoy from the Israeli Teratology Information Service in Jerusalem, Israel.

“Further analysis showed a strong association between major heart anomalies and taking fluoxetine in the first trimester. Women who smoked more than 10 cigarettes a day also had more babies with heart anomalies.”

Women taking paroxetine or smoking less than ten cigarettes a day also faced elevated risks, but not to the same extent.

The women had all contacted either the Israeli Teratology Information Service in Jerusalem, Israel, the Servizio di Informazione Teratologica in Padua, Italy, or the Pharmakovigilanz-und Beratungszentrum fur Embryonaltoxikologie in Berlin, Germany.

All three belong to the European Network of Teratology Information Services, which comprises organizations that investigate, and provide counselling on, environmental exposure during pregnancy.

The women in the control group had contacted the services because of concerns about exposure to substances that are not known to cause birth defects and the women in the medication groups because of their use of paroxetine and fluoxetine.

When the researchers looked at the outcomes of all of the pregnancies they found that:

• The prevalence of major heart anomalies was 2.8% in the fluoxetine group, 2% in the paroxetine group and 0.6% in the control group. There was no increase in other major congenital anomalies.
• Previous pregnancy terminations were also higher in the fluoxetine and paroxetine groups than the control group (7.8%, 4.8% and 2.8%). All groups included some terminations because of diagnosed anomalies.
• Birth weights were slightly lower in the fluoxetine and paroxetine groups than the control group (3200g, 3250g and 3300g).
• Women taking fluoxetine and paroxetine were more likely to smoke than women in the control group (20.1%, 20.7% and 7.5%) and more likely to smoke more than ten cigarettes a day (12.3%, 14% and 4.4%).
Taking all the factors into account, the authors calculated that the overall risk posed by antidepressant use and cigarette consumption was as follows:
• Women who took fluoxetine during pregnancy were 4.47 times more likely to have a baby with a heart anomaly and women who took paroxetine were 2.66 times more likely.
• Those smoking more than ten cigarettes a day were 5.40 times more likely to have a baby with a heart anomaly and women smoking less than ten cigarettes a day were 2.75 times more likely.

“These findings clearly show a significant association between major heart anomalies and taking fluoxetine and smoking during pregnancy” says Professor Ornoy.

“There is an ongoing debate in the medical literature about the possible association between women taking one of these two drugs during pregnancy and having a baby with a heart anomaly and we are keen to see further research in this area.

“We should point out that there is no evidence of any increased risk posed by citalopram and sertraline, which belong to the same group of antidepressants.”

The authors say that it is important that women are aware of these findings, especially if they smoke. However if they are taking fluoxetine, they should speak to their family doctor or consultant and should not stop taking their medication unless advised to do so.

“It’s estimated that as many as one in seven women suffer from clinical depression during pregnancy and clinicians need to weigh up the individual risks of pregnant women taking, or not taking, drugs like fluoxetine” stresses Professor Ornoy.

“Many heart anomalies can now be treated, so it is important to bear that in mind when making a decision about whether or not to continue with one of these drugs during pregnancy. The health of the mother and the baby are both important.

“We hope that this study will provide both doctors and pregnant women on antidepressants with some of the information they need to help them make those difficult decisions.”

Source: Wiley-Blackwell

Employees also experienced higher levels of psychological distress and physical problems than those who were not harassed.

Darius K-S Chan, Chun Bun Lam, Suk Yee Chow, and Shu Fai Cheung examined the job-related, psychological, and physical outcomes of sexual harassment in the workplace.

Using statistical techniques, the researchers analyzed findings from 49 studies on workplace harassment, with a total sample size of 89,382 people. The sample consisted of employees from different countries, with Americans being the vast majority.

Female employees did not appear to be more strongly impacted than males.

Age, however, did play a role. Sexual harassment experiences were found to be more consistently tied to job-related outcomes, psychological well-being, and physical health among younger employees than older employees.

“An accurate understanding of sexual harassment outcomes sustains organizational efforts directed at preventive information and legislation,” the authors conclude.

“Our results provide solid information for organizations to address the issue of sexual harassment.”

The research was published in the journal Psychology of Women Quarterly.

Source: Blackwell Publishing

Researchers discovered smokers with attention deficit and hyperactivity symptoms, those who exhibited elevated hyperactivity and impulsivity, with or without inattention, showed lower quit rates after 8 weeks than those with inattention symptoms alone or those without the ADHD symptoms.

The study, now available online in Nicotine and Tobacco Research, could help smokers and physicians to better tailor cessation treatment for individuals with ADHD.

“Greater understanding of the divergent associations that exist between the different kinds of ADHD have important public health consequences for smoking cessation and decreased tobacco-related mortality in this population,” said the study’s lead author Lirio Covey, Ph.D.

“The effect of A.D.H.D. by itself on smoking cessation has rarely been examined; the effects of the individual ADHD symptoms on smoking cessation, even less so. To our knowledge, the effects of inattention or hyperactivity at baseline as separate domains of A.D.H.D. on cessation treatment outcome have never been examined,” Dr. Covey reported.

During the initial, eight-week phase of a maintenance treatment study, 583 adult smokers, 43 of whom were identified with clinically significant attention deficit disorder symptom subtypes using the ADHD Current Symptom Scale, were treated with the medication buproprion (brand name Zyban®), the nicotine patch and regular cessation counseling.

Compared to smokers without ADHD, smokers of both ADHD subtypes combined showed lower abstinence rates throughout the study.

Breakdown of the attention deficit disorder group by subtype, however, revealed a more complicated picture. The researchers found that by the end of the treatment, the proportion of abstainers among A.D.H.D. smokers with inattention were nearly identical to those without ADHD (55 percent compared to 54 percent, respectively).

By contrast, the attention deficit subgroup with hyperactivity, with or without inattention, exhibited lower quit rates throughout the treatment period compared to smokers without ADHD, essentially finding that only in the presence of hyperactivity and impulsivity, were differences observed between smokers with or without ADHD symptoms.

“The knowledge gained from further study of how these early onset disorders of nicotine dependency and ADHD are related could lead to early prevention of either one or both of these conditions,” concluded Dr. Covey. More research is needed to tease out why hyperactivity causes less cessation success.

The greater propensity to smoke and difficulty quitting among persons with mental illness is thought to play a role in the “hardening” phenomenon, or the increased resistance to smoking cessation among certain smokers.

Much evidence that nicotine improves attentiveness and performance deficits among persons with attention deficit disorder provides a “self-medicating” rationale for tobacco use among persons with ADHD. Pre-clinical data showing that dopamine, a neurotransmitter relevant to attentional processes and impulse control, is released upon smoking, is consistent with the self-medication hypothesis.

ADHD is a mental disorder that begins in early childhood and, in most cases, persists to adolescence and adulthood. The core symptoms in attention deficit disorder are inattention and hyperactivity/impulsivity. ADHD has been sub-classified into three subtypes: predominantly inattention, predominantly hyperactivity/impulsivity, and combined inattention and hyperactivity/impulsivity. You can also learn more about ADHD.

Source: Columbia University Medical Center

Neuroscientists at the Indiana University School of Medicine combined international data with information from their own studies to determine the best candidate genes for the illness.

The methodology developed at the IU Institute of Psychiatric Research enabled Alexander B. Niculescu III, M.D., Ph.D., and his team to mine the data from the genome-wide association studies and other study results on the levels of gene activity in human blood samples and in animal models.

Genes with the highest levels of prominence were determined to be the most active in contributing to the disorder.

The researchers also were able to analyze how these genes work together and created a comprehensive biological model of bipolar disorder.

“Based on our work, we now project that there will be hundreds of genes – possibly as much as 10 percent of the human genome – involved in this illness,” said Dr. Niculescu, who is an assistant professor of psychiatry and director of the laboratory of neurophenomics at the IU School of Medicine.

“Not all genetic mutations will occur in every individual with bipolar disorder. Different individuals will have different combinations of genetic mutations. This genetic complexity is most likely what made past attempts to identify genes for the disorder through genetic-only studies so difficult and inconsistent.”

Dr. Niculescu compared the process to a Web search.

“The process was similar to a Google approach, the more links there are to a page on the Internet, the more likely it is to come up at the top of your search list. The more experimental lines of evidence for a gene, the higher it comes up on your priority list of genes involved in the disorder.”

Until now there have been few statistically significant findings in searches of the human genome as it applies to bipolar disorder, he said.

“By integrating the findings of multiple studies, we were able to sort through, identify genes that were most likely to be involved in bipolar disorder, and achieve this major breakthrough in our understanding of the illness,” Dr. Niculescu said.

Bipolar disorder, sometimes called manic depression, affects nearly 2.3 million Americans. A serious illness, people who suffer from it can experience mild or dramatic mood swings, shifts in energy and a diminished capacity to function.

Dr. Niculescu, a practicing psychiatrist and a molecular geneticist, said this work opens exciting avenues for psychiatric researchers and clinicians, as well as for patients and their families.

“First and foremost, these studies will lead to a better understanding of bipolar and related disorders,” he explained. “Second, the researchers now plan to study individuals to see which combination of genes is present in individuals to come up with a genetic risk score.”

The goal, he said, is to be able to apply the risk score to test individuals even before the illness manifests itself for preventive measures — lifestyle changes, counseling, low-dose medications — or to delay or stop the illness from developing.

“Third, in individuals who already have the illness, genetic testing in combination with blood biomarkers for the disease, could help determine which treatments works best so personalized treatments could be developed,” Dr. Niculescu said.

The research is published online in the American Journal of Medical Genetics.

Source: Indiana University

Studies by University of Bonn scientists suggest the neural connection between areas of the brain is particularly well-developed among innovative people.

The reward system which urges us to take action is located in the brain region called the striatum, whereas the hippocampus is responsible for specific memory functions.

Scientists Michael X. Cohen and Dr. Bernd Weber believe if the hippocampus identifies an experience as new, it then sends the corresponding feedback to the striatum.

There certain neurotransmitters are then released which lead to positive feelings. With people who constantly seek new experiences, striatum and hippocampus are evidently wired particularly well.

Up to now, it has been extremely difficult to make the individual wiring of the brain visible.

“In principle this was only possible using cross sections of the brain of deceased people, which in addition had to be stained in a complex process,” Dr. Weber explains.

Thanks to a new method this process is now a lot easier. With modern MRI scanning techniques, researchers can actually determine in which directions the water in the tissue diffuses. Nerve fibers are an impenetrable obstacle for tissue fluid. It can only flow along them. These ‘directional’ streams of water are visible in the tomography image.

“With this hazard-free method we can work on completely new issues related to the function of the brain,” Cohen notes.

In the current study the Bonn scientists focused on the ‘wiring’ of the striatum. Moreover, the test candidates had to choose descriptions that characterised their personality best from a questionnaire, e.g. ‘I like to try out new things just for fun or because it’s a challenge’ or alternatively ‘I prefer to stay at home rather than travelling or investigating new things.’

By contrast, descriptions such as ‘I want to please other people as much as possible’ or ‘I don’t care whether other people like me or the way I do things’, were about social accept-ance. Here too the researchers noticed a link.

‘The stronger the connection between frontal lobe and ventral striatum, the more distinctive the desire for recognition by that person’s environment,’ Weber says. That is not quite unexpected. For example, it is known that people with defects of the frontal lobe violate social norms more frequently.

The Bonn scientists wish to confirm their results even more. In experiments they would like to investigate whether people actually behave differently depending on the ‘wiring’ of their brain.

Source: University of Bonn

The disclosure followed an investigation by U.S. Senator Charles Grassley’s office into Goodwin’s connections to pharmaceutical companies, following a media report in May published by Slate, an online magazine.

Dr. Fred Goodwin is a former director of the National Institute of Mental Health and has been hosting The Infinite Mind on NPR radio stations for over 15 years.

On May 9, Slate published a rebuke of the independence of an episode of the Infinite Mind, a public radio program on mental health, brain and behavior topics. In question was a program devoted to discussing the link between antidepressants and suicide.

But in a bias not disclosed during the program, all four of the experts on the program, including Goodwin himself, have financial ties to the makers of antidepressants. That information was never mentioned to listeners during the program and only finally disclosed because of Slate’s reporting.

The report apparently caught the eye of Sen. Grassley’s office, which has been investigating the failure to disclose financial links between drug makers and researchers.

The New York Times reported today that “Dr. Goodwin’s radio programs have often touched on subjects important to the commercial interests of the companies for which he consults.”

In a program broadcast on Sept. 20, 2005, Dr. Goodwin warned that children with bipolar disorder who are left untreated could suffer brain damage, a controversial view. “But as we’ll be hearing today,” Dr. Goodwin reassured his audience, “modern treatments — mood stabilizers in particular — have been proven both safe and effective in bipolar children.”

That very day, GlaxoSmithKline paid Dr. Goodwin $2,500 to give a promotional lecture for its mood stabilizer drug, Lamictal, at the Ritz Carlton Golf Resort in Naples, Fla. Indeed, Glaxo paid Dr. Goodwin more than $329,000 that year for promoting Lamictal, records given Congressional investigators show.”

Unbeknownst to long-time listeners, these are the same drugmakers, by the way, that Dr. Goodwin would adamantly defend during radio programs.

Bill Lichtenstein, the producer of The Infinite Mind, said that he was unaware of Dr. Goodwin’s financial ties, except those related to continuing medical education that Dr. Goodwin sometimes did on behalf of drugmakers.

When contacted today, Mr. Lichtenstein stated that Dr. Goodwin’s contract expressly called for Goodwin to report any potential conflicts of interest to the producer, or any new business relationship as they arose.

Goodwin claims that since he’s been doing this for so long, the rules have changed about ethics reporting and he apparently wasn’t aware of the changes and the need to report this additional income to his employer.

The New York Times further reported that Goodwin “said that he has never given marketing lectures for antidepressant medicines like Prozac, so he saw no conflict with a program he hosted in March titled “Prozac Nation: Revisited” that he introduced by saying, “As you will hear today, there is no credible scientific evidence linking antidepressants to violence or to suicide.””

The Times then went on to note that that same week, Dr. Goodwin earned around $20,000 from Glaxo, which for years suppressed studies showing that its antidepressant, Paxil, increased suicidal behaviors.

Sen. Grassley’s investigations have been so revealing that it has caused every major university and medical institution to reassess how they interact with pharmaceutical companies and how to ensure that all future payments are properly disclosed. But beyond that, some universities are also looking for ways to curb such direct payments to researchers, for fear of the appearance of a conflict of interest (whether one actually exists or not).

The Infinite Mind has won more than 60 journalism awards and has had more than one million listeners in more than 300 radio markets.

According to the Times reporting, Mr. Lichtenstein said that the last original program aired in October, that reruns have been airing since and that “the show is going off the air.”

Sources: The New York Times and wire reports

Lauren Jones, a psychology doctoral student working with Jeansok Kim, a UW associate professor of psychology, found that stressed rats took significantly longer to respond to a change in rewards given to them in a maze and their performances never matched those of other rats not exposed to stress.

Another group of rats was given a small dose of the drug muscimol, which temporarily inactivated the amygdala in their brains, prior to being subjected to the same stress. These rats were unaffected by the stress and performed as well as the animals that were not stressed. The amygdala is located in the forebrain and processes information about such things as fear (the so-called fight-or-flight response), stress and rewards.

“Stress can be long-lasting, depending on what it is. The rats that received the drug were tested on the maze the day after they were exposed to stress and it was as if the experience had never happened to them. Inactivation of the amygdala took the stress away,” said Jones.

“Whatever stress these rats experienced was not being processed,” said Kim. “They seemed to be immune to the stressful experience.”

Stress is known to contribute to a number of psychopathologies in humans including anxiety, depression, schizophrenia and drug-use relapse.

Neuroscientists also know that stress affects cognition, and believe research exploring how it relates to learning, memory and decision making will help them understand potential problems stressed people experience in their daily lives.

The UW researchers worked with three groups of rats – a control group, a stress group and a stress plus amygdala inactivation group. All of the rats were acclimated to an automated figure-eight-shaped maze that consisted of a center track leading to two loops that ran to the left and right and back to the center.

The animals were trained for several days until they were able to complete 40 laps or trials in less than 30 minutes. For each trial, a rat would start in the center, then was allowed to freely run to either the right or the left loop, consume a water reward and return to the center for the next trial.

Both loops always had an 80 percent chance of containing 0.04 milliliters of water, and the animals made a comparable number of visits to each loop. The animals were kept on a daily water restriction schedule to motivate them to run the maze.

After this, rats in the stress group and those that were given the drug were restrained and subjected to an unpredictable series of tail shocks for one hour. The following day, all of the rats were returned to the maze for a new series of trials. Once again the animals could run either loop of the maze, but this time the reward amount was increased on one side to 0.12 milliliters.

Within three days the control group and stress plus amygdala inactivation group were reliably able to navigate the maze and collect the larger reward on 35 out of 40 trials. The stress group, meanwhile, was only successful on about 23 of 40 trials, and after several more days their performance only increased to about 26 out of 40 trials.

“The stressed animals took longer to learn and weren’t adjusting their behavior in the maze,” said Jones. “From this research we can see the effects of stress on rats and how one episode of stress impairs their decision making for several days.

“We know humans have to make numerous higher-level decisions, some of which are complex and require deliberations. Rats are guided by survival, and seeking out the larger of two rewards for the same effort should be fundamentally easy. The fact that stress can have such an effect on a simple but critical task is amazing.”

Kim added: “Decision making, both large and small, is part of our lives. People are prone to make mistakes under stress. Look at what has been going on with the stock market. People are under huge amounts of stress and we have to question some of the decisions that are being made.”

The research was presented at a press conference on “Our Stressed Out Brains” during the Society for Neuroscience’s annual meeting.

Source: University of Washington

Participants’ brain activity was measured as they completed a series of tasks and were given clear positive, clear negative or ambiguous feedback.

Study authors Jacob Hirsh and Michael Inzlicht looked at the response of the anterior cingulate cortex (ACC), a brain area associated with error-monitoring and conflict-related anxiety.

They found that individuals with high levels of neuroticism, a personality trait related to negative emotion and anxiety, showed stronger responses in this brain region when they were given uncertain feedback, compared to when they were given unambiguous negative feedback.

“Uncertainty can be very stressful,” says Hirsh, a doctoral student and lead author on the paper.

“What this study shows is that neurotic individuals are actually more comfortable with clear negative information than they are with uncertainty – even when the outcome of that uncertainty could be positive.

“In other words, people who are high in neuroticism appear to prefer the devil they know over the devil they don’t know.”

Source: University of Toronto